Medical Education: the Patients Training in Chronic Peritoneal Dialysis and Peritonitis - Essay Example

Review of the Literature Review of the Literature Barone R.J., Campora M.I., Gimenez N.S., Ramirez, L, Santopietro, M. & Panese S.A. (2011). The importance of the patient’s training in chronic peritoneal dialysis and peritonitis. Advances in Peritoneal Dialysis, 27, 97-100. Summary of Article: The work of Barone et al (2011) explains the importance of the training of patients in the course of peritoneal dialysis and peritonitis. Continuous medical training and education has been termed as a major contributor to the patient outcomes, as well as assesses the therapy process. During Peritoneal Dialysis (PD) treatment, improvement in the patients has been linked to continuous education, training in self-treatment that allows for long term therapy. Research Elements: To demonstrate the content of the research, the researcher used quantitative research methodology. The means of the patients undertaking the PD program that had completed 2 to 3 training lessons prior to placement on the catheter. Outcome(s): From the study, it was discovered that out of the 90 patients that were treated for three months, most of them benefited from continuous education (Barone et al., 2011). Significance to Nursing and Patient Care: This study is useful since it explains that in as much the training programs were varied, the outcomes of the patients undergoing PD improved since a good number learn the different aspects of how to change an individual’s treatment program Bernardini, B. (2010). Training and Retraining: Impact on Peritonitis. Perit Dial Int 30 (4), 434-436. Summary of Article: In this work, Bernardini (2010) explains that Peritoneal Dialysis (PD) was regarded as a common infection for patients in the era of continuous ambulatory PD. However, it was extremely challenging to get the best treatment for peritonitis as well as determine the risk factors for peritonitis and how to prevent the same. Research Elements: Qualitative research methodology was used. To establish the content of the research, author used literature review to assess the level of infection of the patients from the 1970s and 1980s once in 6-12 months in an effort to assess the possibility of infection among these patients (Bernardini, 2010). Through repetitive tasks such as use of the catheter led to the patients adhere to the different connection procedures. Outcome(s): It was found out that the PD nurses can easily train patients on the principles of adult education; thus, inculcate them with skills that allow for evidence based practice and ultimately minimizing the risks of peritonitis through redirecting behavior among the patients. Significance to Nursing and Patient Care: This study is significant since it explains how the proactive protocols have been effective since they prevent chances of worsening of existing conditions or even developing the kidney condition (Bernardini, 2010). Bordin, G., Casati, M., Sicolo, N., Zucherato, N., & Eduati, V. (2007). Patient education in peritoneal dialysis: an observational study in Italy. Journal Of Renal Care, 33(4), 165-171. Summary of Article: Bordin et al (2007) highlight the concept of patient education in peritoneal dialysis (PD) in Italy. In the work, the authors explain the features of the education programs in the PD centers in Italy in an attempt to establish the link between the PD rates and the education programs. Research Elements: Qualitative and quantitative research methodologies were used. The study applied the survey technique to gather information from 150 selected non-pediatric PD centers in Italy (Bordin et al., 2007). Outcome(s): The study found out that lower levels of peritonitis are linked to the forms of training in the PD centers especially with the help of a skilled personnel (Bordin et al., 2007). Significance to Nursing and Patient Care: This study is important since it highlights how in the dialysis centers, different methods of teaching are used in training such as home visits, training, re-training and pre-dialysis to establish the relationship between the education programs and the rate of peritonitis. Cox, S., Steddon, S., Mallinder, S., Fan, S., & Punzalan, S. (2006). Re-training and switching of PD system to reduce recurrent gram-positive PD peritonitis. Journal Of Renal Care, 32(4), 