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Implementation of standardized follow-up care significantly reduces peritonitis in children on chronic peritoneal dialysis.
- Source :
-
Kidney international [Kidney Int] 2016 Jun; Vol. 89 (6), pp. 1346-54. Date of Electronic Publication: 2016 Apr 13. - Publication Year :
- 2016
-
Abstract
- The Standardizing Care to improve Outcomes in Pediatric End stage renal disease (SCOPE) Collaborative aims to reduce peritonitis rates in pediatric chronic peritoneal dialysis patients by increasing implementation of standardized care practices. To assess this, monthly care bundle compliance and annualized monthly peritonitis rates were evaluated from 24 SCOPE centers that were participating at collaborative launch and that provided peritonitis rates for the 13 months prior to launch. Changes in bundle compliance were assessed using either a logistic regression model or a generalized linear mixed model. Changes in average annualized peritonitis rates over time were illustrated using the latter model. In the first 36 months of the collaborative, 644 patients with 7977 follow-up encounters were included. The likelihood of compliance with follow-up care practices increased significantly (odds ratio 1.15, 95% confidence interval 1.10, 1.19). Mean monthly peritonitis rates significantly decreased from 0.63 episodes per patient year (95% confidence interval 0.43, 0.92) prelaunch to 0.42 (95% confidence interval 0.31, 0.57) at 36 months postlaunch. A sensitivity analysis confirmed that as mean follow-up compliance increased, peritonitis rates decreased, reaching statistical significance at 80% at which point the prelaunch rate was 42% higher than the rate in the months following achievement of 80% compliance. In its first 3 years, the SCOPE Collaborative has increased the implementation of standardized follow-up care and demonstrated a significant reduction in average monthly peritonitis rates.<br /> (Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Follow-Up Studies
Guidelines as Topic
Humans
Infant
Infant, Newborn
Male
Odds Ratio
Patient Compliance
Peritoneal Dialysis adverse effects
Peritonitis etiology
Quality Improvement standards
Aftercare standards
Guideline Adherence standards
Kidney Failure, Chronic therapy
Patient Care Bundles standards
Peritoneal Dialysis standards
Peritonitis epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1523-1755
- Volume :
- 89
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Kidney international
- Publication Type :
- Academic Journal
- Accession number :
- 27165827
- Full Text :
- https://doi.org/10.1016/j.kint.2016.02.015