Authors (including presenting author) :
Lau KW (1), Lee YK (1), Wong HC (1), Tsang KY (1)
Affiliation :
(1) Department of Medicine, Yan Chai Hospital
Keyword 1: :
AVF education
Keyword 2: :
Nurse-led program
Introduction :
Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis but suffers from high rates of early failure due to thrombosis or poor maturation, leading to prolonged catheter use, increased morbidity, and higher healthcare costs. While patient education is crucial for AVF success, a structured program was lacking in the clinical unit.
Objectives :
This study aimed to enhance AVF functionality in hemodialysis patients by implementing a nurse-led education program designed to improve patient knowledge and self-care behaviors. Specific objectives were to improve the early success rate of first AVF cannulation, accelerate the removal of hemodialysis catheters, and lower AVF complication rates.
Methodology :
A quasi-experimental study was conducted in the Renal Unit of Yan Chai Hospital from March 2019 to February 2025. Twenty-four patients were divided into a control group (n=11, receiving standard care) and an intervention group (n=13). The intervention was a structured, multi-component nurse-led education program delivered by a designated renal nurse, covering preoperative education, postoperative care, post-cannulation instructions, and ongoing AVF surveillance. Primary outcomes measured were time to first successful AVF cannulation and time to hemodialysis catheter removal. The secondary outcome was the angioplasty rate, indicating complications like thrombosis or stenosis.
Result & Outcome :
The intervention group demonstrated improved outcomes compared to the control group. The mean time to first successful cannulation was slightly reduced (12.46 vs. 12.8 weeks). More substantially, the mean time to catheter removal was reduced by 5.21 weeks (18.15 vs. 23.36 weeks). The complication rate, indicated by angioplasty, was lower in the intervention group (15% vs. 27%). The findings suggest that the structured nurse-led education program enhanced AVF functionality by reducing catheter dependence and access-related complications.
