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- Title
Implementation of a vascular access quality programme improves vascular access care.
- Authors
M. van Loon; W. van der Mark; N. Beukers; C. de Bruin; P. J. Blankestijn; R. M. Huisman; J. J. Zijlstra; F. M. van der Sande; J. H. M. Tordoir
- Abstract
Introduction. In the Netherlands an access quality improvement plan (QIP) was introduced by vascular access coordinators (VAC) with the aim to decrease vascular access-related complications by preemptive intervention of malfunctioning accesses. A vascular access QIP was established in 24 centres (46% of all Dutch facilities) and a structural multidisciplinary vascular access meeting was instituted. In these centres, including 2300 patients, a protocol for enhancement of fistula creation and access surveillance programme was implemented, with instruction of physicians and nurses, and rounds to discuss complications and evaluate vascular access interventions. The number and type of vascular access, permanent catheters, thrombosis rates and number of interventions were evaluated at the start and end of the study period. Results. After the surveillance programme, the number of autogenous arterio-venous fistulas (AVFs) had increased significantly from 69 to 77% (P vs 11%) (P P P Conclusion. These data demonstrate that a vascular access QIP resulted in placement of more autogenous AVFs, increased number of PTAs and surgical interventions. These findings suggest that a vascular access care QIP is worthwhile to improve dialysis patientsâ care and access morbidity.
- Publication
Nephrology Dialysis Transplantation, 2007, Vol 22, Issue 6, p1628
- ISSN
0931-0509
- Publication type
Academic Journal
- DOI
10.1093/ndt/gfm076