scholarly journals Quality and Quality Indicators in Peritoneal Dialysis

10.5772/23194 ◽  
2011 ◽  
Author(s):  
Javier Arrieta
Keyword(s):  
Peritoneal Dialysis ◽  
Quality Indicators

scholarly journals An Environmental Scan and Evaluation of Home Dialysis Quality Indicators Currently Used in Canada

2020 ◽  
Vol 7 ◽  
pp. 205435812097739
Author(s):  
Lisa Dubrofsky ◽  
Ali Ibrahim ◽  
Karthik Tennankore ◽  
Krishna Poinen ◽  
Sachin Shah ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Peritoneal Dialysis ◽  
Quality Indicators ◽  
Patient Centered ◽  
High Quality ◽  
Home Dialysis ◽  
Environmental Scan ◽  
Starting Point

Background: Quality indicators are important tools to measure and ultimately improve the quality of care provided. Performance measurement may be particularly helpful to grow disciplines that are underutilized and cost-effective, such as home dialysis (peritoneal dialysis and home hemodialysis). Objective: To identify and catalog home dialysis quality indicators currently used in Canada, as well as to evaluate these indicators as a starting point for future collaboration and standardization of quality indicators across Canada. Design: An environmental scan of quality indicators from provincial organizations, quality organizations, and stakeholders. Setting: Sixteen-member pan-Canadian panel with expertise in both nephrology and quality improvement. Patients: Our environmental scan included indicators relevant to patients on home dialysis. Measurements: We classified existing indicators based on the Institute of Medicine (IOM) and Donabedian frameworks. Methods: To evaluate the indicators, a 6-person subcommittee conducted a modified version of the Delphi consensus technique based on the American College of Physicians/Agency for Healthcare Research and Quality criteria. We shared these consensus ratings with the entire 16-member panel for further examination. We rated items from 1 to 9 on 6 domains (1-3 does not meet criteria to 7-9 meets criteria) as well as a global final rating (1-3 unnecessary to 7-9 necessary) to distinguish high-quality from low-quality indicators. Results: Overall, we identified 40 quality indicators across 7 provinces, with 22 (55%) rated as “necessary” to distinguish high quality from poor quality care. Ten indicators were measured by more than 1 province, and 5 of these indicators were rated as necessary (home dialysis prevalence, home dialysis incidence, anemia target achievement, rates of peritonitis associated with peritoneal dialysis, and home dialysis attrition). None of these indicators captured the IOM domains of timely, patient-centered, or equitable care. Limitations: The environmental scan is a nonexhaustive list of quality indicators in Canada. The panel also lacked representation from patients, administrators, and allied health professionals. Conclusions: These results provide Canadian home dialysis programs with a starting point on how to measure quality of care along with the current gaps. This work is an initial and necessary step toward future collaboration and standardization of quality indicators across Canada, so that home dialysis programs can access a smaller number of highly rated balanced indicators to motivate and support patient-centered quality improvement initiatives.

P1156TWO YEAR FOLLOW UP QUALITY INDICATORS COMPLIANCE IN A LARGE INTERNATIONAL PERITONEAL DIALYSIS INSTITUTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Belén Marrón ◽  
Suzanne Pearce ◽  
Claudia Martín ◽  
Dan Munteanu ◽  
Michael Roesch ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Quality Indicators ◽  
Clinical Practices ◽  
Fluid Removal ◽  
Arterial Blood ◽  
Retrospective Data Analysis ◽  
Source Data ◽  
Related Quality ◽  
Definition Of

Abstract Background and Aims Peritoneal dialysis (PD) practice is not universally homogeneous, best clinical practices are not completely understood as reference values are often obtained from small sized populations and/or frequently based on chronic kidney disease (CKD) and/or hemodialysis data. To evaluate two years of follow up of compliance with PD-related quality indicators (QIs) following definition of new targets in an international PD network. Method All English and Spanish language CKD and PD guidelines were reviewed. Twelve Qis were considered being of significant relevance and targets for these QIs were defined (see table). Retrospective data analysis. Results Achievement of QI targets for years 2017-2018 is shown in table. Variability among countries not shown. Conclusion There was a significant increase in QIs achievement in 2018 vs. 2017. ≥75% of patients met the target for the following variables: total weekly Kt/Vurea, 24 h fluid removal, mean arterial blood pressure and serum albumin. Peritonitis rates are clearly over International objectives and were improving. Due to the lack of referral source data, these series may help to understand PD practice and outcomes in a global setting.

Scanning Electron Microscopy of Staphylococcus Epidermidis Adherence to Continuous Ambulatory Peritoneal Dialysis Catheters

1985 ◽  
Vol 43 ◽  
pp. 520-521
Author(s):  
William J. Lamoreaux ◽  
David L. Smalley ◽  
Larry M. Baddour ◽  
Alfred P. Kraus
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Staphylococcus Epidermidis ◽  
Sterile Saline ◽  
Intravascular Devices ◽  
Capd Patient ◽  
Scanning Electron

Infections associated with the use of intravascular devices have been documented and have been reported to be related to duration of catheter usage. Recently, Eaton et al. reported that Staphylococcus epidermidis may attach to silastic catheters used in continuous ambulatory peritoneal dialysis (CAPD) treatment. The following study presents findings using scanning electron microscopy (SEM) of S. epidermidis adherence to silastic catheters in an in vitro model. In addition, sections of polyvinyl chloride (PVC) dialysis bags were also evaluated by SEM.The S. epidermidis strain RP62A which had been obtained in a previous outbreak of coagulase-negative staphylococcal sepsis at local hospitals was used in these experiments. The strain produced surface slime on exposure to glucose, whereas a nonadherent variant RP62A-NA, which was also used in these studies, failed to produce slime. Strains were grown overnight on blood agar plates at 37°C, harvested from the surface and resuspended in sterile saline (0.85%), centrifuged (3,000 rpm for 10 minutes) and then washed twice in 0.1 M phosphate-buffered saline at pH 7.0. Organisms were resuspended at a concentration of ca. 106 CFU/ml in: a) sterile unused dianeal at 4.25% dextrose, b) sterile unused dianeal at 1.5% dextrose, c) sterile used dialysate previously containing 4.25% dextrose taken from a CAPD patient, and d) sterile used dialysate previously containing 1.5% dextrose taken from a CAPD patient.

Case Report. Candida lusitaniae peritonitis in a patient on continuous ambulatory peritoneal dialysis

Mycoses ◽  
2002 ◽  
Vol 45 (3-4) ◽  
pp. 120-122 ◽  
Author(s):  
S. Cinar ◽  
A. Nedret Koc ◽  
H. Taskapan ◽  
A. Dogukan ◽  
B. Tokgoz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Candida Lusitaniae

Peritoneal Dialysis Use and Practice Patterns: An International Survey Study

2020 ◽  
Author(s):  
Yeoungjee Cho ◽  
Aminu K. Bello ◽  
Adeera Levin ◽  
Meaghan Lunney ◽  
Mohamed A. Osman ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Practice Patterns ◽  
Survey Study ◽  
International Survey
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