Research on nursing practice of transcutaneous femoral vein as temporary vascular access for artificial liver

Research on nursing practice of transcutaneous femoral vein as temporary vascular access for artificial liver | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Research on nursing practice of transcutaneous femoral vein as temporary vascular access for artificial liver Fang Liu, Yan Zong This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7575192/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Objective: To investigate the current nursing practice and influencing factors of transcutaneous femoral vein temporary liver access in infection department, so as to provide basis for formulating targeted management measures and improving related nursing procedures. Methods: A questionnaire was designed by ourselves and convenient sampling method was adopted to investigate nursing staff in infection department of 4 Wuhan Grade III hospitals from April to June 2025. The questionnaire included general investigation, establishment of vascular access, management during catheter placement and extubation treatment. Results: A total of 320 questionnaires were sent out, and 305 valid questionnaires were collected, with an effective recovery rate of 95.31%. The total score of the questionnaire was (50.52±6.329), which was at the medium level. Age, years of work experience, job title, educational level, whether a member of the dialysis team, and the number of training sessions received by nursing staff within the past year are relevant influencing factors for the practice of percutaneous femoral arteriovenous hemodialysis access care ( P ＜0.05). Conclusion: The nursing practice of transcutaneous femoral vein artificial liver temporary access is ideal, but there are still some weak links, the main reasons may be related to the shortage of nursing staff, the inability to obtain evidence, and the complicated process. It suggests that clinical institutions should rationally adjust nursing staff scheduling, play an active role of expert groups, carry out information technology, and continuously improve nursing norms and procedures. Artificial liver support system Femoral vein Temporary vascular access Catheter-related complications Nursing care 1. Introduction Liver failure (LF) is a clinical syndrome caused by severe dysfunction of the liver due to various etiologies, with high mortality and poor prognosis [ 1 ] . It is a common type of critical illness in the field of infectious diseases. Currently, there is no specific medication or treatment for comprehensive medical management of liver failure [ 2 ] , and the limited supply of liver transplant donors and high costs make this option less accessible [ 3 ] . Therefore, the non-biologic artificial liver support system (Abiotic artificial liver support system, NBALSS) has been widely used in clinical practice as an indispensable therapeutic method for liver failure. NBALSS requires a specialized vascular access to divert the patient’s blood outside the body, where it passes through separators, filters, and other processing devices before being re-infused back into the patient’s body. This access is known as artificial liver vascular access [ 4 ] . Establishing and maintaining a reliable vascular access is crucial for the successful implementation of artificial liver therapy [ 5 ] . Due to the anatomical characteristics of the femoral vein, with clear landmarks, a larger diameter compared to other vessels, and adequate blood flow, the success rate of a single puncture is relatively high. This is especially important as patients with liver failure often suffer from severe coagulation disorders. Therefore, the femoral vein central venous access is commonly chosen for artificial liver treatment in these patients [ 6 ] . However, the proximity of the femoral puncture site and catheter insertion to the perineum limits patient movement and increases the probability of catheter-related complications [ 7 ] . Proper and standardized management of catheter-related care thus becomes especially important [ 8 ] . Therefore, this study aims to investigate the current status of nursing practices for percutaneous femoral vein artificial liver temporary access, with the goal of identifying issues in clinical nursing practice and providing reference and baseline data for developing targeted quality management measures and improving related processes. 2. Material and methods 2.1 Survey subjects From July to August 2024, a convenience sampling method was used to select nurses from the Infectious Disease Department of four tertiary hospitals in Wuhan as research subjects. Inclusion criteria: 1) Possession of a professional nursing qualification certificate issued by the People's Republic of China; 2) At least 1 year of work experience in the Infectious Disease Department; 3) Informed consent, understanding, and willingness to cooperate with the study. Exclusion criteria: 1) Clinical interns or advanced practice nurses; 2) Nurses who were absent for more than 1 week during the research period for various reasons. 2.2 Survey tools The questionnaire used in this study was independently designed by the research team based on relevant national and international guidelines and expert consensus documents (Supplementary file 1) . The guidelines referenced include the 2022 Clinical Application Expert Consensus on Artificial Liver Blood Purification Technology published by the Chinese Society of Hepatology (CMA) [ 9 ] , the 2022 Expert Consensus on Percutaneous Femoral Vein Temporary Vascular Access Management for Artificial Liver published by the Chinese Nursing Association [ 4 ] , the 2023 Guidelines on Artificial Liver Blood Purification System Treatment for Liver Failure and Artificial Liver by the Chinese Society of Infectious Diseases [ 6 ] , and the 2022 International Expert Consensus on Artificial Liver Support for Liver Failure Patients published by foreign emergency/critical care groups [ 10 ] . The questionnaire was consulted by 4 infectious disease experts, 3 nursing experts, and 1 artificial liver specialist nurse. After a pre-survey with 30 nurses from the Infectious Disease Department of a tertiary hospital in Wuhan, certain items were modified to form the final questionnaire. Statistical results showed: 1) The expert agreement coefficient was 100%; 2) The expert authority coefficient was 0.938; 3) The content validity index (S-CVI) of the questionnaire was 0.970. These results indicate that the questionnaire design is scientifically reasonable and has good content validity. The questionnaire includes basic information about the research subjects (such as gender, age, years of work experience, education level, professional title, membership in a vascular access team, role as a teaching mentor, training frequency in the past year, learning methods, and reasons for failure) and a total of 16 items. The content covers the entire process of percutaneous femoral vein temporary access for artificial liver treatment, including key steps such as vascular access establishment (A1-A4), management during catheter placement (A5-A13), and catheter removal handling (A14-A16). The items are scored using the 4-point Likert scale, with scores ranging from 16 to 64 points. 2.3 Sample size According to the Kendall principle, the sample size should be 5–10 times the number of items in the questionnaire. With 16 items in the questionnaire and considering a 20% non-response rate, the study requires at least 96 to 192 completed questionnaires. 2.4 Data collection and quality control From April to June 2025, the researcher explained the purpose and significance of the survey to the research subjects and distributed the questionnaire online via the Questionnaire Star platform. The questionnaires were completed anonymously and independently. A unified deadline was set for the electronic questionnaire, and responses submitted after the deadline were not included in the study. After the survey was completed, two researchers verified the questionnaires and excluded those with invalid responses, such as completion time less than 1 minute, three consecutive same answers, or missing answers. 2.5 Statistical methods The data from the questionnaire were entered and verified by two researchers using Microsoft Excel. Statistical analysis was conducted using SPSS (version 26.0) software. Descriptive statistics for categorical variables were presented as frequencies and percentages, while continuous variables were analyzed using means and standard deviations ( SD ). 