Authors (including presenting author) :
Cheung SF(1), Yue TT(1), Kwok LM(1), Tam YY(1), CHI CO(1), Chan SK(1), Lok WP(1), Wong Allison(2), Po YT(2), Kwok Roy(2), Kwok KY(2)
Affiliation :
(1) Department of Medicine, Yan Chai Hospital, (2) Department of Occupational Therapy, Yan Chai Hospital
Introduction :
The incidence and prevalence of patients with end stage renal failure (ESRF) requiring renal replacement therapy (RRT) have been increasing in Hong Kong. According to Hong Kong Renal Registry, over 9500 patients required RRT in 2017. Peritoneal dialysis (PD) has been the predominant modality of RRT in Hong Kong. PD can be performed by patients or helpers, depending on their physical or mental capacity. Although helper-assisted PD is an acceptable treatment, there are significant impacts on autonomy and quality of life of patients, carer burden and community healthcare system. Patients with ESRF and physical limitation to perform independent PD catheter connection will be identified by renal specialty nurses. Occupational therapist will assess the need of PD assistive device. The PD connection device will be prescribed for those who fail the 100% hit of connection of catheters. PD connection device aim at 100% hit of the connection of renal catheter and the transfer set of Ultrabag.
Objectives :
1. Involvement of occupational therapy in prescription of PD connection device. 2. Before the application of the device, ESRF patient who cannot perform independent CAPD will move to old aged home if there is no helper for CAPD. The connection device empowered patient for self-management of independent CAPD at home. 3. With the accuracy of the connections, peritonitis rate and re-admission are reduced. 4. The quality of life of CAPD patient was improved.
Methodology :
The peritoneal dialysis connection device is modified from original assistive device which can serve 2 purpose in connection during CAPD: 1) connection of renal catheter and transfer set of Ultra bag 2)Capping of disinfected cap ESRF patient who has physical limitations such as hand tremor, , poor hand eye hand coordination cannot perform 100% hit to the connections. The device can help patient with hand tremor by providing stable stand for renal catheter during connection. It also enhances the accuracy of the connections by providing guidance so as to achieve 100% hit. The device can also allow patient with stroke to perform CAPD independently with one handed technique.
Result & Outcome :
Seven patients were prescribed the PD connection device from Feb 2018 to Nov 2018. There is no incident of Peritonitis happened for all patients after the use the device.