| Author | Subject: Teach staff about the 3 most important issues in vascular access |
| John Newmann | Posted At 13:54:10 04/28/2003 I've been asked to write a chapter, "A Patient's Comments on Vascular Access" in a book for ESRD professionals on Vascular Access. 1. Very simply I'd like to know what you think are the three, ONLY THREE, most important points you would make if writing the chapter for hemodialysis staff, not patients. For practical reasons, I limit this to three, knowing there are more. 2. At the end of your response, please let me know how long you have been a patient; choose one of the following: One year or less Between one and three years Over three years If you responded to this on another site, I'm posting this in a few places, there is no need to duplicate your effort. I was a home hemo patient for 16 years, did PD for a few years, had a cadaver transplant for a few years, and am lucky to have my daughter's kidney (she donated at age 22) since Thanksgiving of 1993. I'm an active patient advocate, and would very much appreciate your views on vascular access, so I can write something constructive, not just from my own experience. Please respond within 10 days and fell free to write to me directly. Thank you! John Newmann johnnewm@aol.com |
| Nancy H. Spaeth RN | Re: Teach staff about the 3 most important issues in vascular access (Currently 0 replies) Posted At 00:34:15 05/11/2003 I have been a kidney patient since 1966, have been on dialysis 4 times, between transplants. I am on my 4th transplant, now. I found your message on the Life Options site. * If I were to have to choose a mode of dialysis, again, I would choose PD and use a Tenckhoff PD catheter. I much preferred CAPD over hemodialysis. It offers much more independance and flexability, as well as a more liberal diet. In realtive terms, I loved it compared to hemo. In five years, I never had an access infection or had to have my catheter revised or replaced. * My second choice would be an AV fistula. It provides better blood flows and people have fewer problems with it. These are more preferable to any other hemodialysis access. * My 3rd choice would be an AV graft. Of course, in the old days, we used Scribner Shunts, what we called our "cannulas". I really appreciate your contribution to the education of kidney patients!! Nancy Spaeth, RN |
| David L. Axtmann | Re: Teach staff about the 3 most important issues in vascular access (Currently 0 replies) Posted At 23:32:12 08/04/2003 Hi John My name is David Axtmann. I am so sorry that I didn°t pick up your post sooner as this is a subject that I have given much thought and work on. In response to your first issue, ´three most important points I would make if writing the chapter° are as follows: 1. Nurses should always be aware that the patient°s access is his/her LIFELINE. There dialysis success depends on it. 2. Nurses must know the difference in a fistula and a shunt as well as the difference in sticking each. 3. A nurse should always evaluate the access first and never be afraid to ask for help of a more experienced person to do the sticking if it looks complicated. In answering your second question, I have been on home Hemodialysis over 3 years, 31 years over 3 years actually. I realize this response is late and may be of little assistance in your writting, but this is such and important issue I wanted to ¿give it a shotî as my grandson would say. In addition, I am including some recommendations for Health Care that I have been considering. I welcome your response as well of any one that may be checking in. ACCRSS CARE III. RECOMMENDATIONS A. There should always be a ¿HIGHLYî experienced individual available for first sticks. B. All new patients and/or transient patients should at least be evaluated, preferably stuck, the first time by the most ¿HIGHLYî experienced nurse, tech, etc. C. Home patients, accompanied by their regular aid, should be allowed to decide who would do their stick: staff member or accompanying aid. D. Any nurse having difficulty, in any stick, should be required to view the ¿HIGHLYî experienced staff member correcting the situation to learn and improve from their error. E. Preferably all centers should have a ¿HIGHLYî experienced person; i.e. IV Nurse, to do all sticks. Accesses are too important to play a training game. F. All DIVE BOMER practices should be rooted out. G. Vascular surgeons should be aware of problems, and they should be satisfied the best care is given? My emai address is axhandle42@hotmail.com. David L. Axtmann P.O. Box 124 Cottage Grove, MN 55016 |