3. Results 3.1 General information of research subjects A total of 320 questionnaires were distributed in this study, with 305 valid responses returned, resulting in an effective response rate of 95.31%. Among the respondents, 14 were male and 291 were female, with an average age of (33.49 ± 7.497) years and average years of work experience of (11.14 ± 7.865) years. Detailed general information is shown in Table 2 . 3.2 Questionnaire scores The results showed that the average questionnaire score was (50.52 ± 6.329), which is considered to be at a moderate level, as detailed in Table 1 . Table 1 Nursing practice questionnaire scores of transcutaneous femoral vein artificial liver temporary access (n = 305). Key Aspect Item Score (Mean ± SD) Vascular Access Establishment A1: Staff qualifications 2.52 ± 0.684 A2: Location requirements 2.82 ± 0.626 A3: Range of skin preparation 2.78 ± 0.665 A4: Hand hygiene and aseptic technique 3.73 ± 0.590 Management during Catheterization A5: Secondary catheter fixation 3.42 ± 0.774 A6: Dressing change 3.56 ± 0.672 A7: Catheter identification 3.14 ± 0.661 A8: Hemorrhage or exudation 3.91 ± 0.347 A9: Catheter fixation 3.88 ± 0.413 A10: Leg circumference measurement 2.68 ± 1.089 A11: Functional exercise 3.03 ± 0.738 A12: Complication management (catheter-related infection, deep vein thrombosis, bleeding or hematoma at the insertion site) 2.79 ± 0.614, 2.93 ± 0.721, 2.82 ± 0.571, 2.65 ± 1.230 A13: Catheter education 3.00 ± 0.612 Catheter Removal A14: Indications for catheter removal 2.95 ± 0.644 A15: Disposal of discarded catheter 3.35 ± 0.705 A16: Post-catheter removal hemostasis 2.96 ± 0.708 Total 50.52 ± 6.329 3.3 Univariate analysis results of nursing practices for percutaneous femoral vein artificial liver temporary access The univariate analysis showed that age, work experience, education level, professional title, membership in the vascular access team, and training frequency were significant factors influencing nursing practices for percutaneous femoral vein artificial liver temporary access ( P < 0.05), as detailed in Table 2 . Table 2 Results of monofactor analysis (n = 305). Factor N (Percentage, %) Score (Mean ± SD) F/t Value P Value Gender Male 14 (4.59) 47.29 ± 6.696 1.8541 Female 291 (95.41) 51.25 ± 5.219 Age (years) 20–30 123 (40.33) 49.35 ± 6.327 7.1162 31–40 122 (40.00) 50.46 ± 6.952 > 40 60 (19.67) 53.03 ± 3.897 Work Experience (years) 1–5 80 (26.23) 47.69 ± 6.405 10.5092 6–15 139 (45.57) 50.32 ± 6.116 > 15 86 (28.20) 53.47 ± 5.291 Education Associate degree 12 (3.93) 46.50 ± 7.404 6.4432 Bachelor's degree 273 (89.51) 50.41 ± 6.332 Master's degree 20 (6.56) 54.40 ± 2.998 Professional Title Nurse 63 (20.66) 47.08 ± 6.764 18.0832 Nurse practitioner 85 (27.87) 48.76 ± 6.697 Head nurse 155 (50.82) 52.86 ± 4.910 Chief nurse 2 (0.66) 52.00 ± 0.000 Vascular Access Team Member Yes 16 (5.25) 60.69 ± 1.740 7.1231 No 289 (94.75) 49.96 ± 6.005 Teaching Mentor Yes 82 (26.89) 53.09 ± 6.668 4.1951 No 223 (73.11) 49.57 ± 5.941 Training Frequency 0 times 72 (23.61) 47.92 ± 7.090 11.9692 1–2 times 202 (66.23) 50.91 ± 5.880 ≥ 3 times 31 (10.16) 54.00 ± 5.040 3.4 Multiple linear regression analysis of nursing practices for percutaneous femoral vein artificial liver temporary access Based on the significant variables from the univariate analysis and correlation analysis (age, work experience, education level, professional title, vascular access team membership, and training frequency), a multiple linear regression analysis was conducted using these as independent variables and nursing practice questionnaire scores as the dependent variable (α_in = 0.05, α_out = 0.10). The following variable assignments were used: The variables used in the multiple linear regression analysis were assigned as follows: Age was categorized into three groups: 20–30 years = 1, 31–40 years = 2, and > 40 years = 3. Work experience was also divided into three ranges: 1–5 years = 1, 6–15 years = 2, and > 15 years = 3. Education level was coded as: Associate degree = 1, Bachelor's degree = 2, and Master's degree = 3. Professional title was categorized as: Nurse = 1, Nurse practitioner = 2, Head nurse = 3, and Chief nurse = 4. Vascular access team membership was coded as: Yes = 1, No = 2. Training frequency was divided into three levels: 0 times = 1, 1–2 times = 2, and ≥ 3 times = 3. The results indicated that age, work experience, professional title, education level, vascular access team membership, and training frequency in the past year were significant factors influencing nursing practices for percutaneous femoral vein artificial liver temporary access ( P < 0.05), as shown in Table 3 . Table 3 Results of multiple linear regression analysis (n = 305). Independent Variable Partial Regression Coefficient Standard Error Standardized Regression Coefficient t -value P -value (Constant) 26.231 2.532 10.360 < 0.001 Age -2.464 0.720 -2.91 -3.421 0.001 Work Experience 2.829 0.816 0.330 3.465 0.001 Education 3.049 1.010 0.156 3.018 0.003 Professional Title 1.891 0.644 0.240 2.937 < 0.001 Vascular Access Team Membership 8.862 1.378 0.313 6.433 < 0.001 Training Frequency 1.669 0.554 0.149 3.015 0.003 Note : R² = 0.333, Adjusted R² = 0.7320, F = 24.810, P < 0.001. 4. Discussion The study results indicate that nursing staff in the Infectious Disease Department have limited knowledge regarding the establishment of artificial liver vascular access, with average scores for personnel qualifications, environmental requirements, and skin preparation all falling below 3. This suggests a weak awareness of risk prevention. The significant correlation between hospital environment and infection risk highlights the importance of good hospital hygiene and hand hygiene in preventing hospital infections. The 2022 consensus [ 10 ] specifies clear requirements for personnel qualifications and environmental standards for artificial liver vascular access, but due to limited clinical training and practical experience, nursing staff do not place adequate emphasis on these aspects. It is recommended that training on artificial liver procedures emphasize these specific guidelines and execution measures. Furthermore, hospitals should enhance personnel qualification screening and monitor the standards of artificial liver room environments. The study shows that during catheterization, lower scores were recorded for leg circumference measurement and complication management, with scores of (2.68 ± 1.089) and (2.79 ± 0.614), respectively. Leg circumference measurement was identified as the weakest link, with some nurses reporting that they had never measured leg circumference in catheterized patients. Catheter-related deep vein thrombosis (CRT) is a common complication for patients requiring long-term venous access [ 11 – 12 ] , with lower limb swelling being one of the key clinical signs. The consensus [ 4 ] points out that appropriate active or passive limb exercises and leg circumference measurement are effective methods for preventing deep vein thrombosis in artificial liver venous access. However, it should be distinguished from liver-related edema, requiring enhanced observation and training to increase risk awareness. Additionally, catheter-related bloodstream infections are another significant complication of percutaneous femoral vein artificial liver catheterization, leading to high morbidity, mortality, increased healthcare costs, and resource utilization [ 13 ] . The consensus [ 14 ] emphasizes that infection prevention is not limited to sterile procedures and environmental requirements during treatment, but also includes proper management during catheterization. Nurses should check the patient's dressing during each shift, and dressings should be changed promptly when blood or exudates are present. Due to the proximity of the femoral vein access to the perineum, patients with urinary or fecal incontinence should have rectal bags or indwelling catheters placed to prevent contamination of the catheter insertion site. The study results indicate that clinical nurses scored low on catheter removal indications and post-removal bleeding management, with scores of (2.95 ± 0.644) and (2.96 ± 0.708), respectively. The guidelines [ 6 ] emphasize that prior to catheter removal, local infection at the insertion site should be assessed, and a vascular ultrasound should be performed to check for deep vein thrombosis. If the catheter is no longer in use