Investigation and analysis of catheter exit-site care by peritoneal dialysis nurses
YIN Chang1 LIAO Yu-mei2▲ ZHANG Li2 HUANG Hui-e2
1.Yangtze University Health Science Center, Hubei Province, Jingzhou 434023, China;
2.Department of Nephrology,Peking University Shenzhen Hospital, Guangdong Province, Shenzhen 518000, China
Abstract:Objective To understand the training status of catheter exit-site care (hereinafter referred to as "exit-site care") in peritoneal dialysis (PD) patients and the condition of exit-site care by PD nurses, so as to provide basis for the establishment of management standards and continuous improvement on quality of PD exit-site care.Methods The nursing version of Peritoneal Dialysis Catheter Exit-site Care Questionnaire was designed by researchers.From April to May 2018, 26 PD nurses in 10 hospitals with PD outpatient clinics in a coastal area of Guangdong Province were investigated through Questionnaire Star and WeChat APP.Results The average incidence of PD catheter-related infections in 10 hospitals with PD clinics in the area was about 0.15 times per year.Five of the ten hospitals had full-time and part-time nurses, and the other five hospitals had only part-time nurses (concurrently with ward nursing job).Among the 26 PD nurses, 9 cases (34.62%) were full-time PD nurses, the ratio of full-time nurses to patients was approximately 1∶95.67, and 17 cases (65.38%) were part-time PD nurses, the ratio of part-time nurses to patients was approximately 1∶37.76.The average training time of each patient was (15.39±5.06) hours by full-time nurses, and that by part-time nurses was (11.13±5.85) hours.All the PD nurses would retrain patients, and among them the retraining frequency of 13 PD nurses was fixed.A total of 92.31% of the PD nurses required post-shower exit-site care, 84.62% of the PD nurses required patients to change dressing once a day when the exit-site infections occurred, or even more frequently in other dressing changes.Only 2 PD nurses asked patients to routinely apply antibacterial ointment to prevent infections.Altogether 92.31% of the PD nurses could complete wound evaluation as suggested, 73.08% of the PD nurses used normal saline and iodine for disinfection and dressing change, and all the PD nurses could use dressings to cover the exit-site before maturity and during infections.Conclusion At present, half of the hospitals in this region that carry out PD treatment are in the initial development stage, and the ratio of nurses to patients among the hospitals varies greatly.The three aspects on training of patients, wound evaluation before dressing change and care points during dressing change are basically consistent with the International Society for Peritoneal Dialysis Guidelines.However, there is a difference in the application of antibacterial ointment from the guideline, which needs to be further studied.
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