SN instructed that check the access for signs of infection or problems with blood flow before each hemodialysis treatment, even if the patient is inserting the needles. Keeping the access clean at all times. Using the access site only for dialysis. Being careful not to bump or cut the access. Checking the thrill in the access every day. The thrill is the rhythmic vibration a person can feel over the vascular access. Watching for and reporting signs of infection, including redness, tenderness, or pus. Not letting anyone put a blood pressure cuff on the access arm. Not wearing jewelry or tight clothes over the access site. Not sleeping with the access arm under the head or body. Not lifting heavy objects or putting pressure on the access arm.