{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:26:38Z","timestamp":1790965598790,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100010754","name":"National Healthcare Group","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cannulation of complex arteriovenous fistula (AVF) or graft (AVG) frequently poses challenges to renal nursing practice. Ultrasound (US) guidance on visualizing central and peripheral venous access has been widely adopted in nephrology, reducing vascular intervention complications. Renal nurses could acquire this point\u2010of\u2010care technique to increase the successful cannulation rate while facilitating confidence build\u2010up during practice. We aim to evaluate the use of handheld US on difficult AVF\/AVG cannulation in a hospital\u2010based dialysis unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single\u2010center randomized controlled trial from January 2021 to January 2022. Ten renal nurses were trained by an interventional nephrologist before patient recruitment and had completed a pre\u2010 and posttraining questionnaire on their confidence level. Fifty hemodialysis patients with complex AVF were randomized to US\u2010guided or conventional cannulation. The total time spent on cannulation and patients' pain scores were also collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Renal nurses increased their confidence level after training (pretraining score 26.6\u2009\u00b1\u20096.9 vs. posttraining score 36.4\u2009\u00b1\u20093.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.014). There was a higher success rate (only one cannulation attempt required) for US\u2010guided (96%) versus conventional (72.0%) cannulation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.049). US\u2010guided cannulation had a lower pain score than the conventional method (1.48\u2009\u00b1\u20090.73 vs. 2.13\u2009\u00b1\u20090.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012). The pre\u2010cannulation assessment time and time spent on cannulation were comparable between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our study showed that US\u2010guided cannulation increased renal nurses' confidence level in difficult cannulation and improved success rate. Larger scale studies are required to further assess the applications of handheld US in AVF cannulation, particularly in different clinical settings (e.g., chronic dialysis centers).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hdi.13050","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T06:39:09Z","timestamp":1666679949000},"page":"21-27","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Handheld ultrasound\u2010guided cannulation of difficult hemodialysis arteriovenous access: A randomized controlled trial"],"prefix":"10.1111","volume":"27","author":[{"given":"Shune","family":"Chen","sequence":"first","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Shuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Ministry of Health Holdings Pte Ltd.  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Cheen","family":"Chai","sequence":"additional","affiliation":[{"name":"Division of Renal Medicine, Department of Medicine Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanjuan","family":"Si","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si Hui","family":"Tan","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanita Rajah","family":"Ravindran","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma Teresa Pedrosa","family":"Martinez","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Gao","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying Ru","family":"Yeap","sequence":"additional","affiliation":[{"name":"Renal Centre, Khoo Teck Puat Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-5548","authenticated-orcid":false,"given":"Allen Yan Lun","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Renal Medicine, Department of Medicine Khoo Teck Puat Hospital  Singapore Singapore"},{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"USRDS annual data report: epidemiology of kidney disease in the United States","author":"System 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