Authors: (including presenting author): :
Lam TY(1), Chung SW(1), Wong PK(1), Tsang WY(1), Wong SHS(1)
Affiliation: :
(1) Renal Unit, Department of Medicine and Geriatric, United Christian Hospital
Keyword 1: :
Hemodialysis
Keyword 2: :
Patient Safety
Keyword 3: :
Bloodline holder
Keyword 4: :
Catheter Dislodgement
Keyword 5: :
Vascular Access
Keyword 6: :
Catheter-related Complications
Introduction: :
During hemodialysis (HD), patients' movement can cause accidental catheter dislodgement or tugging, leading to fatal complications such as massive blood loss, air embolism, and infection. In one case, a patient experienced a dislodgement of the “V” line of the bloodline. To prevent such incidents, the Renal Unit focused on securing bloodlines and minimizing patient movement during HD. After evaluating potential solutions, the HEDclip was identified as a specialized medical device designed to secure bloodlines to a patient’s clothing, reducing the risk of mechanical displacement of vascular access during Haemodialysis
Objectives: :
1. To enhance patient safety by reducing of accidental bloodline or catheter tugging and dislodgement; 2. To improve treatment efficiency by maintaining proper bloodline positioning and minimizing dialysis interruptions related to line displacement; 3. To evaluate user acceptability and perceived safety of the HEDclip among patients and nursing staff compared with traditional medical tape fixation.
Methodology: :
Following initiating hemodialysis, nurses secured the HEDclip to the patient’s clothing and attached the bloodlines into the device. The HEDclip was designed to allow controlled movement of bloodlines while minimizing tension or traction at the vascular access site. A satisfaction survey was conducted in December 2024, followed by a 1-year post-implementation evaluation to assess long-term outcomes, including reported incidents, user feedback, and sustained acceptance among patients and staff. Outcome Measurements: The effectiveness of the HEDclip was assessed using the following key outcome indicators: 1. Incidence of catheter or bloodline tugging/dislodgement events: Events were documented and compared using routine clinical incident reporting records from the periods before and after HEDclip implementation. 2. User-reported safety, satisfaction and perceived effectiveness: An online questionnaire (via Google Forms) was administered to in-center HD patients and nursing staff to gather feedback on the device’s safety, usability and overall satisfaction. Survey categories included perceived safety during use, ease of application and comparisons with traditional medical tape fixation.
Result & Outcome: :
Eighteen in-center HD patients and eleven nurses completed the survey. Notably, no incidents of catheter dislodgement were reported after the implementation of the HEDclip, based on routine clinical incident reporting records over the 1-year evaluation period. This marked a significant improvement compared to pre-implementation periods, with no further events noted even after introducing alternative bloodline fixation methods. Overall satisfaction levels among patients and nursing staff exceeded 75% initially and rose to 90% after 1 year. Most of the respondents described their overall experience as "Satisfied" or "Very Satisfied." Regarding confidence in safety, 80% of patients reported feeling more secure using the HEDclip compared to traditional methods, with only one patient considering medical tape fixation equally safe. Nursing staff expressed even stronger confidence, with most advocating for the HEDclip to be used for all indicated patients due to its perceived effectiveness in preventing tugging and dislodgement. This high level of perceived safety contributed to sustained acceptance among both groups.
