Mrs Deanna Shephard1
1Logan Hospital, Meadowbrrok, Australia
Introduction: Peritonitis is the leading cause of morbidity and mortality in peritoneal dialysis (PD) patients and is a major cause of technique failure and patient admissions. International guidelines recommend routine retraining of patients on PD to reduce the risk of peritonitis. This poster will describe a quality initiative, aimed at improving the process of retraining and empowering patients with the knowledge to reduce their modifiable risk factors for peritonitis, within a metropolitan PD unit.
A template was designed after a literature review, analysis of adult learning principles and collaboration with PDU staff, creating a structured format to utilise for retraining in the patient’s home environment. Home visits were prioritised according to international guidelines which suggest three months post initial train and minimum of annually thereafter, post peritonitis, catheter infection, hospitalisation, decline in dexterity, cognition or vision.
Currently 31 of 62 patients have been retrained. Preliminary data comparing three-months post intervention to the same period in the previous year, indicates a reduction in peritonitis rate from 0.53 to 0.26 per patient year. Total length of hospital stay decreased from 101.7 to 70.7 days and hospital admissions from 15 to 11.7.
Although there are many variables that influence this data, these results indicate improvements that may be amplified once all patients are retrained. Furthermore, data collected from patient retraining has provided insight into specific education topics, that we as clinicians can improve on to assist patients to retain the vital information necessary to safely perform a home-based therapy.
Commencing nursing in haematology and bone marrow transplantation for 18 months, I progressed to working in various areas of nursing before settling into renal nursing, where I have spent the past 13 years. I enjoy the challenge of empowering patients to take charge of their health outcomes, by partnering with them on their health care journey.