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The Effect of Implementing A Protocol of Postoperative Arteriovenous Fistula Care on The Clinical Outcomes of Patients With end Stage Renal Diseases

تأثير تطبيق سياسة الرعاية التمريضية على النتائج السريرية للوصلة الشريانية الوريدية بعد العمل الجراحي لدى مرضى الداء الكلوي النهائي

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 Publication date 2014
and research's language is العربية
 Created by Shamra Editor




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Although complications of arteriovenous fistula infrequent, but they occur, the most important and common complications are: thrombosis, infection, stenosis vascular, bleeding, aneurysm, ischemia. It was observed that preparation and good care of AVF have an important role in reducing complications in addition to accelerate the maturation of arteriovenous fistula. Implementing A protocol of Postoperative Arteriovenous Fistula Care Contributes in preventing complications and improve the maturation of arterial venous connection. Objective: This study was conducted to determine the effect of the application of the policy of nursing care on the clinical outcomes of the arterial venous connection postoperatively in patients with end stage renal disease. Goal: the aim of the present study was to determine the effect of Implementing A Protocol Of Postoperative Arteriovenous Fistula Careon clinical outcomes in patients with end stage renal disease. Materials and Methods: the study was conducted at AL-Assad University Hospital (Lattakia), a convent sample of 20 patientsin the renal dialysis department and the Department of Surgery. Clinical results for AVF were evaluated and the results of application policy of nursing care to of AVF in the control and experimental groups after 40 days of follow-up by using tow development tools: Sociodemographic Data and Arteriovenous Fistula Assessment Sheet. Results: our results demonstrated important of application of A Protocol Of Postoperative Arteriovenous Fistula Care. It decreased the complications in the experimental group and improve maturation of AVF mostly in the twentieth day of the study, while there was complications higher and delay in the maturation of AVF to the fortieth day of the study and after in the control group, which left for routine hospital. Conclusions and recommendations: our present study results advice to apply a protocol of Postoperative Arteriovenous Fistula Care because its affect in decrease and preventing complication in addition to improve maturation of AVF on ESRD patients


Artificial intelligence review:
Research summary
تناولت هذه الدراسة تأثير تطبيق سياسة الرعاية التمريضية على النتائج السريرية للوصلة الشريانية الوريدية بعد العمل الجراحي لدى مرضى الداء الكلوي النهائي. أجريت الدراسة في مستشفى الأسد الجامعي في اللاذقية على عينة مكونة من 20 مريضًا، تم تقسيمهم إلى مجموعتين: تجريبية وضابطة. تم تطبيق سياسة الرعاية التمريضية على المجموعة التجريبية بينما تركت المجموعة الضابطة للرعاية الروتينية في المستشفى. أظهرت النتائج أن تطبيق سياسة الرعاية التمريضية أدى إلى تقليل حدوث المضاعفات وتسريع نضوج الوصلة الشريانية الوريدية بشكل ملحوظ في المجموعة التجريبية مقارنة بالمجموعة الضابطة. وأوصت الدراسة بتطبيق سياسة الرعاية التمريضية لتحسين النتائج السريرية للوصلة الشريانية الوريدية لدى مرضى الداء الكلوي النهائي.
Critical review
دراسة نقدية: تعتبر هذه الدراسة خطوة مهمة في تحسين الرعاية التمريضية لمرضى الداء الكلوي النهائي، إلا أن هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبياً (20 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم تناول تأثير العوامل الأخرى مثل الحالة الصحية العامة للمريض أو العوامل النفسية التي قد تؤثر على النتائج. ثالثاً، كان من الأفضل تضمين فترة متابعة أطول لتقييم النتائج على المدى البعيد. على الرغم من هذه النقاط، فإن الدراسة تقدم مساهمة قيمة في مجال الرعاية التمريضية.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تحديد تأثير تطبيق سياسة الرعاية التمريضية على النتائج السريرية للوصلة الشريانية الوريدية بعد العمل الجراحي لدى مرضى الداء الكلوي النهائي.