or if there is thrombus formation that cannot be aspirated, catheter removal should be performed promptly. Appropriate timing for catheter removal requires proactive nursing strategies, such as strict assessment of the patient's condition before catheter insertion, health education post-insertion, close observation, and scientific management to effectively prevent catheter-related complications. Post-removal bleeding is a common complication that can exacerbate the patient's anxiety and even affect recovery. The two main causes of bleeding are premature removal or early movement post-removal [ 15 ] . Healthcare personnel should not only focus on proper catheter removal technique but also emphasize postoperative education to enhance patient compliance. The consensus [ 4 ] also points out key considerations during the compression process, such as the pressure site, technique, and duration, to avoid bleeding after removal. However, detailed correct compression techniques have not been fully defined. Currently, research on proper compression techniques is limited, with some auxiliary technologies or tools such as ProGlide pre-suturing technique [ 16 ] , self-made venous pressure devices [ 17 ] , and hemostasis devices [ 18 ] emerging. Compression methods vary across medical institutions, and clinical outcomes lack substantial data support, requiring further investigation. The study found that 36.63% of nurses in the Infectious Disease Department believed that heavy clinical workloads affected nursing practices for artificial liver temporary access, 24.91% cited lack of knowledge and difficulty accessing evidence as the main reason, and 16.12% attributed the issue to the complexity of standard procedures and execution challenges. Factors such as age, work experience, professional title, education level, membership in the vascular access team, and the frequency of training in the past year significantly influenced nursing practices for percutaneous femoral vein artificial liver temporary access ( P < 0.05). Therefore, a younger nursing workforce, lack of clinical practice, and insufficient training frequency were identified as unfavorable factors impacting nursing practice. Due to the shortage of nurses in China, the staffing needs to be managed and coordinated by administrators to optimize clinical nursing tasks [ 19 ] and improve nursing quality. Additionally, research [ 20 ] shows that establishing a dedicated team for intravenous therapy is an important factor in successful central venous access maintenance. Both of the tertiary hospitals surveyed have vascular access teams, yet only 5.25% of the Infectious Disease Department nurses are team members, limiting the team's ability to effectively promote best practices. This suggests that the leadership role of specialized teams should be maximized, and nursing staff training should be strengthened. Regular quality assessments of central venous access, data collection, statistics, and analysis, as well as continuous quality improvement projects, should be implemented to enhance the vascular access nursing process. Through information technology [ 21 ] , the collection and processing of large amounts of data can facilitate intelligent management, improve work efficiency, and reduce catheter-related complications, thereby further standardizing artificial liver vascular access management [ 8 , 22 ] and enhancing nursing service satisfaction. 5. Conclusions This study investigated the current status of nursing practices for percutaneous femoral vein artificial liver temporary access in two tertiary hospitals in Wuhan, identifying the weak links in the entire process of infectious disease department artificial liver temporary access management. The findings provide theoretical support and baseline data for updating and improving the nursing process and guidelines for artificial liver temporary access in the future. However, this study used a convenience sampling method and involved a limited number of medical institutions, which presents certain limitations. Future research could adopt a randomized sampling method for a multi-center, large-sample survey to enhance the representativeness of the results. Abbreviations ACL Acute–on–chronic liver failure ALSS Artificial liver support system COVID 19–Coronavirus Disease 2019 CRT Catheter–related thrombosis DVT Deep vein thrombosis HBV Hepatitis B virus IRB Institutional Review Board LF Liver failure NBALSS Non–biologic artificial liver support system S CVI–Scale–level Content Validity Index SPSS Statistical Package for the Social Sciences Declarations Ethics approval and consent to participate This study involving human participants was conducted in full accordance with the ethical principles outlined in the World Medical Association's Declaration of Helsinki. It adhered to the guidelines set by the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The research was approved by the Institutional Review Boards (IRBs) of Union Hospital, ensuring compliance with all relevant ethical standards and protocols. The study was also conducted in line with local legislation and institutional requirements. All participants provided written informed consent prior to their inclusion in the study. Consent for publication All authors confirm that they have reviewed and approved the final version of this manuscript and give their full consent for its publication in BMC Nursing. Availability of data and materials The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. All data supporting the conclusions of this study are included in this article and in additional files. Competing Interests The authors declare that they have no competing interests. Funding This research received no external funding. Authors' contributions F.L. designed and conceptualized the study, conducted data collection and statistical analysis, and drafted the initial manuscript. Y.Z. supervised the overall research design and methodology, provided critical review and substantial revisions, and ensured the scientific integrity of the study. All authors read and approved the final manuscript. Acknowledgements The authors would like to express their sincere gratitude to Dr. Sijia Zhang from the Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany, for his valuable technical assistance and for supporting the preparation and critical review of the figures and tables in this manuscript. References Guo, Wei, et al. "Alternative treatment for liver failure repair: current status and development countermeasures." Chinese Journal of Tissue Engineering Research 24.20 (2020): 3248. WANG, Xia, et al. 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Stadlbauer V, Davies NA, Sen S, Jalan R. Artificial liver support systems in the management of complications of cirrhosis. Semin Liver Dis. 2008;28(1):96-109. Morse L, Duncan H, Apen L V, et al. Centralized Scheduling of Nursing Staff: A Rapid Review of the Literature [J]. Nurs Adm Q, 2024, 48(4): 347-358. Yang F, Ho K Y, Lam K K W, et al. Facilitators and barriers to evidence adoption for central venous catheters post-insertion maintenance in oncology nurses: a multi-center mixed methods study [J]. BMC Nursing, 2024, 23(1): 581. McGee, David C., and Michael K. Gould. "Preventing complications of central venous catheterization." New England journal of medicine 348.12 (2003): 1123-1133. Smith, Reston N., and Jerry P. Nolan. "Central venous catheters." Bmj 347 (2013). Additional Declarations No competing interests reported. Supplementary Files Supplementaryfile1.docx Supplementary material Supplementary file 1 – English Questionnaire on Nursing Practice for Transcutaneous Femoral Vein Temporary Vascular Access in Artificial Liver Support Therapy. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 27 Nov, 2025 Reviews received at journal 26 Nov, 2025 Reviewers agreed at journal 14 Nov, 2025 Reviewers invited by journal 14 Nov, 2025 Editor invited by journal 20 Oct, 2025 Editor assigned by journal 20 Oct, 2025 Submission checks completed at journal 17 Oct, 2025 First submitted to journal 17 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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09:55:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":852831,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7575192/v1/0816d6c4-8924-4fe2-bcf1-2c12ce66fc5e.pdf"},{"id":96746231,"identity":"4a3d271b-f573-474d-85f4-3f9254e9ab14","added_by":"auto","created_at":"2025-11-25 16:03:43","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":28930,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eSupplementary material\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSupplementary file 1 – English Questionnaire on Nursing Practice for Transcutaneous Femoral Vein Temporary Vascular Access in Artificial Liver Support Therapy.