Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment

Lack of cannulation skill during hemodialysis treatments results in poor clinical outcomes due to infiltration and other cannulation-related trauma. Unfortunately, training of patient care technicians and nurses, specifically on the “technical” aspects of cannulation, has traditionally not received...

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Autores principales:	Zhanhe Liu, Joe Bible, Lydia Petersen, Prabir Roy-Chaudhury, Judy Geissler, Deborah Brouwer-Maier, Ravikiran Singapogu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	hemodialysis cannulation medical simulator skill assessment objective metrics patient care Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/a382003b347144309ef3c67197cf3cae
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spelling	oai:doaj.org-article:a382003b347144309ef3c67197cf3cae2021-12-01T15:40:41ZMeasuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment2296-858X10.3389/fmed.2021.777186https://doaj.org/article/a382003b347144309ef3c67197cf3cae2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.777186/fullhttps://doaj.org/toc/2296-858XLack of cannulation skill during hemodialysis treatments results in poor clinical outcomes due to infiltration and other cannulation-related trauma. Unfortunately, training of patient care technicians and nurses, specifically on the “technical” aspects of cannulation, has traditionally not received much attention. Simulators have been successfully deployed in many medical specialties for assessment and training of clinical skills. However, simulators have not been as widely used in nursing, especially in the context of training clinical personnel in the dialysis unit. We designed a state-of-the-art simulator for quantifying skill for hemodialysis cannulation. In this study, 52 nurses and patient care technicians with varying levels of clinical experience performed 16 cannulations on the simulator with different fistula properties. We formulated a composite metric for objectively measuring overall success of cannulation and compared this metric with subjective assessment by experts. In addition, we examined if years of clinical experience correlated with objective and subjective scores for cannulation skill. Results indicated that, while subjective and objective metrics generally correlated with each other, the objective metric was more precise and better suited for quantifying cannulation skill. Further, the simulator-based objective metric provides several advantages over subjective ratings, including providing fine-grained assessment of skill, consistency in measurement unaffected by subjective biases, and basing assessment on a more complete evaluation of performance. Years of clinical experience, however, demonstrated little correlation with either method of skill assessment. The methods presented for cannulation skill assessment in this study, if widely applied, could result in improved cannulation skill among our PCTs and nurses, which could positively impact patient outcomes in a tangible way.Zhanhe LiuJoe BibleLydia PetersenPrabir Roy-ChaudhuryPrabir Roy-ChaudhuryJudy GeisslerDeborah Brouwer-MaierRavikiran SingapoguFrontiers Media S.A.articlehemodialysis cannulationmedical simulatorskill assessmentobjective metricspatient careMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hemodialysis cannulation medical simulator skill assessment objective metrics patient care Medicine (General) R5-920
spellingShingle	hemodialysis cannulation medical simulator skill assessment objective metrics patient care Medicine (General) R5-920 Zhanhe Liu Joe Bible Lydia Petersen Prabir Roy-Chaudhury Prabir Roy-Chaudhury Judy Geissler Deborah Brouwer-Maier Ravikiran Singapogu Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
description	Lack of cannulation skill during hemodialysis treatments results in poor clinical outcomes due to infiltration and other cannulation-related trauma. Unfortunately, training of patient care technicians and nurses, specifically on the “technical” aspects of cannulation, has traditionally not received much attention. Simulators have been successfully deployed in many medical specialties for assessment and training of clinical skills. However, simulators have not been as widely used in nursing, especially in the context of training clinical personnel in the dialysis unit. We designed a state-of-the-art simulator for quantifying skill for hemodialysis cannulation. In this study, 52 nurses and patient care technicians with varying levels of clinical experience performed 16 cannulations on the simulator with different fistula properties. We formulated a composite metric for objectively measuring overall success of cannulation and compared this metric with subjective assessment by experts. In addition, we examined if years of clinical experience correlated with objective and subjective scores for cannulation skill. Results indicated that, while subjective and objective metrics generally correlated with each other, the objective metric was more precise and better suited for quantifying cannulation skill. Further, the simulator-based objective metric provides several advantages over subjective ratings, including providing fine-grained assessment of skill, consistency in measurement unaffected by subjective biases, and basing assessment on a more complete evaluation of performance. Years of clinical experience, however, demonstrated little correlation with either method of skill assessment. The methods presented for cannulation skill assessment in this study, if widely applied, could result in improved cannulation skill among our PCTs and nurses, which could positively impact patient outcomes in a tangible way.
format	article
author	Zhanhe Liu Joe Bible Lydia Petersen Prabir Roy-Chaudhury Prabir Roy-Chaudhury Judy Geissler Deborah Brouwer-Maier Ravikiran Singapogu
author_facet	Zhanhe Liu Joe Bible Lydia Petersen Prabir Roy-Chaudhury Prabir Roy-Chaudhury Judy Geissler Deborah Brouwer-Maier Ravikiran Singapogu
author_sort	Zhanhe Liu
title	Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
title_short	Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
title_full	Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
title_fullStr	Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
title_full_unstemmed	Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment
title_sort	measuring cannulation skills for hemodialysis: objective versus subjective assessment
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a382003b347144309ef3c67197cf3cae
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Measuring Cannulation Skills for Hemodialysis: Objective Versus Subjective Assessment

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