That there is a dull needle

A what?

You heard me a dull needle.

One thing I have noticed in my many years of dialysis (five years) is that once you enter the big bad hospital the word “buttonhole” sends tingles down the spines of acute dialysis nurses.

Why you ask?

Because really dialysis is a relatively new proceedure, I mean, as of twenty years ago the thought of proper P.P.E. (personal protective equipment i.e. gloves, shield, gown) was unknown, and patients were dialysized crazy lengths of time and there was a selection committee that choose peoples fates.

Side note: Davita.com has a good history of dialysis if anyone is interested, I also do not work for them, I just have used their website in the past. If you dislike certain dialysis companies don’t tell me, I have no opinion.

So like what I was saying back in the stone ages of dialysis where face shields just got in the way and eight hour treatments were the norm, using the same site over and over again such as with buttonhole cannulation was frowned upon. Blamed heavily for high infection rates and a breakdown of the fistula, but today with newer practices of aseptic technique and actual “buttonhole” needles things have gotten better.

The Big Bad Dialysis company I work for as recently started promoting the whole buttonhole technique within their clinics. In fact, not to brag but my clinic did one of the first Norther California trials and almost everyone in our clinic is buttonholed with great success. Yippee!

This all seems dandy except for when our patients do end up in the big ole hospital then the nurses who btw, do an amazing job otherwise, are left clueless as to what to do with them, often time infiltrations (needles goes outside vein, very bad, painful complication of dialysis) happen.

I don’t really blame anyone for it, I really think we as a private organization should have a more hands on approach to our patients being in the hospital. I.e. comunication, good lord can it be done?! I think so. Of course in a perfect world we would actually be notified that our patient is in fact in the hospital before their scheduled treatment time and we have called around for about a half an hour, but alas I am a dreamer.

So my proposal would be something along these lines:

Most dialysis clinics are Point of Service or online charting, most hospitals have online charting, so thus lets have access to the two (as needed).

Place a up-to-date picture of dialysis access with directions for buttonhole cannulation per that patient placed inside electronic chart.

Have inservice for hospital staff on buttonhole cannulation and other kidney related facts (not just for acute dialysis nurses, for all nurses).

Thats my plan, a work in progress. I’ve mentioned it to the powers that be but they just had that glazed over look in their eye, perhaps its rounding their yearly vacation. Hmmm….speaking of vacations, in two weeks I’ll be in Seattle.

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~ by Kim on April 1, 2008.

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