Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care

2.50
Hdl Handle:
http://hdl.handle.net/10755/163853
Category:
Abstract
Type:
Article
Level of Evidence:
Systematic Review
Research Approach:
Translational Research/Evidence-based Practice
Title:
Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care
Author(s):
Lockwood, Craig; Hodgkinson, Brent; Page, Tamara
Author Details:
Craig Lockwood, RN, BN, GradDip(ClinNurs), MNSC, Associate Director, Department of Clinical Nursing, Royal Adelaide Hospital, North Terrace, Adelaide, Australia, email: craig.lockwood@adelaide.edu.au; Brent Hodgkinson, MSc; Tamara Page, RN, BN, HyperbaricNursCert, GradDipNSc(HighDep)
Abstract:
Objective: The objective of this review was to appraise and synthesise the best available evidence on the clinical effectiveness of peritoneal dialysis catheter exit-site care. Inclusion criteria: This review considered all randomised controlled trials that evaluated the effectiveness of peritoneal exit-site care. In the absence of randomised controlled trials, other controlled research designs such as non-randomised controlled trials were considered for inclusion in a narrative summary to enable the identification of current approaches and possible future strategies. Participants of interest were adults with chronic renal failure on maintenance peritoneal dialysis. Interventions of interest were those used to manage peritoneal catheter exit sites, and included types of dressings, frequency of dressings, types of skin care, and use of topical antiseptic or antimicrobial agents. Search strategy: The search sought to find both published and unpublished studies. An initial limited search of MEDLINE and CINAHL databases was undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant articles. A second extensive search was undertaken using all identified key words and index terms. The third step was a search of the reference lists and bibliographies of all relevant articles. Methodological quality: All identified studies that met the inclusion criteria were assessed for methodological validity by two reviewers prior to inclusion in the review. Critical appraisal of studies focused on identifying bias in selection, performance, attrition and detection. Results: This review found few studies of sufficient quality to meet the inclusion criteria. The included studies often utilised historical control groups, potentially confounding measurement of their outcomes. The outcome measures varied considerably, thus meta-analysis was not possible. Conclusions: This review suggests topical mupirocin may reduce the risk of exit-site infection; however, the clinical effectiveness of any one antibiotic, antiseptic or dressing procedure was not established for the prevention or reduction of exit-site infection rates or peritonitis. This review has underlined large gaps in the existing knowledge on the care of exit sites in patients on peritoneal dialysis.
Keywords:
Catheter Care; Catheters, Dialysis; Peritoneal Dialysis
Repository Posting Date:
27-Oct-2011
Date of Publication:
2003
Citation:
Lockwood, C., Hodgkinson, B., & Page, T. (2003). Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care.�JBI Reports,�1(6), 167-201.
Publisher:
Joanna Briggs Institute
Conference Date:
2006
Conference Name:
Joanna Briggs Institute 2006 International Convention
Conference Host:
Joanna Briggs Institute
Conference Location:
Hilton Adelaide, South Australia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typeArticleen_GB
dc.evidence.levelSystematic Reviewen_US
dc.research.approachTranslational Research/Evidence-based Practiceen_US
dc.titleClinical effectiveness of different approaches to peritoneal dialysis catheter exit-site careen_GB
dc.contributor.authorLockwood, Craigen_US
dc.contributor.authorHodgkinson, Brenten_US
dc.contributor.authorPage, Tamaraen_US
dc.author.detailsCraig Lockwood, RN, BN, GradDip(ClinNurs), MNSC, Associate Director, Department of Clinical Nursing, Royal Adelaide Hospital, North Terrace, Adelaide, Australia, email: craig.lockwood@adelaide.edu.au; Brent Hodgkinson, MSc; Tamara Page, RN, BN, HyperbaricNursCert, GradDipNSc(HighDep)en_US
dc.identifier.urihttp://hdl.handle.net/10755/163853-
dc.description.abstractObjective: The objective of this review was to appraise and synthesise the best available evidence on the clinical effectiveness of peritoneal dialysis catheter exit-site care. Inclusion criteria: This review considered all randomised controlled trials that evaluated the effectiveness of peritoneal exit-site care. In the absence of randomised controlled trials, other controlled research designs such as non-randomised controlled trials were considered for inclusion in a narrative summary to enable the identification of current approaches and possible future strategies. Participants of interest were adults with chronic renal failure on maintenance peritoneal dialysis. Interventions of interest were those used to manage peritoneal catheter exit sites, and included types of dressings, frequency of dressings, types of skin care, and use of topical antiseptic or antimicrobial agents. Search strategy: The search sought to find both published and unpublished studies. An initial limited search of MEDLINE and CINAHL databases was undertaken to identify key words contained in the title or abstract, and index terms used to describe relevant articles. A second extensive search was undertaken using all identified key words and index terms. The third step was a search of the reference lists and bibliographies of all relevant articles. Methodological quality: All identified studies that met the inclusion criteria were assessed for methodological validity by two reviewers prior to inclusion in the review. Critical appraisal of studies focused on identifying bias in selection, performance, attrition and detection. Results: This review found few studies of sufficient quality to meet the inclusion criteria. The included studies often utilised historical control groups, potentially confounding measurement of their outcomes. The outcome measures varied considerably, thus meta-analysis was not possible. Conclusions: This review suggests topical mupirocin may reduce the risk of exit-site infection; however, the clinical effectiveness of any one antibiotic, antiseptic or dressing procedure was not established for the prevention or reduction of exit-site infection rates or peritonitis. This review has underlined large gaps in the existing knowledge on the care of exit sites in patients on peritoneal dialysis.en_GB
dc.subjectCatheter Careen_US
dc.subjectCatheters, Dialysisen_US
dc.subjectPeritoneal Dialysisen_US
dc.date.available2011-10-27T11:30:46Z-
dc.date.issued2003en_GB
dc.date.accessioned2011-10-27T11:30:46Z-
dc.identifier.citationLockwood, C., Hodgkinson, B., & Page, T. (2003). Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care.�JBI Reports,�1(6), 167-201.en_US
dc.publisherJoanna Briggs Instituteen_US
dc.identifier.issn1479-697X-
dc.conference.date2006-
dc.conference.nameJoanna Briggs Institute 2006 International Convention-
dc.conference.hostJoanna Briggs Institute-
dc.conference.locationHilton Adelaide, South Australia-
dc.identifier.citationLockwood, C., Hodgkinson, B., & Page, T. (2003). Clinical effectiveness of different approaches to peritoneal dialysis catheter exit-site care.�JBI Reports,�1(6), 167-201.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.-
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