Hemodialysis vascular access coordinator: Three-level model for access management

Area of Science:

• Nephrology
• Vascular Surgery
• Healthcare Management

Background:

• Vascular access (VA) maintenance is critical for dialysis patient care.
• Central venous catheters (CVCs) are associated with higher complication rates compared to arteriovenous fistulas (AVFs).
• Optimizing the role of specialized personnel can enhance VA outcomes.

Purpose of the Study:

• To introduce a novel three-level model (3Level_M) for vascular access management.
• To define the specific roles, skills, and training for each level within the model.
• To improve the integration of VA management within the broader dialysis team.

Main Methods:

• Development of a structured, three-tiered VA management framework.
• Definition of instrumental skills and training pathways for VA nurse managers, coordinators, and consultants.
• Clarification of interdisciplinary communication and collaboration protocols.

Main Results:

• The proposed 3Level_M model provides a clear structure for VA management.
• The vascular access coordinator role is pivotal in increasing AVF rates and decreasing CVC utilization.
• Defined roles and training enhance team collaboration and VA care.

Conclusions:

• The 3Level_M model offers a systematic approach to enhance vascular access management in dialysis.
• Implementing a dedicated vascular access coordinator is key to improving AVF prevalence and reducing CVC dependence.
• This structured model supports better VA outcomes and patient care coordination.