UK survey highlights access cannulation experiences and importance of patient-staff discussions

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Johann Nicholas presenting at VASBI 2022

A regional patient survey from the UK has revealed a 71% rate of good experiences with vascular access cannulation, and a “great appreciation” for the supporting efforts of nursing and access teams, but also that roughly 20% of respondents were unaware of the specific cannulation technique being used on their access.

These were among the key findings presented at the 2022 Vascular Access Society of Britain and Ireland (VASBI) annual scientific meeting (29–30 September, Glasgow, UK) by Johann Nicholas (Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, UK)—who initially outlined both the value and limitations of data produced by the national patient-reported experience measures (PREMs) survey. PREMs scores from 2019–2021 were based around a singular question about cannulation, finding a variation in patient experiences across different centres, with further investigations being required, the speaker noted.

As such, the principles of this survey were adapted to construct a new questionnaire, which was rolled out across Shrewsbury and Telford Hospital renal units and sought to gain patient feedback on predialysis care, education, cannulation techniques, means for minimising discomfort, and more. It featured numerous questions under various sections and used a categorical scale from 1–7, with scores >5 being considered a “positive satisfaction level”. The survey was concluded in October 2021, Nicholas reported.

Some 42% of eligible patients (those dialysing with an arteriovenous fistula [AVF]) responded to the survey, with 20% of these patients claiming they were unaware of the type of access cannulation being used. In addition, 71% of respondents described a good experience regarding their access cannulation, and 80% also noted satisfaction with predialysis education of both haemodialysis treatments and cannulation procedures.

Nicholas then detailed that around 70% of patients were aware of different analgesic options during cannulation; 85% felt involved in their care when it came to access cannulation and said “their concerns were heeded”; and, overall, there was a “great appreciation of the efforts of the nursing and access teams in supporting patients”. The speaker then disclosed a number of action points derived from the survey’s results—including encouraging self-care in dialysis patients, better descriptions of analgesic options, the reinforced use of far infrared (FIR) devices, and further exploration of buttonhole cannulation options, as well as planning to repeat the survey in 2023 to ascertain whether these measures have genuinely impacted patient satisfaction.

Discussing the broader implications of the findings from this PREMs-based survey, Nicholas stated that feedback from patients about their care and experience is “vital” and local efforts are required to further investigate important details of this care moving forward. He concluded by adding that “this survey has aided measures that will improve patient experience”, but reiterated that patients and dialysis staff “must be encouraged” to regularly discuss their experiences of access cannulation.

Nicholas highlighted the contributions of his colleagues—Sr J Cooper, Sr D Burton and Sr J Almoneda—to this project as well.

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