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Related Concept Videos

Dialysis01:27

Dialysis

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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
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Dialysis01:15

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Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
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Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Peritoneal Dialysis I: Introduction and Procedure01:30

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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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Decreased pulse rate01:14

Decreased pulse rate

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Bradycardia is a medical condition in which the heart rate is slower than normal. It occurs when the heart's natural pacemaker, the sinus node, generates slower electrical impulses than the standard rhythm. In adults, bradycardia is diagnosed when the pulse rate falls below 60 beats per minute, indicating a deviation from the normal heart rate range.
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Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

Patricia M Rosenberry1, Silke V Niederhaus2, Eugene J Schweitzer2

  • 11 University of Maryland Shore Regional Health, Easton, MD, USA.

The Journal of Vascular Access
|March 27, 2018
PubMed
Summary

A new dialysis access program significantly reduced central venous catheter use, decreasing infections, deaths, and healthcare costs. This initiative lowered catheter rates from over 45% to 8%, saving millions and preventing patient mortality.

Keywords:
Dialysiscentral line–associated bloodstream infectioncentral venous cathetershemodialysis access

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Area of Science:

  • Nephrology
  • Infectious Disease Epidemiology
  • Healthcare Management

Background:

  • Chronic dialysis units face high central venous catheter (CVC) utilization rates, exceeding recommended benchmarks.
  • High CVC rates are linked to increased central line-associated bloodstream infections (CLABSI), mortality, hospitalizations, and healthcare costs.
  • The Eastern Shore of Maryland reported CVC rates exceeding 45%, significantly higher than the <12% guideline.

Purpose of the Study:

  • To evaluate the impact of a multidisciplinary dialysis access program on CVC utilization.
  • To reduce CLABSI rates, associated mortality, and hospital days.
  • To achieve cost savings for the healthcare system.

Main Methods:

  • A 5-year retrospective analysis of catheter rates in three dialysis centers.
  • Utilized published data on CLABSI incidence, costs, and mortality per catheter day.
  • Calculated pre- and post-program CLABSI events, costs, and mortality.

Main Results:

  • The dialysis access program achieved an 82% reduction in central venous catheter days.
  • Central venous catheter rates decreased from an average of 45% to 8%.
  • Estimated cost savings exceeded US$5 million, with 13-27 mortalities averted.

Conclusions:

  • Formalized dialysis access programs effectively decrease CVC rates, CLABSI, hospitalizations, mortality, and costs.
  • Implementing such programs is crucial for areas with high hemodialysis catheter utilization.
  • This approach improves patient outcomes and healthcare system efficiency.