Clinical utility of an alarm-equipped belt to prevent intentional self-removal of the needle during hemodialysis procedures for dialysis patients with dementia

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  • 認知症を呈する血液透析患者に対する自己抜針防止用アラーム付きベルトの臨床的有用性
  • ニンチショウ オ テイスル ケツエキ トウセキ カンジャ ニ タイスル ジコ バツシン ボウシヨウ アラーム ツキ ベルト ノ リンショウテキ ユウヨウセイ

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Abstract

We manufactured a new device, a belt equipped with an alarm, to facilitate monitoring of patients in danger of or with a history of intentional self-removal of the needle during hemodialysis. The device, a belt integrated with an alarm, is wound gently around the wrist of the patient after fixing the blood tube. The fixation system of the belt has two steps using a Velcro and snap fastener. When the snap fastener is detached, an alarm system is tripped.<br>We evaluated the clinical efficacy of this device during hemodialysis for an 86 year-old male patient with a slight degree of dementia, memory disturbances and disorientation. The patient had a history of intentional self-removal of the needle during dialysis twice before.<br>The warning system was activated 20 times, when the patient tried to detach the device, and 5 times after the snap fastener was detached during 11 hemodialysis sessions using the device. We compared the effects of the device in preventing self-removal of the needle with those using a conventional hemostasis belt without an alarm as a control. Such patients are at risk of severe accident during self-removal of the needle if medical staff detect the action too late. Because the device activates an alarm before the belt is detached by the patient, it increases the safety more than the conventional belt.<br>In conclusion, the device can be easily attached to the patient and is a useful method of preventing intentional self-removal of the needle during dialysis.

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