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Achieving patient and management expectations through an interdisciplinary peritoneal dialysis approach.

Background: In 2006, we had only 29 patients left on peritoneal dialysis, from approximately 95 in 1998. We decided to look at the whole peritoneal dialysis process.

Objectives: Revitalize the peritoneal dialysis program in order to increase the number of patients, improve the patient's quality of life and increase productivity.

Methods: An extensive revision of our peritoneal dialysis program began, combined with a participative research approach. We started with the direct involvement of a peritoneal dialysis nurse at the predialysis clinic. A specific surgical team, which consists of a surgeon and two peritoneal dialysis nurses, was created to insert catheters under local anaesthesia. We empowered the hemodialysis nurses with the knowledge of peritoneal dialysis modality, so they can recruit patients among their units. For any peritoneal dialysis patients coming to emergency to rule out peritonitis, an agreement was reached to limit to less than one hour the time needed to evaluate them and to go up to the nephrology unit.

Results: Over an 18-month period, the number of peritoneal dialysis patients increased by 44%. Quality of life seemed a common feeling among the majority of our patients. Adverse events were less frequent and the waiting list for catheter insertions disappeared. The dialysis program cost analysis has demonstrated a substantial cost reduction and increased productivity.

Conclusion: Challenging every step of our peritoneal dialysis program brought positive effects. The involvement of the peritoneal dialysis nurses throughout the whole process of continuum of care has really made the difference.

Sylvie Bureau, inf., Clinicienne, and Nicole Mathieu, infirmiere
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Author:Bureau, Sylvie; Mathieu, Nicole
Publication:CANNT Journal
Article Type:Brief article
Geographic Code:1CANA
Date:Jul 1, 2008
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