scholarly journals Peritoneal dialysis and center effect

2020 ◽  
Vol 3 (4) ◽  
pp. 197-211
Author(s):  
Sonia Guillouët
Keyword(s):  
Nursing Home ◽  
Peritoneal Dialysis ◽  
Beneficial Effect ◽  
Health Professionals ◽  
Home Visits ◽  
Center Effect ◽  
Dialysis Nurses ◽  
Home Assistance

Outcomes of patients treated by peritoneal dialysis depends on their characteristics, which generally cannot be modified. Conversely, center characteristics or practices having an effect on the outcomes of patients and may be subject to change. Study the center effect and identify "center" variables associated with the patient's future is therefore necessary. Taken as part of a science thesis, the importance of the center effect and the role and importance of nursing home visits in preventing peritoneal infections. We also observed that there was a disparity between centers in the use and allocation of home assistance by a nurse for carrying out dialysis. In a context where organizations favor the versatility of health professionals, our work underlines the importance of the experience and expertise of peritoneal dialysis nurses in the success of the method. Increasing the size of the centers and optimizing resources could have a beneficial effect on the survival of the method by improving the experience of the centers.

Family Meaning of Nursing Home Visits Scale

2012 ◽  
Author(s):  
Hsiu-Hsin Tsai ◽  
Yun-Fang Tsai ◽  
Tzu-Shin Huang
Keyword(s):  
Nursing Home ◽  
Home Visits ◽  
Family Meaning

A Survey of Home Visits at Peritoneal Dialysis Centers in the United States

1998 ◽  
Vol 18 (5) ◽  
pp. 528-531 ◽  
Author(s):  
Judith Bernardini ◽  
Carol Dacko
Keyword(s):  
United States ◽  
Peritoneal Dialysis ◽  
Home Visit ◽  
Mail Survey ◽  
Home Visits ◽  
The United States ◽  
Licensed Practical Nurse ◽  
Practical Nurse ◽  
Number Of Patients ◽  
Federal Administration

Objective To determine the frequency and characteristics of home visits in centers that provide training for peritoneal dialysis (PD). Design Mail survey sent to all dialysis centers in the United States providing home PD, using the Health Care Federal Administration (HCFA) Renal Provider list. Results Surveys were mailed to 1247 centers; 13 were undeliverable, resulting in 1234 surveys successfully delivered; 670 (54%) of those surveyed responded. Of those responding, 525 (78.4%) reported home visits were part of the care of home PD patients: 11% made a single home visit, 52% made an initial home visit with at least one followup visit, and 16% made visits only as needed. No home visits were made by 21% of responding centers. A registered nurse (RN) alone made the home visit in 61% of the centers, while a multidisciplinary team accompanied the RN in 35% of centers; 3% of visits were made by a licensed practical nurse, and 1% by the physician. Half of the visits required 0.5 -1 hour, while 41% required 1 -2 hours. Travel time was most often an hour or less one way. Staff were reimbursed for travel expenses by 90% of the centers. The 525 centers making home visits were not different than the 145 centers not making home visits in number of patients per center, number of RNs, rural or urban location, or affiliation with a university. Interpretation of the HCFA regulations concerning home visits was the most important factor influencing centers making home visits. Conclusions Home visits to continuous ambulatory PD and continuous cycling PD patients in the United States are common. Nearly 80% of centers responding to the survey include home visits in the care of their home peritoneal dialysis patients.

