Self-care actions for the maintenance of the arteriovenous fistula: An integrative review.
Natália Ramos Costa Pessoa, Laís Helena de Souza Soares Lima, Gutembergue Aragão Dos Santos and 3 others
PMID 32817861WHAT IT FOUND
Fistula self-care actions nurses can teach include avoiding blood pressure checks, punctures, heavy carrying, and sleeping on the arm, and checking tremor, bleeding, redness, swelling, and steal signs.
Key findings
01To preserve fistula function, patients should avoid venous punctures or infusions, blood pressure checks, carrying excess weight, and sleeping on the arm with the arteriovenous fistula.
02Patients should examine the fistula regularly, check its tremor, and watch for redness or swelling at puncture sites.
03Perioperative care included protecting the arm and doing fistula arm exercises, but most included studies were descriptive.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The final sample was 15 articles, and most were conducted in Brazil, so the findings may not fit every dialysis setting. The review only kept freely available articles from the previous five years and excluded studies judged to have increased bias risk, so it may have missed relevant evidence. Most included studies were descriptive, and the review did not test whether teaching these self-care actions improves fistula outcomes. The exercise findings came from studies with different samples and outcomes.
Declared interests
The authors declared no conflict of interest. The work was supported by the National Council for Scientific and Technological Development in Brazil.
The easy way to misread this
Do not read this as proof that teaching these actions will improve fistula outcomes. The review mostly collected descriptive evidence, and it did not test the full self-care program in a controlled trial.