Vascular Access in the Elderly: Does One Size Fit All?

Dhruve, Miten J.; Chan, Christopher T.

doi:10.1159/000476005

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…7,[28][29][30][31] Our study reiterates the importance of patient appropriate vascular access in individuals. 32 Our study is limited by its observational nature. Given that our vascular-access audit is provided during clinic visit and on an ad hoc basis after an infection.…”

Section: Discussionmentioning

confidence: 99%

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The use of nurse‐administered vascular access audit in home hemodialysis patients: A quality initiative

Dhruve

Faratro

D'Gama

et al. 2019

Hemodialysis International

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Introduction: Vascular access complications are associated with increased morbidity and mortality in home hemodialysis (HHD). Nurse‐administered vascular access checklist is a feasible quality improvement strategy aimed to lower HHD access errors. Methods: We conducted a prospective quality improvement initiative for consecutive HHD patients between April 2013 and December 2016 at the Toronto General Hospital. Vascular access audits were administered every 6 months during clinic visits and during retraining sessions after an infection. We aimed to (1) determine whether prospective serial administration of vascular audit will decrease in the number of errors performed by the patient and (2) to determine whether there is an association between the number of errors and vascular access related infection. Findings: A total of 370 audits were performed on 122 patients with a mean HHD vintage of 6.7 (0.8–19.5) years. The mean number of errors per patient decreased from 1.24 ± 1.75 (baseline) to 0.33 ± 0.49 (last follow‐up), P < 0.001. Among patients who had serial vascular access audits performed, there was a significant decrease in median number of errors (baseline median 1, [0–2] end of study median 0, [0–1] P = 0.01). Patients performing buttonhole cannulation made most proportion of errors as compared to CVC, 54% vs. 40% (P = 0.01) respectively; and as compared to rope ladder cannulation 54% vs. 37% (P = 0.008). We were unable to demonstrate an association between the change in patient reported errors and vascular access related infection. Discussion: Vascular access audit is a feasible quality initiative, which leads to a decrease in the number of patient reported errors in vascular access. The longitudinal clinical sequelae of this strategy warrants further examination.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have already demonstrated CVC to be associated with an increased risk of vascular‐associated infections, hospitalizations, and mortality . Our study reiterates the importance of patient appropriate vascular access in individuals …”

Section: Discussionmentioning

confidence: 99%

The use of nurse‐administered vascular access audit in home hemodialysis patients: A quality initiative

Dhruve

Faratro

D'Gama

et al. 2019

Hemodialysis International

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite this, AVF prevalence is reportedly lower among elderly patients. 3,22 Furthermore, it is currently unclear whether the advanced age plays any modifying role in AV access outcomes. Some studies have shown that age has no significant impact on catheters and AV access outcomes, with older patients having comparable outcomes to their younger counterparts.…”

Section: Introductionmentioning

confidence: 99%