Browsing by Author "Delgado, Elisabete"
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- Hemodialysis vascular access coordinator: Three‐level model for access managementPublication . Sousa, Clemente Neves; Teles, Paulo; Sousa, Rui; Cabrita, Filipa; Ribeiro, Olga; Delgado, Elisabete; Coutinho, Sara; Moura, Sandra Cristina Mendo; Delgado, Millena Freire; Costa, João Filipe; Sá, Tiago Gomes; Teixeira, Sílvia Mónica Pereira; Mendonça, Ana Elza Oliveira; Ozen, NurtenManagement of vascular access is a challenge for the dialysis team, particularly tokeep the arteriovenous access working. The vascular access coordinator can posi-tively contribute to increase the number of arteriovenous fistulas and reduce centralvenous catheters. In this article, we introduce a new approach to vascular accessmanagement centered on (the results of setting up) the role of vascular access coor-dinator. We described the three-level model (3Level_M) for vascular access manage-ment organized in three levels: vascular access nurse manager, vascular accesscoordinator, and vascular access consultant. We defined the instrumental skills andtraining required to be developed by each element and clarify the articulationbetween the model and all members of the dialysis team related to vascular access.1|INTRODUCTIONThe implementation and effectiveness of renal replacement therapy(RRT) depend directly on appropriate vascular access, such as arterio-venous fistula (AVF) (best choice), or alternatively a graft or a centralvenous catheter (CVC).1Nowadays, chronic kidney disease (CKD) patients are older, sufferfrom a larger number of comorbidities, and have more complex vascu-lar accesses. Therefore, the dialysis team and patients face new chal-lenges. The complications of the arteriovenous accesses are alreadydocumented and require supervision (monitoring and surveillance) inorder to decide the appropriate time to intervene.1,2Literature shows that the vascular access coordinator canhave an important contribution in the identification ofthese situations and in the implementation of a new approachleading to the best results in clinical care.3–8The vascularaccess coordinator's role can be crucial to improve the planning oftimely interventions free of thrombosis,7,6improve vascular accessoutcomes,3,7decrease the number of grafts and CVCs,5and applya quality policy with the vascular access.6The purpose of thisarticle is to analyze the vascular access coordinator's contribution(to) in the vascular access outcomes and introduce a newapproach on vascular access management, the three-level model(3Level_M).Received: 12 February 2023 Revised: 22 March 2023 Accepted: 26 March 2023DOI: 10.1111/sdi.13153Semin Dial.2023;1–6.wileyonlinelibrary.com/journal/sdi© 2023 Wiley Periodicals LLC.1
- How to choose the appropriate cannulation technique for vascular access in hemodialysis patientsPublication . Sousa, Clemente Neves; Teles, Paulo; Ribeiro, Olga; Sousa, Rui; Lira, Marta Nunes; Delgado, Elisabete; Oliveira, Debora; Campos, Luís; Fernandes, Filipa; Moura, Sandra Cristina Mendo; Delgado, Millena Freire; Sá, Tiago Gomes; Teixeira, Sílvia Mónica Pereira; Souza, Lara Helk; Ribeiro, Rita Cássia Helú Mendonça; Oliveira, Gabriela Fernanda Neves; Mendonça, Ana Elza Oliveira; Ozen, NurtenThe cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.
- Intervenções de Enfermagem para o empoderamento da pessoa com doença renal crónicaPublication . Delgado, ElisabeteEnquadramento: A doença renal crónica (DRC) é uma patologia que exige grandes mudanças e adaptações na vida da pessoa, de elevado impacte emocional e psicossocial, face à sua imprevisibilidade de evolução e resultados dos tratamentos. O enfermeiro desempenha um papel fundamental, neste processo de transição, através de intervenções promotoras de empoderamento da pessoa. Neste sentido, surge a questão de investigação: “Quais as intervenções de enfermagem para o empoderamento da pessoa com DRC, no estadio 4-5?”. Objetivo: Mapear a evidência científica sobre as intervenções de enfermagem para o empoderamento da pessoa com DRC, no estadio 4-5. Metodologia: Scoping review, conduzida em concordância com a metodologia JBI. Pesquisa realizada nas bases de dados MEDLINE (via PubMed); CINAHL Complete, Cochrane Plus Collection, Nursing & Allied health Collection, MedicLatina (via EBSCOhost – Research Databases); SciELO e RCAAP. Foram incluídos artigos sem limite de temporal e de idioma e utilizado o fluxograma PRISMA-ScR. Resultados: De um total de 304 artigos foram incluídos 15 estudos nesta revisão. Foram identificadas intervenções de enfermagem do tipo ensinar e informar sobre a doença renal, instruir sobre os cuidados de autogestão da doença e apoiar a tomada de decisão partilhada como promotoras do empoderamento da pessoa na fase pré-diálise. Conclusão: As intervenções de enfermagem com enfoque multidimensional no empoderamento, estruturadas em várias consultas presenciais e por telefone, em modo individual e em grupo, com recurso a ferramentas de suporte à tomada de decisão, apresentam melhoria do conhecimento da pessoa, comportamento de autogestão da doença e diminuição do conflito e da incerteza na tomada de decisão. As evidências encontradas servem de ponto de partida para a construção de programas de intervenção de enfermagem, direcionados para a pessoa com DRC a vivenciar o processo de transição saúde/doença, na fase pré-diálise.
- Radio‐cephalic fistula recovered with drainage to median basilic vein by straightening of the forearm cephalic vein: A case reportPublication . Costa, Luísa Lemos; Matos, António Norton; Almeida, Paulo; Teles, Paulo; Loureiro, Luís; Campos, Luís; Delgado, Elisabete; Oliveira, Debora; Campos, Tiago; Inácio, Marta; Fernandes, Filipa; Coutinho, Sara; Ventura, Ana; Pereira, Susana; Castro, Ana; Xavier, Eva; Sousa, Clemente NevesThe distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.
- Radio‐cephalic fistula recovered with drainage to median basilic vein by straightening of the forearm cephalic vein: A case reportPublication . Costa, Luísa Lemos; de Matos, António Norton; Almeida, Paulo; Teles, Paulo; Loureiro, Luís; Campos, Luís; Delgado, Elisabete; Oliveira, Debora; Campos, Tiago; Inácio, Marta; Fernandes, Filipa; Coutinho, Sara; Ventura, Ana; Pereira, Susana; Castro, Ana; Xavier, Eva; Sousa, Clemente NevesThe distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.