A Hashmi1, M Q Cheema, A H Moss. 1. Section of Nephrology, Department of Medicine, West Virginia University School of Medicine, WV 26506-9022, USA.
Abstract
BACKGROUND: the buttonhole technique for arteriovenous fistula cannulation has been recommended as an alternative to the rope ladder technique. AIM: we compared patients' experiences and hypothesized that patients would prefer the buttonhole technique. METHODS: in an observational cross-sectional study using a 23-item questionnaire, we surveyed hemodialysis patients at 3 dialysis centers who had previously used the rope ladder technique and were presently using the buttonhole technique for their experiences with and attitudes toward the two techniques. Twelve months later, patients' attitudes were reassessed. RESULTS: 26 patients met inclusion criteria. On a scale of 0 (not at all satisfied) to 10 (very satisfied), patients reported a mean satisfaction with the buttonhole technique of 8.5 ± 1.9. 96% of patients said they would recommend it, and 83% reported that the buttonhole technique was easier for the nurses to use. Fewer patients reported fistula infiltration with the buttonhole technique (12% vs. 59%, p = 0.008). Twelve months later, 18 of 23 patients (78%) still dialyzing in the study units remained satisfied with the buttonhole technique. CONCLUSIONS: patients reported a high level of satisfaction, fewer complications, and a positive attitude about suggesting the buttonhole technique to other patients. Our findings support the recommendation for its more widespread use.
BACKGROUND: the buttonhole technique for arteriovenous fistula cannulation has been recommended as an alternative to the rope ladder technique. AIM: we compared patients' experiences and hypothesized that patients would prefer the buttonhole technique. METHODS: in an observational cross-sectional study using a 23-item questionnaire, we surveyed hemodialysis patients at 3 dialysis centers who had previously used the rope ladder technique and were presently using the buttonhole technique for their experiences with and attitudes toward the two techniques. Twelve months later, patients' attitudes were reassessed. RESULTS: 26 patients met inclusion criteria. On a scale of 0 (not at all satisfied) to 10 (very satisfied), patients reported a mean satisfaction with the buttonhole technique of 8.5 ± 1.9. 96% of patients said they would recommend it, and 83% reported that the buttonhole technique was easier for the nurses to use. Fewer patients reported fistula infiltration with the buttonhole technique (12% vs. 59%, p = 0.008). Twelve months later, 18 of 23 patients (78%) still dialyzing in the study units remained satisfied with the buttonhole technique. CONCLUSIONS:patients reported a high level of satisfaction, fewer complications, and a positive attitude about suggesting the buttonhole technique to other patients. Our findings support the recommendation for its more widespread use.