Coventry LL, et al. - In this prospective cohort study including hemodialysis patients with a permanent vascular access (VA), researchers investigated patient, VA and nurse factors related to unsuccessful VA cannulations. They gathered information about 1946 episodes of cannulation (83.9% fistula) in 149 patients by 63 nurses. Rope ladder (73.8%) or area (24.7%) technique was used and cannulation included use of tourniquet (62.9%), ultrasound (4.1%). A 4.4% (n = 85) rate of miscannulation was documented. Fistula compared with graft; older access; absence of stent; no ultrasound; no tourniquet; and lack of post graduate certificate in renal nursing comprised the multivariable features of successful cannulation. Overall, a low rate of miscannulation was reported in this study.