198-201. Summary of Article: Cox et al (2006) are of the opinion that intensive training as well as re-education of PD exchange rates is a good technique that minimizes the rate of peritonitis. However, for patients that already established as far as PD is concerned are extremely vulnerable to repeated instances of peritonitis. Research Elements: Quantitative research methodology was used. The study applied Mean follow up on the patients’ conditions after 10 months. Outcome(s): Cox et al (2006) found out that the rate of peritonitis reduced after training and retraining. Significance to Nursing and Patient Care: This study is significant since it focuses on the number of patients suffering from renal failure increasing in the world and how the process of dialysis can be influenced so as to improve the condition of the patients. Technology has been indicated to be one of the factors that have improved the process of PD. Evans, L. M. (2012). Peritoneal dialysis: one units response to improving outcome and technique survival. Renal Society of Australasia Journal, 8(3), 114-119. Summary of Article: Evans’ (2012) work focuses on improving peritoneal dialysis (PD) through highlighting different survival techniques for the patients. The author recommends home therapies such as PD and patient empowerment to improve the outcome of PD. In the event that the clinicians focus on advocating for home therapies, Evans (2012) believes that it will be easy to handle the condition since the patients will be trained on the best survival technique; thus, proactive management of their conditions. Research Elements: Qualitative research methodology was used. The study applied a literature review to collect data. The existing PD service in the case study of Australia was seen to have various gaps such as failure in the techniques applied, educating the patients and monitoring the level of infection. Outcome(s): It was found out that through designing strategic changes such as regular monitoring of the infection rates, improving communication and tracking the peritonitis rates helps improve PD outcomes. Significance to Nursing and Patient Care: This study is significant since it focuses on the improvement strategies for patients with peritonitis in terms of monitoring, tracking and treatment. Figueiredo A.E, Poli-de-Figueiredo C.E, Meneghetti F, Lise G.A., Detofoli C.C., & Silva L.B. (2013). Peritonitis in patients on peritoneal dialysis: analysis of a single Brazilian center based on the International Society for Peritoneal Dialysis. J Bras Nefrol 35(3), 214-219. Summary of Article: Figueiredo et al (2013) write that peritonitis is a major complication in peritoneal dialysis (PD) patients. Research Elements: Qualitative research methodology was used. The study applied a retrospective descriptive study to assess the prevalence rates and the susceptibility of risks in patients of the Sao Lucas Hospital from 1984 to 2012. Outcome(s): From the work, it was discovered that there were recorded 203 cases of peritonitis in the selected patients and out of the patients, 255 of them had at least one episode of peritonitis (Figueiredo et al., 2013). However, other patients could not go on with treatment due to factors such as death and organ transplants. Significance to Nursing and Patient Care: This study is significant since it explains that the success of the PD program is greatly linked to constant monitoring of the complication and commendable clinical treatment. Gadola, L., Poggi, C., Poggio, M., Sáez, L., Ferrari, A., Romero, J., Fumero, S., Ghelfi, G., Chifflet, L., & Borges, P. L. (2013). Using a Multidisciplinary Training Program to Reduce Peritonitis in Peritoneal Dialysis Patients. Perit Dial Int., 33(1), 38–45. Summary of Article: Gadola et al’s (2013) work applies a multi-disciplinary training program to reduce the level of peritonitis in dialysis patients. Research Elements: Qualitative research methodology was used. The study applied retrospective study. The authors considered the age of the patients, the sex, education, and their time under PD, the training sessions as well as the peritonitis episodes. Outcome(s): Through this objective structured form of assessment, the skills of the patients were discerned. In the first phase, patients that that ranged between 22-84 years on PD of 35 ± 30 months- in 1 -107 months- recorded lower peritonitis