PD Retention

Can anyone share any suggestions for ways that staff can provide education, support, and encouragement to help more PD patients stay on PD?

My unit fluctuates between 15-22 PD patients. We hold quarterly meetings called “Be the Best You Can Be”, which focus on maximizing life and health. There patients and families come together for socialization, refreshment, and education. We usually meet mid-day or early afternoon because most of our patients are elderly and drive only during day-light hours. These have been so successful, we have had to reserve a meeting room at the local hospital ( no charge).
The PD nurse is very active in the meetings and in encouraging the patients to attend, so we have a very good turn out. Usually 80% or better. I publish a monthly newsletter for the unit and we always post a notice of upcoming meetings, date, location, subject matter, and encourage all interested to attend.
Past subjects have included
1-Exercise- with an exercise physiologist to recommend easy convenient ways to strengthen… like seated push-ups using the arms of your chair, or rising up on tiptoes while holding onto the kitchen counter, etc.
2- Travel- with costumes and decorations- how to plan for it, what to take, where to find a handy heater/cooler which will plug into your cigarette lighter for warming your dialysate bags or keeping EPO cool.
3-Renal Diet- We cut out foods from those color potassium and phosphorus sheets that pharmaceutical firms provide to our dietitians… made a paper buffet, with paper plates, then had the dietitian rate patient selections for healthy choices. Those with too high phosphorus choices were given pretzels (to suggest how easily your bones could break) and those with good choices were awarded pencils. (to suggest how much more difficult it is to break healthy bones). Phosphorus and binder education followed the buffet.
4-Coping with the Holidays- How to de-stress and tone down the customary entertaining, etc. to make it more managable and pleasurable.
5- This month, it will be on anemia management wtih a presentation and refreshments by the Ferrlecit Rep. We expect all but one or two patients to attend… including one who has not yet trained! Each patient will bring one or more friends/family members.

We sometimes ask for ratings ( as with the buffet) regarding how useful the information was, suggestions for future topics. We always ask the dietitian to approve the refreshment list.

Our PD nurse provides excellent training and maintenance care and inspires admiration in her patients. She is very supportive of social work involvement and readily refers patients to me for appropriate issues.

This sounds like a great way to bring people together, to share tips and ideas, and to allow patients to get support from each other that is so essential to staying on a home treatment. It seems like the members of this group could be great recruiters for your PD program. I bet if PD patients had an opportunity to present to your in-center patients (formally or informally) about how great PD is, some of your in-center patients may think more seriously about changing to PD.

I love this idea. We did it once a few years ago to share the reults of a two year study we did. We had almost 100% attendance. You have inspired me to do it again.

If anyone starts an education/support group for your PD patients, please let us know what works and what doesn’t. This way other staff don’t have to reinvent the wheel.

A few years ago, I talked with Cathie Clark at Medical Center Dialysis in Detroit. At that time they had an aerobics class for their PD patients. They even videotaped a routine with costumes and all. Patients that attended learned about safe exercise and built up their strength, flexibiltiy, and endurance while having fun.

One way you can get buy-in from patients for an education/support group is to involve them in the meetings…bringing food for a potluck, surveying them for topics and speakers, etc.

A way you can get buy-in from physicians and staff is to invite them to present. This way they can see how many patients attend and how much they value the education/support. Physicians and other staff may then encourage more patients to attend and the outcome could be that more patients start and stay on PD.

Our PD meeting on Anemia management went very well. We had 16 out of 18 patients present and all brought at least one family member or friend.
We have a “PD Awareness Day” scheduled for Sept 29 and 30. We will be in the waiting room area to catch patients and family during turnover. Several PD patients have volunteered to be there in rotation for a couple of hours to give hemo patients a first hand account of what they like or don’t like about PD.
Our next “Be the Best You Can Be” meeting will be the first part of December and we will have a Baxter person there to answer patient questions about the cycler and trouble shooting. This topic was suggested by a pt at the August meeting.