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We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience. Necessary Necessary. Although patients are provided with these manuals to guide them in addressing these alarms, most patients tend to look at the display screen for guidance rather than refer to the large manual.
If future models of the cyclers incorporated features of more specific alarm trouble shooting and guiding patients via the display screen, it would certainly make the cycler even more user friendly.
Numerical data are entered using arrow keys to adjust values. An optional, compact keyboard for data entry could be a more user friendly and feasible future alternative. Many patients with end-stage renal disease are elderly, and the level of their technical education and experience varies widely. Some may initially perceive the cycler as being complicated, and are doubtful regarding their ability to learn to perform CCPD.
These patients need reassurance about the ease of use of the newer cycler models, its advantages, the support system available via the dialysis unit, on-call PD nurses, and help lines provided by Baxter and Fresenius.
We propose a future opportunity for development to be the capability of remote live access to cyclers. This would be particularly comforting for the elderly patients who may be initially fearful. Although help-lines and on call PD nurses are currently available as mentioned, live support would be a stronger backup for these patients. Baxter already offers a feature of phone line and modem use to transfer therapy information on the Pro Card to the dialysis unit, hence remote live access of the cycler may be the next step in development for future cyclers.
The need for re-training patients with reminders of key techniques and providing refreshers in sterile techniques during connections was a common need among many of the centers we surveyed. Additionally, despite home visits, staff are unable to mock a full home treatment and have to teach in sections, while trying to fast forward through sections they are not focusing on at that time.
This may make it difficult for the learner, and it can take up to a week of performing CCPD at home before it all comes together for the patients. Both Baxter and Fresenius provide help lines available to patients and staff. We have received good feedback in our survey from the nursing staff, about the support provided to patients via these help lines, where company representatives are able to assist with trouble-shooting problems.
Although few patients make this transition, we wanted to explore what factors contribute to this decision. One common reason appears to be a persistently positional catheter that will not drain unless the patient sits or stands. This causes the cycler to alarm every time it attempts to drain unsuccessfully while the patient is asleep. We have one case where the patient sets an alarm clock and awakens to sit up in bed to allow the cycler to drain with each exchange.
Of course, this is a tedious and impractical choice for many other individuals and has resulted in patients preferring to perform CAPD during the day. Both Fresenius and Baxter models now provide the feature of a digital card that can store dialysis therapy information for patients varying from 30 days to 90 days, depending on the cycler model and size of the card. The dialysis unit can then download this information during the monthly visits.
The digital cards are certainly a convenient and efficient method of transferring therapy details and work well for many patients.
However, there have been occasional problems encountered with the digital cards where at times some therapies and, at other times, complete therapy information is deleted or missing on reliable patients. In addition, some patients forget to bring their Pro Cards to their monthly visits at times. Here, the Baxter feature of therapy transfer via a modem and phone line can be a key solution. The cycler is a major advancement in the field of PD and has improved the convenience and efficiency of PD for a large number of patients.
Both Baxter and Fresenius continue to work on technical advancements, and newer models of the cycler are in the development phase, to be available in the near future. Have you had problems with transferring data from the Pro Card to your operating system? National Center for Biotechnology Information , U. Journal List Med Devices Auckl v. Med Devices Auckl.
Published online Jan Author information Copyright and License information Disclaimer. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
This article has been cited by other articles in PMC. Abstract Peritoneal dialysis PD is a widely accepted and increasingly popular form of dialysis. Keywords: peritoneal dialysis, automated peritoneal dialysis, cycler peritoneal dialysis. Introduction The concept of peritoneal dialysis PD first surfaced in the late s, but George Ganter was the first scientist to formally publish the trials of PD, as reviewed by Palmer.
Cycler components include: — heater, — cassette with chambers and valves, — dialysate bag, and — drain bag 15 L or drain into commode. Increased intra-peritoneal volume or overfill and drain pain Overfill or increased intraperitoneal volume is a complication inherent to the current modes of operation of the PD cycler, and not specific or limited to a particular model, manufacturer, or technique.
Alarms While the purpose of alarms that were built into the cyclers is to ensure patient safety and use of proper technique, they can sometimes pose challenges for the patients and staff.
Data entry Numerical data are entered using arrow keys to adjust values. Challenges perceived by patients Many patients with end-stage renal disease are elderly, and the level of their technical education and experience varies widely. Challenges faced by nursing staff The need for re-training patients with reminders of key techniques and providing refreshers in sterile techniques during connections was a common need among many of the centers we surveyed.
Company support Both Baxter and Fresenius provide help lines available to patients and staff. Digital card Both Fresenius and Baxter models now provide the feature of a digital card that can store dialysis therapy information for patients varying from 30 days to 90 days, depending on the cycler model and size of the card.
Supplementary material Survey for PD nurses What three problems do you face most frequently in operating the cycler? What would you change in the cycler if you could? What are the three major challenges in training the patients to use the cycler? What three complications do you feel patients develop most on the cycler?
Why do patients transition off cycler to manual PD? Footnotes Disclosure The authors report no conflicts of interest in this work. References 1. Ganter G. Uber die beseitigung giftiger stoffe aus dem blute durch dialyse. Munvpch Med Wschr. Palmer R. As it was in the beginning: a history of peritoneal dialysis. Both groups were similar in age, race, gender, and presence of diabetes mellitus, coronary artery disease, peripheral vascular disease, and gastrointestinal disease.
There was no difference in the overall rate of peritonitis between the two groups of patients [1 episode in The rates of Staphylococcus aureus peritonitis [1 episode in
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