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- Title
Improving assessment and escalation of threatened haemodialysis access.
- Authors
Connor, Jennifer; Forcey, Dana; Tran, Dan; Ayudhya, Priya Kusuma Na; Ocampo, Christian; Nelson, Criag; Crikis, Sandra
- Abstract
Background: A 12-month retrospective analysis of the rate of arteriovenous fistula (AVF) and graft (AVG) thrombosis at our hospital showed 0.33 episodes per 1000 patient-days. Current literature reported a rate of 0.24 events per 1000 patient-days. This prompted the development of an education pathway to assist haemodialysis staff with timely and appropriate escalation for threatened haemodialysis access. Aim: The aim of this study was to assess the impact of implementing an escalation pathway for threatened haemodialysis access, on the rates of vascular access thrombosis and inpatient bed days. Methods: Development of a colour-coded pathway for the appropriate escalation of threatened haemodialysis access. The pathway was based on clinical markers that indicate the possibility of underlying AVF/AVG stenosis and/or imminent thrombosis. Education program was implemented to roll out the pathway. Reassessment of AVF/AVG thrombosis rate over 12-month period Results: After the pathway was implemented, there was a reduced rate of acute thrombosis of haemodialysis access from 0.33 to 0.15 episodes per 1000 patient-days (p=0.02), with an associated reduction in inpatient admission rate from 2.2 to 0.69 per 1000 patient-days. Conclusion: Acute thrombosis of haemodialysis access can lead to increased patient morbidity and adds a significant cost to the healthcare system. This study highlights that a nursing-led education program can successfully identify vascular access at risk of imminent thrombosis, reduce rates of acute thrombosis and reduce associated healthcare costs.
- Subjects
NEW South Wales; THROMBOSIS prevention; NURSING education; CONFERENCES &; conventions; HUMAN services programs; RISK assessment; QUALITY assurance; HOSPITAL care; HEMODIALYSIS; CATHETERIZATION; EDUCATIONAL outcomes
- Publication
Renal Society of Australasia Journal, 2023, Vol 19, Issue 1, p18
- ISSN
1832-3804
- Publication type
Article