We have located links that may give you full text access.
Increasing the placement of native veins arteriovenous fistulae--the role of access surgeons' education and profiling.
Clinical Nephrology 2004 July
BACKGROUND: The utilization of native veins arteriovenous (AV) fistulae in the US remains low despite their superiority over other types of hemodialysis access.
METHODS: A nephrologist-driven, quality improvement project that concentrated on access surgeons was utilized to increase fistulae placement. Period I of the project (1998-2000) entailed surgeons' education about advantages of fistulae and methods to increase their placement. During period II (2001-2002), referral patterns to surgeons were altered according to their performance, and surgeons out of the area were utilized. Data on patient characteristics, type of access placed and access complications were measured.
RESULTS: Fistulae constituted 45% of AV access placed in period I and 79% of those placed in period II. Fistulae prevalence, which was 15% at the end of the pre-project period, increased to 27% at the end of period I and 49% at the end of period II. All changes were statistically significant. Complication rates did not increase. Fistulae placement by surgeons operating in both periods increased in period II. The distribution of types of access placed and outcomes differed significantly among surgeons.
CONCLUSIONS: Fistulae placement could be increased when the nephrologist works with access surgeons and monitors their performance. Profiling of access surgeons by policy-makers could be a useful method for the identification of surgeons with better skill.
METHODS: A nephrologist-driven, quality improvement project that concentrated on access surgeons was utilized to increase fistulae placement. Period I of the project (1998-2000) entailed surgeons' education about advantages of fistulae and methods to increase their placement. During period II (2001-2002), referral patterns to surgeons were altered according to their performance, and surgeons out of the area were utilized. Data on patient characteristics, type of access placed and access complications were measured.
RESULTS: Fistulae constituted 45% of AV access placed in period I and 79% of those placed in period II. Fistulae prevalence, which was 15% at the end of the pre-project period, increased to 27% at the end of period I and 49% at the end of period II. All changes were statistically significant. Complication rates did not increase. Fistulae placement by surgeons operating in both periods increased in period II. The distribution of types of access placed and outcomes differed significantly among surgeons.
CONCLUSIONS: Fistulae placement could be increased when the nephrologist works with access surgeons and monitors their performance. Profiling of access surgeons by policy-makers could be a useful method for the identification of surgeons with better skill.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
Perioperative echocardiographic strain analysis: what anesthesiologists should know.Canadian Journal of Anaesthesia 2024 April 11
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app