A 5-Minute Delay in Needle Removal After Haemodialysis Reduces Complications in Newly Created Arteriovenous Fistulas: A Retrospective Cohort Study.

AIMS: To evaluate the impact of a 5-min delay in needle removal after haemodialysis on complications and patient satisfaction in newly created arteriovenous fistulas.

DESIGN

Retrospective cohort study.

METHODS

This study analysed 109 patients with new arteriovenous fistulas undergoing initial cannulation 8-12 weeks post-surgery. Participants were divided into two cohorts: a conventional group (n = 42) receiving immediate needle removal after pump cessation, and a delayed group (n = 67) retaining needles for 5 min post-pump cessation before removal. Outcomes included haemostasis time, hematoma incidence, 3-month reintervention rates, and patient satisfaction measured by a 5-point scale.

RESULTS

Delaying needle removal by 5 min reduced mean haemostasis time by 32% compared to immediate removal (16.4 min vs. 24.1 min). Hematoma incidence decreased substantially by 76% in the delayed group (3.3% vs. 13.1%). At 3-month follow-up, reintervention rates were 66% lower with delayed removal (9.0% vs. 26.2%). Patients also reported 50% less procedure-related pain and significantly higher satisfaction scores (median 4.5 vs. 2).

CONCLUSION

A brief 5-min delay in needle removal significantly reduces complications and enhances patient-centered outcomes during early arteriovenous fistula use.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This protocol establishes an evidence-based standard for post-dialysis needle management, directly reducing compression-induced pain and reintervention needs while requiring no additional nursing resources. Implementation can immediately improve vascular access safety in haemodialysis units.

IMPACT: The study addresses high complication rates (26.2%) from immediate needle removal in immature fistulas. Key findings demonstrate 76% fewer hematomas and 66% lower reinterventions with 5-min delayed removal. This evidence may transform global haemodialysis nursing protocols, benefiting a substantial population of patients receiving new fistulas annually.

REPORTING METHOD: This study follows the STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: Patients and the public were not involved in the design, conduct, or reporting of this retrospective medical record analysis.