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Sensing Savvy

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

How Do Flow Measurements Help Cardiothoracic Surgeons?

Posted by Roger DeLong, CP, PE, MBA on Jun 5, 2017 7:00:00 AM

 

“Not a day goes by when this flowmeter doesn’t solve a problem for me.” - BP Mindich, MD

During coronary artery bypass grafting (CABG), Transonic Flowmeters are used to measure the flow of blood through newly anastomosed bypass grafts.

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Topics: flow measurements help cardiothoracic surgeons

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

Resident Work Hour Limits: Should They Be Extended?

Posted by Thomas Gole, DO, FAAFP on May 22, 2017 7:00:00 AM

An 18-year-old woman was taken to the ER of New York Hospital on March 4, 1984. Suspecting she had a viral syndrome after presenting with a fever and jerking movements, physicians admitted her for observation and hydration.

As the night wore on, however, the woman became more and more agitated, leading her doctors — a first- and second-year resident and an attending — to order additional medications and restraints. A few hours later the woman was dead. This was the infamous case of Libby Zion, and it forced the medical establishment to take a hard look at resident work hours and supervision due to errors made during her care.

Before work hour restrictions were implemented, it wasn’t uncommon for residents to stay awake for upward of 36 hours. In 2011, the Accreditation Council for Graduate Medical Education (ACGME) limited resident shifts to 16 hours, but the ACGME proposed in late 2016 that the shifts be extended to 28 hours.

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Topics: Clinical Trends

4 Ways Surgeons Can Build Trust with Their Staff

Posted by Thomas Gole, DO, FAAFP on May 15, 2017 7:00:00 AM

“Patients trust us. We can’t take that trust for granted.”

This was the sentiment from Leonard Arnold, a surgical technician at Advocate Illinois Masonic Medical Center. Arnold was explaining a situation in an OR where the surgical team was participating in a “time-out” — a pre-surgery routine where all surgical staff take time to ensure they are operating on the correct patient, the correct site and the correct procedure. But there was one important person missing from this time-out: The performing surgeon.

 In Arnold’s story, the surgeon had refused to participate until a hospital official finally reprimanded him.

While surgeon-patient trust is often discussed, trust and collaboration between a surgeon and his or her staff can be overlooked.

Improved collaboration not only creates more trust among your staff, it also helps improve the patient experience.

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Topics: cardiothoracic surgery

Temporary Doctors are Gaining Popularity: 5 Things to Know

Posted by Thomas Gole, DO, FAAFP on May 10, 2017 6:30:00 AM

For the past 10 years, Dr. Louise Henson has been working as locum tenens physician. Because she’s a temporary doctor, Henson can avoid long hours and being on call, and can set her own hours and doesn’t have to worry about taking time off for family or personal commitments.

Until recently, locum tenens physicians traditionally filled in for colleagues who were ill, traveling or otherwise unable to work. Now, the opportunity to work as a temporary doctor is becoming an attractive option for physicians who feel burned out. Healthcare facilities are also seeing the benefits of employing more locum tenens staff members.

A recent report from locum tenens staffing agency Staff Care found temporary doctors are on the rise. Here are five things to know about the increase in locum tenens physicians.

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Topics: Clinical Trends

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

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