ArticlePediatric nephrology (Berlin, Germany)2021
Structured re-training to reduce peritonitis in a pediatric peritoneal dialysis program: a quality improvement intervention.
Article in Pediatric nephrology (Berlin, Germany), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Training programs for families of children on home peritoneal dialysis: a scoping review.Pediatric nephrology (Berlin, Germany) · 2026Review
- Peritoneal Dialysis-Related Peritonitis and Kidney Transplant Outcomes.JAMA network open · 2026Article
- Chronic peritoneal dialysis in children with chronic kidney disease: An experience from a North Indian teaching institute.Journal of family medicine and primary care · 2021Article
- Article
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Authors and funding
13 authors.
Funding
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Abstract
backgroundDecline in skills and knowledge among patients and/or caregivers contributes to peritoneal-dialysis (PD)-related peritonitis. Re-training is important, but no guidelines exist. We describe the implementation of a structured re-training program to decrease peritonitis rates.
methodsThis is a prospective quality improvement study involving pediatric patients on long-term home automated PD at National University Hospital, Singapore, between 2012 and 2018. With increasing peritonitis rates, systematic root cause analysis was performed, and based on the contributory factors identified, a structured re-training program was implemented from 2015. This was conducted in 5 cycles, each consisting of 4 modules (hand hygiene, exit site care, peritonitis, and PD troubleshooting).
resultsPeritonitis rates were analyzed in 2 phases: Phase 1 (2012-2014) when no re-training was performed and Phase 2 (2016-2018) after re-training was instituted. Fifty-nine patients were included. Of these, 45 patients were in Phase 1, 32 in Phase 2, and 18 in both phases. Peritonitis rates decreased from 0.37 ± 0.67 episodes per patient-year in Phase 1 to 0.13 ± 0.32 episodes per patient-year in Phase 2. After adjusting for age at kidney failure onset, PD vintage, years of nursing experience, and the average patient-to-nurse ratio over the study period for each patient, the adjusted peritonitis rates decreased by 0.38 episodes per patient-year (95% CI, 0.09 to 0.67, p = 0.011) from Phase 1 to Phase 2.
conclusionDespite an improvement in staffing ratio, peritonitis rates only improved significantly after intensive structured re-training was instituted.
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