Cannulation of the Arteriovenous Fistula (AVF) Lynda K. Ball, RN, BSN, CNN Quality Improvement Director Northwest Renal Network Seattle, Washington Activity.

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Presentation transcript:

Cannulation of the Arteriovenous Fistula (AVF) Lynda K. Ball, RN, BSN, CNN Quality Improvement Director Northwest Renal Network Seattle, Washington Activity Chair: Lawrence M. Spergel, MD, FACS Clinical Chair, Fistula First National Breakthrough Initiative San Francisco, California Authors: Deborah Brouwer, RN, CNN Director, Therapeutic & Clinical Programs Renal Solutions, Inc. Warrendale, Pennsylvania

2 Overview Cannulation of the Arteriovenous Fistula is designed to help you: –Increase understanding of AV fistulas –Increase knowledge of assessment, cannulation, and protection of new and mature fistulas –Troubleshoot problems during cannulation and dialysis –Communicate effectively with care team members –Encourage your healthcare team to develop a “New AVF Cannulation Protocol”

3 Overview (cont’d) Assessment of the New AVF for Maturity Protocol for New AVF Cannulation Cannulation Site Selection and Preparation Cannulation Techniques Self-Cannulation Complications

4 Fact When Fistula First was initiated in early 2003, it was reported that 80% of prevalent hemodialysis patients in Europe and only 30% of prevalent hemodialysis patients in the United States used an AVF. Fistula First, National Vascular Access Improvement Initiative. Available at: Accessed January 11,

5 Risks Associated with Poor Cannulation & Improper Care of Fistula Loss of the fistula Further hospitalization Creation of temporary access measures Inconvenience Disruption of regular treatment regimen Higher treatment costs

6 Mature Arteriovenous Fistula - - Photo courtesy of J. Rowland

7 Arteriovenous Graft Photo courtesy of J. Rowland

8 Catheter Used for Dialysis Photo courtesy of J. Rowland

9 Benefits of Arteriovenous Fistula (AVF) –Lowest rate of failures and complications –Longevity –Lowest costs Merrill D, et al. Dial Transplant. 2005;34:

10 Cannulating a Fistula The formal description of the process of inserting needles into a vascular access Graphic courtesy of Medisystems HemoDYNAMIC Devices™

11 Program Overview The new AV fistula: –How to assess for:  Maturity  Complications  Cannulation sites –Correct way to cannulate it The mature AV fistula: –How to assess –How to select cannulation site –How to prepare cannulation site –How to cannulate site using site rotation and the buttonhole technique

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