rates while in phase two that recorded the PD education program recorded extreme low levels of peritonitis rate (Gadola et al., 2013). Significance to Nursing and Patient Care: This study is significant since it explains the aspect of education on the concept of peritoneal dialysis and the impacts on the patients. Paudel, K., Namagondlu, G., Samad, N., McKitty, K., & Fan, S. L. (2014). Lack of Motivation: a new modifiable risk factor for peritonitis in patients undergoing peritoneal dialysis? Journal of Renal Care, 41 (1), 33–42. Summary of Article: Paudel et al (2014) identifies the risk factors in peritonitis patients that are undergoing dialysis. In the work, the authors make attempts to evaluate if the PD exchange technique as well as patient motivation has any impact on patents with the peritonitis. Research Elements: Qualitative research methodology was used. The study applied the use of PHQ-9 questionnaires to collect data. Outcome(s): It was found out that patients that lack motivation have high chances of getting depression and require psychosocial support for survival. Significance to Nursing and Patient Care: This study is substantial since it explains that the lack of motivation and depression among the patients worsens their peritonitis condition and even increases chances of individuals succumbing to peritonitis. This helps in nursing care in terms of improving hygiene and boosting the motivation levels for the patients undergoing PD. Price, V., Ramalakshmi, S., & Cheuk-Chun, S. (2011). ISPD position statement on reducing the risks of peritoneal dialysis–related infections. Perit Dial Int; 31(6), 614-630. Summary of Article: Price, Ramalakshmi & Cheuk-Chun (2011) are of the opinion that peritonitis dialysis (PD) program can only be successful in the event that other factors are highlighted such as focus to prevent occurrence of other ex- site, tunnel and peritonitis infections. In light with this argument, the authors are of the opinion that the number of patients are increasing due to the lack of emphasis on the prevalence rates of other infection rates that contribute to kidney failure. Monitoring peritonitis was recommended for very program and through team work so as to categorize the cause of peritonitis and evaluating the training program. Research Elements: Quantitative research methodology was used.The study applied the use of means of Peritonitis Rates from different states in the world to make contrasts and comparisons. Outcome(s): It was found out that there are identifiable risks of peritonitis and the same can be avoided to prevent further infections (Price, Ramalakshmi & Cheuk-Chun, 2011). Nonetheless, further research needs to be done on prevention mechanism of peritonitis. Significance to Nursing and Patient Care: This study is significant as it gives measures on how to reduce the possibilities of peritoneal dialysis–related infections. Russo, R., Manili L., Tiraboschi G., Amar K., De Luca, M., Alberghini E., Ghiringhelli P., De Vecchi A., Porri M.T., Marinangeli, G., Rocca, R., Paris, V., & Ballerini, L. (2006). Patient re-training in peritoneal dialysis: Why and when it is needed. Kidney International, 70, S127–S132. Summary of Article: Russo et al (2006) accept the fact that renal replacement treatment poses major threats on the lifestyle of a patient. The authors also explain that PD can be managed at home bout with strict supervision, support and advice from the multidisciplinary team. The patients on the other hand, are expected to comply with the specifications; failure to comply has been linked with infection complications on the patients. In this regard, this work was founded on the grounds that educational intervention is almost compulsory in an assessment of the patient compliance on dialysis treatment. Research Elements: The study applied quantitative and observational methods to collect data. Tools such as Patient Questionnaire and Score Card were used in the study. Outcome(s): It was found out that patients that out of the 1819 selected patients that went through renal replacement therapy, 28% and 72 % were on PD and hemodialysis respectively (Russo et al., 2006). Significance to Nursing and Patient Care: This study is important since it explains that there is need for retraining the patients and staff on infection rates and prevention and even the need to have a dedicated