Change Concept 8: AV Fistula Cannulation Training

Prevent fistulae from being destroyed by inexperienced staff. Discuss the basics of needle cannulation with all staff.

• Facility uses best cannulators and best teaching tools (e.g., videos) to teach AVF cannulation to all appropriate dialysis staff.
• Dialysis staff use specific protocols for initial dialysis treatments with new AVFs and assign the most skilled staff to such patients.
• Facility offers option of self-cannulation to patients who are interested and able.

Changes for Improvement

• Use Experienced Staff and Teaching Tools to Train All Appropriate Dialysis Staff on AVF Cannulation
• Identify the experienced cannulators on your staff; make sure they are available to cannulate all new fistulae and to train inexperienced staff.  Identify and make available to your staff appropriate teaching tools.
• Use Protocols for Initial Dialysis Treatments with New AVF Patients
• Dialysis staff should develop and use a specific protocol for initial dialysis treatments with new AV fistula patients and assign the most skilled staff to such patients.
• Teach Self-Cannulation to Patients Who Are Interested and Able
• Facilities should offer the option of self-cannulation to patients who are interested and able.