Impact of continuous quality improvement on reducing the incidence of peritoneal dialysis-related peritonitis in patients within the first year of peritoneal dialysis initiation
10.3760/cma.j.cn441217-20200205-00107
- VernacularTitle:持续质量改进对降低腹膜透析患者首年腹膜透析相关性腹膜炎发生率的作用
- Author:
Jianxiong LIN
1
;
Chunyan YI
;
Xiaoli YU
;
Xiaodan ZHANG
;
Xiaofeng WU
;
Xiao YANG
;
Haiping MAO
;
Xueqing YU
Author Information
1. 中山大学附属第一医院肾内科，广州 510080；中山大学附属第一医院卫生部重点实验室，广州 510080
- From:
Chinese Journal of Nephrology
2020;36(8):588-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of continuous quality improvement (CQI) on reducing the incidence of peritoneal dialysis (PD)-related peritonitis in patients within the first year of PD initiation.Methods:The patients who received catheter placement from January 2006 to December 2016 in our hospital were enrolled in this study. All patients were divided into four groups: pre-CQI group patients who initiated PD treatment from 2006 to 2007 (before CQI phase, group A), CQI Ⅰphrase patients who initiated PD treatment from 2008 to 2010 (group B), CQI Ⅱ phrase patients who initiated PD treatment from 2011 to 2013 (group C), and CQI Ⅲ phrase patients who initiated PD treatment from 2014 to 2016 (group D). The method of plan, do, check and act (PDCA) was conducted to decrease the incidence of PDRP. All the patients were followed up for 12 months or until they withdrew from PD in this period. Poisson analysis was used to compare the incidence of PDRP among the groups.Results:There were 2 383 PD patients recruited in this study, including 346 cases in group A, 850 cases in group B, 688 cases in group C and 499 cases in group D, with an age of (47.1±15.8) years, among whom 59.1% of the patients were male, and 21.4% with diabetes. The follow-up time was (10.9±2.8) months. Compared with group A, the incidence of PDRP was lower than that in group C (0.156 episodes/patient year vs 0.234 episodes/patient year, P=0.020); the incidence of gram positive PDRP decreased (0.052, 0.049, 0.054 episodes/patient year vs 0.104 episodes/patient year, all P<0.05) in group B, C, D; the incidence of gram negative PDRP increased in group B, then decreased in group C and group D (all P>0.05). Cox regression analysis indicated that CQI was independently associated with the incidence of gram positive PDRP ( HR=0.526, 95% CI 0.349-0.792, P=0.002). Conclusion:CQI can effectively reduce the incidence of gram positive PDRP in patients within the first year of PD initiation.
