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Part 3: Clinical Experiences |
Akdeniz University Medical School, Department of Medicine, Division of Nephrology, Antalya, Turkey
Correspondence to: F.F. Ersoy, Akdeniz University Medical School, Department of Medicine, Division of Nephrology, Dumlupinar Bulvari, Akdeniz University Campus, 07070 Antalya, Turkey. ersoy{at}akdeniz.edu.tr
The continuous quality improvement approach in peritoneal dialysis
practice necessitates definition of the factors and the procedures that may
possibly be contributing to the final success of peritoneal dialysis. The
philosophy of continuous quality improvement uses the Plan, Do, Check, Act
(PDCA) cycle. To improve the procedures used during peritoneal dialysis, the
first step is to create a plan, then to carry out the plan, to check it, and
after the collection of satisfactory information, to execute the chosen
improvement action.
Several studies have identified the most frequent causes of transfer
from PD to HD as infection, catheter problems, inadequate dialysis, and
psychosocial factors, among others. According to training guidelines from the
International Society for Peritoneal Dialysis, seven points are of major
importance to decrease infection risks: exit-site care, catheter placement,
antibiotic prophylaxis for procedures, prevention of bowel-source peritonitis,
prevention of fungal peritonitis, and connection methods. On the other hand,
other factors such as hypoalbuminemia, depression, and obesity should also be
taken into consideration for better technique survival in peritoneal dialysis
patients.
KEY WORDS: Technique survival; peritonitis.
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