  2. ما هي أهم المضاعفات التي يمكن أن تحدث للوصلة الشريانية الوريدية؟

    أهم المضاعفات تشمل التخثر، الإنتان، التضيق الوعائي، النزف، تشكل أم دم، ونقص التروية.

  3. كيف تم تقسيم العينة في الدراسة؟

    تم تقسيم العينة إلى مجموعتين: مجموعة تجريبية تعرضت لسياسة الرعاية التمريضية، ومجموعة ضابطة تعرضت للرعاية الروتينية في المستشفى.

  4. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    النتائج الرئيسية أظهرت أن تطبيق سياسة الرعاية التمريضية أدى إلى تقليل حدوث المضاعفات وتسريع نضوج الوصلة الشريانية الوريدية في المجموعة التجريبية مقارنة بالمجموعة الضابطة.


References used
Grassmann A.,etal . ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrology Dialysis Transplantation journal. 2005; 38 (20):2587–93
Mantik L. Medical Surgical Nursing. 5th ed., London: Mosby; 2000. 1323-40
Ronco C. Hemodialysis vascular access and peritoneal dialysis access. American Journals access. American Journals of Kidney of Nephrology. 2004; (142): 94– 111.of Kidney of Nephrology. 2004; (142): 94–111
Lameire, N., and R. L. Mehta, eds. "Complications of Vascular Access."In Complications of Dialysis.New York, NY: Marcel Dekker, Inc., 2000, pp.1-2
Arthur G. Primer on Kidney Diseases. 2nd ed., San Diego: Academic Press.2000. 408- 14
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Dysphagia considers the most important and common in neurological system patient on critical care units. Objective: The aim of this study was to study the effect of nursing care policy on dysphagia in neurological system patients in critical care u nits. Material and method: the study was conducted on 40 patients divided on four groups (Shaker Exercise, Mendelsohn maneuver, [Shaker Exercise, and Mendelsohn maneuver] and control group) in critical care units in the Assad university hospital and the National Hospital whom have dysphagia. The data was collected by using the personal information form, and the dysphagia severity scale. Results: This study showed that Shaker Exercise, and Mendelsohn maneuver together were the most effective in reduce dysphagia levels and recommended about importance of Shaker Exercise, and Mendelsohn maneuver for patients with dysphagia.
Introduction: Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay. Post-operative ileus (POI) is an important reason for remaining patients not permit oral (NPO) in post-operativ e period. The tradition was that when patients passed flatus, they were ready to consume a liquid diet, and then a solid food diet was gradually introduced. This approach was taken to avoid aspiration, gastric and intestinal distension, and anastomotic dehiscence. Although studies demonstrated that the conventional strict feeding regimens were not necessary, many surgeons still hesitated to allow early oral feeding. There has been concern that early oral intake would result in vomiting and severe paralytic ileus with subsequent aspiration pneumonia, wound dehiscence and anastomotic leakage. This belief has become surgical dogma, unsupported by scientific evidence. Aim: to investigates the effect of early oral postoperative carbohydrates feeding on postoperative outcome. Material and methods: forty abdominal surgery patients were randomly assigned to early oral postoperative feeding group (20) or traditional feeding group (20). In the early feeding group (study group), patients were initially started on clear fluid only 16 h after surgery and progressed to liquids (after 24 h) and then soft and regular diet in next day (after 48 h). In the post-operative period, the patients were visited each 12 h and clinical signs and symptoms such as, time of passed flatus and moved their bowels, nausea and vomiting, and the length hospital stay were assessed. Conclusions: This study showed that early oral postoperative carbohydrates feeding group passed flatus and moved their bowels much sooner than the control group thus reducing the duration of POI and hospital stay, but there is no increase in occurrence of of nausea and vomiting between tow groups.
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