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Vascular access surveillance : the role of the access nurse in the renal dialysis unit.

Schoch, Monica and McClure, David 2007, Vascular access surveillance : the role of the access nurse in the renal dialysis unit., in Vascular 2007 : Proceedings, [The Meeting], [Melbourne, Vic.], pp. 1-3.

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Title Vascular access surveillance : the role of the access nurse in the renal dialysis unit.
Author(s) Schoch, Monica
McClure, David
Conference name Vascular 2007 Meeting (2007 : Melbourne, Vic.)
Conference location Melbourne, Vic
Conference dates 17-22 Aug. 2007
Title of proceedings Vascular 2007 : Proceedings
Editor(s) [unknown]
Publication date 2007
Conference series Vascular Meeting
Start page 1
End page 3
Total pages 3
Publisher [The Meeting]
Place of publication [Melbourne, Vic.]
Keyword(s) vascular access
renal dialysis unit
Summary Introduction
In January 2006, the Renal Dialysis Unit at Geelong Hospital appointed a Vascular Access Nurse. A Transonic Flow Qc HDO2 Ultrasound Dilution Monitor was purchased to monitor access flow and recirculation in arteriovenous fistulae in an attempt to predict AVF stenoses requiring early surgical correction.

Methods
A bi-monthly monitoring program tested all facility-based patients. 82 patients were assessed for access flow and recirculation between February and December 2006.

Results
18 (22%) had poor AVF function; 13 with access flows <500ml/minute on initial testing and 5 with an access flow decreasing >25% over a four month period. Of the 18 patients shown to have poor access flow, 2 died within one month of measurement while 5 were too frail to attempt corrective surgery. The remaining 11 proceeded to ultrasound or fistulography. A >50% stenosis was detected in all 11 cases. Of these, 4 had successful vein patch surgery and one had PTFE grafting, each with marked improvement in access flow. One had failed vein patch surgery requiring creation of a femoral AVF, one patient required cvc insertion to await AVF creation, and one had failed stenting requiring a permanent cvc. 3 died before planned surgery.

Conclusion
5 of the 82 patients that had access flow assessment, and needed further evaluation, proceeded to successful pre-emptive surgical intervention. We believe the Transonic is a useful adjunct to routine clinical AVF surveillance, in providing early evidence of AVF failure that can be avoided by pre-emptive surgery.

Notes Winner of 'Best Presentation' Award (Nursing)
The Vascular 2007 meeting, held at the Melbourne Exhibition & Convention Centre from the 17th to the 22nd of August 2007 is a combined meeting of: The Australian and New Zealand Society for Vascular Surgery; The ANZSVS Vascular Imaging Symposium; The Victorian Chapter of the Society for Vascular Nurses Seminar; and The ANZ Chapter of the International Union of Angiology.
Language eng
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category E2.1 Full written paper - non-refereed / Abstract reviewed
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046497

Document type: Conference Paper
Collection: School of Nursing and Midwifery
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Created: Tue, 31 Jul 2012, 12:24:59 EST by Monica Schoch

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