Objective To evaluate the current status of clinical nurses' knowledge mastery of artificial liver vascular access maintenance, identify the weak links in the knowledge system, and provide reference for the formulation of targeted training strategies.

Methods A cross-sectional survey design was adopted in this study. From June to July 2025, clinical nurses working in a tertiary Class A hospital with certified qualification for artificial liver therapy in a certain region were selected as research participants via convenience sampling. A self-developed questionnaire constructed based on the knowledge-attitude-practice (KAP) theory was used for data collection. The questionnaire included general demographic information, and three core dimensions: knowledge dimension, attitude dimension and practice dimension. Specifically, the knowledge dimension covered four independent sub-dimensions: basic knowledge of artificial liver vascular access, standardized maintenance operation knowledge, complication prevention and management knowledge, and patient education knowledge.

Results A total of 322 clinical nurses were included. The score of the knowledge dimension was (11.84 ± 1.96), with a scoring rate of 74.0%, which was lower than that of the attitude dimension (92.7%) and practice dimension (94.4%). Univariate analysis results showed that there was no statistically significant difference in knowledge scores among nurses with different demographic characteristics (P＞ 0.05). The weak links of knowledge were mainly concentrated in the field of standardized maintenance operation knowledge. The six items with the lowest scoring rates were selection of common sealing solution types (19.0%), selection of sealing solution for patients with bleeding tendency or heparin allergy (27.0%), gold standard for confirming catheter position after catheterization (57.0%), guideline-compliant catheter sealing operation (63.0%), preferred disinfectant for skin disinfection at the puncture site (71.0%), and first-line measure for managing puncture site bleeding (71.0%).

Conclusion Clinical nurses have structural defects in the knowledge of artificial liver vascular access maintenance, which are concentrated in clinical decision-making links. This reflects the deficiency of the current training system in the in-depth transformation of knowledge. It is recommended to construct a training system centered on clinical decision-making competence.

1. 皮伟珍,莫丹,李好,等.经皮股静脉人工肝临时血管通路管理的专家共识[J].循证护理,2022,8(5):614-619.PiWZ,MoD,LiH,et al.Expert consensus on management of transcutaneous femoral vein as temporary vascular access for artificial liver[J].Chinese Evidence-Based Nursing,2022,8(5):614-619.DOI:10.12102/j.issn.2095-8668.2022.05.009.

2. 中华医学会肝病学分会重型肝病与人工肝学组.人工肝血液净化技术临床应用专家共识(2022年版)[J].临床肝胆病杂志,2022,38(4):767-775.Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association.Expert consensus on clinical application of artificial liver and blood purification (2022 edition)[J].Journal of Clinical Hepatology,2022,38(4):767-775.DOI:10.3969/j.issn.1001-5256.2022.04.007.

3. 欧阳姗,何娜,王娟,等.基于HFMEA预防人工肝支持系统导管相关血流感染的效果评价[J].国际医药卫生导报,2025,31(2):340-344.OuyangS,HeN,WangJ,et al.Effect of HFMEA in prevention of catheter-related bloodstream infections in artificial liver support system therapy[J].International Medicine and Health Guidance News,2025,31(2):340-344.DOI:10.3760/cma.j.cn441417-20240729-02033.

4. 侯冬藏,何文英,陈泽阳,等.FMEA在人工肝中心静脉导管相关风险管理中的应用[J].现代中西医结合杂志,2023,32(17):2452-2456.HouDC,HeWY,ChenZY,et al.Application of FMEA in risk management of central venous catheter in artificial liver[J].Modern Journal of Integrated Traditional Chinese and Western Medicine,2023,32(17):2452-2456.DOI:10.3969/j.issn.1008-8849.2023.17.023.

5. 刘琴,宁丽,杨旭女,等.外科护士术后亚谵妄综合征知信行现况调查问卷的研制及信效度检验[J].中华现代护理杂志,2024,30(6):784-790.LiuQ,NingL,YangXN,et al.Development of postoperative subdelirium syndrome knowledge, attitude, and practice questionnaire for surgical nurses and its reliability and validity[J].Chinese Journal of Modern Nursing,2024,30(6):784-790.DOI:10.3760/cma.j.cn115682-20230703-02615.

6. 滕兰波.人工肝血液净化技术的临床应用[J].实用器官移植电子杂志,2024,12(2):132.TengLB.Clinical application of artificial liver blood purification technology[J].Practical Journal of Organ Transplantation (Electronic Version),2024,12(2):132.DOI:10.3969/j.issn.2095-5332.2024.02.009.

7. 王静,曾英,朱林芳,等.住院-门诊血液透析患者血管通路一体化医护随访管理新模式初探[J].华西医学,2024,39(3):490-493.WangJ,ZengY,ZhuLF,et al.Exploration of a new model for integrated medical and nursing follow-up management of vascular access for patients with hemodialysis during hospitalization and outpatient period[J].West China Medical Journal,2024,39 (3):490-493.DOI:10.7507/1002-0179.202306081.

