Standardised training for reducing peritoneal dialysis-related infection: a cluster randomised controlled study

Area of Science:

• Nephrology
• Clinical Trials
• Infectious Disease Prevention

Background:

• Peritoneal dialysis (PD) is a common treatment for kidney failure.
• PD-related infections (exit-site, tunnel, peritonitis) are frequent complications.
• The impact of standardized nurse and patient training on PD infection rates is unclear.

Purpose of the Study:

• To evaluate if a standardized international guideline-based training curriculum reduces PD-related infections.
• To compare standardized training against existing local training practices for PD patients and trainers.

Main Methods:

• The Targeted Education ApproaCH to improve Peritoneal Dialysis (TEACH-PD) trial was a cluster-randomised controlled trial.
• Adult PD patients and nurse trainers were randomized to standardized training or usual care.
• Primary outcome was time to first PD-related infection; secondary outcomes included infection types, catheter removal, and mortality.

Main Results:

• A total of 1462 incident PD patients were included across 42 clusters.
• Standardized training was associated with a non-significant increase in PD-related infections (SHR 1.230, p=0.0457).
• No significant differences were observed in secondary outcomes between the groups.

Conclusions:

• Implementing a standardized training curriculum based on international guidelines did not decrease PD-related infections in incident PD patients.
• Further research is needed to identify optimal training elements for safe and effective PD care.