Application of Continuous Quality Improvement Measures in Prevention of Peritoneal Dialysis Related Peritonitis_West China Medical Journal

Authors：

 ZHOUXue-li , QINMin , RENYing , HEXue-qin ,  DIAOYong-shu

Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DIAOYong-shu, Email: dszhbf@163.com

Keywords：

Continuous quality improvement; Peritoneal dialysis; Peritonitis; Hospital management

DOI：

10.7507/1002-0179.20150553

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate whether continuous quality improvement (CQI) measures can reduce the episodes of peritonitis. Methods We analyzed the data of 114 cases of peritoneal dialysis related peritonitis from January to December 2011 before applying CQI measures and 72 cases from January and December 2012 after applying CQI measures in West China Hospital. Then we studied the episodes, cause and pathogenic bacteria species of peritonitis in peritoneal dialysis patients. We implemented the process of reducing the episodes of peritonitis by applying PDCA four-step design: plan-do-check-act. Results The episodes of peritonitis were reduced from per 60.8 patient-months (0.197/patient-years) to per 66.6 patient-months (0.180/patient-years) after applying CQI measures. The positive rate of pathogenic bacteria culture was both 50.0% before and after applying CQI measures, in which 66.7% were gram-positive cocci. The curing rate of peritonitis was increased from 57 case/times (76.3%) to 87 case/times (79.2%). Switching to hemodialysis rate was reduced from 17 cases/times (14.9%) to 10 cases/times (13.9%). Death cases was reduced from 9 cases/times (7.9%) to 5 cases/times (6.9%). Conclusion These results show that the incidence of peritoneal dialysis related peritonitis decreases and the curing rate increases through CQI measures.

Citation： ZHOUXue-li, QINMin, RENYing, HEXue-qin, DIAOYong-shu. Application of Continuous Quality Improvement Measures in Prevention of Peritoneal Dialysis Related Peritonitis. West China Medical Journal, 2015, 30(10): 1936-1939. doi: 10.7507/1002-0179.20150553 Copy

1.	黎伟, 廖蕴华, 薛超, 等. 腹膜透析相关性腹膜炎相关因素分析[J]. 广东医学, 2007, 28(8):1292-1294.
2.	Schaubel DE, Blake PG, Fenton SSA. Trends in CAPD technique failure:Canada, 1981-1997[J]. Perit Dial Int, 2001, 21:365-371.
3.	刘伏友, 彭佑铭. 腹膜透析[M]. 北京:人民卫生出版社, 2000:405.
4.	Figueiredo A, de Figueiredo CE, d'Avila DO. Bag exchange in continuous ambulatory peritoneal dialysis without use of a face mask:experience of five years[J]. Adv Perit Dial, 2001, 17:98-100.
5.	郝继英, 刘洪波, 王质刚. 腹膜透析患者使用O型管和双袋系统对腹膜炎发生率的影响[J]. 北京医学, 2001, 23(6):337.
6.	李开龙, 贾昆霞, 张建国, 等. 162例次腹膜透析相关性腹膜炎临床分析[J]. 第三军医大学学报, 2001, 23(7):860-862.
7.	Kim GC, Vonesh SM. The effect of technique failure on outcome in black patients on continuous ambulatory peritoneal dialysis[J]. Perit Dial Int, 2002, 22:53-59.
8.	Piraino BM, Bailie GR, Bernardini J, et al. ISPD Ad Hoc Advisory Committee. Peritoneal dialysis-related infections recommendations:.
9.	update[J]. Peritoneal Dialysis International, 2005, 25(2):107-131.
10.	Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis:best demonstrated practices[J]. Kidney Int Suppl, 2006, 70(13):S44-S54.
11.	汪涛. 持续性质量改进(CQI)在腹膜透析中心管理中的应用[J]. 中国血液净化, 2006, 5(3):121-122.
12.	骆素平, 董捷. 持续质量提高在腹膜透析相关性腹膜炎防治中的应用[J]. 中国血液净化, 2008, 7(4):227-229.
13.	Hall G, Bogan A, Dreis S, et al. New directions in peritoneal dialysis patient training[J]. Nephrol Nurs J, 2004, 31(2):149-154, 159-163.
14.	Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis:best demonstrated practices[J]. Kidney Int, 2006 (Suppl):44-54.
15.	Li PK, Szeto CC, Piraino B, et al. Peritoneal dialysis-related infections recommendations:2010 update[J]. Perit Dial Int, 2010, 30(4):393-423.
16.	Shigidi MM, Fituri OM, Chandy SK, et al. Microbial spectrum and outcome of peritoneal dialysis related peritonitis in Qatar[J]. Saudi J Kidney Dis Transpl, 2010, 21(1):168-173.
17.	吴晶晶, 刘佳, 张莉, 等. 腹膜透析相关性腹膜炎致病菌及耐药性分析[J]. 中华医院感染学杂志, 2011, 21(16):3521-3523.
18.	Dong J, Chen Y. Impact of the bag exchange procedure on risk of peritonitis[J]. Perit Dial Int, 2010, 30(4):440-447.
19.	Owen, WF, Pereria BJG, Sayegh MH. 透析与移植[M]. 北京:科学出版社, 2001:160-178.
20.	周雪丽, 温月, 江维, 等. 腹膜透析相关性腹膜炎的原因分析[J]. 华西医学, 2013, 28(4):576-578.

