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Maintaining high arteriovenous fistula prevalence rate; a single haemodialysis unit experience
Barrios, Bernard
Barrios, Bernard
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Affiliation
University Hospitals Birmingham NHS Foundation Trust
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Publication date
2024-09-09
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Abstract
INTRODUCTION:
Arteriovenous Fistula (AVF), the standard for haemodialysis vascular access, minimizes infections risk. Inadequate AVF function is the leading cause of renal patient hospitalization, resulting to high-cost hospital admissions and severe morbidity and mortality consequences.
METHODS:
BRS Pre-Cannulation Assessment Tool was used for AVF monitoring. The New AVF Assessment and Cannulation Tool ensures thorough evaluation of new AVFs. Enhanced surveillance includes Access Flow (Qa) Measurements and Referral Algorithm, with nurses utilizing an in-centre ultrasound machine for AVF scanning.
Education is a critical component. 20.8% of staff attended ultrasound workshops, 41.7% engaged in ultrasound training with the Vascular Access Nurse, and 37.5% participated in the Vascular Access Study Day. Qa measurement training was provided to all staff and peer-to-peer ultrasound training further enhanced patient experience and safety. Nurse Link Role improves the collaborative framework for effective communication.
RESULTS:
Starting in 2007 with 70 patients and a 79.8% AVF rate, our haemodialysis unit achieved an 89.6% AVF rate with 107 patients in 2023. From 2007 to 2023, the AVF prevalence rate has averaged 90.4%. National guidelines recommend at least 80% of haemodialysis recipients use AVF or AVG (53% national average, Renal Registry Report 2021). This strategic focus on AVF utilization demonstrates sustained success and a strong commitment to optimal patient care.
DISCUSSIONS:
Achieving optimal AVF prevalence requires systematic monitoring, surveillance, and nurse education. Overcoming challenges like low staffing and maintaining continuity is crucial for improving AVF outcomes and patient care.
Citation
Barrios, B. (2024) 'Maintaining high arteriovenous fistula prevalence rate; a single haemodialysis unit experience'. School of Nursing, AHP and Midwifery Conference. Birmingham: 9-10 September.
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Conference Output