Quality control in a peritoneal dialysis program

A reliable and effective quality-control program in the peritoneal dialysis (PD) unit requires a team effort. Historically, the nursing staff has been responsible for PD program development, and in some programs the physicians are frankly uninvolved. An enthusiastic, knowledgeable, and committed physician is necessary. In the early days of continuous ambulatory peritoneal dialysis in the United States, lack of physician understanding and commitment tarnished the image of this promising, evolving therapy. After recognizing this problem, Baxter embarked on an intensive effort to upgrade the expertise of the physicians. Concurrently, PD programs were identified with successful outcomes and "best demonstrated practice" techniques were promulgated. The key to quality control is the involvement of all members of the team, including physicians, nurses, dietitians, social workers, technicians, administrators, and patients. A commitment is needed for continuing education, continuing reevaluation of policies and procedures, and the empowerment of all team members to achieve the programmatic goals.