Hemodialysis requires vascular access by way of an arteriovenous fistula (AVF), arteriovenous graft (AVG), or intravenous hemodialysis catheter. There is overwhelming evidence that an AVF should be the access of choice due to its lowest infection rate compared to an AVG or hemodialysis catheter; however, less than 17% of patients on hemodialysis have a functional AVF when hemodialysis treatment is initiated. Most patients with end stage kidney disease begin hemodialysis using a hemodialysis catheter, which has a higher infection rate. Nephrology nurses can advocate for best evidence-based practice, understanding that AVFs have lower infection and lower thrombosis rates, and provide more effective hemodialysis. This article provides a literature review for types and indications of hemodialysis access and how nurses can promote this best practice.

Continuing Education Instructions and Disclosure Information:

Contact hours available until 6/30/2024.

Requirements for Successful Completion:
Complete the learning activity in its entirety and complete the online nursing continuing professional development evaluation. You will be able to print your NCPD certificate after you complete the evaluation.

Disclosure of relevant financial relationships with ineligible companies (planners, faculty, reviewers, authors):

Editorial Board Disclosures:
Paula Dutka, MSN, RN, CNN, discloses that she is a consultant for Rockwell Medical.

All other members of the Editorial Board had no actual or potential conflict of interest in relation to this nursing continuing professional development education activity.

Author(s) Disclosures:
The author(s) reported no actual or potential conflict of interest.

Commercial Support:
No commercial support declared.

This article was reviewed and formatted for contact hour credit by Beth Ulrich, EdD, RN, FACHE, FAONL, FAAN, Nephrology Nursing Journal Editor-in-Chief, and Sally Russell, MN, CMSRN, CPP, ANNA Education Director.

Accreditation Statement:
The American Nephrology Nurses Association (ANNA) is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

ANNA is an approved provider of continuing nursing education by the California Board of Registered Nursing, Provider Number CEP 17499.

This NCPD article meets the Nephrology Nursing Certification Commission’s (NNCC’s) continuing nursing education requirements for certification and recertification.

ANNA urges participants to be aware of the CE requirements for re-licensure in the states in which they hold a license.

Learning Outcome:
After completing this learning activity, the learner will advocate for best practice evidence in regard to the use of arteriovenous fistula (AVF) for hemodialysis.

Suzanna Fitzpatrick DNP, ACNP-BC, FNP-BC

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