staff if improvements in patients has to be recorded. Sayed, S., A.M., Abu-Aisha, H., Ahmed, M. A., & Elamin, S. (2011). Effect of the Patient’s Knowledge on Peritonitis Rates in Peritoneal Dialysis. Perit Dial Int., 33(4), 362–366. Summary of Article: Sayed et al’s (2011) work focuses on the effect of the patient’s awareness on the rates of peritonitis in peritoneal dialysis. Through training, the authors indicate that the patients in question have the ability to follow their own treatment especially when they have the required tools and home visits. Research Elements: Qualitative research methodology was used. The study applied the survey method. Through the survey method, the authors carried their study in Sudan to assess how the housing conditions, the home environment and patient’s awareness of peritoneal dialysis determine patient outcomes. Outcome(s): After the research, it was found out that the patients that has undergone continuous training on peritoneal dialysis has lower rates of infections and recorded fewer hospitalization cases. Significance to Nursing and Patient Care: This study is significant since it can help the nurses understand the impact of the patient’s awareness on the rates of peritonitis in peritoneal dialysis. Schaepe, C. & Bergjan, M. (2015).  Educational interventions in peritoneal dialysis: a narrative review of the literature. International Journal of Nursing Studies, 52 (4), 882–898. Summary of Article: Schaepe & Bergjan (2015) review the existing literature on educational interventions in the course of peritoneal dialysis. Through the educational interventions, individuals have been said to participate in their own treatment, therapy and even manage their own condition. This form of education has been directed both to the patients and to the nurses. Education has been termed as the major way in which guidance on treatment and management of peritoneal conditions can be done. Research Elements: Qualitative research methodology was used. The study applied a description review of primary research. Outcome(s): It was found out that the education intervention for PD was extremely under-researched. This explains the need to conduct more research on education and training for nurses and patients if long term solutions have to be found. Significance to Nursing and Patient Care: This study is significant since it gives a deep insight on the educational interventions in peritoneal dialysis. Segal, J. H., & Messana, J. M. (2013). Prevention of Peritonitis in Peritoneal Dialysis. Seminars In Dialysis, 26(4), 494-502. Summary of Article: In the work of Segal & Messana (2013), it is noted that reducing the frequency of the patients going through peritoneal dialysis is a major challenge. This fact is linked to aspects such as catheter care, the patients and other factors that contribute to high infection rates. In the event that the nurses are not efficient and skilled, there are high chances of the cases of PD increasing as well as lack of education on PD among the patients and the staff. Research Elements: Qualitative research methodology was used. The study reviewed related literature to base its findings. Outcome(s): It was found out that pathogens can cause exit site and peritonitis infections but the same can be controlled through training and re-training. Significance to Nursing and Patient Care: This study is significant as it explains the need for retraining in peritonitis patients. Re-training has been identified as one of the major factors that boosts behavior in patients in an attempt to reduce fungal infections. Shetty, A. (2014). Reducing Peritoneal Dialysis-Related Peritonitis Rate. The Ochsner Journal, 14(3), 386–391. Summary of Article: Shetty (2014) writes that peritonitis that emanates from peritoneal dialysis (PD) is a major negative risk in PD. This is because such infections occur when the immune system cannot prevent infections from taking place. In the work, the author indicates that the interventions vary according to the organisms that cause peritonitis. Some of the causes may result from the organism causing peritonitis resulting from contaminations. Research Elements: Research Elements: Qualitative research methodology was used. The study reviewed related literature to get its findings. Outcome(s): It was found out that the level of peritonitis can be reduced if a strong team is