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Related Experiment Videos

Continuous peritoneal dialysis and the extended care facility.

H B Carey1, W Chorney, K Pherson

  • 1Yale University and Hospital of Saint Raphael, New Haven, CT, USA. hcarey@snet.net

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|March 3, 2001
PubMed
Summary

Community nursing homes can successfully manage continuous peritoneal dialysis (CPD) for elderly patients with end-stage renal disease. Training ECF staff ensures positive patient outcomes, making CPD feasible in these settings.

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Area of Science:

  • Nephrology
  • Geriatrics
  • Healthcare Management

Background:

  • End-stage renal disease (ESRD) demographics are shifting towards an elderly population.
  • Nursing homes (extended care facilities - ECFs) are becoming crucial for long-term ESRD patient care and rehabilitation.
  • Previous evaluations of continuous peritoneal dialysis (CPD) in ECFs were limited to a single specialized facility.

Purpose of the Study:

  • To assess the feasibility and outcomes of implementing CPD programs in multiple community-based ECFs.
  • To evaluate the effectiveness of training ECF personnel to manage CPD therapy.
  • To compare outcomes in multi-ECF CPD programs versus single-facility models.

Main Methods:

  • Trained personnel across 10 community ECFs to manage CPD for 93 patients (289.3 patient-months) from Nov 1993 to Dec 1998.

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  • Monitored key outcome measures including hospitalization, mortality, technique failure, and peritonitis rates.
  • Emphasized a structured CPD education program delivered by nephrology staff.

    • Main Results:

    • All participating ECFs successfully maintained their CPD programs.
    • Outcome measures demonstrated the success and feasibility of community-based ECFs for CPD.
    • Utilizing multiple ECFs offered advantages without compromising patient outcomes.

    Conclusions:

    • Community-based ECFs are a viable setting for managing CPD in elderly ESRD patients.
    • A structured, nephrology-led education program for ECF staff is critical for successful CPD implementation.
    • Multi-ECF CPD programs show promise for broader accessibility and effective patient management.