Establishment of indexes and analysis of obstacle factors for prolonging service life of autologous arteriovenous fistula in hemodialysis patients based on Stetler model
DU Aiyan
ZHAO Congmin
XU Renyan
YU Yan
WANG Yawen
ZHANG Yuan
ZHOU Wei
SHI Xiaofen
Abstract：Objective:To carry out evidence-based practice for prolonging the service life of autologous arteriovenous fistula,formulate review indicators,analyze the obstacles and promoting factors,and construct clinical change strategies.Methods:With Stetler model as the theoretical framework,an evidence-based practice group was formed to construct review indicators.A baseline review was conducted from October to December 2023,and the practice behaviors of nurses were observed on site with patients as a unit.Based on the baseline review results,and the obstacles and promoting factors in evidence-based practice were analyzed,then formulate the corresponding action strategies.Results:A total of 20 best evidence pieces were included in the study,and 16 review indicators were developed,of which 13 had an implementation rate of<60%and 7 had an implementation rate of 0.The main obstacle factors are the big gap between the best evidence and the clinical status quo,the low level of nursing and patient knowledge and practice,the lack of system,process and assessment mechanism,etc.The main promoting factors are the high degree of leadership attention,the high quality of evidence-based team research,and the perfection of information system.Based on this,the clinical change strategy was established.Conclusion:Based on the summary of the best evidence,the establishment of scientific and rational review indicators,the analysis of obstacle factors and promoting factors,and the formulation of clinical change strategies are important guarantees to promote the evidence-based practice of extending the service life of autologous arteriovenous fistula in patients with maintenance hemodialysis.
Keywords：autologous arteriovenous fistulaStetler modelreview indicatorsobstacle factorsevidence-based practice
Publication Date：2025-10-25
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：6( 3801-3806 )