The development of the Western Australian Haemodialysis Vascular Access Complexity instrument.
Linda L Coventry, Jon Hosking, Evelyn Coral and 6 others
PMID 34181822WHAT IT FOUND
The WAHVAC haemodialysis access complexity checklist mostly agreed between nurses and over two weeks, but the challenging category and viable vessel length were less consistent.
It may guide nurse assignment, not predict patient outcomes.
Key findings
01The instrument was reduced to 20 items, and the final content validity score was 0.89.
0217 variables had excellent agreement between nurses, and 16 variables had excellent agreement over time.
03The challenging category had an agreement value of 0.23 over time, and viable vessel length under 10 cm had 0.31.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study reports instrument agreement, not patient outcomes. Some WAHVAC variables were rare in the sample, so their reliability was limited. The challenging category and viable vessel length under 10 cm had low agreement values over time. No patients had buttonhole establishment phase, thigh, necklace, or brachio-basilic access, so those situations were not tested. The reliability data came from one in-centre and one satellite haemodialysis unit in Perth. The content validity panel had 8 experts.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that using the WAHVAC reduces missed cannulation or complications. The study tested whether nurses rated access complexity consistently, not whether the ratings improved patient care. Some categories had low agreement over time.