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Dealing with Difficult Accesses: A Surgical Perspective

‐ Sep 21, 2013 5:00pm

We've all had those patients – they are a challenge to cannulate and have them run a good treatment, or our hearts race hoping all goes well with the first stick. Are there ways to improve the process? From determining access type to assessment to surgical creation and to the final line – the nurse is making the Olympic attempt. Learn about the surgical issues that can arise and how we as nurses can develop collaborative strategies for these difficult-to-approach accesses.

Contact hours available until 9/22/2015.

Requirements for Successful Completion:
Complete the learning activity in its entirety and complete the online CNE evaluation.

Conflict of Interest Disclosure:
Speaker(s) have no disclosures to declare.

Conference Committee Disclosures:
Dawn Koonkongsatian – Employee, Fresenius Medical Care
Kristin Larson – Employee, NxStage Medical
Denise Murcek – Employee, Fresenius Medical Care
Beth St. John - Employee, Fresenius Medical Care
Lucy Todd – Employee, Baxter Healthcare
Kyra Trappett – Employee, DaVita

Commercial Support and Sponsorship:
No commercial support or sponsorship declared.

Accreditation Statement:
American Nephrology Nurses’ Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

ANNA is a provider approved by the California Board of Registered Nursing, provider number CEP 00910.

  • Summarize the current products and strategies to assist in difficult-to-cannulate AV fistula.
  • Identify the characteristics of the difficult-to-cannulate AV fistula that would benefit from surgical or nonsurgical intervention.
  • Compare and contrast the safety and efficacy of current measures to promote cannulation and preservation in the difficult-to-cannulate AV fistula.


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