Specialist pediatric dialysis nursing improves outcomes in children on chronic peritoneal dialysis

Chronic peritoneal dialysis (PD) for children in Singapore was instituted in 1988 at the National University Hospital with adult nurses providing dialysis services during the first 10 years. In 1998, a specialist pediatric dialysis nursing team was recruited. This study was conducted to determine th...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2010-10, Vol.25 (10), p.2141-2147
Main Authors: Gunasekara, W. D. Vindya N., Ng, Kar-Hui, Chan, Yiong-Huak, Aragon, Eric, Foong, Pei-Pei, Lau, Yew-Weng, Lim, Lee-Kean, Liew, Chien-Wyei, Yeo, Wee-Song, Yap, Hui-Kim
Format: Article
Language:English
Subjects:
Automation
Catheters
Child
Child, Preschool
Chronic illnesses
Female
Hemodialysis
Hospitals
Humans
Infant
Infant, Newborn
Infection
Infections
Male
Medicine
Medicine & Public Health
Nephrology
Nurse specialists
Nurses
Nursing
Original Article
Patient outcomes
Patients
Pediatric nursing
Pediatric Nursing - statistics & numerical data
Pediatrics
Peritoneal dialysis
Peritoneal Dialysis - adverse effects
Peritoneal Dialysis - nursing
Peritonitis
Peritonitis - epidemiology
Peritonitis - etiology
Treatment Outcome
Urology
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Summary:Chronic peritoneal dialysis (PD) for children in Singapore was instituted in 1988 at the National University Hospital with adult nurses providing dialysis services during the first 10 years. In 1998, a specialist pediatric dialysis nursing team was recruited. This study was conducted to determine the impact of dialysis nursing service on PD-related outcomes during the two nursing periods. Comparing the adult (group 1) and pediatric (group 2) nursing periods, the peritonitis rate was significantly higher in group 1 (RR 1.90; 95%CI 1.27–2.84), and this association did not weaken after adjusting for age, gender, and exit site infections. Exit site infection rate (RR 2.16; 95%CI 1.44–3.23), risk of peritonitis during the first year (RR 3.65; 95%CI 1.68–7.90), and multiple peritonitis attacks (RR 2.45; 95%CI 1.32–4.55) were higher in group 1. The peritonitis rates for adult patients cared for by the same adult nurses declined sharply from 1.05 episodes per patient-year between 1989 and 1992 to 0.41 episodes per patient-year between 1995 and 1997, however the corresponding pediatric rates did not change (1.48 to 1.06 episodes per patient-year, respectively) until the second era when specialized pediatric nurses were available. In conclusion, establishment of a specialist pediatric dialysis nursing team resulted in significant improvement in infection-related PD outcomes.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-010-1581-3