embraced to prevent reoccurrence of infections. Significance to Nursing and Patient Care: This study is significant because it strongly outlines how to reduce peritonitis by defining the root causes then getting interventions. Yahn-Bor, C., Pei-Shan H., Li-Chueh, K., & Jin-Bor, C. (2013). Lower Education Level Is A Major Risk Factor For Peritonitis Incidence In Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study With 12-Year Follow-Up. Peritoneal Dialysis International, 33(5), 552-558. Summary of Article: Yahn-Bor et al (2013) write that peritonitis is one of the adverse effects of peritoneal dialysis (PD) and will continue to increase the death rates if nothing is done to alleviate the same. In the event that the patient goes through repeated episodes of peritonitis, they may suffer more consequences since their membranes may be completely damaged and may even make them permanent patients of hemodialysis. Research Elements: Qualitative research methodology was used. The study applied the retrospective cohort study, in Taiwan from 1999 to 2010 and analyzed data using chi-square tests. Outcome(s): It was found that low levels of education were major causative factors of PD- related peritonitis. Significance to Nursing and Patient Care: This study is substantial as it recommends that PD education is done so as the patients get conversant with the cause of peritonitis, and how to manage the same. References Barone, R.J., Campora M.I., Gimenez N.S., Ramirez, L, Santopietro, M. & Panese S.A. (2011). The importance of the patient’s training in chronic peritoneal dialysis and peritonitis. Advances in Peritoneal Dialysis, 27, 97-100. Bernardini, B. (2010). Training and Retraining: Impact on Peritonitis. Perit Dial Int 30 (4), 434-436. Bordin, G., Casati, M., Sicolo, N., Zucherato, N., & Eduati, V. (2007). Patient education in peritoneal dialysis: an observational study in Italy. Journal Of Renal Care, 33(4), 165-171. Cox, S., Steddon, S., Mallinder, S., Fan, S., & Punzalan, S. (2006). Re-training and switching of PD system to reduce recurrent gram-positive PD peritonitis. Journal Of Renal Care, 32(4), 198-201. Evans, L. M. (2012). Peritoneal dialysis: one units response to improving outcome and technique survival. Renal Society of Australasia Journal, 8(3), 114-119. Figueiredo A.E, Poli-de-Figueiredo C.E, Meneghetti F, Lise G.A., Detofoli C.C., & Silva L.B. (2013). Peritonitis in patients on peritoneal dialysis: analysis of a single Brazilian center based on the International Society for Peritoneal Dialysis. J Bras Nefrol 35(3), 214-219. Gadola, L., Poggi, C., Poggio, M., Sáez, L., Ferrari, A., Romero, J., Fumero, S., Ghelfi, G., Chifflet, L., & Borges, P. L. (2013). Using a Multidisciplinary Training Program to Reduce Peritonitis in Peritoneal Dialysis Patients. Perit Dial Int., 33(1), 38–45. Paudel, K., Namagondlu, G., Samad, N., McKitty, K., & Fan, S. L. (2014). Lack of Motivation: a new modifiable risk factor for peritonitis in patients undergoing peritoneal dialysis? Journal of Renal Care, 41 (1), 33–42. Price, V., Ramalakshmi, S., & Cheuk-Chun, S. (2011). ISPD position statement on reducing the risks of peritoneal dialysis–related infections. Perit Dial Int; 31(6), 614-630. Russo, R., Manili L., Tiraboschi G., Amar K., De Luca, M., Alberghini E., Ghiringhelli P., De Vecchi A., Porri M.T., Marinangeli, G., Rocca, R., Paris, V., & Ballerini, L. (2006). Patient re-training in peritoneal dialysis: Why and when it is needed. Kidney International, 70, S127–S132. Sayed, S., A.M., Abu-Aisha, H., Ahmed, M. A., & Elamin, S. (2011). Effect of the Patient’s Knowledge on Peritonitis Rates in Peritoneal Dialysis. Perit Dial Int., 33(4), 362–366. Schaepe, C. & Bergjan, M. (2015).  Educational interventions in peritoneal dialysis: a narrative review of the literature. International Journal of Nursing Studies, 52 (4), 882–898. Segal, J. H., & Messana, J. M. (2013). Prevention of Peritonitis in Peritoneal Dialysis. Seminars In Dialysis, 26(4), 494-502. Shetty, A. (2014). Reducing Peritoneal Dialysis-Related Peritonitis Rate. The Ochsner Journal, 14(3), 386–391. Yahn-Bor, C., Pei-Shan H., Li-Chueh, K., & Jin-Bor, C. (2013). Lower Education Level Is A Major Risk Factor For Peritonitis Incidence In Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study With 12-Year Follow-Up. Peritoneal Dialysis International, 33(5), 552-558. Read More