Optimizing vascular access: a team perspective using the National Kidney Foundation-Dialysis Outcomes Quality...

The implementation of the Dialysis Outcomes Quality Initiative (DOQI) Vascular Access Guidelines can appear as an overwhelming task. This article suggests very basic and practical actions the entire end-stage renal disease (ESRD) team can take to help put the DOQI Guidelines into every day practice. The simple format of an early prerenal education program may help increase the number of native arterio-venous fistula placed in new ESRD patients. The focus is on the ESRD team working together to remove common barriers preventing the implementation of the DOQI Guidelines. Examples about the role the social worker and renal dietitian can fulfill as part of the Guideline implementation are presented. This article is based on previous personal work experience as a member of the ESRD Team and as a Work Group Member.