ESRD NETWORK 16 REACHES FISTULA BENCHMARK

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ESRD NETWORK 16 REACHES FISTULA BENCHMARK
11 hours ago0 CommentsPosted in News, End-Stage Renal Disease (ESRD) Networks, Fistulas, Vascular Access, Grafts, Practice Management, Clinical & Pharma Print
SEATTLE—The Northwest Renal Network (ESRD Network 16), said March 9 that it is the first ESRD Network in the United States to reach and surpass the benchmark of 66 percent arteriovenous (AV) fistula rate for prevalent dialysis patients.

The Northwest Renal Network—which oversees Alaska, Idaho, Montana, Oregon and Washington—has an AV fistula rate exceeding 66.5 percent, which is almost 10 percent above the national average, according to the Network.

There are nearly 11,000 dialysis patients within the Northwest Renal Network, and each patient must have a dialysis access—site where the patient’s bloodstream is accessed.

There are three types of vascular access: AV fistula, the surgical joining of a vein and artery; AV graft, an artificial piece of tubing surgically placed between an artery and a vein; and hemodialysis catheter, a tube placed into a large blood vessel in the patients’ neck or chest.   

AV fistulas are considered the gold standard for hemodialysis vascular access based on their superior patency, low complication rates, improved adequacy, decreased risk of patient mortality, and lower cost to the healthcare system. While hemodialysis catheters do not require needle insertion for dialysis, infection rates are highest among individuals who use a catheter for dialysis. According to the Centers for Disease Control “infections are one of the leading causes of hospitalization and the second leading cause of death for hemodialysis patients.”

In 2003, the Centers for Medicare & Medicaid Services (CMS) launched Fistula First with the goal of increasing the use of AV fistulas in eligible patients. Both CMS and the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF/KDOQI) set a national goal of 66 percent AV fistula rate for the United States. Currently the national AV fistula rate is 57.5 percent

“We are thrilled that the Northwest Renal Network leads the country in AV fistula rates,” stated Dr. Margaret Eddy, Chairperson of Northwest Renal Network. “This has taken tremendous hard work and dedication by those within the Network.  However, for the health and safety of our region’s patients, we as a community must continue to reduce the number of catheters and increase the number of AV fistulas utilized for dialysis.”

Education and collaboration amongst all parties involved has been crucial to AV fistula placement and maturation. In-person training, webinars, informational toolkits and other resources promoting best practices for vascular access are provided to facilities.

“Our experience has shown that without buy-in from nephrologists and clinical staff, AV fistula rates are lower,” stated Lynda Ball, Northwest Renal Network’s Quality Improvement Director.  “Providing information on best practices and promoting collaboration between all parties involved is essential.”

http://www.renalbusiness.com/news/2011/03/esrd-network-16-reaches-fistula-benchmark.aspx