Discussion
hematomas, pain
ADVERSE EVENTS, EVENTS, HEMATOMAS, COMPLICATIONS
AVF puncture in patients undergoing chronic hemodialysis is a procedure that nurses repeat many times. The quality of the procedure determines the success of the treatment and the patient’s comfort. This procedure requires specific skills to avoid multiple complications.Currently, the technique for puncturing AVF is passed by companionship within hemodialysis departments. Standardization of the procedure is part of a drive to optimize practices and continuously improve care. In this study, we expect to observe a significant reduction in pain intensity for patients, as well as a reduction in the number of hematomas. The reduction in these adverse events will lead to an extension of AVF lifespan, an increase in dialysis quality, and possibly a gain in quality of life for the patient.The strong point of our study is the use of procedural training, which is innovative in several aspects. It is little used in the continuing education of professionals. It enables the team approach to AVF puncture to be conceptualized and then modeled in procedural simulation. The contribution of therapeutic communication in procedural workshops enables a holistic approach to patient management, despite the technical nature of the treatment. Moreover, the evaluation of the direct benefit of training for the patient (Kirkpatrick level 4) is poorly described in the literature.This study has several limitations. Firstly, data collection concerning the occurrence of adverse events is declarative in nature. Nurses may underreport/overreport the occurrence of events for fear of being judged. This risk is present in both the data collection and the comfort questionnaire. Then, with regard to distance learning, we cannot be totally sure that it is the nurses who log on, carry out the distance learning, and validate the quizzes.