SAT-271 Using Plan-Do-Check-Act Circulation To Reduce The Occurrence Of Peritonitis In PD

Abstract

Using Plan-Do-Check-Act circulation (PDCA) to develop effective interventions and reduce the occurrence of peritonitis in patients with peritoneal dialysis (PD). A quality control team was established in our department. All patients with peritonitis occurring between 1 July 2016 and 31 December 2016 (pre-PDCA period) were analyzed and compared with data obtained between January 2017 (implementation of PDCA) and 31 December 2018 to investigate possible causes of peritonitis and to develop corresponding interventions. Fishbone analysis, including laboratory parameters, was carried out monthly. The overall rate of peritonitis was 0.24 episodes per year of PD in 2016 before the PDCA, and decreased to 0.18, 0.15 episodes per year between 2017 and 2018 after PDCA (p<0.05). The incidence of peritonitis caused by Gram-positive bacteria reduced from 0.15 in 2016 to 0.06 and 0.03 episodes per year between 2017 and 2018 (p<0.05), the incidence of Gram-negative bacteria peritonitis remained static. While the incidence of Culture-negative peritonitis increased from 0.06 in 2016 to 0.05 and 0.09 episodes per year between 2017 and 2018 (p<0.05). Nonstandard procedures, gastrointestinal tract dysfunction, and immune system disorder (got peritonitis after other infection) were found to be the top three risk factors for peritonitis. Nonstandard procedures was the most likely cause of peritonitis in 61% of the subjects in 2016 and decreased to 33% and 21% between 2017 and 2018 (p<0.05). PDCA can effectively reduce the occurrence of PD-related peritonitis.

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