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Sensing Savvy

Deborah Brouwer-Maier RN, CNN

Deborah Brouwer-Maier is a nephrology nurse for more than 30 years. Her area of expertise is hemodialysis vascular access. She served on the KDOQI Vascular Access Work Groups in 1997, 2000 and 2006. She also served in various volunteer roles for the Fistula Frist Initiates since the formation of the initial Work Group. She is the support for the Hemodialysis Circle of Care Transonic products to support access creation, surveillance and preservation.

Recent Posts

Is Timing a Factor In Flow Measurements Performed During Hemodialysis?

Posted by Deborah Brouwer-Maier RN, CNN on Jun 7, 2017 6:30:00 AM

NKF-KDOQI guidelines recommend that the vascular access flow assessment be performed during the first 90 minutes of hemodialysis to eliminate error caused by decrease in cardiac output or blood pressure related to ultrafiltration and/or hypotension. This measurement time restriction to within the first 90 minutes limits the number of measurements that can be performed by one operator, which is a significant issue in clinical practice.

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Topics: Hemodialysis

Hemodialysis in Children: Dedicated Pediatric Vascular Access Clinics Are Key to Success

Posted by Deborah Brouwer-Maier RN, CNN on Jun 7, 2017 6:30:00 AM

Children undergoing hemodialysis present unique challenges for dialysis providers. Hemodialysis in children presents challenges: Little is known about their ideal vein and artery sizes, maturation times and expected volume flow rates to achieve a functioning fistula.

After clinicians at London’s Great Ormond Street Hospital for Children reviewed the outcomes of 25 children who received an arteriovenous fistula (AVF), they found that five had primary AVF failure, and three had secondary AVF failure.

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Topics: Hemodialysis

Which Is Better, Percutaneous Transluminal Angioplasty or Surgical Repair?

Posted by Deborah Brouwer-Maier RN, CNN on May 31, 2017 6:30:00 AM

Two of the most common options for treating a vascular access stenosis in hemodialysis patients are percutaneous transluminal angioplasty (PTA) and fistula reconstruction/revision surgery. Because it is more convenient, PTA has become preferable to surgical revision.

To examine the efficacy of and compare percutaneous transluminal angioplasty or surgical repair, clinicians from three hospitals in Taiwan investigated the duration of fistulas and maintenance costs for dialysis patients. Their study was published in the 2017 February issue of the Journal of Vascular Access.

In the study, charts were reviewed retrospectively from 544 hemodialysis patients from two dialysis units in a teaching hospital in the southern area of Taiwan. Researchers analyzed the frequency of PTA or revascularization surgery and the use of related medical resources.

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Topics: Hemodialysis

Your Hemodialysis Access: A Lifeline for a Lifetime

Posted by Deborah Brouwer-Maier RN, CNN on May 29, 2017 7:00:00 AM

It only takes minutes to save your hemodialysis access, your lifeline. All you have to do is look, listen, feel and then also measure.

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Topics: Hemodialysis

Kidney Care News to Know

Posted by Deborah Brouwer-Maier RN, CNN on May 24, 2017 7:00:00 AM

DaVita Appoints Robert Lang President of International Market

Before joining DaVita, Lang led the international markets business at insurance provider Bupa. He has experience working in Europe, the Middle East, Asia and Latin America.

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Topics: Hemodialysis

Create a Culture of Patient Safety at Your Dialysis Clinic

Posted by Deborah Brouwer-Maier RN, CNN on May 8, 2017 7:30:00 AM

Do Dialysis Patients Feel Safe?

According to data from the 2007 Renal Physicians Association (RPA) Health and Safety Survey Project, nearly half of dialysis patients surveyed said they “sometimes, usually or always worry that someone will make a medical mistake during one of their dialysis treatments.” Not only that, 87 percent of staff indicated a mistake had been made in a patient’s treatment over the last three months.

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Topics: Hemodialysis, dialysis patients

Kidney Care News to Know from April

Posted by Deborah Brouwer-Maier RN, CNN on May 4, 2017 6:30:00 AM

Ashfaq Named Senior VP of OPKO Health Renal Division

Dr. Akhtar Ashfaq has been named senior vice president of clinical research and development of OPKO Health’s renal division. He will support the adoption of Rayaldee extended-release capsules by healthcare professionals caring for patients with stage 3 or 4 kidney disease.

He’ll also lead the development of the drug to treat secondary hyperparathyroidism (SHPT) in adults on hemodialysis with vitamin D insufficiency as well as the development of Alpharen for the treatment of hyperphosphatemia in adults with stage 5 kidney disease.

Source: Nephrology News & Issues

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Topics: kidney care

An Interview with Vascular Access Coordinator Joan Covert

Posted by Deborah Brouwer-Maier RN, CNN on Apr 17, 2017 7:00:00 AM

Joan Covert had been working as a dialysis technician when her friend told her she might be a good fit for a newly vacant vascular access coordinator position at their clinic. Since taking the position five years ago, she has seen it evolve as patient needs and technology change.

We sat down with Joan to learn why she loves being a vascular access coordinator and what you should consider if you want to be one.

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Topics: Hemodialysis

Vascular Access Coordinator Interview: Forest Rawls

Posted by Deborah Brouwer-Maier RN, CNN on Apr 10, 2017 7:00:00 AM

Forest Rawls had his first kidney care experience while serving in the U.S. Navy as a transplantation technician in 1974. He held the following positions, operating room technician, plasmapheresis technician, hemodialysis technician, tissue bank technician and as a tissue and organ harvest procurement team member — but it was kidney care that really stood out to him.

Now, he’s a vascular access coordinator with Emory Healthcare Dialysis Clinics, a position he intends to hold until he retires.

We sat down with Forest to learn why he loves being a vascular access coordinator and what you should consider if you want to be one.

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Topics: Hemodialysis

Kidney Care News to Know From March

Posted by Deborah Brouwer-Maier RN, CNN on Mar 29, 2017 6:30:00 AM

Fresenius, Cigna Partner for Collaborative Care

The national program aims to lower the cost of care for patients with end stage renal disease undergoing dialysis while also improving quality. The program will be part of Cigna’s Collaborative Care, a value-based model that uses incentives to engage healthcare providers.

Fresenius Medical Care North America will still be paid for the dialysis services it provides to Cigna patients and Fresenius Health Partners will assume separate responsibility to manage medical costs and improve patient outcomes.

Source: Nephrology News & Issues

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Topics: kidney care

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