Use of private duty nurses for daily CCPD and family relief in pediatric PD patients.

STUDY OBJECTIVE

To evaluate the role of trained home nurses in the care of end-stage renal disease (ESRD) pediatric patients on continuous cycling peritoneal dialysis (CCPD) and/or for family relief.

DESIGN

The study was designed to investigate trained home nurses in the care of pediatric ESRD patients receiving peritoneal dialysis (PD) who entered the home program between February 1991 and October 1993.

SETTING

Tertiary-referral university hospital.

PATIENTS AND METHODS

We trained the nursing staff of nursing agencies to perform PD with a special emphasis on pediatric care. A weekly nursing summary including daily vital signs, PD flow sheet, medications, and progress notes was sent to the home program. The trained nurses were also utilized for family relief to prevent burn-out.

RESULTS

Five children (4 female, 1 male) with ages ranging from 3-14 years were studied. The total number of patient-months was 81 with a range of 4-33 patient-months. During this time, there was only one hospital admission for hyperkalemia and hypertension. Five episodes of peritonitis occurred over 81 patient-months, and all were treated at home. The clinic visit compliance was 100% in patients having nursing help. The administration of erythropoietin at home in these patients was consistent, resulting in higher hematocrit (Hct) levels. The added support to patients and family resulted in a low incidence of complications and infrequent need for hospital admissions.

CONCLUSIONS

Our experience suggests that the use of private duty nurses for performing CCPD or for family relief in ESRD children has a favorable outcome and would benefit most pediatric home dialysis programs.