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Hemodialysis Arteriovenous Fistula Self-cannulation: Moving Theory to Practice in Developing Patient-Teaching Resources


doi: 10.1097/NUR.0b013e3181f903b8
Feature Articles

Purpose/Objectives: This article discusses how Orem's theory was applied to the revision of supporting documents in the patient-teaching process and subsequently the nurse's role in the patient's learning experience.

Background/Rationale: Teaching based on didactic, provider-focused objectives is ineffective in meeting patient's learning needs. There is a lack of conclusive research on the development of appropriate patient-teaching endeavors for the acquisition of knowledge and skills related to the performance of hemodialysis arteriovenous fistula self-cannulation.

Description of the Project/Innovation: To prepare patients for home hemodialysis, Orem's self-care-deficit nursing theory was used to guide the revisions of a patient assessment and learning documentation template, the development of a self-cannulation teaching resource and to foster a renewed sense of the nurse's role in the teaching process.

Interpretation/Conclusion: The application of self-care-deficit nursing theory to the update and development of patient-teaching documentation and resources for self-cannulation provides the nurse with a theoretical approach to assess, plan, evaluate, and document teaching from a patient-focused perspective. Theory in practice provides a means to support and highlight the role of nurses in the patient-learning process. The utilization of practical activities to introduce theory into teaching provides a means to structure care processes and to enhance nurse's adoption of theory in practice.

Implications: Orem's theory provides a relevant, useful framework to guide nurses in teaching patients self-care. Research on the exploration of nurse's attitudes related to the benefit of adopting theory when teaching patients to perform hemodialysis self-care is needed.

Author Affiliations: Capital District Health Authority (Ms Hudson) and School of Nursing, Dalhousie University (Dr Macdonald), Halifax, Nova Scotia, Canada.

Correspondence: Shawna Hudson, RN, BScN, C (Neph) C, 106 Stonegate Dr, Halifax, Nova Scotia, Canada B3N 3L2 (;

© 2010 Lippincott Williams & Wilkins, Inc.