Cuidar da pessoa com fístula arteriovenosa: modelo para a melhoria contínua

introduction and objective: throughout the twentieth century, chronic kidney disease (ckd) has acquired the proportions of a public health problem, mobilizing financial resources and causing big social changes. it is intended to describe a conceptual framework of nursing practice, seeking continuous improvement of nursing therapies targeted at people with arteriovenous fistula (avf). material and methods: this is an exploratory, descriptive and transversal study. the sample consisted of 98 nurses who provided nursing care to people with avf in hemodialysis (hd) in the district of porto, with a mean age of 36.55 years. the exercise time in hd is 8.66 years. the instrument for data collection was a questionnaire. results: the structure contains two focus areas. each area is subdivided into dimensions, which are subdivided into items, that inter-relate and complement each other. together they allow you to implement therapeutic nursing. the first dimension is called "capacity building of self-care", being decomposed, within the teaching, a set of therapeutic nursing to develop according to the stage of ckd, which promote self-care behaviors with existing or future vascular access. the second area is called "monitoring of access," describing in detail the therapeutic nursing that contributes to early identification of complications of avf. in this area, care practices aimed at maintaining the avf are emphasized. conclusion: the existences of a structure with focus areas for the purpose of taking care of people with acf facilitates the development of cognitive skills and the acquisition of skills that allow nurses to identify and diagnose early changes in the functioning of the avf. this structure reorganizes and outlines the areas of care where the nurse can help maximize the longevity of the avf and minimize the implications for health systems in each country.