Behind the Needle: Healthcare Professionals' Perspectives on HD Needling

NCT06845605 | Recruiting

• 1 other identifier: RD2024-55
• Study Type: observational
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

Haemodialysis is essential for patients with End-Stage Renal Disease (ESRD), requiring consistent vascular access through arteriovenous fistulas or grafts. This involves frequent needling, a procedure that is painful and distressing for many patients, causing significant emotional and physical demands on healthcare professionals working in the dialysis units. In the UK, about 30,000 patients receive haemodialysis, involving over 300 needling procedures annually. Healthcare professionals (Registered nurses and healthcare assistants) play a crucial role, with their expertise directly affecting patient outcomes. However, 60% of HCPs (healthcare professionals) report high job-related stress, particularly due to needling demands. Effective needling requires not only technical proficiency but also managing patient pain and anxiety. Strong staff-patient relationships, characterized by empathy and understanding, can enhance the needling experience. Challenges for dialysis unit staff includes the technical difficulty of needling and the emotional burden of patient care. Studies highlight the need for better training and support systems to help them cope with these demands. Understanding healthcare professionals' perspectives can identify areas for improvement, inform training programs, and improve experiences in dialysis units. Research by Rahmah et al. (2018) and Duncanson (2023) emphasizes the importance of HCPs skills and the psychological toll on them, suggesting further exploration of this area is needed. The primary aim of this research is to examine HCPs perspectives on the needling experience in haemodialysis, aiming to identify improvement areas and inform targeted training programs to enhance patient experiences. The study will utilize a qualitative exploratory design with semi-structured interviews to gather in-depth insights from HCPs. Data will be collected from renal dialysis units at East and North Hertfordshire NHS Trust, involving 12 to 16 registered nurses performing needling procedures. Thematic analysis will be used to analyse interview transcripts and identify key themes related to technical skills, communication barriers, and patient-related factors. The study will run for 10 months.

Conditions

Perspective of Healthcare Professionals Haemodialysis Needling; Dialysis

Keywords

Haemodialysis; Haemodialysis needling; End-Stage Renal Disease; Fistula; Cannulation

Outcome Measures

Primary Outcomes (1)

• Healthcare professionals' (registered nurses and healthcare assistants) perspectives on the needling experience, with a focus on identifying areas for improvement and informing targeted training programs to enhance the overall patient experience.

  March 2024

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All data will be collected in the renal dialysis units of ENHT consisting of one main unit and four satellite units. The service provides in-centre haemodialysis to over 600 patients. Eligible nursing staff will be drawn from all service dialysis units. The study aims to recruit between 12 to 16 HCPs (registered nurses and healthcare assistants) from dialysis units within East and North Hertfordshire NHS Trust (ENHT). The sample size will be determined based on the concept of information power, ensuring that the data collected is sufficient to address the research questions effectively.

You may qualify if:

• Participants must be registered nurses or Band 3 healthcare assistants who perform needling procedures in a haemodialysis unit.
• Participants must be employed at the renal dialysis units of East and North Hertfordshire NHS Trust (ENHT), including both the main unit and its satellite units.
• Participants must be willing to participate in the study and share their experiences.
• Participants must be able to speak English fluently to ensure they can communicate effectively, providing rich and comprehensive information.

You may not qualify if:

• Registered nurses or healthcare assistants who do not perform needling procedures in a haemodialysis unit will not be eligible to participate.

Sponsors & Collaborators

• East and North Hertfordshire NHS Trust: lead

Study Sites (1)

East and North Hertfordshire NHS Trust

Stevenage, Hertfordshire, SG1 4AB, United Kingdom

RECRUITING

Related Publications (11)

• Sutton J, Austin Z. Qualitative Research: Data Collection, Analysis, and Management. Can J Hosp Pharm. 2015 May-Jun;68(3):226-31. doi: 10.4212/cjhp.v68i3.1456. No abstract available.

  PMID: 26157184 BACKGROUND

• Manoochehri H, Imani E, Atashzadeh-Shoorideh F, Alavi-Majd A. Competence of novice nurses: role of clinical work during studying. J Med Life. 2015;8(Spec Iss 4):32-38.

