Abstract：
BACKGROUND: Utilising point-of-care ultrasound for assessment and cannulation of vascular access in people receiving haemodialysis has shown positive clinical results. Nonetheless, there is variation in how renal health care professionals worldwide embrace this method, and there\'s a lack of research on the factors that promote or hinder its adoption.
OBJECTIVE: To explore regional differences, and barriers and facilitators, to the use of point-of-care ultrasound for assessment and cannulation of vascular access in haemodialysis.
METHODS: Exploratory descriptive cross-sectional web-based survey.
METHODS: Healthcare clinicians working in haemodialysis responsible for cannulation of arteriovenous fistula or grafts.
RESULTS: The survey was completed by 645 health care clinicians from 38 countries. 75% to 93% of respondents from Australia/New Zealand, Canada, Europe and United Kingdom/Ireland reported access to ultrasound, compared to 26% (n = 43/167) from the United States respondent\'s reported lower levels of ultrasound training than other regions. Facilitators for using ultrasound were: the availability of ultrasound training (87%, n = 558), to reduce miscannulations (76%, n = 255/336) and to improve patient outcomes (73%, n = 246/336). Point-of-care ultrasound barriers were lack of access to ultrasound education (82%, n = 196/239), lack of ultrasound machines (33%, n = 212/645) or believing that ultrasound was someone else\'s role (38%, n = 29/86).
CONCLUSIONS: This study revealed national and regional differences related to haemodialysis point-of-care ultrasound. Understanding the regions requiring more education and implementation of ultrasound and what motivates staff, or deters from using ultrasound, is crucial for effectiveness of future implementation and workplace change initiatives.
OBJECTIVE: To explore regional differences, and barriers and facilitators, to the use of point-of-care ultrasound for assessment and cannulation of vascular access in haemodialysis.
METHODS: Exploratory descriptive cross-sectional web-based survey.
METHODS: Healthcare clinicians working in haemodialysis responsible for cannulation of arteriovenous fistula or grafts.
RESULTS: The survey was completed by 645 health care clinicians from 38 countries. 75% to 93% of respondents from Australia/New Zealand, Canada, Europe and United Kingdom/Ireland reported access to ultrasound, compared to 26% (n = 43/167) from the United States respondent\'s reported lower levels of ultrasound training than other regions. Facilitators for using ultrasound were: the availability of ultrasound training (87%, n = 558), to reduce miscannulations (76%, n = 255/336) and to improve patient outcomes (73%, n = 246/336). Point-of-care ultrasound barriers were lack of access to ultrasound education (82%, n = 196/239), lack of ultrasound machines (33%, n = 212/645) or believing that ultrasound was someone else\'s role (38%, n = 29/86).
CONCLUSIONS: This study revealed national and regional differences related to haemodialysis point-of-care ultrasound. Understanding the regions requiring more education and implementation of ultrasound and what motivates staff, or deters from using ultrasound, is crucial for effectiveness of future implementation and workplace change initiatives.
摘要：
背景：在接受血液透析的患者中，使用定点护理超声评估和插管血管通路已显示出积极的临床结果。尽管如此，世界各地的肾脏保健专业人员采用这种方法的方式有所不同，并且缺乏对促进或阻碍其采用的因素的研究。
目的：探索地区差异，障碍和促进者，在血液透析中使用即时超声评估和插管血管通路。
方法：基于网络的探索性描述性横断面调查。
方法：从事血液透析工作的医疗保健临床医生负责动静脉瘘或移植物的插管。
结果：调查由来自38个国家的645名卫生保健临床医生完成。75%至93%的受访者来自澳大利亚/新西兰，加拿大,欧洲和英国/爱尔兰报告使用超声波，相比之下，26%(n=43/167)的美国受访者报告的超声训练水平低于其他地区。使用超声的促进者是：超声培训的可用性(87%，n=558)，为了减少误插(76%，n=255/336)，并改善患者预后(73%，n=246/336）。护理点超声障碍是缺乏超声教育(82%，n=196/239)，缺乏超声波机(33%，n=212/645)或认为超声波是别人的角色(38%，n=29/86）。
结论：这项研究揭示了与血液透析点护理超声相关的国家和地区差异。了解需要更多超声教育和实施的地区，以及激励员工的因素，或者阻止使用超声波，对于未来实施和工作场所变革举措的有效性至关重要。
目的：探索地区差异，障碍和促进者，在血液透析中使用即时超声评估和插管血管通路。
方法：基于网络的探索性描述性横断面调查。
方法：从事血液透析工作的医疗保健临床医生负责动静脉瘘或移植物的插管。
结果：调查由来自38个国家的645名卫生保健临床医生完成。75%至93%的受访者来自澳大利亚/新西兰，加拿大,欧洲和英国/爱尔兰报告使用超声波，相比之下，26%(n=43/167)的美国受访者报告的超声训练水平低于其他地区。使用超声的促进者是：超声培训的可用性(87%，n=558)，为了减少误插(76%，n=255/336)，并改善患者预后(73%，n=246/336）。护理点超声障碍是缺乏超声教育(82%，n=196/239)，缺乏超声波机(33%，n=212/645)或认为超声波是别人的角色(38%，n=29/86）。
结论：这项研究揭示了与血液透析点护理超声相关的国家和地区差异。了解需要更多超声教育和实施的地区，以及激励员工的因素，或者阻止使用超声波，对于未来实施和工作场所变革举措的有效性至关重要。
