Nurses' impact on the choice and longevity of vascular access.

A preponderance of data highlights significant improvements in outcomes when patients dialyze with arteriovenous fistulae compared with either catheters or grafts. "Fistula First" is a nationwide, evidence-based, quality improvement effort that is striving to improve vascular access outcomes by increasing the percentage of patients who dialyze with arteriovenous fistulae. Nephrology nurses will have a profound effect on achieving the goals outlined by Fistula First, including both the choice and longevity of vascular accesses.