\u003c/p\u003e","description":"","filename":"Supplementaryfile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7575192/v1/08229d45d3fa36f36e72ca69.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Research on nursing practice of transcutaneous femoral vein as temporary vascular access for artificial liver","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eLiver failure (LF) is a clinical syndrome caused by severe dysfunction of the liver due to various etiologies, with high mortality and poor prognosis\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. It is a common type of critical illness in the field of infectious diseases. Currently, there is no specific medication or treatment for comprehensive medical management of liver failure\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e, and the limited supply of liver transplant donors and high costs make this option less accessible\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Therefore, the non-biologic artificial liver support system (Abiotic artificial liver support system, NBALSS) has been widely used in clinical practice as an indispensable therapeutic method for liver failure. NBALSS requires a specialized vascular access to divert the patient\u0026rsquo;s blood outside the body, where it passes through separators, filters, and other processing devices before being re-infused back into the patient\u0026rsquo;s body. This access is known as artificial liver vascular access\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Establishing and maintaining a reliable vascular access is crucial for the successful implementation of artificial liver therapy\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. Due to the anatomical characteristics of the femoral vein, with clear landmarks, a larger diameter compared to other vessels, and adequate blood flow, the success rate of a single puncture is relatively high. This is especially important as patients with liver failure often suffer from severe coagulation disorders. Therefore, the femoral vein central venous access is commonly chosen for artificial liver treatment in these patients\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e. However, the proximity of the femoral puncture site and catheter insertion to the perineum limits patient movement and increases the probability of catheter-related complications\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. Proper and standardized management of catheter-related care thus becomes especially important\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. Therefore, this study aims to investigate the current status of nursing practices for percutaneous femoral vein artificial liver temporary access, with the goal of identifying issues in clinical nursing practice and providing reference and baseline data for developing targeted quality management measures and improving related processes.\u003c/p\u003e"},{"header":"2. Material and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Survey subjects\u003c/h2\u003e\u003cp\u003eFrom July to August 2024, a convenience sampling method was used to select nurses from the Infectious Disease Department of four tertiary hospitals in Wuhan as research subjects. Inclusion criteria: 1) Possession of a professional nursing qualification certificate issued by the People's Republic of China; 2) At least 1 year of work experience in the Infectious Disease Department; 3) Informed consent, understanding, and willingness to cooperate with the study. Exclusion criteria: 1) Clinical interns or advanced practice nurses; 2) Nurses who were absent for more than 1 week during the research period for various reasons.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Survey tools\u003c/h2\u003e\u003cp\u003eThe questionnaire used in this study was independently designed by the research team based on relevant national and international guidelines and expert consensus documents \u003cb\u003e(Supplementary file 1)\u003c/b\u003e. The guidelines referenced include the 2022 Clinical Application Expert Consensus on Artificial Liver Blood Purification Technology published by the Chinese Society of Hepatology (CMA)\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e, the 2022 Expert Consensus on Percutaneous Femoral Vein Temporary Vascular Access Management for Artificial Liver published by the Chinese Nursing Association\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e, the 2023 Guidelines on Artificial Liver Blood Purification System Treatment for Liver Failure and Artificial Liver by the Chinese Society of Infectious Diseases\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e, and the 2022 International Expert Consensus on Artificial Liver Support for Liver Failure Patients published by foreign emergency/critical care groups\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. The questionnaire was consulted by 4 infectious disease experts, 3 nursing experts, and 1 artificial liver specialist nurse. After a pre-survey with 30 nurses from the Infectious Disease Department of a tertiary hospital in Wuhan, certain items were modified to form the final questionnaire. Statistical results showed: 1) The expert agreement coefficient was 100%; 2) The expert authority coefficient was 0.938; 3) The content validity index (S-CVI) of the questionnaire was 0.970. These results indicate that the questionnaire design is scientifically reasonable and has good content validity. The questionnaire includes basic information about the research subjects (such as gender, age, years of work experience, education level, professional title, membership in a vascular access team, role as a teaching mentor, training frequency in the past year, learning methods, and reasons for failure) and a total of 16 items. The content covers the entire process of percutaneous femoral vein temporary access for artificial liver treatment, including key steps such as vascular access establishment (A1-A4), management during catheter placement (A5-A13), and catheter removal handling (A14-A16). The items are scored using the 4-point Likert scale, with scores ranging from 16 to 64 points.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Sample size\u003c/h2\u003e\u003cp\u003eAccording to the Kendall principle, the sample size should be 5\u0026ndash;10 times the number of items in the questionnaire. With 16 items in the questionnaire and considering a 20% non-response rate, the study requires at least 96 to 192 completed questionnaires.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Data collection and quality control\u003c/h2\u003e\u003cp\u003eFrom April to June 2025, the researcher explained the purpose and significance of the survey to the research subjects and distributed the questionnaire online via the Questionnaire Star platform. The questionnaires were completed anonymously and independently. A unified deadline was set for the electronic questionnaire, and responses submitted after the deadline were not included in the study. After the survey was completed, two researchers verified the questionnaires and excluded those with invalid responses, such as completion time less than 1 minute, three consecutive same answers, or missing answers.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Statistical methods\u003c/h2\u003e\u003cp\u003eThe data from the questionnaire were entered and verified by two researchers using Microsoft Excel. Statistical analysis was conducted using \u003cem\u003eSPSS\u003c/em\u003e (version 26.0) software. Descriptive statistics for categorical variables were presented as frequencies and percentages, while continuous variables were analyzed using means and standard deviations (\u003cem\u003eSD\u003c/em\u003e).