“Can I go to Glasgow?” Learnings from patient involvement at the 17th Congress of the International Society for Peritoneal Dialysis (ISPD)

2020 ◽  
Vol 40 (1) ◽  
pp. 12-25 ◽  
Author(s):  
Talia Gutman ◽  
Karine E Manera ◽  
Amanda Baumgart ◽  
David W Johnson ◽  
Martin Wilkie ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
International Society ◽  
Health Professionals ◽  
Best Practice ◽  
Patient Involvement ◽  
Learning Experience ◽  
Research Priorities ◽  
Self Management ◽  
Structured Interviews ◽  
Research Activities

Background: Recognition of the discrepancy between the research priorities of patients and health professionals has prompted efforts to involve patients as active contributors in research activities, including scientific conferences. However, there is limited evidence about the experience, challenges, and impacts of patient involvement to inform best practice. This study aims to describe patient and health professional perspectives on patient involvement at the Congress of the International Society for Peritoneal Dialysis (ISPD). Methods: Semi-structured interviews were conducted with 14 patients/caregivers and 15 health professionals from six countries who attended ISPD. Interviews were recorded and transcribed verbatim, and transcripts were analyzed thematically. Results: We identified four themes: protecting and enhancing scientific learning (grounding science in stories, sharing and inspiring new perspectives, distilling the key messages of research presentations, striking a balance between accommodating patients and presenting the science); democratizing access to research (redistributing power, challenging the traditional ownership of knowledge, cultivating self-management through demystifying research); inadequate support for patient/caregiver delegates (lacking purposeful inclusion, challenges in interpreting research findings, soliciting medical advice, difficulty negotiating venue and program, limited financial assistance in attending); and amplifying impact beyond the room (sparking innovation in practice, giving patients and families hope for the future). Conclusions: Patient involvement at the ISPD Congress clarified the applicability of research to patient care and self-management, democratized science, and strengthened the potential impact of research. More structured support for patients to help them purposefully articulate their experience in relation to session objectives may enhance their contribution and their own learning experience.

scholarly journals A Proof of Concept of a Mobile Health Application to Support Professionals in a Portuguese Nursing Home

Sensors ◽  
2019 ◽  
Vol 19 (18) ◽  
pp. 3951
Author(s):  
Márcia Esteves ◽  
Marisa Esteves ◽  
António Abelha ◽  
José Machado
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Mobile Health ◽  
Health Professionals ◽  
Point Of Care ◽  
Healthcare Delivery ◽  
Proof Of Concept ◽  
Mobile Health Application ◽  
And Performance

Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.

A Survey of Home Visits at Peritoneal Dialysis Centers in the United States

1998 ◽  
Vol 18 (5) ◽  
pp. 528-531 ◽  
Author(s):  
Judith Bernardini ◽  
Carol Dacko
Keyword(s):  
United States ◽  
Peritoneal Dialysis ◽  
Home Visit ◽  
Mail Survey ◽  
Home Visits ◽  
The United States ◽  
Licensed Practical Nurse ◽  
Practical Nurse ◽  
Number Of Patients ◽  
Federal Administration

Objective To determine the frequency and characteristics of home visits in centers that provide training for peritoneal dialysis (PD). Design Mail survey sent to all dialysis centers in the United States providing home PD, using the Health Care Federal Administration (HCFA) Renal Provider list. Results Surveys were mailed to 1247 centers; 13 were undeliverable, resulting in 1234 surveys successfully delivered; 670 (54%) of those surveyed responded. Of those responding, 525 (78.4%) reported home visits were part of the care of home PD patients: 11% made a single home visit, 52% made an initial home visit with at least one followup visit, and 16% made visits only as needed. No home visits were made by 21% of responding centers. A registered nurse (RN) alone made the home visit in 61% of the centers, while a multidisciplinary team accompanied the RN in 35% of centers; 3% of visits were made by a licensed practical nurse, and 1% by the physician. Half of the visits required 0.5 -1 hour, while 41% required 1 -2 hours. Travel time was most often an hour or less one way. Staff were reimbursed for travel expenses by 90% of the centers. The 525 centers making home visits were not different than the 145 centers not making home visits in number of patients per center, number of RNs, rural or urban location, or affiliation with a university. Interpretation of the HCFA regulations concerning home visits was the most important factor influencing centers making home visits. Conclusions Home visits to continuous ambulatory PD and continuous cycling PD patients in the United States are common. Nearly 80% of centers responding to the survey include home visits in the care of their home peritoneal dialysis patients.

