Table 1.

Nephrologists Transforming Dialysis Safety focus group responses from nephrologists and advanced practice providers

CategoryResponse from Focus Group Participant
Patient selection“It needs to be the right patient at the right time.”
“Home patients are more attentive.”
“Currently patients who dialyze at home are in the top tier of self-motivation and are currently self-selected. As we increase home dialysis, it will be essential to adapt current practices to allow for more patients who [may not fit these criteria].”
Modality specific“Fewer patients would be able to choose home if they can’t use buttonholes.”
“Buttonholes should not be created for in-center patients, there is a lot of infection historically, but it’s okay for home patients.”
Technique and training“There should be a checklist for buttonhole cannulation.”
“Multiple cannulators increase the risk of infection, for example, when there is an in-center creation by clinic staff before the patient is sent home.”
“Strict aseptic technique needs to be followed (do not use ‘scab removers’).”
Best practices guidance“NTDS should create a buttonhole registry.”
“If NTDS would come up with a position or recommendations on using buttonholes, [we] would go with that.”
  • NTDS, Nephrologists Transforming Dialysis Safety.