‘Home Visits – So much more than just a cup of tea’

Mr Peter Tregaskis1, Mrs Maria Buena1

1Alfred Health, , Australia


The International Society of Peritoneal Dialysis (ISPD) empirically recommend that home visits should be part of any Peritoneal Dialysis (PD) program though, there are no clear recommendations around frequency/format of assessment. The perceived benefits of a robust and consistent home visit program are: reduced PD related infections, therapy longevity, reduced PD-related admissions and improved patient satisfaction.


In 2013, the PD team at Alfred Health developed a triage risk assessment tool along with a form-based assessment tool to stratify patients and consequently guide frequency (and specific goals) of home visits. Covering 6 domains of technique, troubleshooting capacity, environment, stock management, clinical and well-being parameters, the tool subcategorises patients as either low, moderate or high risk to therapy.


Introduced in conjunction with the development of a percutaneous Tenckhoff insertion program, the implementation of this tool has been associated with significant overall improvement in PD outcomes. Mean peritonitis episodes per patient year fell from the pre-intervention era (2008 – 2012) 0.48 episodes per patient year to post-implementation (2013 – 2018) 0.18 episodes per patient year with a median time on therapy (transplant censored) of 686 days. Assessment and home-visit frequency (approximately 30-35 home visits/month for a cohort of ~ 100) was maintained during, and contributed to, a significant increase in total patient numbers from n=47 in 2012 to n=110 in 2015.


The next phase is to audit the existing tool for currency in the context of a review of current practice recommendations to identify areas of potential refinement.


Has worked in renal nursing for 15 years both in Australia and overseas. Has a post-graduate diploma in renal nursing and a masters of Nurse Practitioner. Took on the PD coordinator role in 2010 and evolved the role into a Nurse Practitioner role, becoming endorsed in 2013. Has seen the unit grow in numbers from 22 patients in 2010 to a peak of 110 patients in 2015 all while maintaining excellent patient outcomes. Currently leads a dynamic team of 5 PD nurses with aspirations for constant innovative and patient centred ideas.


The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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