scholarly journals Estimation of the Center Effect on Early Peritoneal Dialysis Failure: A Multilevel Modelling Approach

2016 ◽  
Vol 36 (5) ◽  
pp. 519-525 ◽  
Author(s):  
Sonia Guillouët ◽  
Ghislaine Veniez ◽  
Christian Verger ◽  
Clémence Béchade ◽  
Maxence Ficheux ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Random Effect ◽  
Multilevel Modelling ◽  
French Language ◽  
Significant Heterogeneity ◽  
Individual Level ◽  
Center Effect ◽  
The Individual ◽  
Observation Period ◽  
Modelling Approach

IntroductionThis study was carried out to investigate the center effect on the risk of peritoneal dialysis (PD) failure within the first 6 months of therapy using a multilevel approach.MethodsThis was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 5,406 incident patients starting PD between January 2008 and December 2012 in 128 PD centers. The end of the observation period was December 31, 2013.ResultsOf the 5,406 patients, 415 stopped PD within the first 6 months. There was a significant heterogeneity between centers (variance of the random effect: 0.10). Only 3% of the variance of the event of interest was attributable to differences between centers. At the individual level, only treatment before PD (odds ratio [OR]: 1.93 for hemodialysis and OR: 2.29 for renal transplantation) and underlying nephropathy ( p < 0.01) were associated with early PD failure. At the center level, only center experience was associated (OR: 0.78) with the risk of PD failure. Center effect accounted for 52% of the disparities between centers.ConclusionCenter effect on early PD failure is significant. Center experience is associated with a lower risk of transfer to hemodialysis.

Ten Years’ Experience with Capd in a Nursing Home Setting

1997 ◽  
Vol 17 (3) ◽  
pp. 255-261 ◽  
Author(s):  
John E. Anderson
Keyword(s):  
Nursing Home ◽  
Peritoneal Dialysis ◽  
Patient Outcomes ◽  
Survival Rates ◽  
Home Setting ◽  
Technical Problems ◽  
Logistic Analysis ◽  
Survival Expectations ◽  
Home Placement ◽  
Esrd Patients

Objective We reviewed our experience with end-stage renal disease (ESRD) patients treated with continuous ambulatory peritoneal dialysis (CAPD) in a nursing home with the aims of describing their demographic and clinical characteristics, evaluating CAPD technique success and patient outcomes. Setting University-based, teaching nursing home. Design Retrospective review of patients in our nursing home treated with CAPD between 1 June 1986 and 1 June 1996. Patients One hundred and nine patients: 66 (60.5%) were female and 59 (54%) were white. Their mean age was 62.7 years ± 12.8 SD (range 31 -88). Females were significantly older than males (64.9 years ± 10.7 SD vs 59.1 years ± 14.6 SD, p < 0.05). Sixty-eight (62.4%) were diabetics. Main outcomes studied:Cox -adjusted patient survival. Cause of death. Peritonitis and hospitalization rates. Logistic analysis of predictors of discharge home. Results Six and 12-month survival rates were 51.7% and 37.2%, respectively. Age greater than 75, poor functional status, coronary artery disease (CAD), and decubitus ulcers were significant mortality risks. Vascular disease was the leading cause (41.7%) of death. The peritonitis rate in the nursing home was 1.19 episodes per patient year. Gram-positive organisms predominated. The hospitalization rate was 22.4 days per patient year. Gangrene/ stump infections and peritonitis accounted for 14% and 10% of admissions. Those patients admitted for rehabilitation and with higher activity of daily living (ADL) scores were more likely, and those with diabetes, age ≥75, and CAD less likely to be discharged. Conclusions We continue to believe that peritoneal dialysis is a reasonable option for ESRD patients placed in nursing homes. Technical problems do not limit its use, but overall poor patient outcomes are an important issue. Patients, their families, and referring physicians should be informed of the limited survival expectations particularly for the very old and/or severely functionally impaired patient. Patients whose discharge is anticipated on admission are those most likely to return to the community and are the most likely to truly benefit from nursing home placement.

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