Training with ultrasound-guided puncture simulator of arteriovenous fistula for hemodialysis: experience from a center of excellence in Pará, Brazil

Abstract Background Arteriovenous fistulas (AVF) and arteriovenous grafts are important arteriovenous accesses (AVA) for patients who need hemodialysis. However, in approximately 20 to 40% of AVFs, professionals fail to successfully cannulate a new AVA for consistent use. Therefore, the ability to perform ultrasound-guided puncture is a necessary skill, particularly for accesses classified as 'difficult'. However, only a minority of nursing professionals consider themselves capable of handling ultrasound. Therefore, simulated practice environments can enable trainees to develop the skills and dexterity needed to simultaneously handle the ultrasound probe and insert the needle. Objectives The object of this study was to analyze the effects of training with an ultrasound-guided arteriovenous fistula access simulator at a center of excellence in Belém, PA, Brazil. Methods This analytical intervention study assessed a nursing team (17 nurses) before and after training in ultrasound-guided puncture using a simulator model comprising a chicken breast and a latex balloon, chosen because of its low cost and high fidelity. Training was carried out on January 26th and 27th, 2024, at the Fundação Hospital de Clínicas Gaspar Vianna. Results After training with a simulator, participants’ performance improved in all analyzed variables, with statistical significance differences. Furthermore, they rated the model as a good simulation of reality and as important for professional training and reported feeling more confident after training. Conclusions Training with the ultrasound-guided puncture simulator positively influenced the performance of hemodialysis professionals.