I’m always enthusiastic and motivated after attending a national conference focussed on renal dialysis access. Witnessing the opportunities for nurses networking from this kind of event are incredible, as you may observe and learn that there are regional differences on how haemodialysis access standards are applied to our own local trust practice even though there are regulatory bodies or national protocols dictated specifically on standards of patient care.
For example, the cannulation competency assessment for haemodialysis nurses, it is well-known that there are variations of local policy or protocols available across the UK, nevertheless the one main goal is to ensure that nurses will safely plan and perform an uneventful cannulation on patients’ arterio-venous access. However, even with all the passion and effort amongst the access specialist nurses, nurse mentors or clinical practice educators to train and educate correct cannulation practice, vascular access complications and its care and management are still in question. Patients’ experience from one unit to another also varies and contrasts perhaps due to non-standardised practice in renal vascular access.
When I received an opportunity to lead the nursing group for Vascular Access Society of Britain and Ireland (VASBI), it made me realise that rather than just meeting every year with the other nurse specialists or renal nurses, nephrologists, radiologists and surgeons across the country and listening to current debates in dialysis access, we can in fact effectively work together to implement national guidelines with an aim to standardise nursing practice in renal vascular access.
I organised our national nurse meeting event in early 2016, we recognised and agreed that a ‘joint partnership’ is essential to influence our momentum to work stronger as a group of nurses who have an absolute passion in renal vascular access care. I approached Katie Fielding, who chairs the British Renal Society Vascular Access Special Interest Group (BRS VA SIG), who is highly passionate and dedicated in vascular access and we agreed both groups needed to work together to a common aim. Both special interest groups are aiming to identify, develop and provide clarity with evidence on what is the best practice in renal vascular access. Both BRS and VASBI VA SIG have set projects in vascular access care such as cannulation, physical assessment of AV access, monitoring and surveillance and access management.
At present we currently share our current best practices in dedicated meetings that enabled us to learn from our own clinical experiences nationally, this has given us collaborative ideas on how we can strategically set national projects focusing in national clinical practice recommendations on cannulation of AV fistulae and grafts.
It is also acknowledged in the UK that there are several key stakeholder organisations involved in providing care and services for kidney patients. The BRS and VASBI VA SIG have also teamed up with KQuIP to provide support for a national quality improvement project focussed on Cannulation Recommendations. This collaboration now includes KQuIP who will be supporting us, as two groups, to take the best practice we have identified in cannulation practice and use a quality improvement project to support units in implementing this best practice. MAGIC (Managing Access by Generating Improvements in Cannulation) is one such collaboration we are working on together. It is exciting moving forwards to include KQuIP in this collaboration. The key to good collaboration is not promoting one individual or renal unit opinion or agenda, but focussing on comparing and improving practice for the benefit of patients.
More information on the MAGIC project can be found here.
Kristine Paule – Renal Dialysis Access Clinical Nurse Specialist at the Royal Free Hospital in London
Email: kristine.paule@nhs.net