August 12, 2015
ADMS affiliates, Springfield Dialysis Center (Queens) and New York Renal Associates (Bronx) recently reported that they each exceeded the Arteriovenous Fistula Goals (AVF) set by CMS and the IPRO Network, respectively. Both facilities reported their Facility AVF Goal at over 75% as compared to their CMS Goals of 68% and Network Goals of 66.59%
The Fistula First Breakthrough Initiative (FFBI) is a national campaign to increase AVF usage in all eligible End-Stage Renal Disease (ESRD) patients. All dialysis facilities are expected to meet or exceed these goals.
Hemodialysis is a process of cleaning the blood of waste products when the kidneys can no longer perform this function. All hemodialysis patients need a “connection” that allows blood from an artery to flow into the vein and provide access for dialysis. An Arteriovenous Fistula (AVF) is considered by professionals to be the “gold standard.” National practice guidelines, which were developed by renal experts, recommend that 40% of all current patients and 50% of new patients should have an AV fistula as their primary access. Currently, only about 30% of Medicare beneficiaries dialyze with a fistula.
AVFs are considered the best vascular access because they demonstrate the best overall performance, have fewer infections which can lead to hospitalizations, tend to last for a longer time than other access types and allow for increased blood low resulting in a more adequate dialysis treatment.
A surgeon creates an AVF by connecting an artery directly to a vein, usually in the forearm. Connecting the artery to the vein causes more blood to flow into the vein. As a result, the vein grows larger and stronger, making repeated needle insertions easier. The procedure can be performed on an outpatient with a local anesthetic but requires some advanced planning.
Patients can also have a graft or a catheter, which is usually a temporary access. If you have small veins that won’t develop properly into a fistula, you an have a vascular access that uses a synthetic tube implanted under the skin in your arm. The tube becomes an artificial vein that can be used repeatedly for needle insertion. If your kidney disease has progressed quickly, you may not have time to get a permanent vascular access before you start hemodialysis treatments. A catheter is a tube inserted into a vein in your neck, chest or leg. It has two chambers to allow two-way flow of blood. Catheters are not ideal for permanent access as they can clog, become infected or cause narrowed veins. It is recognized that fistulas are the best access.
Springfield Dialysis Center’s Nurse Administrator/Center Compliance Officer is Teresita deGuzman, RN and its Medical Directors are J. Ganesh Bhat, MD and David Scott III (Associate Medical Director).
New York Renal Associate’s Nurse Administrator/Center Compliance Officer is Ronald Pascual, RN and its Medical Director is J. Ganesh Bhat, MD.