Moment of Truth

I am a Nurse working full time in a Home Peritoneal Dialysis program. A large part of of my job is training new patients to do their treatments at home. Also in our system it is often necessary to train a spouse or assistant caregiver to aid the patient or sometimes completely control the treatment process.

There are many aspects to delivering and maintaining continued safe practices inside the realm of Peritoneal Dialysis but I believe the most important thing overall is the actual connection and disconnection of the patient catheter to the Peritoneal Dialysis system. This is what I refer to as "the moment of truth" and I actually use this phrase when training patients.

Infection (Peritonitis) is the number one problem that a Peritoneal Dialysis(PD) patient may encounter while on this modality of treatment. If a patient does develop Peritonitis they may be able to remain on PD with the aid of Antibiotic treatment, they may have to come off of PD temporarily to heal and rest their system or they may not be able to do PD at all again.

There are several ways that the PD patient may contract peritonitis but a very common reason is a touch contamination during connections and disconnections to the system. The patient connection is accomplished in a matter of seconds but must be continually meticulously executed using sterile technique in an attempt to continue on this modality of dialysis.
The mechanics of the connections are quite simple and very user friendly. There are differing brand names of PD equipment but the patient to system connection is very similar across the board. At the moment of truth the patient or caregiver has to remove a sterile cap from the end of their patient line and remove a sterile cap from the PD system line and make a safe quick connection. Once this union is made the circut is closed off to the outside world and the exchange of PD fluid can now occur in a sterile fashion. At the end of the PD fluid exchange the same careful technique is used to disconnect from the PD fluid line and a new sterile cap is placed onto the patient line. These patient to PD system connections are basically the same whether using a manual or automated PD system.

That's all for now on this topic. In one of my future posts I will discuss preparing for the "moment of truth". So to all you PD patients and PD trainers never fall short of that meticulous PD mindset.