Implementation of a vascular access quality programme improves vascular access care

Loon, Magda van; Märk, Walter; Beukers, N.; Bruin, Cor de; Blankestijn, Peter J.; Huisman, Roel M.; Zijlstra, Jan J; Sande, Frank M. van der; Tordoir, Jan H.M.

doi:10.1093/ndt/gfm076

Cited by 22 publications

(18 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6 Streamlining patients with better predialysis care and the implementation of vascular access coordinators may improve referral, access planning, and outcome. 7,8 A large study cohort of 17,511 patients > 67 years old, with an AVF placed as the first predialysis access, studied the optimal time for AVF placement. AVF success was defined as dialysis initiation using the AVF, with time between AVF placement and starting dialysis as the primary variable of interest.…”

Section: Late Referral and Vascular Access Creation And Outcomementioning

confidence: 99%

Preferred Strategy for Hemodialysis Access Creation in Elderly Patients

Tordoir

Bode

Loon

2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

show abstract

Section: Late Referral and Vascular Access Creation And Outcomementioning

confidence: 99%

Preferred Strategy for Hemodialysis Access Creation in Elderly Patients

Tordoir

Bode

Loon

2015

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

show abstract

“…The clinical implication of this study is that it encourages healthcare providers to have regular feedback on their practice in order to detect deficiencies and improve their outcomes. [5] In our quality process, we tried to select the patients and limit the indications of Broviac® catheters and we opted for other alternatives like subclavian percutaneous catheters, or peripherally inserted central catheters (PICCs) which could be applied effectively as traditional central venous devices in neonates allowing central venous access saving [7], with lower rates of morbidity. [8] However, PICC lines are not always available in our hospital, and the need for surgical Broviac® catheters still has expanded indications [9], even in an emergency context.…”

Section: Discussionmentioning

confidence: 99%

Improvement of Broviac catheter-related outcomes after the implementation of a quality management system: A before-and-after prospective observational study

et al. 2023

View full text Add to dashboard Cite

Background: Because of the high rates of Broviac catheter complications, we started an urgent quality process to reduce this morbidity. The aim is to assess the efficiency of the main actions we have taken in enhancing our practice and improving Broviac outcomes. Methods: We included all neonates and young infants requiring surgical central venous access using a Broviac tunneled catheter. We compared the catheters’ outcomes before and after the implementation of a quality program based on a nurse teaching program, patient selection, and catheter management multidisciplinary protocol. The significance threshold was set at p<0.05. Results: We included 94 patients: 51 in the protocol group and 43 in the control group. The complication rate was reduced from 60.3% to 25.5% with p=0.001. The lifetime of the catheter was improved from 11.3 ± 4.3 days to 19.1 ± 9 days with p=0.007. The catheter infection was reduced from 65.3% to 46.1% with p≤0.001. Conclusion: This quality improvement project shows the utility of a quality assurance program based on careful indications and patient selection, a nursing teaching program, and a multidisciplinary catheter management protocol, in reducing Broviac catheter-related morbidity.

show abstract

“…The use of temporary subclavian vein catheters declined (34% vs 11%; p<0.01), with a substantially higher percentage of jugular vein catheters (from 23% to 35%). The number of endovascular and surgical interventions for malfunctioning VA rose from 0.39 to 0.50 procedures per patient/year (p<0.001) and from 0.06 to 0.12 operations per patient/year (p<0.001), respectively (2).…”

Section: Discussionmentioning

confidence: 99%