Guidelines on vascular access cannulation and care
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Guidelines on Vascular Access Cannulation and Care . Joint project of EDTNA/ERCA and Fresenius Medical Care to achieve enhanced multidisciplinary renal team practice in dialysis and establish VA guidelines. Project Coordinators :.

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Guidelines on Vascular Access Cannulation and Care

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Guidelines on vascular access cannulation and care

Guidelines on Vascular Access Cannulation and Care

Joint project of EDTNA/ERCA and Fresenius Medical Care to achieve enhanced multidisciplinary renal team practice in dialysis and establish VA guidelines


Project coordinators

Project Coordinators:

Maria Teresa Parisotto- General and Scientific Coordinator on behalf of Fresenius Medical Care

Jitka Pancirova - General Coordinator on behalf of EDTNA/ERCA

Jean Pierre Van Waeleghem- Scientific Coordinator on behalf of EDTNA/ERCA


Guidelines on vascular access cannulation and care

Raise awareness for the importance of vascular access management as the “patient’s lifeline”

Define vascular access cannulation practices based on clinical evidence (six months observational study) to minimize complications

Develop guidelines for vascular access cannulation and care

Project Objectives:


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

  • Project Framework Definition

  • Preparation of Observational Study Protocol (VASACC)

  • Selection of Participating Countries and Centres

  • Data Collection (Jan - Jul 2013)

  • Data Analysis (Aug - Dec 2013)

  • Development of Vascular Access Guidelines (Jan - Jun 2014)

  • Launch of Vascular Access Guidelines - EDTNA/ERCA 2014


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Data Collection study beginning:

  • Descriptive parameters – per centre

  • Number of patients on chronic HD treatment

  • Number of nurses and physicians in charge,

  • Descriptive paramters – per enrolled patient

  • Age & gender

  • Medical diagnoses, type of vascular access, including location

  • Status of AVF creation (primary, secondary, previous complications, etc.)

  • Medication

  • Dialysis prescription

  • Measured dialysis dose Kt/V


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Data Collection per patient per treatment:

  • VA - General setting

  • AVF localisation (forearm, elbow, upper arm, other)

  • Needle characteristics (size, back-eye (y/n), sharp vs. blunt)

  • Medication with impact on coagulation

  • VA - Cannulation technique

  • Rope ladder vs. area vs. button hole

  • Antegrade vs. retrograde puncture

  • Distance between needle puncture sites (<3, 3-6, >6 cm)

  • Primary bevel-up vs. bevel-down

  • Needle rotation after insertion (y/n)


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Outcome parameters:

  • VA Complications

  • Patencyimpairment, indicated by

    • QBdrop* <50% of prescribed value

    • Signs and symptoms of fistula thrombosis or manifest occlusion

  • AVF infection (necessary: evident local signs)

  • Haematoma with swelling and/or induration

  • Numbers of punctures >=4 / session

  • Hospitalisation*

  • Death*

* attributable to AVF (complication)


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Development of Guideline:

  • Project Team Members kick-off meeting:

  • 18.19 of April 2013

Picture

* attributable to AVF (complication)


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Project Team Memebers:

  • Team Members (EDTNA/ERCA and FME):

    • Iris Romach,Theodora Kafkia, RaffaellaBeltrandi, Joao Fazendeiro, Ricardo Peralta, MihaiPreda, Alberto Iglesias, Nicola Ward, Iain Morris, Francesco Pelliccia, Cristina Miriunis, Jean Pierre van Waeleghem.

Picture

* attributable to AVF (complication)


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Definition of Guideline Outline:

  • Workshop

  • Home work

Pictures

* attributable to AVF (complication)


Guidelines on vascular access cannulation and care

Vascular Access

Project Status

Next Steps:

  • Literature research

  • Development of Guideline full content

  • Revision of the content

  • Endorsement of VAS

  • Final revision

  • Printing

  • Distribution at the next EDTNA/ERCA conference

* attributable to AVF (complication)


Results from the va survey 2012

Results from the VA Survey 2012

  • For the third consecutive year a questionnaire about vascular access assessment was distributed at the Strasbourg Conference 2012 in seven languages.

  • A total of 9xxx participants from more than 44different countries participated in the survey.


Guidelines on vascular access cannulation and care

Which Country are you from?

% of Completed Questionnaires per European Country

N. of Country 44


How many years have you been working in dialysis

How many Years have you been Working in Dialysis?


Guidelines on vascular access cannulation and care

In which setting are you working?


Guidelines on vascular access cannulation and care

Which needle do you remove first?


Guidelines on vascular access cannulation and care

How do you perform haemostasis after removing the needle?


Guidelines on vascular access cannulation and care

Are you in favour of asking for patient’s help, by applying pressure during haemostasis?


Guidelines on vascular access cannulation and care

Depending on the characteristics of the patient, on average how long does the haemostasis of a puncture site take?

Multiple answers were possible


Guidelines on vascular access cannulation and care

In your opinion, should vascular access care be included in a patients training and education programme?


Guidelines on vascular access cannulation and care

Is there currently a vascular access training programme

for patients in your centre?


Guidelines on vascular access cannulation and care

In your opinion is the current patient’s training and education

programme for vascular access sufficient?


Guidelines on vascular access cannulation and care

In your opinion who should be responsible for organising a

training and education programme?


Guidelines on vascular access cannulation and care

Please rank the following topics on a scale of 1 to 6 according to importance when teaching a patient about vascular access.

(1 for most important, 6 for the least important)


Guidelines on vascular access cannulation and care

On a regular basis, do you currently use a vascular access

monitoring tool in your clinic?


Guidelines on vascular access cannulation and care

Who is the professional in charge of organising the vascular access monitoring programme on regular basis?


Va survey 2 012 conclusion

VA Survey 2012 - Conclusion

43.7% of participants work in public hospitals

The first needle removed is the arterial one (82%)

77.5% of the respondents consider the current patient’s training and education programme for vascular access sufficient

For 75.6% of the respondents, the professional in charge of organising the vascular access monitoring is the nurse, followed by the nephrologist with 18.5% and vascular access surgeon with 5.8% .


Guidelines on vascular access cannulation and care

Thank you !Vielen Dank !Merci beaucoup !¡Muchas gracias !

Obrigado !

Grazie Mille !

Mulţumesc !

Děkujeme!

Dziekuje !

Teşekkür Ederim !

Sagolun !

Hvala !

Köszönöm !


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