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논문분류	춘계학술대회 초록집
제목	Clinical Usefulness of Monitoring Using the Physical Findings Ordinal Scale for Vascular Access
저자	Katsuya Tokuda
출판정보	2024; 2024(1):
키워드
초록	Objectives: Physical findings by palpation and auscultation are very important in screening for vascular access stenosis. However, physical findings are sensory assessments that are difficult to evaluate in a standardized manner, and the experience of the medical staff performing the physical findings has a significant impact on their evaluation. The purpose of the present study was to develop an ordinal scale of vascular access physical findings and to determine whether the use of this scale can contribute to early detection and intervention of vascular access abnormalities. Methods: An ordinal scale for palpation and auscultation of vascular access was developed for hemodialysis patients with an arteriovenous fistula (AVF) or arteriovenous graft (AVG). The Vascular Access Physical Finding Ordinal Scale (VAPOS) was assessed before each dialysis session. The number of cases of vascular access abnormalities that prompted nurses and clinical engineers to consult physicians was examined one year before the introduction of the VAPOS and after the start of the VAPOS evaluation. Results: Prior to the introduction of VAPOS, the most common reason for physician consultation for vascular access abnormalities was poor blood draw (28 cases, 50.9%), while physical examination findings were the trigger in 24 cases (43.6%). After the introduction of VAPOS, poor blood draw significantly decreased to 13 cases (14.7%) and physical findings significantly increased to 88 cases (61.5%). Physical findings included auscultation: 19 (21.6%) cases of volume change, 22 (25.0%) cases of high-pitched sounds, and 16 (18.2%) cases of intermittent sounds and palpation: 7 cases (8.0%). Conclusions: The use of an ordinal scale for physical findings by auscultation and palpation of vascular access achieved early physician consultation before poor blood draw occurred, contributing to early intervention.
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