**required article from week 6** Sousa, C. N., Paquete, A. R., Teles, P., Pinto, C. M.,  Dias, V. F., Ribeiro, O. M., Manzini, C. S., Nicole, A. G., Souza, L. H., Ozen, N. (2021). Investigating the effect of a structured intervention on the development of self-care behaviors with arteriovenous fistula in hemodialysis patients. (6), 866-874. Application and implications for practice come from the interpretation of meaning from research findings. Communicating and using research evidence is an expectation of a BSN graduate.

Introduction
Nursing is an evidence-based practice that requires nurses to stay up-to-date with the latest research findings and apply them to their everyday practice. This includes understanding the application and implications of research in clinical settings. In the article “Investigating the effect of a structured intervention on the development of self-care behaviors with arteriovenous fistula in hemodialysis patients,” Sousa et al. (2021) explore the impact of a structured intervention on the development of self-care behaviors in hemodialysis patients with arteriovenous fistula (AVF). This paper aims to critically analyze the article and discuss its application and implications for nursing practice.

Summary of the Article
The study conducted by Sousa et al. (2021) investigates the impact of a structured intervention called the AVF Self-Care Program on the development of self-care behaviors in hemodialysis patients with AVF. The researchers conducted a quasi-experimental study with a sample of 75 participants, dividing them into two groups: an intervention group and a control group. The intervention group received the AVF self-care program, which consisted of educational sessions and hands-on training on AVF self-care. The control group did not receive any structured intervention.

The researchers collected data using a structured questionnaire to assess self-care behaviors related to AVF maintenance. The questionnaire was administered at baseline and at a three-month follow-up to measure changes in self-care behaviors. The study found that the intervention group showed significant improvements in self-care behaviors compared to the control group. These improvements were observed in areas such as hygiene, inspection, and protection of AVF.

Application for Nursing Practice
The findings of Sousa et al. (2021) have significant implications for nursing practice, particularly in the care of hemodialysis patients with AVF. AVF is a commonly used vascular access for hemodialysis, but its success and longevity depend on proper self-care by the patient. The AVF Self-Care Program developed by Sousa et al. (2021) provides nurses with a structured intervention that can be implemented in clinical practice to improve self-care behaviors in hemodialysis patients with AVF.

Nurses can use the AVF Self-Care Program as a guide to educate and train patients on self-care techniques for AVF maintenance. This program emphasizes the importance of hygiene, inspection, and protection of AVF, which are key factors in preventing complications such as infection and thrombosis. By implementing this program, nurses can empower patients to take an active role in their care and enhance their self-care behaviors.

Moreover, the findings of Sousa et al. (2021) highlight the need for nurses to provide ongoing education and support to hemodialysis patients with AVF. Nursing interventions should not be limited to the initial education provided at the start of hemodialysis but should be ongoing throughout the patient’s journey. By continually reinforcing self-care behaviors and providing personalized education based on individual needs, nurses can help patients develop and maintain optimal self-care practices.

Furthermore, the implementation of the AVF Self-Care Program can also improve patient outcomes and reduce healthcare costs. Proper self-care of AVF can prevent complications and hospitalizations, leading to improved patient outcomes and reduced healthcare expenditures. By investing in structured interventions like the AVF Self-Care Program, healthcare facilities can potentially save resources by preventing avoidable complications and hospitalizations.

Implications for Future Research
While the study conducted by Sousa et al. (2021) provides valuable insights into the impact of the AVF Self-Care Program, there are several areas for future research to consider. Firstly, the study had a relatively small sample size, which may limit the generalizability of the findings. Future studies should consider larger sample sizes to ensure robustness and validity of the results.
Secondly, the study only measured self-care behaviors at a three-month follow-up. It would be beneficial to conduct long-term follow-ups to assess the sustainability of the intervention’s effects on self-care behaviors. This would help determine if the positive changes in self-care behaviors observed in the short term persist over an extended period.

Conclusion
The article by Sousa et al. (2021) provides evidence of the positive impact of the AVF Self-Care Program on the development of self-care behaviors in hemodialysis patients with AVF. The study’s findings have important implications for nursing practice, highlighting the need for structured interventions and ongoing education to improve self-care behaviors in this patient population. Nurses can actively apply the AVF Self-Care Program in their clinical practice to empower patients and enhance their self-care practices, leading to improved patient outcomes and reduced healthcare costs.