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Self‐cannulation of the vascular access in home hemodialysis: Overcoming patient‐level barriers
Author(s) -
Ward Frank L.,
Faratro Rose,
McQuillan Rory F.
Publication year - 2018
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12708
Subject(s) - medicine , home hemodialysis , hemodialysis , health care , identification (biology) , vascular access , intensive care medicine , medical emergency , healthcare system , nursing , surgery , botany , economics , biology , economic growth
Patients with end‐stage kidney disease who are considering home hemodialysis ( HHD ) face the challenge of learning to self‐cannulate their arteriovenous access. Current practice discourages the use of tunneled central venous catheters, with recent indications that self‐cannulating patients have superior outcomes. Patient‐level barriers do not appear to preclude a successful HHD program and should not be viewed as insurmountable by healthcare staff or patients. The healthcare team must address patient fears while instructing the patient to perform self‐cannulation safely. Identification and understanding of the barriers perceived by the patient will allow the patient and healthcare team work collaboratively, toward the goal of independence with self‐cannulation both during initial training and follow‐up care. The aim of this review was to provide a practical resource to aid in the identification and resolution of these patient‐level barriers, with the overall goal of improving the patient experience and medical outcomes in home hemodialysis programs.