Hemoodialysis Cannulation Techniques

What the nurse need to know about the two main different types of hemodialysis cannulation techniques?

The literature review is an interpretation of a specific topic or question comprehensively seeking to find the answers (Aveyard , 2014). The main purpose of this dissertation is to explore what the nurses need to know about the two main different types of dialysis cannulation techniques.

Background and rational

Chronic Kidney Disease (CKD), affects an estimated of 27 million adults in the United States asso¬ciate with increase mor¬tality, morbidity and costs (Baumgarten and Gehr, 2011). In the United Kingdom (UK), there were 1,739,443 people aged 18 who were registered with CKD which represent 9% of the English adult population (East

They should be inserted into a vascular access, which is a surgically created either by natural vessels called arteriovenous (AV) fistula or by synthesis teflon called arteriovenous graft. The fistula has two ways of cannulatation one called rope-ladder technique, which is to rotate the needling site in each dialysis session by the use of a sharp needle. The other type is called buttonhole (BH) technique, which is to cannulate at the same exact site every dialysis session by the use of a dull needle (Akoh and Hakim, 2001).

Patients require long-term dialysis, access is their lifeline and with poor or complicated access, patient’s quality of life will be affected (Fluck, 2007). The consequence of infection, pain, access survival, aneurysm and haemorrhage has a direct impact to the patient physical and psychological life. Aneurysm is a common complication of AV fistula, which devolved mainly from inappropriate cannulation preformed by nurses (Pasklinsky et al., 2010). That means nurse plays a crucial part in developing quality of life for patients with kidney diseases. For instance, patient with aneurism cannot simply wear any normal T-shirt or jacket. The T-shirt sleeves must be lose or uncovered in one side to allow the blood to flow and prevent damaging the access. On the other hand, some patients tend to feel embarrassed of showing their vascular aneurism to the community, which can affect their

I was involved in patient journey from their early diagnosis of CKD stage one to the end stage of renal failure. That gave me an insight of how patient’s life can be improved by giving good care to the vascular access and make it last long. There is conflicting evidence about the best technique to use for needling the AV fistula; therefore I believe extended literature review is needed. There is lack of international guidelines or specific criteria to divide if the patient suitable for rope ladder or Buttonhole technique. For example, the National Institute for Health and Clinical Excellence (NICE) has no clear guidelines classifying dialysis patient for which cannulation technique need to be