\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1 General information of research subjects\u003c/h2\u003e\u003cp\u003eA total of 320 questionnaires were distributed in this study, with 305 valid responses returned, resulting in an effective response rate of 95.31%. Among the respondents, 14 were male and 291 were female, with an average age of (33.49\u0026thinsp;\u0026plusmn;\u0026thinsp;7.497) years and average years of work experience of (11.14\u0026thinsp;\u0026plusmn;\u0026thinsp;7.865) years. Detailed general information is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Questionnaire scores\u003c/h2\u003e\u003cp\u003eThe results showed that the average questionnaire score was (50.52\u0026thinsp;\u0026plusmn;\u0026thinsp;6.329), which is considered to be at a moderate level, as detailed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eNursing practice questionnaire scores of transcutaneous femoral vein artificial liver temporary access (n\u0026thinsp;=\u0026thinsp;305).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKey Aspect\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eItem\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScore (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVascular Access Establishment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA1: Staff qualifications\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.684\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA2: Location requirements\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.626\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA3: Range of skin preparation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.665\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA4: Hand hygiene and aseptic technique\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.590\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManagement during Catheterization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA5: Secondary catheter fixation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.774\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA6: Dressing change\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.672\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA7: Catheter identification\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.661\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA8: Hemorrhage or exudation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.347\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA9: Catheter fixation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.413\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA10: Leg circumference measurement\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.68\u0026thinsp;\u0026plusmn;\u0026thinsp;1.089\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA11: Functional exercise\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.738\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA12: Complication management (catheter-related infection, deep vein thrombosis, bleeding or hematoma at the insertion site)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.614, 2.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.721, 2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.571, 2.65\u0026thinsp;\u0026plusmn;\u0026thinsp;1.230\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA13: Catheter education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.612\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCatheter Removal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA14: Indications for catheter removal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.644\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA15: Disposal of discarded catheter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.705\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA16: Post-catheter removal hemostasis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.708\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e50.52\u0026thinsp;\u0026plusmn;\u0026thinsp;6.329\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Univariate analysis results of nursing practices for percutaneous femoral vein artificial liver temporary access\u003c/h2\u003e\u003cp\u003eThe univariate analysis showed that age, work experience, education level, professional title, membership in the vascular access team, and training frequency were significant factors influencing nursing practices for percutaneous femoral vein artificial liver temporary access (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as detailed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of monofactor analysis (n\u0026thinsp;=\u0026thinsp;305).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN (Percentage, %)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScore (Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eF/t\u003c/em\u003e Value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (4.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.29\u0026thinsp;\u0026plusmn;\u0026thinsp;6.696\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1.8541\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e291 (95.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e51.25\u0026thinsp;\u0026plusmn;\u0026thinsp;5.219\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e123 (40.33)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e49.35\u0026thinsp;\u0026plusmn;\u0026thinsp;6.327\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.1162\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31\u0026ndash;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e122 (40.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e50.46\u0026thinsp;\u0026plusmn;\u0026thinsp;6.952\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60 (19.67)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e53.03\u0026thinsp;\u0026plusmn;\u0026thinsp;3.897\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork Experience (years)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e80 (26.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.69\u0026thinsp;\u0026plusmn;\u0026thinsp;6.405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10.5092\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6\u0026ndash;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e139 (45.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e50.32\u0026thinsp;\u0026plusmn;\u0026thinsp;6.116\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86 (28.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e53.47\u0026thinsp;\u0026plusmn;\u0026thinsp;5.291\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAssociate degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12 (3.93)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e46.50\u0026thinsp;\u0026plusmn;\u0026thinsp;7.404\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.4432\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e273 (89.51)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e50.41\u0026thinsp;\u0026plusmn;\u0026thinsp;6.332\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaster's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20 (6.56)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e54.40\u0026thinsp;\u0026plusmn;\u0026thinsp;2.998\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProfessional Title\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e63 (20.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.08\u0026thinsp;\u0026plusmn;\u0026thinsp;6.764\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e18.0832\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNurse practitioner\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e85 (27.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e48.76\u0026thinsp;\u0026plusmn;\u0026thinsp;6.697\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHead nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e155 (50.82)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e52.86\u0026thinsp;\u0026plusmn;\u0026thinsp;4.910\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChief nurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2 (0.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e52.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVascular Access Team Member\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16 (5.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e60.69\u0026thinsp;\u0026plusmn;\u0026thinsp;1.740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e7.1231\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e289 (94.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e49.96\u0026thinsp;\u0026plusmn;\u0026thinsp;6.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTeaching Mentor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e82 (26.