The current status and its related factors of vascular access team building in hemodialysis centers in China
10.3760/cma.j.cn441217-20240809-00808
- VernacularTitle:我国血液透析中心血管通路团队建设的现况调查及相关因素分析
- Author:
Yao LIU
1
;
Jing LI
;
Liyun CAO
;
Qizhuang JIN
;
Xizi ZHENG
;
Xiufang DUAN
;
Chun LI
;
Jing XIANG
;
Mo SU
;
Zhiwen WANG
Author Information
1. 北京大学第一医院肾内科 北京大学肾脏疾病研究所 国家卫生健康委员会肾脏疾病重点实验室（北京大学）慢性肾脏病防治教育部重点实验室 中国医学科学院免疫介导肾病诊治创新单元，北京100034
- Publication Type:Journal Article
- Keywords:
Renal dialysis;
Arteriovenous fistula;
Personnel management;
Crew resource management, health care;
Root cause analysis;
Vascular access;
Team building;
Mana
- From:
Chinese Journal of Nephrology
2025;41(2):90-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current status of vascular access team building and analysis its related factors in hemodialysis centers in China.Methods:The study was a cross-sectional survey. Using a convenience sampling method, a questionnaire was designed to investigate the clinical practice of vascular access teams in 527 hemodialysis centers in China from March to April 2022. The related factors of the formation of vascular access teams and the setting up of vascular access coordinators (VAC) were analyzed by multivariate logistic regression method.Results:A total of 506 valid questionnaires were recovered, with a recovery rate of 96.02%. There were 247 (48.81%) and 193 (38.14%) hemodialysis centers respectively across China that had built vascular access teams and set up VAC. Hemodialysis centers with more than 10 years of practice had higher rate of implementation than those in hemodialysis centers with practice years less or equal than 10 years in developing standardized procedures for vascular access management ( χ 2=8.288, P=0.004), holding continuous quality improvement meetings on vascular access ( χ 2=8.210, P=0.004), establishing vascular access teams ( χ 2=33.805, P<0.001) and setting up vascular access coordinators ( χ 2=16.038, P<0.001), and the difference was statistically significant. The results of multivariate logistic regression analysis showed that the number of dialysis machines ( OR=2.221, 95% CI 1.118-4.415, P=0.023), the number of patients on dialysis( OR=2.946, 95% CI 1.375-6.310, P=0.005), and the establishment of VAC positions ( OR=9.463, 95% CI 5.307-16.874, P<0.001), and the standardized vascular access management process ( OR=3.383, 95% CI 2.012-5.687, P<0.001) were the related factors of vascular access team building. The related factors of setting up a VAC position in hemodialysis center were opening vascular access clinic ( OR=2.704,95% CI 1.382-5.290, P=0.004), the formation of a vascular access team ( OR=9.464, 95% CI 5.312-16.860, P<0.001), and constructing standardized procedures for vascular access management ( OR=3.663, 95% CI 2.243-5.982, P<0.001). Conclusion:The implementation rates of vascular access team and VAC position in hemodialysis centers were 48.81% and 38.14%, respectively. The number of dialysis machines, the number of patients on dialysis, the standardized procedures for vascular access management, the vascular access clinic, the vascular access team, and the VAC position were the relevant factors of the team building for vascular access.
