Exit site care in the Netherlands: the use of guidelines in practice

Hoekstra, Bettie; Vries-Hoogsteen, Anneke de; Winkels, Bieneke; Zevenbergen-Osinga, Helma; Thijssen-Broers, Ingrid; Bellemakers, Trian; Pd, Vreede

doi:10.1111/jorc.12199

Cited by 8 publications

(12 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Swimming in sea water was recommended by most units in this study, which is consistent with recommendations found in the literature (13–15). Swimming in private swimming pools but not public pools was also mostly recommended and align with recommendations from Austrian PD units (15).…”

Section: Discussionsupporting

confidence: 89%

“…The majority of PD units in this study recommend covering the PD catheter and exit site with either a clear waterproof dressing or colostomy bag for patients who swim, which are similar to recommendations from the literature (14)(15)(16)(17)(18)(19)(20)(21)(22). There is no evidence to suggest one dressing or covering is superior to the other or that no dressing/covering at all puts patients at increased risk.…”

Section: Discussionsupporting

confidence: 67%

“…Literature regarding practice patterns is scant. A survey of PD centers to evaluate the use of PD exit-site guidelines from the Netherlands found that most centers allowed people on PD to bathe, swim, or visit a sauna but precautions or safeguards were not consistent (14).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Swimming on Peritoneal Dialysis: Recommendations from Australian PD Units

Lee

2019

Perit Dial Int

View full text Add to dashboard Cite

Background There is no evidence to support the need for protection of the peritoneal dialysis (PD) catheter and exit site for people on PD who want to swim. Swimming with a PD catheter is perceived to potentially put that person at increased risk of infection. Objectives of this study were to determine the proportion of Australian PD units supporting swimming for people on PD, recommendations made to protect the PD catheter, and exit site and any subsequent infective complications. Method Phone surveys were conducted with PD nurses from a cross section of 39 Australian PD units. Results Almost all units reported that patients on PD do swim despite only 77% of units advocating swimming. Swimming in sea water (85%) or a private swimming pool (90%) is mostly recommended. Covering the exit site and PD catheter is recommended with a waterproof film dressing or colostomy bag. Performing routine exit-site care after swimming is recommended (100%). There were 7 reported exit-site infections and 2 episodes of peritonitis perceived to be associated with swimming with a PD catheter. Conclusion Most PD units in Australia report that patients on PD swim. Swimming is recommended in either sea water or private swimming pools. The PD catheter and exit site should be covered with either a clear waterproof dressing or colostomy bag. Routine exit-site care should be performed after swimming. Infections were rarely reported in those who swim. Until further research is available, best practice recommendations are warranted for the safety of those on PD who want to swim.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 67%

See 1 more Smart Citation

Swimming on Peritoneal Dialysis: Recommendations from Australian PD Units

Lee

2019

Perit Dial Int

View full text Add to dashboard Cite

show abstract

“…The Dutch dialysis quality improvement system is increasingly promoting dialysis guidelines. In line with Hoekstra et al (2017) who demonstrated improved care for exit sites in the Netherlands after widespread guideline implementation.…”

Section: Discussionsupporting

confidence: 57%

Changing Nursing Care Time as an Effect of Changed Characteristics of the Dialysis Population

Kleijn

Groot

Hagen

et al. 2020

Journal of Renal Care

View full text Add to dashboard Cite

Background: The population of dialysis patients is ageing. Dialysis nurses are confronted with geriatric patients with multiple comorbidities. Nurses are confronted with an increasing burden of care. Objectives: The present study focused on the question of whether, over time, the increasing age and comorbidities of the haemodialysis population increased nursing care time. Furthermore, we studied potential changes in the predictors of the required nursing time. Design: Observational study. Participants: A total of 980 dialysis patients from 12 dialysis centres were included. Measurements: Nurses filled out the classification tool for each patient and completed a form for reporting patient characteristics for groups of relevant haemodialysis patients at baseline and after 1 and four years. Changes in patient and dialysis characteristics were analysed, as well as the estimated nursing care time needed. Results: An increase in the nursing time needed for dialysis was largely due to decreased mobility, closing of the vascular access and a greater need for psychosocial attention and was most strongly present in incident dialysis patients. The time needed for dialysis decreased as patient participation increased and vascular access changed from catheters to fistulae. Over the four-year period, the average overall needed nursing care time per haemodialysis session did not change. Conclusions: Our study shows that the average nursing time needed per patient did not change in the four-year observation period. However, more time is required for incident patients; thus, if a centre has high patient turnover, more nursing care time is needed.

show abstract

“…As for the fixation method, Hoekstra et al. (2017) conducted three surveys on all dialysis centres in the Netherlands in 2002, 2009, and 2016 and found that patients on PD generally used belt for catheter fixation and used tape or band‐aid to strengthen the fixation.…”

Section: Introductionmentioning

confidence: 99%

Daily self‐care practices influence exit‐site condition in patients having peritoneal dialysis: A multicenter cross‐sectional survey

Ding

Huang

Liao

et al. 2021

Journal of Advanced Nursing

View full text Add to dashboard Cite

Aims To investigate practice patterns in exit‐site care and identify the risk factors for exit‐site infection. Design A quantitative cross‐sectional design. Methods Data were collected in 12 peritoneal dialysis (PD) centres in 2018. Daily exit‐site care practice patterns and exit‐site status of patients receiving PD were assessed through interviews and questionnaires. Results/findings Most of the 1,204 patients adhered with the protocols about main aspects of exit‐site care, such as cleansing agents selection, frequency of cleansing, catheter fixation, and following the catheter protective measures. However, their adherence levels on hand hygiene, mask wearing, observing exit site, examining secretion, and communicating with PD staff were rather low. Eighty‐four patients' exit sites were evaluated as problematic exit site (PES). And 186 patients had catheter‐related infection (CRI) history. After multivariable logistic regression analysis, diabetes (OR = 1.631), traction bleeding history (OR = 2.697), antibiotic agents use (OR = 2.460), compliance on mask wearing (OR = 0.794), and observing exit site (OR = 0.806) were influencing factors of CRI history. Traction bleeding history (OR = 2.436), CRI history (OR = 10.280), and effective communication (OR = 0.808) with PD staff were influencing factors for PES. Conclusions The adherence levels on different aspects of exit‐site care were varied in patients having PD. Their self‐care behaviours did correlate with the exit‐site status. Impact The adherence level of patients’ exit‐site care practice needs attention of medical staff. Further studies about the optimal procedure in exit‐site care were warranted.

show abstract

Exit site care in the Netherlands: the use of guidelines in practice

Cited by 8 publications

References 14 publications

Swimming on Peritoneal Dialysis: Recommendations from Australian PD Units

Swimming on Peritoneal Dialysis: Recommendations from Australian PD Units

Changing Nursing Care Time as an Effect of Changed Characteristics of the Dialysis Population

Daily self‐care practices influence exit‐site condition in patients having peritoneal dialysis: A multicenter cross‐sectional survey

Contact Info

Product

Resources

About