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e53.09\u0026thinsp;\u0026plusmn;\u0026thinsp;6.668\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.1951\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e223 (73.11)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e49.57\u0026thinsp;\u0026plusmn;\u0026thinsp;5.941\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraining Frequency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e72 (23.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e47.92\u0026thinsp;\u0026plusmn;\u0026thinsp;7.090\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11.9692\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u0026ndash;2 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e202 (66.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e50.91\u0026thinsp;\u0026plusmn;\u0026thinsp;5.880\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;3 times\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31 (10.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e54.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.040\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.4 Multiple linear regression analysis of nursing practices for percutaneous femoral vein artificial liver temporary access\u003c/h2\u003e\u003cp\u003eBased on the significant variables from the univariate analysis and correlation analysis (age, work experience, education level, professional title, vascular access team membership, and training frequency), a multiple linear regression analysis was conducted using these as independent variables and nursing practice questionnaire scores as the dependent variable (α_in\u0026thinsp;=\u0026thinsp;0.05, α_out\u0026thinsp;=\u0026thinsp;0.10). The following variable assignments were used: The variables used in the multiple linear regression analysis were assigned as follows: Age was categorized into three groups: 20\u0026ndash;30 years\u0026thinsp;=\u0026thinsp;1, 31\u0026ndash;40 years\u0026thinsp;=\u0026thinsp;2, and \u0026gt;\u0026thinsp;40 years\u0026thinsp;=\u0026thinsp;3. Work experience was also divided into three ranges: 1\u0026ndash;5 years\u0026thinsp;=\u0026thinsp;1, 6\u0026ndash;15 years\u0026thinsp;=\u0026thinsp;2, and \u0026gt;\u0026thinsp;15 years\u0026thinsp;=\u0026thinsp;3. Education level was coded as: Associate degree\u0026thinsp;=\u0026thinsp;1, Bachelor's degree\u0026thinsp;=\u0026thinsp;2, and Master's degree\u0026thinsp;=\u0026thinsp;3. Professional title was categorized as: Nurse\u0026thinsp;=\u0026thinsp;1, Nurse practitioner\u0026thinsp;=\u0026thinsp;2, Head nurse\u0026thinsp;=\u0026thinsp;3, and Chief nurse\u0026thinsp;=\u0026thinsp;4. Vascular access team membership was coded as: Yes\u0026thinsp;=\u0026thinsp;1, No\u0026thinsp;=\u0026thinsp;2. Training frequency was divided into three levels: 0 times\u0026thinsp;=\u0026thinsp;1, 1\u0026ndash;2 times\u0026thinsp;=\u0026thinsp;2, and \u0026ge;\u0026thinsp;3 times\u0026thinsp;=\u0026thinsp;3. The results indicated that age, work experience, professional title, education level, vascular access team membership, and training frequency in the past year were significant factors influencing nursing practices for percutaneous femoral vein artificial liver temporary access (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eResults of multiple linear regression analysis (n\u0026thinsp;=\u0026thinsp;305).\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIndependent Variable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePartial Regression Coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStandard Error\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eStandardized Regression Coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003et\u003c/em\u003e-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e(Constant)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26.231\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.532\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10.360\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e-2.464\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.720\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-2.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-3.421\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWork Experience\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.829\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.816\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.330\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.465\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.049\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.156\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProfessional Title\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.891\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.644\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.240\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.937\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVascular Access Team Membership\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8.862\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.378\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.313\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.433\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTraining Frequency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.669\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.554\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3.015\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote\u003c/b\u003e: \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.333, Adjusted \u003cem\u003eR\u0026sup2;\u003c/em\u003e = 0.7320, \u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;24.810, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe study results indicate that nursing staff in the Infectious Disease Department have limited knowledge regarding the establishment of artificial liver vascular access, with average scores for personnel qualifications, environmental requirements, and skin preparation all falling below 3. This suggests a weak awareness of risk prevention. The significant correlation between hospital environment and infection risk highlights the importance of good hospital hygiene and hand hygiene in preventing hospital infections. The 2022 consensus\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e specifies clear requirements for personnel qualifications and environmental standards for artificial liver vascular access, but due to limited clinical training and practical experience, nursing staff do not place adequate emphasis on these aspects. It is recommended that training on artificial liver procedures emphasize these specific guidelines and execution measures. Furthermore, hospitals should enhance personnel qualification screening and monitor the standards of artificial liver room environments.\u003c/p\u003e\u003cp\u003eThe study shows that during catheterization, lower scores were recorded for leg circumference measurement and complication management, with scores of (2.68\u0026thinsp;\u0026plusmn;\u0026thinsp;1.089) and (2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.614), respectively. Leg circumference measurement was identified as the weakest link, with some nurses reporting that they had never measured leg circumference in catheterized patients. Catheter-related deep vein thrombosis (CRT) is a common complication for patients requiring long-term venous access\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e, with lower limb swelling being one of the key clinical signs. The consensus\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e points out that appropriate active or passive limb exercises and leg circumference measurement are effective methods for preventing deep vein thrombosis in artificial liver venous access. However, it should be distinguished from liver-related edema, requiring enhanced observation and training to increase risk awareness. Additionally, catheter-related bloodstream infections are another significant complication of percutaneous femoral vein artificial liver catheterization, leading to high morbidity, mortality, increased healthcare costs, and resource utilization\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. The consensus\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e emphasizes that infection prevention is not limited to sterile procedures and environmental requirements during treatment, but also includes proper management during catheterization. Nurses should check the patient's dressing during each shift, and dressings should be changed promptly when blood or exudates are present. Due to the proximity of the femoral vein access to the perineum, patients with urinary or fecal incontinence should have rectal bags or indwelling catheters placed to prevent contamination of the catheter insertion site.