Authors (including presenting author) :
Yeung ST(1) ,Ho KM(1) ,Sung KMD(1)
Affiliation :
(1)Renal Unit, Department Of Medicine, Queen Elizabeth Hospital
Introduction :
Hong Kong has implemented a PD-first policy since 1985, resulting in the majority of chronic kidney disease patients receiving peritoneal dialysis (PD) as their renal replacement modality. PD-associated peritonitis is a serious and common PD-related infection that can lead to significant morbidity and mortality, including catheter loss, peritoneal membrane failure, and even death. Rapid and accurate identification of the causative pathogens is crucial for formulating optimal antibiotic treatment and improving patient outcomes. However, the reliability of laboratory results depends heavily on human factors. In light of this, it is imperative to review and standardize the nursing technique for collecting dialysate fluid samples.
Objectives :
1. To maintain a standard nursing technique in sampling dialysate fluid.
2. To reduce the negative culture rate in peritonitis cases.
Methodology :
This quality improvement project was conducted in two phases from March 2023 to July 2023. First, training materials including procedure posters and instructional videos were developed to educate nursing staff on the proper dialysate fluid sampling technique. All nursing staff in the renal unit were then provided with comprehensive training on the standardized sampling procedure.
In the second phase, nursing audits were conducted to assess the compliance of nursing staff with the standardized sampling technique. The impact of the improved sampling technique was evaluated by comparing the pre- and post-implementation culture-negative peritonitis rates.
Result & Outcome :
After the implementation of the standardized dialysate fluid sampling technique, 100% (33/33) of the nursing staff successfully passed the competency audit. The project also monitored the culture-negative peritonitis rate, which showed a significant improvement. The rate decreased from 40% between January and May 2023 to 27.8% between October and December 2023, indicating that the interventions were effectively enhanced pathogen identification and optimized patient treatment.