  PMID: 28316703 BACKGROUND

• Hagerty TA, Samuels W, Norcini-Pala A, Gigliotti E. Peplau's Theory of Interpersonal Relations: An Alternate Factor Structure for Patient Experience Data? Nurs Sci Q. 2017 Apr;30(2):160-167. doi: 10.1177/0894318417693286.

  PMID: 28899257 BACKGROUND

• Duncanson EL, Chur-Hansen A, Le Leu RK, Macauley L, Burke ALJ, Donnelly FF, Collins KL, McDonald SP, Jesudason S. Dialysis Needle-Related Distress: Patient Perspectives on Identification, Prevention, and Management. Kidney Int Rep. 2023 Sep 14;8(12):2625-2634. doi: 10.1016/j.ekir.2023.09.011. eCollection 2023 Dec.

  PMID: 38106606 BACKGROUND

• Rahmah NM, Hariyati TS, Sahar J. Nurses' efforts to maintain competence: a qualitative study. J Public Health Res. 2021 Dec 1;11(2):2736. doi: 10.4081/jphr.2021.2736.

  PMID: 35244357 BACKGROUND

• Napalkov P, Felici DM, Chu LK, Jacobs JR, Begelman SM. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis. BMC Cardiovasc Disord. 2013 Oct 16;13:86. doi: 10.1186/1471-2261-13-86.

  PMID: 24131509 BACKGROUND

• Alsbrooks K, Hoerauf K. Prevalence, causes, impacts, and management of needle phobia: An international survey of a general adult population. PLoS One. 2022 Nov 21;17(11):e0276814. doi: 10.1371/journal.pone.0276814. eCollection 2022.

  PMID: 36409734 BACKGROUND

• Hill K, Sharp R, Childs J, Esterman A, Le Leu R, Juneja R, Jesudason S. Cannulation practices at haemodialysis initiation via an arteriovenous fistula or arteriovenous graft. J Vasc Access. 2020 Sep;21(5):573-581. doi: 10.1177/1129729819869093. Epub 2019 Aug 18.

  PMID: 31423945 BACKGROUND

• Lamb PC, Norton C. Nurses experiences of using clinical competencies a qualitative study. Nurse Educ Pract. 2018 Jul;31:177-181. doi: 10.1016/j.nepr.2018.06.006. Epub 2018 Jun 12.

  PMID: 29929090 BACKGROUND

• Fielding C, Bramley L, Stalker C, Brand S, Toft S, Buchanan H. Patients' experiences of cannulation of arteriovenous access for haemodialysis: A qualitative systematic review. J Vasc Access. 2023 Sep;24(5):1121-1133. doi: 10.1177/11297298211067630. Epub 2022 Jan 16.

  PMID: 35034481 BACKGROUND

• Bello AK, Okpechi IG, Osman MA, Cho Y, Htay H, Jha V, Wainstein M, Johnson DW. Epidemiology of haemodialysis outcomes. Nat Rev Nephrol. 2022 Jun;18(6):378-395. doi: 10.1038/s41581-022-00542-7. Epub 2022 Feb 22.

  PMID: 35194215 BACKGROUND

Related Links

• Moore, C., Ellis-Caird, H., Fielding, C., et al. (2024). Patients' perspectives on key aspects influencing needling for haemodialysis: A qualitative study. Manuscript in preparation
• Edgar, Denise \& Wilson, Valerie \& Moroney, Tracey. (2020). Which is it, person-centred culture, practice or care? It matters. International Practice Development Journal, 10, 1-17. 10.19043/ipdj.101.008.
• Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101

MeSH Terms

Conditions

Kidney Failure, Chronic; Fistula

Condition Hierarchy (Ancestors)

Renal Insufficiency, Chronic; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pathological Conditions, Anatomical

Central Study Contacts

Eunice Ann Doctolero, Bachelor of Science in Nursing

CONTACT

+447737044516; eunice.doctolero@nhs.net

Toral Odedra

CONTACT

01438284379; toral.odedra@nhs.net

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 30, 2024
• First Posted: February 25, 2025
• Study Start: October 30, 2024
• Primary Completion: January 31, 2025
• Study Completion: May 1, 2025
• Last Updated: February 25, 2025

Record last verified: 2024-10

Locations

GB (1)