"Everyone should buttonhole": a novel technique for a regional Australian renal service

The buttonhole, or constant-site, cannulation technique, although used elsewhere, had not been used in North Queensland, Australia, prior to 2005. This paper reports the results from a survey of patients' and nurses' initial experiences with the buttonhole cannulation technique 20 months after its introduction into a renal service in North Queensland. The use of the buttonhole technique increased the ease and decreased the discomfort associated with access cannulation for both patients and nurses; both groups reported less anxiety associated with this technique. The patients were especially pleased with the improved cosmetic appearance and indicated that they would be more likely to become involved in self-care, including self-cannulation. The nursing service has implemented strategies to ensure that buttonhole cannulation continues to be used as one means of arteriovenous fistula access across the region. A current study is examining longer-term outcomes of using the buttonhole technique within this regional service.