Factors associated with complications of vascular access site in hemodialysis patients in Isfahan Aliasghar hospital.
BACKGROUND
Vascular access complications are a major cause of excessive morbidity and mortality in the dialysis population. Moreover, there is not sufficient research regarding the factors correlated with vascular access complications among hemodialysis patients. This study aimed to evaluate the vascular access complications and their related factors such as nursing techniques and self-care in hemodialysis patients.


METHODS
A cross-sectional study was performed on 110 patients undergoing hemodialysis in Isfahan Aliasghar hospital during 9 months from July 2010 to March 2011. The data collection tools were a demographic questionnaire and three checklists designed to assess the complications of vascular access and care techniques. Data were collected by observations and interviews with the patients. Fisher's exact test, chi-square test, Pearson correlation coefficient, and descriptive statistics were used to analyze the data through SPSS 16.


RESULTS
Among 110 subjects, there were 63 male and 47 female subjects. Subjects' mean age was 55.88 (15.51) years. There were 72 patients undergoing hemodialysis through arteriovenous fistula and 38 through permanent intra-jugular catheters. Insufficient blood flow in the catheter was the most common complication in patients with jugular catheters. Also, aneurysm was the most prevalent complication in patients with arteriovenous fistula. Low self-care of patients and needling into the aneurysm were correlated with aneurysm size. Presence of underlying diseases was related to ischemia.


CONCLUSIONS
Nursing techniques and self-care of patients were correlated with the occurrence of complications. Therefore, it draws the attention of the nurses toward continuing professional education and patients' education, which can increase the longevity of vascular access.
Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
Mohsen
M
Adib-Hajbagheri
Department of critical care Nursing, Noor and Aliasghar Hospital, Esfahan Universiy of Medical Sciences, Esfahan, Iran.
Narjes
N
Molavizadeh
Department of Medical Surgical nursing,Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
Negin Masoodi
NM
Alavi
Department of community Health Nursing, Noor and Aliasghar Hospital, Esfahan Universiy of Medical Sciences, Esfahan, Iran.
Mahmood Hosseiny Mosa
MH
Abadi
Complication; correlation agents; hemodialysis; nursing techniques; self-care; vascular access