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[Improve the Ability of Nurses to Implement Continuous Veno-Venous Hemodialysis].

BACKGROUND & PROBLEM: Many critically ill patients require continuous veno-venous hemodialysis (CVVH) due to their hemodynamic instability and high-dose inotropic use. However, our surgical intensive care unit nursing staffs are often unable to set up the dialysis circuit in a correct and timely manner, which necessitates requesting the assistance of nearby units. After detailed investigation and analysis, this problem is attributable to the lack of nursing staff hands-on practice, an over reliance on oral instructions, the insufficiency of in-service education, and a lack of familiarity with CVVH set-up equipment.

PURPOSE: This project was designed to augment the comprehension and accuracy rates of clinical CVVH practice among nursing staff to >90%.

RESOLUTIONS: In order to help our nursing staffs master the skills necessary to manage the CVVH device, we employed versatile and effective strategies that included providing electronic teaching materials and instruction handbooks as well as practical hands-on sessions and clinical scenario simulations. Moreover, we conducted serial core courses and held case conferences that focused on the topic of CVVH nursing care. Furthermore, training programs for new members were devised, the standard CVVH device checklist was modified, and a specialized preparation area was delineated in hopes of improve nursing-care standards.

RESULTS: Under these schemes, the rate of comprehension of CVVH among nursing staffs increased from 55.2% to 90.8% and the accuracy rate of clinical practice increased from 61.9% to 90.5%.

CONCLUSION: Our implementation of various effective strategies not only promoted the CVVH management ability of nursing staffs but also provided quality care to critically ill patients.

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