In the U.K. in the last five years a reassessment of the central role of the hospital has taken place, with a fundamental shift in care for people with increased dependencies to community settings. For patients using peritoneal dialysis a need has been realized for a home-visiting service by specialist renal nurses who can manage and coordinate the program of care, thus reducing the strain on hospital resources. In addition, the provision of a community nurse to visit the patient at home means that ongoing education and training can be undertaken in a suitable learning environment. The home-visiting program creates an opportunity to develop an holistic care plan using strategies of general health promotion as well as practical nursing care. This paper highlights the experiences of a pioneering model of community continuous ambulatory peritoneal dialysis care in the South London. Auditing of this unusually funded post has shown significant reductions in peritonitis, exit-site infections, and hospital admissions in this growing patient population.

Copyright © 1996 by Multimed Inc.