Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.202401841
Jornal Vascular Brasileiro
Original Article

Treinamento em simulador de punção ecoguiada de fístulas arteriovenosas para hemodiálise: experiência de um centro de referência no Pará, Brasil

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

Elisa Maria Novaes Barros; Glauco dos Santos Melo; Murilo Vasconcelos de Oliveira; Victor Hugo Guerreiro Americo Gomes; Gabriel Henrique de Paiva Ramos; Silvio Jorge de Oliveira Bentes; Humberto Balbi Reale Neto; José Maciel Caldas dos Reis

http://dx.doi.org/10.1590/1677-5449.202401841 J Vasc Bras, vol.24, e20240184, 2025
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Resumo

Contexto: A fístula arteriovenosa e o enxerto arteriovenoso são formas importantes de acesso para pacientes submetidos à hemodiálise. No entanto, a falha em canular com êxito um novo acesso arteriovenoso para um uso consistente ocorre em aproximadamente 20 a 40% das fístulas arteriovenosas. Dessa forma, a habilidade de realizar punção guiada por ultrassonografia se faz necessária, principalmente para acessos considerados difíceis. Contudo, a minoria dos profissionais de enfermagem se considera apta na manipulação da ultrassonografia. Assim, um ambiente de prática simulada permite que o treinando desenvolva suas habilidades e destreza para a manipulação simultânea da sonda e a inserção da agulha.

Objetivos: Analisar os impactos do treinamento com simulador de acesso ecoguiado para fístulas arteriovenosas em um centro de referência em Belém, Pará.

Métodos: Neste estudo analítico de intervenção, foram coletados dados referentes à equipe de enfermagem (17 enfermeiros) antes e após o treinamento de punção ecoguiada, utilizando um modelo de simulação com peito de frango e balão de látex, escolhido por seu baixo custo e elevada fidedignidade. O curso foi realizado em 26 e 27 de janeiro de 2024 na Fundação Hospital de Clínicas Gaspar Vianna.

Resultados: Após o treinamento com simulador, os participantes tiveram um desempenho melhor em todas as variáveis analisadas, com diferença estatisticamente significativa. Ademais, avaliaram o modelo como um bom simulador da realidade, importante para o treinamento profissional, e relataram sentir-se mais confiantes após o treinamento.

Conclusões: Os resultados indicam que o treinamento melhorou significativamente as habilidades dos profissionais de hemodiálise.

Palavras-chave

ultrassonografia, exercício de simulação, fistula arteriovenosa, diálise, enfermagem

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.

Keywords

ultrasonography; simulation exercise; arteriovenous fistula; dialysis; nursing

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Submitted date:
02/24/2025

Accepted date:
10/30/2025

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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