Diseño de un protocolo para el cambio de prolongador en Diálisis Peritoneal

Abstract

Changing the extension tube in peritoneal dialysis equipment is an intervention for which nursing is responsible, and which must be carried out following a protocol that minimizes the risk of contamination and, therefore, the appearance of peritonitis. There are no clear and unanimous recommendations on how to disinfect connectors, as this will depend basically on whether or not the catheter connector is made of titanium, and how the new extension tube should be fitted. Objective: To determine how extension tubes are changed in the different renal units in Spain, in order to reach a consensus as to the most adequate procedure. Material and method: Descriptive transversal study carried out in February 2008 based on a structure self-completed questionnaire of our own design that guaranteed validity and reliability. The questionnaire recorded the experience of the person surveyed in the filed of PD, the system used, and compliance with the items considered fundamental for good practice in the extension tube replacement procedure, based on the literature consulted and the recommendation of PD product suppliers. Results: Questionnaires were obtained from 53 nurses who stated that they had experience in PD of between 3 months and 32 years. The degree of compliance of the actions necessary to change the extension tube (washing hands, preparing sterile field, washing the connector) was between 95 and 100%, while the items of disinfection the connector and draining the peritoneal liquid after the change obtained degrees of compliance of between 28 and 83%. Conclusions: Our study presents limitations, as it aimed to be an initial prospective study of the matter. More in-depth study is required to reach a consensus as to a valid protocol for replacing extension tubes for any of the systems offered by the industry and define very clearly the connector disinfection process and the advisability or otherwise of complete peritoneal replacement after the change.