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Nursing contacts and outcomes in a pediatric CCPD program
1Children and Young People's Kidney Unit, Nottingham City Hospital, NHS Trust, UK.
Insights
A pediatric renal nursing service supports children on continuous cycling peritoneal dialysis (CCPD), aiming to reduce hospitalizations. This study highlights the nursing support provided to enhance patient care and family well-being.
Area of Science:
- Pediatric Nephrology
- Nursing Care
- Renal Replacement Therapy
Background:
- Specialist pediatric renal nursing services are crucial for bridging hospital and home care.
- Such services aim to minimize hospitalization and disruptions to children's education and family life.
- Continuous cycling peritoneal dialysis (CCPD) is a treatment option for pediatric kidney disease.
Purpose of the Study:
- To document the nursing support provided to children undergoing CCPD.
- To evaluate the impact of nursing services on hospitalization rates and family routines.
- To analyze the spectrum of care needs and outcomes for pediatric patients on CCPD.
Main Methods:
- A 3-year prospective study involving 13 children on CCPD.
- Monitoring of nursing support, home/clinic contacts, and inpatient days.
- Documentation of patient outcomes including peritonitis, transplant, and mortality.
Main Results:
- Mean CCPD duration was 14 months, with extensive home and clinic contacts.
- Nine peritonitis episodes occurred (1 per 20 patient-months); one death from cardiovascular collapse.
- Seven children received transplants with a median waiting time of 7 months.
Conclusions:
- Pediatric renal nursing services offer vital support for children on CCPD.
- Comprehensive nursing care can help reduce morbidity and hospitalization in this population.
- The study outlines evolved nursing strategies to optimize care for children and families on CCPD.
Abstract:
A specialist pediatric renal nursing service provides a link between hospital and home. Such support aims to reduce hospitalization and disruption to schooling and family routine. A 3-year prospective study monitored the progress and documented the nursing support to and contacts with 13 children (5 of whom were under 5 years of age) who commenced continuous cycling peritoneal dialysis (CCPD). Mean duration of CCPD was 14 months. Home and clinic contacts included telephone calls (65% of contacts), home, school, nursery, respite care, and community visits. Nine families received respite care from a home-care pediatric renal nurse, with children under 5 years receiving 68% of such visits. A total of 388 inpatient days were recorded. These included admission for catheter and dialysis training (125 days). hypertension (83 days), dialysis-related admissions (66 days), peritonitis (43 days), vomiting (31 days), and surgical procedures and infections (40 days). Nine peritonitis episodes occurred in 8 children (incidence 1 per 20 patient-months), and one death (cardiovascular collapse) occurred on CCPD. Seven children received a transplant, with the median waiting time for transplant being 7 months (range: 3-14 months). This study documents the spectrum of nursing support we have evolved to support children on CCPD and their families in the hope of reducing morbidity and hospitalization.