The appearance and control of complications during hemodialysis treatment

Uvod: Hemodializno zdravljenje je eno izmed najkompleksnejših načinov nadomestnega zdravljenja. Popolnoma razumljivo je, da pri tem prihaja tudi do različnih zapletov in s tem tudi to do specifičnih ukrepov. Namen zaključnega dela je bil predstaviti akutne, kronične in tehnične zaplete med hemodializo ter s pomočjo raziskave ugotoviti pogostnost in ukrepanje ob zapletih. Metode: V raziskavi je bila uporabljena triangulacija s kombiniranjem dveh raziskovalnih pristopov, tehnik in virov podatkov zaposlenih v zdravstveni negi. V raziskavi je sodelovalo 70 zaposlenih v zdravstveni negi iz 8 dializnih centrov ter 50 pacientov zdravljenih z hemodializo v enem izmed sodelujočih dializnih centrov, katerih parametre smo spremljali v obdobju zadnjih 3 let dializnega zdravljenja. Rezultati: Najpogostejši zapleti med hemodializo so bili hipotonija (M = 2,5SO = 0,66), mišični krči (M = 2,3SO = 0,68), arterijska hipertenzija (M = 2,2SO = 0,75) in glavobol (M = 1,5SO = 0,58). Ugotovljena je bila razlika med zaposlenimi v zdravstveni negi v ukrepanju med pojavom zapletov med hemodializo glede na stopnjo izobrazbe (x2 = 9,914p = 0,019). Prav tako obstajajo statistične značilne razlike med zaposlenimi v zdravstveni negi v ukrepanju med pojavom zapletov med hemodializo glede na delovne izkušnje (x2 = 32,637p < 0,001). Razprava in sklep: Zaposleni v zdravstveni negi na hemodializni enoti si morajo prizadevati za nadaljnje učenje in izobraževanje o zapletih in ukrepih med hemodializo skozi celotno poklicno kariero ter uporabljati in deliti to znanje v praksi, da bi zagotovili najboljšo oskrbo za paciente zdravljene z hemodializo.Introduction: Hemodialysis treatment is one of the most complex methods of replacement therapy. Understandably, there are also various complications and thus specific measures. The purpose of the final thesis was to present the acute, chronic and technical complications during hemodialysis and to determine the frequency and response to complications with help of research. Methods: Triangulation was used in the study by combining two research approaches, tehniques and data sources of nursing staff. The study involved 70 nursing staff from 8 dialisys centers and 50 patients treated with hemodialysis in one of the participating dialisys centres, whose parameters were monitored during the last 3 years of dialysis treatment. Results: The most common complications during hemodialysis were hypotension (M = 2.5SO = 0.66), muscle cramps (M = 2.3SO = 0.68), arterial hypertension (M = 2.2SO = 0.75) and headache (M = 1.5SO = 0.58). A difference was found between nursing staff in the response to hemodialysis complications according to education level (x2 = 9.914p = 0.019). There are also statistically significant differences among nursing staff in response to complications during hemodialysis based on work experience (x2 = 32.637p < 0.001). Discussion and conclusion: Employees in the hemodialysis unit should strive to continue learning and education about complications and measures during hemodialysis throughout their careers and apply and share this knowledge in practice to provide the best care for hemodialysis patients