Ms NATALIE MCCALL1
1Austin Health, Heidelberg, Australia
Biography:
Natalie is a Clinical Nurse Specialist with the Nephrology team at Austin Health where she has worked for the past 14 years. Following Postgraduate studies in 2018, Natalie found a passion caring for patients receiving haemodialysis. Since that time, her roles have touched on many facets of renal care, with a particular focus on the complex health needs and psychosocial wellbeing of the renal patient. Time spent creating meaningful relationships with her patients, piqued her interest in research and she strived to support positive changes to support patient wellbeing that are crucial to the progress of nephrology.
Background: Patient experience data are a key component of quality improvement in healthcare. Concerns about vascular access and fear of needling are common among Haemodialysis (HD) patients. To monitor these concerns, the Needling Patient Reported Experience Measure (NPREM) was developed.
Abstract:
Aim: To assess the feasibility and outcomes of using the NPREM with Austin Health (AH) HD patients.
Methods:
All eligible patients across three HD units were invited to complete the 26-item NPREM (rated on a 7-point Likert scale) on two occasions 4–6 months apart. Psychometric properties, including internal consistency, test–retest reliability, and validity across patient cohorts were evaluated.
Results: Seventy-seven HD patients completed the NPREM, with 56 completing follow-up. Ratings for all 26 items and five underlying factors were strongly negatively skewed (skewness range −0.513 to −2.635), with mean item scores exceeding 5 out of 7. Three factors (Communication, My fistula, and Working together) had mean scores greater than 6 (SD <1.0), with 65%, 79%, and 87% of respondents endorsing scores of 6 or 7, consistent with overall good experience of AVF needling. Internal consistency was high (α=0.893). Test–retest reliability was moderate for the Total NPREM scale (ρ=0.561) and the factors My Fistula, Working together, and Personal Experience (ρ=0.526, 0.456 & 0.525), while remaining factors demonstrated low reliability. NPREM was sensitive to patient concerns related to fistula care and needling experience.
Conclusion:
The NPREM is recommended as an outcome measure for HD patients and may facilitate communication regarding needling experiences.