Vascular access and patient empowerment

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Abstract:

BACKGROUND: Patients requiring haemodialysis have diverse clinical needs impacting on the longevity of their vascular access and their quality of life. A clinical practice scenario is presented that raises the potential of unsafe cannulation of a patient’s vascular access as a result of minimal patient empowerment. Vascular access care is the responsibility of everyone, including the patient and carer.

AIM: The aim of this narrative literature review (1997-2014) is to explore the current understanding of what factors influence the care of vascular access for haemodialysis.

METHOD: A narrative literature review allows the synthesis of the known literature pertinent to the research question into a succinct model or unique order to enable new understandings to emerge. The bio-ecological model was used to guide the thematic analysis of the literature.

RESULTS: The narrative literature review revealed five themes related to care of vascular access: patient experience; relationships-empowerment and shared decision making; environment of healthcare; time; and quality of life as the outcome of care.

CONCLUSION: The management of vascular access is complicated. Current available literature predominantly concentrates on bio-medical aspects of vascular access care. Contextualised vascular access care in the complex ecology of the patient and carer’s lives has the potential to enhance nursing practice and patient outcomes.

Reference:

Cowan, D., Smith, L. and Chow, J. (2015) Care of a patient’s vascular access for haemodialysis: A narrative literature review. Journal of Renal Care. September 30th. [epub ahead of print].

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