Si-Yuan Yang,Li-Min Guo,Yuan Jia,Qian Wu,Fan-Jie Meng

1College of Postgraduate, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China. 2Tianjin University of Traditional Chinese Medicine,Tianjin,300193,China.

Abstract Objective: To design and apply a multifunctional uniform for hemodialysis patients. The new patients’uniform is designed as a medium-to-long dress.A PVC transparent pocket locates under the right collar with the size of 6 cm x 4 cm; an oblique opening starts from the collar to the downright by 46 cm x 2 cm, with 6 ties and concealed fasteners; a 45 cm opening at the edge of both side of the sleeves, with 4 ties and concealed buttons;There is a 5 cm x 1.5 cm urinary catheter opening at the crotch, with 2 cross-opening perforations and concealed buttons. The lower thighs of both sides of the patients’uniform, at which an elastic tie and a concealed button locate, are not sutured. Therefore, during hemodialysis, patients can fix the vascular access, prevent such adverse events as channel compression and detachment, improve the safety, comfort and privacy of dialysis patients, and reduce the incidence of complications such as infection compared with the traditional uniform. The design of the new multifunctional uniform for hemodialysis patients is reasonable, which ensures the safety of hemodialysis patients and is suitable for clinical application and promotion.

Keywords:Hemodialysis,Patient Uniform,Design.

Introduction

The end stage is the fifth period of chronic kidney disease, when the kidney merely works and demands regular hemodialysis 2 or 3 times each week [1].Currently, the traditional uniform is suitable to the patient who is lightly sick and needs general care, but not to the needed patient. During the dialysis, such complications may occur, as hypotension and shock and so on, hence, the patient shall be monitored.Especially, the severe patient shall be treated as emergency by catheterization,oxygen and electrocardiography monitor. Compared with this new uniform, the traditional one takes those disadvantages:difficult to put on and take off,inconvenient to connect the cable of monitor, uncomfortable for the patient,impacting the catheterization and nursing and causing the detachment. What’s worse, the closed crotch trousers will cover the privacy, impacting the observation of the condition of the skin under pressure[2] (Graph1). Hence, the daily wearing cannot satisfy the requirements of the treatment. Therefore, in order to settle those issues,we advance the uniform based on the traditional one,aiming to secure the convenience of the treatment and nursing, and improve the safety,comfort and privacy during the treatment.

Graph 1 Draft of the traditional uniform

Material and structure

Material

High-quality cotton cloth, transparent PVC with the size of 6cm*4cm, medical elastic tie at the length of 22cm,14 buttons,2 crossing opening.

Manufacturing method

This new uniform is designed as a medium-to-long dress, for male and female individually, with the size of Large, Medium and small. The main body of this uniform comprises a neckline, chest, waist and crotch.A uniform Size M for Male is taken as an example to demonstrate the method. And the draft is shown in Graph 2.

Graph 2 Draft of the Multifunctional Uniform

Neckline

The neckline is designed collarless and elliptic, with the diameter 25cm, convenient for the hemodialysis patient, as well as patient with catheterization in Central artery,to put on and take off.

Chest

①A transparent pocket made of PVC at the size of 6cm*4cm locates at the right side, depositing the information card to identify the patient. ②There is an oblique opening 46cm*2cm starting from the left side of the neckline to the 6th costa.Between those opening lie 6 ties and 6 buttons (Shown in Graph 3). This oblique opening is used for fixing the catheter,monitoring the electrocardiogram and other fixtures,as well as the emergency treatment and nursing of severe patients, avoiding taking off his wearing directly leading to the overexposing of his body.

Graph 3 Draft of Button

Gusset

There is a 45cm length opening lying at the each gusset from button to biceps, between which there are 4 ties and 4 buttons. This opening will allow the operation of hemodialysis and fixture of catheter, and prevents the bondage and detachment compared with the traditional uniform.

Waist

①There is a 5cm*1.5cm opening beneath the waist(at the crotch) working for urinary catheterization, tied by 2 crossing opening (Shown in Graph 4), in order to operate and fix the catheterization.

②At the middle-to down of each lateral thigh, lies an opening tied by a medical elastic tie and a common tie,which will be applicable to the fixture of catheterization for bigger size.

Method of application

Graph 4 Draft of the Crossing Hole

Before the treatment, the patient should wear the new uniform, depositing the information card and then lay down.After checking the information, the medical staff will assess the vessel, choose the appropriate position for stabbing, and setup the data. Based on the condition of vessel, the medical staff will choose the appropriate method: ① For the patient of internal arteriovenous fistula: Choose the position, then complete the stabbing, after that, tie the opening leaving the stabbing part, at last fix the catheterization under the button. ②For the patient who catheters at the neck: According the stabbing position, open the oblique opening, connect the catheter and dialysis machine, then tight the opening and fix the catheter under the button. ③For the patient who catheters at the waist or thigh:fix the catheter at the lateral of thigh after crossing the opening at the crotch.

Discussion

Hemodialysis is a therapy that drains the blood externally to purify and then leads the blood back into the patient. Blood vessel, which is call the life line, is vital to the patient. If well protected, it will extend the lifetime [3,4]. During this process, displacement,detachment, block, infection hypotension and other complications may occur, which threatens the life and health seriously. Hence, in order to improve the positive effect and decrease the influence of the side effect, nursing plays quite an important role. Firstly,the increase of risk prevention awareness of the nursing staff will ensure the safety and effectiveness of the treatment. Then, the comprehensive regulation will decrease the conflict between nursing staff and patient.At the same time,professional responsibility and ethics will help the communication between them. Last but not least, the nursing staff shall evoke the consciousness of the patient to cooperate the treatment,such as awareness of importance of the health,revision of the inappropriate gesture, and prevention of strenuous excises, so as to avoid the displacement and detachment[5,6].

Besides the facts foregoing, this new uniform will prevent some adverse events. For example, this new uniform reflects the humanized nursing service of the hospital, protects the privacy of the patient and increases the efficiency of the nursing staff by easy operation and avoiding unnecessary on and off.Moreover, this new uniform overcomes the disadvantages of traditional one due to the materialcotton-which is sweat absorbing and ventilated.Specifically, ①all buttons, ties and fasteners allocates in the front or both sides of the uniform, this design exposes just part of the patient, protects the privacy and is easy to put on and take off. ②The information card in this transparency pocket will help the nursing staff to identify the patient easily in order to decrease the errors. ③This oblique opening will enable the connection of monitor without touching the skin directly, decrease the uncomfortableness when the catheter comes out from the neck, and ensure the monitor result by preventing the distortion of the catheter. ④ Compared with neckline with V-shape or other design, this collarless neckline is more safe and practical. ⑤ The fasteners at the gusset will be helpful for puncture and monitor of pressure of blood.⑥This uniform is designed as a dress instead of trousers, due to preventing the inconvenience of the trousers, decreasing the pulling of the catheter and improving the observation of the condition of the limbs and buttock.

Generally speaking, we can conclude that this new uniform will be more convenience in operation,saveing the time and labor of medical staff. On the other hand, it is more easily manufactured, less cost,and can be applied to the practice of hemodialysis,catheterization and electrocardiography monitor.Hence, the new uniform is worthy of promotion and application.

Abbreviations

None.

Acknowledgments

None.

Competing interests

The authors declare that there is no conflict of interests regarding the publication of this paper.