Obtain and maintain vascular access for, and cease access following, haemodialysis therapy

This standard covers obtaining and maintaining vascular access for haemodialysis therapy where this is accepted as appropriate according to the individual’s condition and your organisational policies, procedures and guidelines.

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1. access and accurately interpret all relevant work instructions and information
2. work safely at all times and in accordance with all relevant legislation, guidelines, policies, procedures and protocols
3. deal promptly and effectively with any problems within your control and report those which cannot be solved
4. identify and minimise hazards and risk in the workplace
5. communicate with the individual and key people at a pace, in a manner and at a level appropriate to the individual's understanding, preferences and needs
6. respect the individual's rights and wishes relating to their privacy, beliefs, and dignity
7. provide support to the individual and ensure health and safety measures are implemented at all times
8. gain valid, informed consent from the individual in accordance with specific procedures
9. confirm the individual's identity and confirm the planned action
10. identify potential sites and types of vascular access correctly with the appropriate member of the care team, and assess using the relevant criteria and protocols which site is the most appropriate to use
11. recognise any problems with the vascular access and report them immediately to the appropriate member of the care team **
12. prepare and clean the vascular access site effectively according to the plan of care and agreed protocols
13. insert the appropriate size and type of cannula(e) if cannulation is required, and secure them  safely and  correctly and in a manner which aims to cause minimum discomfort to the individual and to maximise the continuing viability of the vascular access
14. confirm effective blood flow, using the relevant criteria or protocols, before connecting the individual to the extra-corporeal circuit, taking appropriate action if the blood is not flowing effectively
15. administer the prescribed anti-coagulant if this is required according to the prescription and protocols
16. connect the cannula(e) or catheter and dialysis line according to protocol, correctly at the appropriate time in a manner likely to prevent infection
17. recognise adverse reactions to, and problems with, the procedure promptly and take the appropriate action to resolve them according to the individual, the setting and the problem and/or refer them to an appropriate member of the care team according to protocols
18. encourage individuals to recognise and report any unusual or unexpected change or feeling during therapy
19. monitor the patency of the vascular access effectively during haemodialysis therapy and make appropriate adjustments to maintain the effective flow of blood
20. recognise any problems with blood flow promptly and take action appropriate to the individual and the problem immediately
21. confirm the administration of products to avoid blood coagulation has occurred as specified in the plan of care
22. disconnect the cannula(e) or catheter and dialysis line(s) at the appropriate time and remove it in a manner which aims to cause minimum discomfort to the individual and maximise the continuing viability of the vascular access
23. apply the appropriate dressing to the vascular access site according to the type of access and the plan of care
24. complete and store all relevant documentation in accordance with organisational requirements

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1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
3. how to access and interpret all relevant work instructions and information
4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
5. the duty to report any acts or omissions that could be unsafe/detrimental to you or others
6. the hazards and risks which may arise during the execution of your work role and how you can minimise these
7. how to adapt communication styles in ways which are appropriate to the needs of the individual 
8. the correct use of any equipment and PPE to protect the health and safety of you and others
9. the principles, practice and procedures associated with informed consent
10. organisational management structures, roles, and responsibilities
11. the importance of applying standard precautions to the obtaining and maintaining of vascular access for, and ceasing access following, haemodialysis therapy and the potential consequences of poor practice
12. the structure of blood vessels
13. blood clotting processes and factors influencing blood clotting
14. how the individual's dignity might be compromised during access procedures and what measures to take to avoid this
15. how to provide support to individuals which is appropriate to their needs and concerns
16. the different types of vascular access and why different types of access are used for different individuals
17. what factors to consider when assessing and choosing the best site for cannulation, and why it is important to choose an appropriate site
18. the type and function of materials and equipment used to obtain, maintain and cease vascular access for haemodialysis
19. the particular requirements when dealing with new fistulas
20. the importance of having close and effective observation of the individual, the vascular access site and the dialysis machine monitors when connecting the needle and the dialysis line
21. why it is important to maintain the safety, placement, and patency of access during dialysis
22. what to look for when assessing venous catheters
23. the complications and problems may occur during cannulation and connection procedures, how you would recognise them and what action you would take
24. the types of problems that might occur in relation to blood flow and vascular access, how you would recognise them and what action you would take
25. how to prepare different types of vascular access sites
26. how to insert and secure cannulae for dialysis
27. the importance of effective blood flow, how you would check it and what action you may take if there is poor blood flow
28. how to monitor blood flow, what to look for in terms of the individual's condition, the dialysis machine monitors and the vascular access site
29. how patency of access during therapy is maintained
30. how to disconnect lines and remove cannulae
31. when and how to treat and dress vascular access sites

32. the information that needs to be recorded and/or reported regarding:

    • obtaining and maintaining vascular access for haemodialysis therapy
    • on cessation of vascular access
      

33. how to complete and safely store all relevant documentation in accordance with organisational requirements

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2

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2026

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Current

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Original

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Skills for Health

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SFHCHS30

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Health and Social Care, Health and Social Services Officers, Health Associate Professionals, Health Professionals, Health, Public Services and Care, Healthcare and Related Personal Services

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2259

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Vascular, access, haemodialysis, therapy

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