\u003c/p\u003e\u003cp\u003eThe study results indicate that clinical nurses scored low on catheter removal indications and post-removal bleeding management, with scores of (2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.644) and (2.96\u0026thinsp;\u0026plusmn;\u0026thinsp;0.708), respectively. The guidelines\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e emphasize that prior to catheter removal, local infection at the insertion site should be assessed, and a vascular ultrasound should be performed to check for deep vein thrombosis. If the catheter is no longer in use or if there is thrombus formation that cannot be aspirated, catheter removal should be performed promptly. Appropriate timing for catheter removal requires proactive nursing strategies, such as strict assessment of the patient's condition before catheter insertion, health education post-insertion, close observation, and scientific management to effectively prevent catheter-related complications. Post-removal bleeding is a common complication that can exacerbate the patient's anxiety and even affect recovery. The two main causes of bleeding are premature removal or early movement post-removal\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Healthcare personnel should not only focus on proper catheter removal technique but also emphasize postoperative education to enhance patient compliance. The consensus\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e also points out key considerations during the compression process, such as the pressure site, technique, and duration, to avoid bleeding after removal. However, detailed correct compression techniques have not been fully defined. Currently, research on proper compression techniques is limited, with some auxiliary technologies or tools such as ProGlide pre-suturing technique\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, self-made venous pressure devices \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e, and hemostasis devices\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e emerging. Compression methods vary across medical institutions, and clinical outcomes lack substantial data support, requiring further investigation.\u003c/p\u003e\u003cp\u003eThe study found that 36.63% of nurses in the Infectious Disease Department believed that heavy clinical workloads affected nursing practices for artificial liver temporary access, 24.91% cited lack of knowledge and difficulty accessing evidence as the main reason, and 16.12% attributed the issue to the complexity of standard procedures and execution challenges. Factors such as age, work experience, professional title, education level, membership in the vascular access team, and the frequency of training in the past year significantly influenced nursing practices for percutaneous femoral vein artificial liver temporary access (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Therefore, a younger nursing workforce, lack of clinical practice, and insufficient training frequency were identified as unfavorable factors impacting nursing practice.\u003c/p\u003e\u003cp\u003eDue to the shortage of nurses in China, the staffing needs to be managed and coordinated by administrators to optimize clinical nursing tasks\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e and improve nursing quality. Additionally, research\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e shows that establishing a dedicated team for intravenous therapy is an important factor in successful central venous access maintenance. Both of the tertiary hospitals surveyed have vascular access teams, yet only 5.25% of the Infectious Disease Department nurses are team members, limiting the team's ability to effectively promote best practices. This suggests that the leadership role of specialized teams should be maximized, and nursing staff training should be strengthened. Regular quality assessments of central venous access, data collection, statistics, and analysis, as well as continuous quality improvement projects, should be implemented to enhance the vascular access nursing process. Through information technology\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e, the collection and processing of large amounts of data can facilitate intelligent management, improve work efficiency, and reduce catheter-related complications, thereby further standardizing artificial liver vascular access management\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e and enhancing nursing service satisfaction.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study investigated the current status of nursing practices for percutaneous femoral vein artificial liver temporary access in two tertiary hospitals in Wuhan, identifying the weak links in the entire process of infectious disease department artificial liver temporary access management. The findings provide theoretical support and baseline data for updating and improving the nursing process and guidelines for artificial liver temporary access in the future. However, this study used a convenience sampling method and involved a limited number of medical institutions, which presents certain limitations. Future research could adopt a randomized sampling method for a multi-center, large-sample survey to enhance the representativeness of the results.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eACL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eAcute\u0026ndash;on\u0026ndash;chronic liver failure\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eALSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eArtificial liver support system\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCOVID\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003e19\u0026ndash;Coronavirus Disease 2019\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCRT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCatheter\u0026ndash;related thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDVT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDeep vein thrombosis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHBV\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHepatitis B virus\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIRB\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInstitutional Review Board\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eLF\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eLiver failure\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNBALSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNon\u0026ndash;biologic artificial liver support system\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eCVI\u0026ndash;Scale\u0026ndash;level Content Validity Index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study involving human participants was conducted in full accordance with the ethical principles outlined in the World Medical Association's Declaration of Helsinki. It adhered to the guidelines set by the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The research was approved by the Institutional Review Boards (IRBs) of Union Hospital, ensuring compliance with all relevant ethical standards and protocols. The study was also conducted in line with local legislation and institutional requirements. All participants provided written informed consent prior to their inclusion in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors confirm that they have reviewed and approved the final version of this manuscript and give their full consent for its publication in BMC Nursing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. All data supporting the conclusions of this study are included in this article and in additional files.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting Interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors' contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eF.L. designed and conceptualized the study, conducted data collection and statistical analysis, and drafted the initial manuscript. Y.Z. supervised the overall research design and methodology, provided critical review and substantial revisions, and ensured the scientific integrity of the study. