Nursing contacts and outcomes in a pediatric CCPD program.
A specialist pediatric renal nursing service provides a link between hospital and home. Such support aims to reduce hospitalization and disruption to schooling and family routine. A 3-year prospective study monitored the progress and documented the nursing support to and contacts with 13 children (5 of whom were under 5 years of age) who commenced continuous cycling peritoneal dialysis (CCPD). Mean duration of CCPD was 14 months. Home and clinic contacts included telephone calls (65% of contacts), home, school, nursery, respite care, and community visits. Nine families received respite care from a home-care pediatric renal nurse, with children under 5 years receiving 68% of such visits. A total of 388 inpatient days were recorded. These included admission for catheter and dialysis training (125 days). hypertension (83 days), dialysis-related admissions (66 days), peritonitis (43 days), vomiting (31 days), and surgical procedures and infections (40 days). Nine peritonitis episodes occurred in 8 children (incidence 1 per 20 patient-months), and one death (cardiovascular collapse) occurred on CCPD. Seven children received a transplant, with the median waiting time for transplant being 7 months (range: 3-14 months). This study documents the spectrum of nursing support we have evolved to support children on CCPD and their families in the hope of reducing morbidity and hospitalization.
Gartland
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Children and Young People's Kidney Unit, Nottingham City Hospital, NHS Trust, UK.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003152:Community Health Nursing; D005260:Female; D006801:Humans; D008297:Male; D010371:Pediatric Nursing; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000451:nursing*; D010538:Peritonitis / Q000209:etiology / Q000451:nursing; D011446:Prospective Studies; D012574:Schools