Assignment: Peritoneal Dialysis

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Assignment: Peritoneal Dialysis

Assignment: Peritoneal Dialysis

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Model showed bundle saved 0.8 CLABSI and 0.3 lives per 100 patients Increased survival by 3.55 years and 2.72 QALYs

Identified need for standardized definitions for blood stream infections

Garrison & Beverage (2018)

Process for NPD tracking ROI to increase awareness

Reviewed 2 projects: peritoneal dialysis (PD) and colon clean closure (Colon).

PD: Results are 91% ROI; staff comfort level went from 2.8 to 4.2

Colon: 409% ROI if reduction of one SSI; staff comfort level was measured as 4.11

PD: Quarterly PD review, three stations with education and return demonstration

Colon: 30-minute live, poster presentations and electronic learning module

PD: Increased nurse comfort level with PD; decreased LOS by 1 day/ year; measured nurse comfort level and learning needs assessment

Colon: Reduced SSI rates and increased comfort level of nursing staff to prevent SSIs

Kram et al. (2015)

ABCDE bundle, delirium, EBP

Awakening, breathing, coordination, delirium, and early mobility

Saved an average of $2,156 per patient

Did not provide the cost of educating staff

Live CE in evidence for bundle; live CE on proper administration of ICDSC tool; online module and paper version available

Decreased average LOS by 1.8 days; reduced length of mechanical ventilation by 1 day; established baseline delirium prevalence of 19% over 3 months

Young et al. (2015)

Quasiexperimental, quality improvement project with pre- and postmeasurement design

$27,019 cost education (84 nurses; 41 PCTs)

Cost to care for single stage PrU can be up to $130,000, making this a good investment

Implementation of MEDLINE Pressure Ulcer Prevention program & Tracked for 24 months & Training: RN 7.5 hours, PCT 5.5 hours

& New skin care products & Algorithm for tx protocols

Significant reduction in nosocomial PrU preprogram (mean = 5.9) and postprogram (mean = 0.2)

Facility had nearly 6 PrUs per month, reduced to nearly 0

Note. CE = Continuing Education program; CLABSI = central line-associated bloodstream infections; ICDSC = Intensive Care Delirium Screening Check- list; LOS = length of stay; NPD = nursing professional development; PCTs = patient care technicians; PrU = pressure ulcer; QALYs = quality-adjusted life- years; ROI = return on investment; SSI = Surgical Site Infection; tx = treatment.

304 www.jnpdonline.com November/December 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

for two different programs: Peritoneal Dialysis Quarterly Review (reduce length of stay) and a Colon Clean Closure program (reduced surgical site infection). In 2017, their NPDpractitioners challenged themselves to each completed an ROI calculation for at least one project, resulting in a to- tal of 13 calculations. From this effort, they reported an increased awareness of program effectiveness and eco- nomic impaAssignment: Peritoneal Dialysisarrison and Beverage listed lessons learned as the need to (a) identify an economic impact leader within NPD; (b) repeatedly revisit the topic with articles, examples, and reminders to keep NPD practi- tioners engaged; (c) lead by example

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