Significance of Choosing the Right Solution for Peritoneal Dialysis
Journal of Clinical Nephrology and Therapeutics is open access and peer-reviewed scientific journal. The journal serves as a bridge between scientific explorations and findings in the clinical field.
Shyalini Jeevakaran from University Health Network, Toronto, Canada published short communication on Significance of Choosing the Right Solution for Peritoneal Dialysis. Chronic kidney failure is a long-term condition whereby kidney function declines progressively. The decline of kidney function can be diminished by maintaining good blood pressure control and anemia management. Nurses play an important role in teaching, training, assessment, and management of Peritoneal Dialysis (PD) treatment. According to Kazancioglu, the PD nurses should continuously assess the quality of the peritoneal dialysis that patients receive and evaluate the treatment outcomes. Reviewing current patient clinical outcomes is critical in assessing quality improvement; therefore, greater attention has to be paid to such outcomes because the success of PD treatment will depend very strongly on the efforts and commitment of healthcare teams. Kazancioglu further notes that adult education is affected by chronic diseases and nursing education on peritoneal dialysis is crucial as nurses have to educate and provide guidance to patients who are responsible for their treatment at home. Furthermore, effective peritoneal dialysis can only be achieved by providing suitable dialysis which includes the assessment of ultra-filtration, number and timing of exchanges, and residual renal function.
The goal of this quality improvement project is to improve peritoneal dialysis (PD) treatment therapy by increasing nursing knowledge in identifying the right peritoneal dialysis solution according to patient symptoms. Choosing the right solution is of paramount importance because it will improve the patients’ condition and in effect potentially decrease their length of stay in the hospital, and potentially decrease the progression of current disease conditions. When an inappropriate solution is chosen it can lead to dehydration or fluid overload; the former can cause electrolyte imbalance, confusion, hyperthermia and constipation (fatal if not diagnosed), whilst the latter can lead to shortness of breath, congestive heart failure, swelling of ankles and lower legs, and skin breakdown. This quality improvement fellowship project is aligned with the University Health Network’s (UHN) current strategic focus on patient safety. In particular, the link between the selection of PD solutions and the hospital-acquired condition (HAC) of patients’ falls. When the patient’s fluid removal during peritoneal dialysis is more than is required, the patient will have low blood pressure and this can lead to falls in hospital. As per best practice guidelines on falls and fall prevention, one of the risk factors for falls is hypotension.
Journal of Clinical Nephrology and Therapeutics