Dialysis Facility

The following are some specific things facility staff can do to begin to increase AV fistula use in dialysis patients. These are actions that can be taken immediately. They will help to begin to increase AV fistula use, but will probably not be sufficient to achieve dramatic improvements. This will require the cooperation between and, perhaps, changes in practice of all providers in the system.

1. Know the rates of AV fistula use for the patients treated at your facility.
   • Review data provided by your Network.
   • Develop a log that contains the access type for each patient.
   • Develop a process to keep the log current.
     
2. Review the recommended strategies from the Fistula First Change Package and choose those that make  the most sense for your practice. 
   
   Consider getting started with the following Changes:
• Change Concept 1 - Routine CQI Review of Vascular Access
• Change Concept 6 - Secondary AVF Placement in Patients with AV Grafts
• Change Concept 7 - AVF Placement in Patients with Catheters Where Indicated
• Change Concept 8 - Cannulation Training for AVFs
• Change Concept 9 - Monitoring and Maintenance to Ensure Adequate Access Function
• Change Concept 10 - Education for Caregivers and Patients
• Change Concept 11 - Outcomes Feedback to Guide Practice

If you are a social worker, there is an educational slide presentation on the role of the social worker in Fistula First, shared by Barbara Campbell MSW, ACSW, LSW from ESRD Network 15.

Educational Materials

Cannulation of the Arteriovenous Fistula (AVF) -
A Series of Educational Videos for Professionals.