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1 University of Pittsburgh, Pittsburgh, Pennsylvania, USA; 2 Saint John Regional Hospital, New Brunswick, Canada; 3 Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil;4 Stichting Dianet, Academic Medical Center, Amsterdam, The Netherlands; 5 Tuen Mun Hospital, Hong Kong, China
Correspondence to: J. Bernardini, University of Pittsburgh, 3504 Fifth Avenue,
Suite 200, Pittsburgh, Pennsylvania, 15213,
USA.
bernardini{at}dom.pitt.edu
Objective: To survey nurses around the world about current
practices for peritoneal dialysis (PD) home training programs. Design: Random sampling of nurses to complete a written
survey from the International Society for Peritoneal Dialysis Nursing Liaison
Committee. Settings: United States, Canada, South America (Brazil,
Columbia), The Netherlands, Hong Kong. Methods: Surveys and responses were sent by fax whenever
possible, or by regular mail, or hand carried, or conducted by telephone.
Results were stratified by geographic areas as well as by cumulative responses
and were expressed as medians with ranges. Kruskal-Wallis was used to evaluate
differences in responses. Associations between variables were tested with
Pearson correlation. Univariate regression analysis was used to evaluate the
impact of variables on peritonitis rates. Variables with p < 0.10
were included in a multivariate analysis. Results: A total of 317 nurses responded: 88 in the United
States, 46 in Canada, 58 in South America, 58 in Hong Kong, and 67 in The
Netherlands. This represented 37% of all surveys distributed. Respondents had
a median of 12 years' experience in nephrology (range 1-35 years), but only
31% had a formal background in adult education. Nearly half received their
guidance to patient training from a nurse colleague, 11% were guided by a
corporate colleague, and 8% were simply self-taught. Clinics responding had a
median of 30 PD patients (range 1-400) and reported they trained a median of 8
patients per year (range 0-86). Reported peritonitis rates were a median 0.46
per year or 1 episode every 26 months. Peritonitis rates, however, were not
known by 53% of respondents. Total training time per patient had a very wide
range of hours, from 6 to 96. There was no correlation between training time
and peritonitis rates among the study respondents (p = 0.38), nor
with any other variables. Conclusions: There is wide variation in practices for PD
patient training programs within countries and around the world. Training time
did not appear to be related to peritonitis rates. Randomized trials of
training practices are needed to determine which approaches produce the best
outcomes for patients.
KEY WORDS: Patient training; nurses; outcomes; current practices.
Received 15 December 2005; accepted 28 March 2006.
This article has been cited by other articles:
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  K. M. Chow, C. C. Szeto, M. C. Law, J. S. Fun Fung, and P. Kam-Tao Li Influence of Peritoneal Dialysis Training Nurses' Experience on Peritonitis Rates Clin. J. Am. Soc. Nephrol., July 1, 2007; 2(4): 647 - 652. [Abstract] [Full Text] [PDF]
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