Mr Patrick Borres1, Mr Rommel Cudal1
1Western Health – Victoria, , Australia
Biography:
Clinical Nurse Consultant and Clinical Nurse Specialist working at Western Health Victoria – Renal Service
Background: Vascular access is the strongest predictor of outcomes for patients receiving haemodialysis, affecting morbidity, mortality, quality of life, and healthcare costs in end-stage kidney disease (ESKD). Despite international guidelines promoting permanent arteriovenous access, many patients commence and remain on dialysis using central venous catheters (CVCs). Prolonged catheter use is associated with increased risks of catheter-related bloodstream infection (CRBSI), hospitalisation, access failure, and death. At Western Health (WH), delayed access planning and ongoing CVC dependence reflect medical complexity, fragmented care pathways, and the absence of a systematic, proactive approach to vascular access risk assessment.
Abstract:
Objective: This project aims to develop a Haemodialysis Vascular Access Risk Assessment Tool to support structured, personalised access planning. The tool will integrate clinical, surgical, and psychosocial risk factors to generate a patient-specific access care plan aligned with the ESKD Life-Plan framework. Objectives include standardising assessment, improving interdisciplinary coordination, and enabling timely, evidence-based intervention. Expected outcomes include reduced CVC prevalence and CRBSI rates, shorter time to permanent access creation, improved arteriovenous fistula maturation, and enhanced shared decision-making through targeted patient education.
Methods and Innovation: The tool will be embedded into routine haemodialysis and predialysis workflows at WH. Patients will be stratified according to infection risk and likelihood of AVF maturation, guiding targeted interventions such as early vascular referral, prioritised access creation, infection prevention strategies, or consideration of alternative access options, including grafts, peritoneal dialysis, permanent catheters, or palliative approaches. Standardised data collection will enable outcome monitoring and continuous quality improvement.
Conclusion: Improves haemodialysis access care preventively.