The outcome of preventive care for peritonitis in pediatric patients undergoing peritoneal dialysis: A case management approach
Keywords:
case management, peritoneal dialysis, pediatric patients with end stage kidney disease, peritonitisAbstract
Peritonitis is a common and serious complication in pediatric patients undergoing peritoneal dialysis. The interdisciplinary team caring for children with renal diseases, therefore, has developed a care guideline to prevent peritonitis in children undergoing peritoneal dialysis in 2021, using case management concept. In this approach, case management nurses who are advanced practice nurses, manage continuous care. The care process has been developed and improved through the LINE Application. This includes communication, coaching, counseling, empowerment, and helping to manage problems to prevent peritonitis.
This retrospective observational study aimed to evaluate the outcomes of this preventive care approach for peritonitis in pediatric patients undergoing peritoneal dialysis using a case management concept. This was a retrospective study based on patient medical records, hospital information system, peritonitis incidence records, and records of knowledge and skill assessment of caregivers of children receiving peritoneal dialysis. The sample consisted of the medical records of pediatric peritoneal dialysis patients who were cared for at the Pediatric Nephrology Unit between 1 January 2020-31 December 2020 (20 cases), and between 1 January 2021-31 December 2021 (22 cases). Statistical analysis was conducted using descriptive statistics and the incidence of peritonitis was compared using Chi-square test.
The results indicated a significant reduction in the incidence of peritonitis in 2021, with a rate of 0.11 cases per patient per year, compared to 2020, where the rate was 0.67 cases per patient per year (p-value<0.05). Furthermore, the assessment of caregivers' knowledge and skills revealed high levels of knowledge and skills (100%), with mean knowledge score of 18.31 (SD=1.25) and mean skill score of 22.27 (SD=1.93).
A care guideline to prevent peritonitis in pediatric patients undergoing peritoneal dialysis, with advanced practice nurses as case managers in collaboration with the interdisciplinary team, providing continuous individualized care demonstrated a substantial decrease in peritonitis incidence and improved care outcomes.
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