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Title

Vascular Access in the Chronic Hemodialysis Patient (1 credit hours)

Abstract

The reusable vascular access is the hemodialysis patient's lifeline, allowing blood to be circulated to the dialyzer and returned to the patient. This module describes the three types of vascular access in use today: the ateriovenous (AV) graft, the arteriovenous (AV) fistula, and the venous catheter. Complications and care of these accesses are discussed, as well as the National Kindey Foundation's K-DOQI recommendations for the creation of accesses.

Planners, content specialists and feedback personnel have declared that there is no conflict of interest in the preparation and content of this module. There is no commercial support for or endorsement of products in this module.

Author

Marguerite Read, RN BS CNN

Margie Read has been a Nephrology Nurse for over 28 years. In this time period she has been involved in Chronic Hemodialysis, Acute Hemodialysis and Critical Care and the use of Continuous Renal Replacement Therapies as well as education in all of these areas. Her teaching experience includes Clinical Specialists for a large dialysis manufacturer, where she has functioned as a consultant and in-service educator for dialysis facilities through out the United States. She is currently a Clinical Educator for another large Dialysis Corporation. Here her teaching experience involves New Hire orientation and ongoing in-service presentations on new policies and procedures and updating staff on new technologies and techniques in the dialysis arena. Margie has been a Certified Nephrology Nurse for over 14 years and has presented numerous topics locally, state wide and nationally to ANNA chapters. She is currently serving a second term as President of her local ANNA Chapter.

Objectives

Upon completion of the module the learner will be able to:

Describe important historical events associated with advancements in hemodialysis and access methods.
Describe 3 types of vascular accesses used in hemodialysis.
Describe the advantages, disadvantages and complications of each vascular access method.
Discuss important patient care considerations associated with the care of the vascular access site.

Resources

Bibliography
Amgen Advisory Board for Core Curriculum. Core Curriculum For the Dialysis Technician: A Comprehensive Review of Hemodialysis. 3rd ed. Module 5: Vascular Access. Amgen, Inc.; 2006. Available online at: http://www.meiresearch.org/CoreCurriculum/index.php. Accessed September 25, 2007.

Fan PE, Schwab SJ. Hemodialysis Vascular Access. Chapter 3, p 22-37.

Raja RM. Vascular Access for Hemodialysis. Handbook of Dialysis. Chapter 4. pp53-77.

Stackiewicz L. Nursing Assessment: Preservation of the Angio-Access. Dialysis and Transplantation. June 1994 pp 331-334.

Uldall P. Roberts Vascular Access for Hemodialysis. Dialysis Therapy. Chapter 2. pp 5-22.

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