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgements\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their sincere gratitude to Dr. Sijia Zhang from the Department of Biophysics, Center for Integrative Physiology and Molecular Medicine (CIPMM), School of Medicine, Saarland University, Homburg, Germany, for his valuable technical assistance and for supporting the preparation and critical review of the figures and tables in this manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGuo, Wei, et al. \u0026quot;Alternative treatment for liver failure repair: current status and development countermeasures.\u0026quot; Chinese Journal of Tissue Engineering Research 24.20 (2020): 3248.\u003c/li\u003e\n\u003cli\u003eWANG, Xia, et al. \u0026quot;Advances in Diagnostic Criteria for Acute-on-chronic Liver Failure.\u0026quot; Chinese General Practice 26.07 (2023): 886.\u003c/li\u003e\n\u003cli\u003eShan-shan, L. I., et al. \u0026quot;Analysis of hospitalization costs for patients with HBV-ACLF in Beijing You\u0026apos;an Hospital from 2012 to 2021.\u0026quot; Chinese Hepatolgy 28.4 (2023): 405.\u003c/li\u003e\n\u003cli\u003eLingli, Hu, et al. \u0026quot;Expert consensus on the prevention and control of blood borne pathogen infections related to artificial liver support.\u0026quot; Electronic Journal of Emerging Infectious Diseases 9.3 (2024): 98.\u003c/li\u003e\n\u003cli\u003eCardiopulmonary Resuscitation Specialize of Chinese Research Hospital Association. \u0026quot;Expert consensus on cardiopulmonary resuscitation of cardiac arrest associated with COVID-19.\u0026quot; Jie Fang Jun Yi Xue Za Zhi 45.4 (2020): 345.\u003c/li\u003e\n\u003cli\u003eLingli, Hu, et al. \u0026quot;Expert consensus on the prevention and control of blood borne pathogen infections related to artificial liver support.\u0026quot; Electronic Journal of Emerging Infectious Diseases 9.3 (2024): 98.\u003c/li\u003e\n\u003cli\u003eSchwanke A A, Danski M T R, Pontes L, et al. Central venous catheter for hemodialysis: incidence of infection and risk factors [J]. Rev Bras Enferm, 2018, 71(3): 1115-1121.\u003c/li\u003e\n\u003cli\u003eHongqi, R. E. N., H. E. Qunpeng, and J. I. A. Fengyu. \u0026quot;Analysis of vascular access in hemodialysis patients.\u0026quot; Chinese Journal of Nephrology, Dialysis \u0026amp; Transplantation 26.3 (2017): 235.\u003c/li\u003e\n\u003cli\u003eJain V, Dhawan A. Extracorporeal Liver Support Systems in Paediatric Liver Failure. J Pediatr Gastroenterol Nutr. 2017;64(6):855-863.\u003c/li\u003e\n\u003cli\u003eSaliba F, Ba\u0026ntilde;ares R, Larsen F S, et al. Artificial liver support in patients with liver failure: a modified DELPHI consensus of international experts [J]. Intensive Care Med, 2022, 48(10): 1352-1367.\u003c/li\u003e\n\u003cli\u003eMessina A, Luce E, Hussein M, Dubart-Kupperschmitt A. Pluripotent-Stem-Cell-Derived Hepatic Cells: Hepatocytes and Organoids for Liver Therapy and Regeneration. Cells. 2020;9(2):420.\u003c/li\u003e\n\u003cli\u003eGirardi L, Di Nisio M, Candeloro M, et al. Catheter-related deep vein thrombosis: Where are we at and where are we going? Updates and ongoing unmet clinical needs [J]. Eur J Clin Invest, 2024: e14311.\u003c/li\u003e\n\u003cli\u003eTorres C J, Rupp M E, Cawcutt K A. Intravascular Catheter-Related Bloodstream Infections: Contemporary Issues Related to a Persistent Problem [J]. Infect Dis Clin North Am, 2024.\u003c/li\u003e\n\u003cli\u003eLi G, Zhang P, Zhu Y. Artificial liver support systems for hepatitis B virus-associated acute-on-chronic liver failure: A meta-analysis of the clinical literature. J Viral Hepat. 2023;30(2):90-100.\u003c/li\u003e\n\u003cli\u003eBrown RS Jr, Fisher RA, Subramanian RM, et al. Artificial Liver Support Systems in Acute Liver Failure and Acute-on-Chronic Liver Failure: Systematic Review and Meta-Analysis. Crit Care Explor. 2025;7(1):e1199.\u003c/li\u003e\n\u003cli\u003eLiu JP, Gluud LL, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for liver failure. Cochrane Database Syst Rev. 2004;2004(1):CD003628.\u003c/li\u003e\n\u003cli\u003eKjaergard LL, Liu J, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure: a systematic review. JAMA. 2003;289(2):217-222.\u003c/li\u003e\n\u003cli\u003eStadlbauer V, Davies NA, Sen S, Jalan R. Artificial liver support systems in the management of complications of cirrhosis. Semin Liver Dis. 2008;28(1):96-109.\u003c/li\u003e\n\u003cli\u003eMorse L, Duncan H, Apen L V, et al. Centralized Scheduling of Nursing Staff: A Rapid Review of the Literature [J]. Nurs Adm Q, 2024, 48(4): 347-358.\u003c/li\u003e\n\u003cli\u003eYang F, Ho K Y, Lam K K W, et al. Facilitators and barriers to evidence adoption for central venous catheters post-insertion maintenance in oncology nurses: a multi-center mixed methods study [J]. BMC Nursing, 2024, 23(1): 581.\u003c/li\u003e\n\u003cli\u003eMcGee, David C., and Michael K. Gould. \u0026quot;Preventing complications of central venous catheterization.\u0026quot; New England journal of medicine 348.12 (2003): 1123-1133.\u003c/li\u003e\n\u003cli\u003eSmith, Reston N., and Jerry P. Nolan. \u0026quot;Central venous catheters.\u0026quot; Bmj 347 (2013).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Artificial liver support system, Femoral vein, Temporary vascular access, Catheter-related complications, Nursing care","lastPublishedDoi":"10.21203/rs.3.rs-7575192/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7575192/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo investigate the current nursing practice and influencing factors of transcutaneous femoral vein temporary liver access in infection department, so as to provide basis for formulating targeted management measures and improving related nursing procedures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA questionnaire was designed by ourselves and convenient sampling method was adopted to investigate nursing staff in infection department of 4 Wuhan Grade III hospitals from April to June 2025. The questionnaire included general investigation, establishment of vascular access, management during catheter placement and extubation treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eA total of 320 questionnaires were sent out, and 305 valid questionnaires were collected, with an effective recovery rate of 95.31%. The total score of the questionnaire was (50.52±6.329), which was at the medium level. Age, years of work experience, job title, educational level, whether a member of the dialysis team, and the number of training sessions received by nursing staff within the past year are relevant influencing factors for the practice of percutaneous femoral arteriovenous hemodialysis access care (\u003cem\u003eP\u003c/em\u003e＜0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe nursing practice of transcutaneous femoral vein artificial liver temporary access is ideal, but there are still some weak links, the main reasons may be related to the shortage of nursing staff, the inability to obtain evidence, and the complicated process. It suggests that clinical institutions should rationally adjust nursing staff scheduling, play an active role of expert groups, carry out information technology, and continuously improve nursing norms and procedures.\u003c/p\u003e","manuscriptTitle":"Research on nursing practice of transcutaneous femoral vein as temporary vascular access for artificial liver","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-25 16:03:38","doi":"10.21203/rs.3.rs-7575192/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"232410906039172975641443133253945653333","date":"2025-11-27T09:10:15+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-26T07:49:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"93332494014822467744675556442508439991","date":"2025-11-14T06:21:59+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-14T06:18:35+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-20T12:35:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-20T12:31:58+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-18T00:30:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-10-18T00:27:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6c294b33-cdd4-412b-9c3c-836064c4eafb","owner":[],"postedDate":"November 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-25T16:03:38+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-25 16:03:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7575192","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7575192","identity":"rs-7575192","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}