AVF care and Management
Respicio, R McQuaid, M, Watson, A, Holian, J, Kelly, F
St Vincent’s University Hospital, Dublin, Ireland
Introduction: Haemodialysis (HD) remains the most-used form of renal replacement
therapy that provides life saving for patients with end stage renal disease (van Loon et al. 2009). This modality has made survival possible for more than million people throughout the world. However, there are pre-requisites for successful haemodialysis treatment, which includes effectively functioning vascular access. Different vascular accesses are being used in HD that includes arteriovenous fistula (AVF), arteriovenous graft, central venous catheter and vascath as temporary access (Dixon et al. 2002, NKF KDOQI 2006, Tordoir et al. 2007).
In this study, the writer specifically has chosen, AVF as a preferred vascular access for evaluation and change initiative to be developed. The AVF is considered the best access to initiate patients onto haemodialysis because of its longer survival and lower complication rates (KDOQI 2006) compared with other forms of vascular access such as arteriovenous graft and central venous catheter.
AVF is the surgical creation of an anastomosis between an artery and vein, this allowing arterial blood to flow through the vein. After the fistula is surgically created, it can take weeks to months before the fistula is ready to be used for haemodialysis (AAKP, Vachharajani 2010).
Method: With all the evidences citing that AVF is the best access for HD, the writer brought together the important information regarding AVF, specifically as the proper care and management of the AVF. This will help healthcare professionals in providing optimal quality of care to HD patients. The writer implements the introduction of healthcare information leaflet regarding AVF care as evaluation tool.
Result: The completed information brochure.
The AVF is acknowledged worldwide as the “Gold Standard” of vascular access, however, cares and management of this vascular access is not without challenges. It is a well-known fact that many accidental mistakes caused by healthcare providers are not reported. This may be due to the performance of staff in dialysis unit who fails to meet guidelines. Standardisation of guidelines is essential to prevent confusion and inconsistencies in practice for staff in dialysis unit. Continued education and training of the HD nurses towards theoretical knowledge and clinical expertise is a must and required to ensure best practice is well carried out. Both the HD nurse and patient have essential role in supporting and keeping the longevity of vascular access.