Fistula First | End Stage Renal Disease Network 8 Incorporated

Vascular Access

As the "lifeline" of the patient on hemodialysis, vascular access should be a primary focus of quality improvement activities. While efforts are underway to improve vascular access outcomes by increasing the use of AV fistulas (see Fistula First), the majority of patients in Network 8 continue to dialyze with AV grafts or central venous catheters. Dialysis facility staff and other vascular access team members must work together to:

Establish the most appropriate vascular access for each patient
Maintain the access once established
Minimize the risks associated with each vascular access type
Preserve future sites for vascular access

These goals may be accomplished through better communication, education, vascular access monitoring, early referral for intervention, and utilization of proper procedures.

Fistula First: Forging Forward

The 2011-2012 Statement of Work requires Network 8 to achieve a Network-wide AVF prevalence rate of 57.4% by March 2012. In order to reach this goal, the current Quality Improvement Project focuses on all facilities with AVF rates < 58% along with additional focus on the four metropolitan areas in Network 8 with overall lowest AVF rates. At project initiation, based on June 2011 AVF rates, 201 Network 8 facilities were included in AVF focused-review, 78 of which were located within Jackson (MS), Birmingham, Montgomery, or Nashville metropolitan area.

You are encouraged to participate in project activities and utilize information received from the Networks in assessing and developing your own plan for improving vascular access outcomes.

Please contact Sheila McMaster, Network 8 Quality Improvement Coordinator, for more information (601-936-9260 or Email).