Continuous quality improvement for peritoneal dialysis patients.
In addition to a significant savings in time, several qualitative factors were impacted positively by this change in practice. Clear guidelines provided a structure that both physicians and nursing supported, thereby improving their relationship. The LPN's role was amended to include the stop-and-start procedure, which enhanced their self-esteem. Having the assistive personnel contribute to the dialysis regimen allowed the RN more latitude in managing patient care and efficient use of time. Because the procedure was now done more efficiently, therapy was initiated without delay. Lastly, patients expressed satisfaction because the nursing staff's own technique and the patient was now being discharged without their own technique and the patient was now being discharged without delay. All RN and LPN staff continue to be trained in the procedure. Cases of peritonitis continue to be investigated with favorable results. Results of this project were shared not only with the staff but also with the management committee of the hospital. Management had embraced the philosophy of continuous QI. The management committee was anxious to see the principles of continuous QI improve efficiency and patient outcomes. Reducing the complexity and decreasing the time required for the procedure maintained quality patient outcomes. Applying the continuous quality monitoring process and tools to the management of one group of chronically ill patients was shown to be an effective means of improving patient care and efficiency as well as of reducing costs.
Dillon
P
P
College of Nursing, Rush University, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois.
Murphy
M
M
Larson
S
S
D000046:Academic Medical Centers; D002641:Chicago; D006436:Hemodialysis Units, Hospital / Q000458:organization & administration; D006801:Humans; D009936:Organizational Innovation; D010530:Peritoneal Dialysis / Q000451:nursing / Q000592:standards*; D017749:Total Quality Management