特集名 | [特集]腎不全医療におけるクリニカルパスの再考 | |
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題名 | 各病態におけるクリニカルパス (4) CAPD腹膜炎 | |
発刊年月 | 2005年 03月 | |
著者 | 森石 みさき | あかね会中島土谷クリニック/土谷総合病院人工臓器部 |
著者 | 川西 秀樹 | 土谷総合病院人工臓器部 |
著者 | 渡部 恵理子 | 土谷総合病院看護師 |
【 要旨 】 | CAPD腹膜炎は緊急疾患であり個々の臨床症状が異なるため、治療のスケジュール化は難しく,工夫を要する.今回,腹膜炎治療の標準化,看護の省力化,リスクマネジメントを目的として,CAPD腹膜炎クリニカルパスを作成した.その結果,クリニカルパス導入前2年間に発生した腹膜炎27例と,導入後2年間に発生した37例を比較すると,治癒例の平均入院期間は導入前14.6±7.9日(23/27例,85.2%)から導入後12.8±5.8日(33/37例,89.2%)に短縮し,難治性腹膜炎例での腹膜カテーテル抜去までの期間が導入前23.5±9.0日(4/27例,14.8%)から導入後13.8±2.6日(4/37例,10.8%)に短縮した (p<0.08). クリニカルパスはCAPD腹膜炎の管理に有効であり,今後,個別の臨床経過に対応できる形式に変更し,総合医療管理ツールとして活用できる. |
Theme | Revisit of Clinical Path in Renal Replacement Therapy | |
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Title | Clinical pathway for CAPD peritonitis | |
Author | Misaki Moriishi | Akane Foundation Nakajima Tsuchiya Clinic / Department of Artificial Organ, Akane Foundation Tsuchiya General Hospital |
Author | Hideki Kawanishi | Department of Artificial Organ, Akane Foundation Tsuchiya General Hospital |
Author | Eriko Watanabe | Department of Nursing, Akane Foundation Tsuchiya General Hospital |
[ Summary ] | Since the introduction of peritoneal dialysis (PD) peritonitis has become an acute disease with various clinical symptoms, for which it is difficult to establish a treatment schedule. For the purpose of standardization of CAPD peritonitis treatment, to save nursing work hours and improve risk management, we developed a clinical pathway for treatment of CAPD peritonitis. In this study, we evaluated 64 patients with peritonitis for 2 years before and after the introduction of the clinical pathway (27 patients before the introduction, 37 patients after the introduction). The mean admission period for recovered cases was 14.6±7.9 days (23/27 patients, 85.2 %) before the introduction and 12.8±5.8 days (33/37 patients, 89.2 %) after the introduction. In patients who failed to demonstrate clinical improvements, the mean period between the start of peritoneal treatment and peritoneal catheter removal was reduced from 23.5±9.0 days (4/27 patients, 14.8) before the introduction to 13.8±2.6 days (4/37 patients, 10.8 %) after the introduction. The clinical pathway is useful for management of CAPD peritonitis. In the future, the clinical pathway for CAPD peritonitis will make it possible to utilize this as a tool to integrate medical treatment, by making changes in clinical courses. |