8. 王刚,潘月帅,孟艳雷,等.ICU患者血液净化专用中心静脉导管封管情况的调查[J].中华护理杂志,2022,57(5):525-531.WangG,PanYS,MengYL,et al.The status of central venous catheter closure for blood purification in ICU patients[J].Chinese Journal of Nursing,2022,57 (5):525-531.DOI:10.3761/j.issn.0254-1769.2022.05.002.

9. 朱崇宽,秦军丽,邢崔崔,等.社区老年人居家适老化改造知信行问卷的编制及信效度检验[J].护理学杂志,2025,40(12):100-104.ZhuCK,QinJL,XingCC,et al.Development and psychometric validation of a Knowledge,Attitude,and Practice(KAP) Questionnaire on Home Modification for Aging in Place Among Community-Dwelling Older Adults[J].Journal of Nursing Science,2025,40(12):100-104.DOI:10.3870/j.issn.1001-4152.2025.12.100.

10. 刘小敏,刘彩飞,龙卓,等.陕西省血液净化从业护士中心静脉导管相关血流感染预防知信行水平调查[J].中国卫生质量管理,2024,31(10):60-66.LiuXM,LiuCF,LongZ,et al.Investigation on knowledge, attitude and practice level of central venous catheter-related bloodstream infection prevention among blood purification nurses in Shaanxi Province[J].Chinese Health Quality Management,2024,31(10):60-66.DOI:10.13912/j.cnki.chqm.2024.31.10.12.

11. 陆素芳,黄睿,赵红利,等.风险评估模型预测人工肝治疗肝衰竭患者发生静脉血栓栓塞症的价值分析[J].临床肝胆病杂志,2023,39(3):613-619.LuSF,HuangR,ZhaoHL,et al.Value of a risk assessment model in predicting venous thromboembolism in patients with liver failure after artificial liver support therapy[J].Journal of Clinical Hepatology,2023,39 (3):613-619.DOI:10.3969/j.issn.1001-5256.2023.03.019.

12. 程凤,章新琼,胡少华,等.安徽省9所三甲医院ICU护士中心静脉导管维护知信行现状及影响因素分析[J].中华现代护理杂志,2022,28(15):2018-2023.ChengF,ZhangXQ,HuSH,et al.Status and influencing factors of knowledge, attitude, practice in maintenance of central venous catheters among ICU nurses in 9 class Ⅲ grade a hospitals in Anhui Province[J].Chinese Journal of Modern Nursing,2022,28(15):2018-2023.DOI:10.3760 / cma.j.cn115682-20211202-05438.

13. 刘元,王燕,卢芳燕,等.器官移植科护士专科培训知信行现状及培训需求调查[J].中国护理管理,2025,25(8):1246-1252.LiuY,WangY,LuFY,et al.Investigation on the current status of knowledge,attitude,and practice of the specialized knowledge among organ transplant department nurses and their training needs[J].China Nursing Management,2025,25(8):1246-1252.DOI:10.3969/j.issn.1672-1756.2025.08.023.

14. ForsetlundL,O'BrienMA,ForsénL,et al.Continuing education meetings and workshops: effects on professional practice and healthcare outcomes[J].Cochrane Database Syst Rev,2021,9(9):CD003030.DOI:10.1002/14651858.CD003030.pub3.

15. 王艳杰,李婉晴,李魏,等.高仿真模拟教学在护理本科教育中应用效果的meta分析[J].中华医学教育杂志,2023,43(1):58-62.WangYJ,LiWQ,LiW,et al.Effect of high-fidelity simulation in undergraduate nursing education: a meta-analysis[J].Chinese Journal of Medical Education,2023,43(1):58-62.DOI:10.3760/cma.j.cn115259-20220613-00776.

16. 翁艳秋,郝建玲,张玲娟.阶梯式专科护士培养与使用[J].中华护理教育,2019,16(9):661-664.WengYQ,HaoJL,ZhangLJ.Staged training of specialty nurses[J].Chinese Journal of Nursing Education,2019,16 (9):661-664.DOI:10.3761/j.issn. 1672-9234.2019.09.005.

17. ÄngebyE,AdrianM,BozovicG,et al.Central venous catheter tip misplacement: a multicentre cohort study of 8 556 thoracocervical central venous catheterisations[J].Acta Anaesthesiol Scand,2024,68(4):520-529.DOI:10.1111/aas.14380.

18. 王倩.护理专业学生临床决策能力培养的困境与对策研究[J].科教导刊,2025, (30):91-93.WangQ.Research on the difficulties and countermeasures in the cultivation of clinical decision-making ability of nursing students[J].The Guide of Science & Education,2025, (30):91-93.DOI:10.16400/j.cnki.kjdk.2025.30.029.