Knowledge, skills, and attitudes of renal nurses working with patients undergoing haemodialysis who fear needles

Abstract

Thousands of Australians living with end-stage kidney disease undergo haemodialysis at least three times per week to survive. The process involves the insertion and removal of two large needles into the veins of the arm each session. Although needle fear is common in patients undergoing haemodialysis, little research has been conducted that investigates appropriate strategies for minimising fear. Even less is known about how the renal nurses responsible for the insertion and removal of the needles work with fearful patients undergoing haemodialysis. Therefore, the focus of the present research is to identify the core knowledge, skills, and attitudes of renal nurses, and how they approach working with dialysis patients experiencing fear of needles. Seventeen pre-existing interviews with South Australian renal nurses were analysed via thematic analysis to explore the experiences of working with patients undergoing haemodialysis. Information was coded according to a competency framework, detailing thirty-six features of knowledge, skills, and attitudes (KSAs) of nurses regarding the management of patients’ needle fear. KSAs were then categorised to describe seven competencies pertinent to renal nursing and working with patients with fear of needles. Two main themes: Flexibility, and Responsibility, overarched all KSAs and competencies. The challenging and multi-faceted nature of needle fear was detailed by participants as a hindrance to effective care. Recommendations for continued professional development for renal nurses are suggested, highlighting the need for the education and resources specific to working with patients with needle fear. Findings are translatable across multiple healthcare settings, not only in renal nursing.