Identify current trends in vascular access. List three interventions that can be done at the facility level to impact arteriovenous fistula (AVF) placement and/or maintenance. Describe two aspects of the CMS Breakthrough Initiative that can impact AVF rates. Describe the major differences between the rope ladder and the buttonhole cannulation techniques. Explain changes that will occur during track development to enable changing from sharp to blunt needles. List appropriate techniques for removing scabs prior to cannulation.