一个服务重新配置包,以扩大对腹腔透析的访问,包括老年较弱的患者
Michael Corr1,2, Carolyn Hunter3, Daniel Conroy4
1Centre of Public Health, Queen's University Belfast, Belfast BT7 1NN, UK.
Healthcare (Basel, Switzerland)
|June 10, 2023
概括
一个服务重新配置包成功地使北爱尔兰的腹透析 (PD) 患者数量翻了一番. 这种灵活的方法扩大了家庭透析的可用性,改善了患者的治疗结果和成本效益.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 手术服务手术服务.
- 医疗保健管理的管理
背景情况:
- 北爱尔兰的腹腔透析 (PD) 率在历史上一直很低.
- PD是血液透析对末期脏疾病的经济有效的替代方案.
- 国际目标强调增加家庭透析选择.
研究的目的:
- 评估服务重新配置包对北爱尔兰PD接入的影响.
- 展示服务变化如何扩大PD利用率.
- 与家庭透析疗法的国家战略保持一致.
主要方法:
- 实施了一套服务包,包括用于插入PD导管的外科和放射学导线.
- 已建立的科领导的超声波引导的PD导管插入服务.
- 在一年内,前性地跟踪了所有PD导管插入,收集了人口统计,程序和结果数据.
主要成果:
- 每年的PD导管插入量翻了一番,达到66名患者.
- 多种插入技术 (腹腔镜,皮肤穿透,开放) 适应了不同患者的需求.
- 97%的患者成功启动了PD,48%的选择性插入发生在去中心化中心.
结论:
- 一个捆绑的服务重新配置有效地使事件PD人口翻了一番.
- 灵活的服务交付模式可以快速增强对PD的访问.
- 这种方法支持家庭透析治疗的扩大.
相关概念视频
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
46
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...
46
Peritoneal Dialysis III: Nursing Management
55
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...
55
Peritoneal Dialysis I: Introduction and Procedure
64
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...
64
Dialysis
390
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...
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...
390
Hemodialysis II: Procedure and Complications
42
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
42
Acute Kidney Injury V: Interprofessional Care
30
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
30


