[Improving Completion Rate of Pre-Dialysis Arteriovenous Access in Patients With End-Stage Renal Disease].

Background & problems: In patients with end-stage renal disease (ESRD), not establishing arteriovenous access prior to the commencement of dialysis necessitates the use of temporary vascular access, which negatively impacts quality of life and survival. Statistics for the period June 2021 to May 2022 showed the rate of completion of arteriovenous (AV) access in patients with ESRD in our hospital to be only 20.4%. The identified reasons for this low rate were: (1) only 49.3% of patients / family members had correct knowledge regarding the establishment of AV access; (2) relevant education methods varied among case managers; (3) patient decisions were not queried after implementing shared decision-making; (4) no structured communication platform was available to patients after expressing their preferred dialysis modality, leading to inconsistencies in receiving relevant education and establishing AV access.

Purpose: The objective of this project was to raise the pre-dialysis AV access completion rate in patients with ESRD to 40.1%.

Resolution: (1) Add auxiliary educational tools; (2) optimize education materials and processes; and (3) strengthen the shared-decision making tracking mechanism.

Results: The completion rate of pre-dialysis AV access increased from 20.4% to 41.2% in the target patient group.

Conclusions: Conclusion: In addition to meeting the main objective, additional benefits of the project included reduced average hospitalization duration and lower consumption of medical consumables per patient.