1. 黎伟, 廖蕴华, 薛超, 等. 腹膜透析相关性腹膜炎相关因素分析[J]. 广东医学, 2007, 28(8):1292-1294.
2. Schaubel DE, Blake PG, Fenton SSA. Trends in CAPD technique failure:Canada, 1981-1997[J]. Perit Dial Int, 2001, 21:365-371.
3. 刘伏友, 彭佑铭. 腹膜透析[M]. 北京:人民卫生出版社, 2000:405.
4. Figueiredo A, de Figueiredo CE, d'Avila DO. Bag exchange in continuous ambulatory peritoneal dialysis without use of a face mask:experience of five years[J]. Adv Perit Dial, 2001, 17:98-100.
5. 郝继英, 刘洪波, 王质刚. 腹膜透析患者使用O型管和双袋系统对腹膜炎发生率的影响[J]. 北京医学, 2001, 23(6):337.
6. 李开龙, 贾昆霞, 张建国, 等. 162例次腹膜透析相关性腹膜炎临床分析[J]. 第三军医大学学报, 2001, 23(7):860-862.
7. Kim GC, Vonesh SM. The effect of technique failure on outcome in black patients on continuous ambulatory peritoneal dialysis[J]. Perit Dial Int, 2002, 22:53-59.
8. Piraino BM, Bailie GR, Bernardini J, et al. ISPD Ad Hoc Advisory Committee. Peritoneal dialysis-related infections recommendations:.
9. update[J]. Peritoneal Dialysis International, 2005, 25(2):107-131.
10. Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis:best demonstrated practices[J]. Kidney Int Suppl, 2006, 70(13):S44-S54.
11. 汪涛. 持续性质量改进(CQI)在腹膜透析中心管理中的应用[J]. 中国血液净化, 2006, 5(3):121-122.
12. 骆素平, 董捷. 持续质量提高在腹膜透析相关性腹膜炎防治中的应用[J]. 中国血液净化, 2008, 7(4):227-229.
13. Hall G, Bogan A, Dreis S, et al. New directions in peritoneal dialysis patient training[J]. Nephrol Nurs J, 2004, 31(2):149-154, 159-163.
14. Bender FH, Bernardini J, Piraino B. Prevention of infectious complications in peritoneal dialysis:best demonstrated practices[J]. Kidney Int, 2006 (Suppl):44-54.
15. Li PK, Szeto CC, Piraino B, et al. Peritoneal dialysis-related infections recommendations:2010 update[J]. Perit Dial Int, 2010, 30(4):393-423.
16. Shigidi MM, Fituri OM, Chandy SK, et al. Microbial spectrum and outcome of peritoneal dialysis related peritonitis in Qatar[J]. Saudi J Kidney Dis Transpl, 2010, 21(1):168-173.
17. 吴晶晶, 刘佳, 张莉, 等. 腹膜透析相关性腹膜炎致病菌及耐药性分析[J]. 中华医院感染学杂志, 2011, 21(16):3521-3523.
18. Dong J, Chen Y. Impact of the bag exchange procedure on risk of peritonitis[J]. Perit Dial Int, 2010, 30(4):440-447.
19. Owen, WF, Pereria BJG, Sayegh MH. 透析与移植[M]. 北京:科学出版社, 2001:160-178.
20. 周雪丽, 温月, 江维, 等. 腹膜透析相关性腹膜炎的原因分析[J]. 华西医学, 2013, 28(4):576-578.

Previous Article
日间手术费用和感知调查与分析
Next Article
Application of Oral Wash Care by Compound Chlorhexidine Giuconatie Gargle for Patients after Radical Surgery of Tongue Cancer

West China Medical Journal

Application of Continuous Quality Improvement Measures in Prevention of Peritoneal Dialysis Related Peritonitis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content