2.50
Hdl Handle:
http://hdl.handle.net/10755/158114
Type:
Presentation
Title:
Vascular Access Measures and Interventions with Rural Hemodialysis Patients
Abstract:
Vascular Access Measures and Interventions with Rural Hemodialysis Patients
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Stoddard, Gloria, MS, FNP
P.I. Institution Name:University of Wyoming
Contact Address:PO Box 3063, Laramie, WY, 82071-3065, USA
Co-Authors:Sharon Ann Cumbie, PhD, RN
Problem Statement: End-stage renal disease patients must engage in hemodialysis to sustain life. This treatment will continue for the remainder of their lives or until a renal transplant may be obtained. Vascular access is the cornerstone of hemodialytic therapy, yet dialysis units frequently have no standard approach to assessment. Vascular access patency assessment and intervention is critical in maintaining ongoing hemodialysis. A model to guide effective assessment and maintenance of vascular access can significantly impact the patient’s quality of life and survival. Purpose: The purpose of this evaluative research was to conduct an implementation analysis to determine the clinical efficacy of an algorithmic protocol to assess arteriovenous patency of hemodialysis vascular access. This study addresses the outcomes of providing a vascular access program for the prevention and intervention of access thrombosis in the rural, chronic, hemodialysis patient. Design and Method: Quantitative-descriptive study utilizing a quasi-experimental time series design was the methodoligical approach for the research. The independent variable was the algorithmic protocol treatment and the dependent variable was the determination of the state of vascular access patency. The algorithmic protocol was developed prior to the study and based on a literature review and the researcher’s experience. Impact analysis was used to evaluate efficacy of the vascular access assessment protocol. Baseline data were obtained prior to beginning the study with pre-treatment data being obtained from the subject’s medical records. The treatment assessment and protocol evaluation occurred over a seventeen-week period. Population: Patients in a rural hemodialysis setting who had arteriovenous (AV) fistulas and arteriovenous grafts were the population for this study. The sample for the study was obtained from a dialysis center located in a rural setting of Wyoming and included 29 adult dialysis patients. Results: Nurses predicted with 100% accuracy the need for patency intervention using the protocol, as determined by radiographic assessment. Several patients identified for intervention thrombosed because the recommendation was not followed. In tracking the patients over several months, the nurses utilizing the algorithmic protocol could systematically identify the declining patency of the graft. Conclusion: Utilizing the algorithm for vascular access assessment gives the practitioner a cookbook approach to assessing, predicting, and preventing access thrombosis. Unfortunately, endothelial cell injury cannot be entirely prevented in the hemodialysis patient. But, this algorithm can provide the health care provider with a process to assess and recommend maintenance. In turn, the patient’s well-being and quality of life may be improved through diminished morbidity and mortality of the vascular access.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleVascular Access Measures and Interventions with Rural Hemodialysis Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158114-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Vascular Access Measures and Interventions with Rural Hemodialysis Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Stoddard, Gloria, MS, FNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Wyoming</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">PO Box 3063, Laramie, WY, 82071-3065, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sharon Ann Cumbie, PhD, RN</td></tr><tr><td colspan="2" class="item-abstract">Problem Statement: End-stage renal disease patients must engage in hemodialysis to sustain life. This treatment will continue for the remainder of their lives or until a renal transplant may be obtained. Vascular access is the cornerstone of hemodialytic therapy, yet dialysis units frequently have no standard approach to assessment. Vascular access patency assessment and intervention is critical in maintaining ongoing hemodialysis. A model to guide effective assessment and maintenance of vascular access can significantly impact the patient&rsquo;s quality of life and survival. Purpose: The purpose of this evaluative research was to conduct an implementation analysis to determine the clinical efficacy of an algorithmic protocol to assess arteriovenous patency of hemodialysis vascular access. This study addresses the outcomes of providing a vascular access program for the prevention and intervention of access thrombosis in the rural, chronic, hemodialysis patient. Design and Method: Quantitative-descriptive study utilizing a quasi-experimental time series design was the methodoligical approach for the research. The independent variable was the algorithmic protocol treatment and the dependent variable was the determination of the state of vascular access patency. The algorithmic protocol was developed prior to the study and based on a literature review and the researcher&rsquo;s experience. Impact analysis was used to evaluate efficacy of the vascular access assessment protocol. Baseline data were obtained prior to beginning the study with pre-treatment data being obtained from the subject&rsquo;s medical records. The treatment assessment and protocol evaluation occurred over a seventeen-week period. Population: Patients in a rural hemodialysis setting who had arteriovenous (AV) fistulas and arteriovenous grafts were the population for this study. The sample for the study was obtained from a dialysis center located in a rural setting of Wyoming and included 29 adult dialysis patients. Results: Nurses predicted with 100% accuracy the need for patency intervention using the protocol, as determined by radiographic assessment. Several patients identified for intervention thrombosed because the recommendation was not followed. In tracking the patients over several months, the nurses utilizing the algorithmic protocol could systematically identify the declining patency of the graft. Conclusion: Utilizing the algorithm for vascular access assessment gives the practitioner a cookbook approach to assessing, predicting, and preventing access thrombosis. Unfortunately, endothelial cell injury cannot be entirely prevented in the hemodialysis patient. But, this algorithm can provide the health care provider with a process to assess and recommend maintenance. In turn, the patient&rsquo;s well-being and quality of life may be improved through diminished morbidity and mortality of the vascular access.</td></tr></table>en_GB
dc.date.available2011-10-26T20:31:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:31:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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