Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 12-14

Caring for a Hemodialysis Access

(Arteriovenous Fistula or Graft)

Goal:The graft or fistula remains patent; the patient verbalizes

appropriate care measures and observations to be made,

and demonstrates care measures. Comments

1. Perform hand hygiene and put on PPE, if indicated.


2. Identify the patient.


3. Close curtains around bed and close the door to the room,
   if possible. Explain what you are going to do, and why you
   are going to do it, to the patient.
   4.Inspect area over access site for any redness, warmth,
   tenderness, or blemishes. Palpate over access site, feeling
   for a thrill or vibration. Palpate pulses distal to the site.
   Auscultate over access site with bell of stethoscope,
   listening for a bruit or vibration.


4. Ensure that a sign is placed over head of bed informing
   the healthcare team which arm is affected. Do not measure
   blood pressure, perform a venipuncture, or start an IV on
   the access arm.


5. Instruct the patient not to sleep with the arm with the access
   site under head or body.


6. Instruct patient not to lift heavy objects with, or put
   pressure on, the arm with the access site. Advise the patient
   not to carry heavy bags (including purses) on the shoulder
   of that arm.


7. Remove PPE, if used. Perform hand hygiene.

ExcellentSatisfactoryNeeds Practice