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Specialist pediatric dialysis nursing improves outcomes in children on chronic peritoneal dialysis

W D Vindya N Gunasekara1, Kar-Hui Ng, Yiong-Huak Chan

  • 1Shaw-NKF Children's Kidney Centre, University Children's Medical Institute, National University Health System, Singapore, Singapore.

Pediatric Nephrology (Berlin, Germany)
|June 19, 2010
PubMed

Insights

Establishing a dedicated pediatric dialysis nursing team significantly reduced peritonitis and exit site infection rates in children undergoing chronic peritoneal dialysis (PD). This specialist care improved PD outcomes by minimizing infection risks.

Area of Science:

  • Nephrology
  • Pediatric Nursing
  • Dialysis Care

Background:

  • Chronic peritoneal dialysis (PD) in children in Singapore began in 1988, initially managed by adult nurses.
  • A specialized pediatric dialysis nursing team was introduced in 1998 to address specific needs.

Purpose of the Study:

  • To evaluate the impact of nursing service models on PD-related outcomes in pediatric patients.
  • To compare infection-related outcomes between periods managed by adult nurses versus a specialist pediatric nursing team.

Main Methods:

  • Retrospective analysis comparing two nursing periods: adult nurses (1988-1998) and pediatric nurses (1998 onwards).
  • Key outcomes assessed include peritonitis rates, exit site infection rates, and frequency of infections.
  • Statistical analysis using relative risks (RR) and 95% confidence intervals (CI), adjusted for relevant factors.

Main Results:

  • Higher rates of peritonitis (RR 1.90), exit site infections (RR 2.16), and peritonitis risk in the first year (RR 3.65) were observed under adult nursing care.
  • Multiple peritonitis attacks were also more frequent in the adult nursing group (RR 2.45).
  • Pediatric PD peritonitis rates remained high until the establishment of the specialist pediatric nursing team.

Conclusions:

  • The establishment of a specialist pediatric dialysis nursing team significantly improved infection-related outcomes for children on chronic peritoneal dialysis.
  • Specialized pediatric nursing care is crucial for optimizing the safety and effectiveness of PD in pediatric populations.

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