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Goal: To provide an overview of the effect of the buttonhole method vs. the traditional method of AV fistula cannulation on hemostasis, needle stick pain, pre-needle stick anxiety, and presence of aneurysms in ambulatory patients on hemodialysis.

Objectives:

Explain the difference between the buttonhole method and the constant site method in cannulation.
Describe the benefits of the buttonhole site as determined by this study.

Acknowledgments: The authors would like to acknowledge the contributions of the following members of the nursing staff at the Good Samaritan Hospital Medical Center Chronic Dialysis Unit: Kathy Adams, Barbara Blom, Debbie Brennan, Ann Marie Culhane, Joanne Faber, Cathy Miller, Dawn Rose, Melissa Thompson, Connie Smalling, Judi Smith Stenger, Vesna Stryska, and Koreen Vicciardo.

Statement of Disclosure: The authors reported no actual or potential conflict of interest in relation to this continuing nursing education article.

Ellen Rich PhD, RN, FNP, FAANP

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