Winner Development of telemedicine-enhanced peritoneal dialysis training protocols during COVID-19
Our goal is to facilitate peritoneal dialysis (PD) training using telemedicine to supplement in-person training visits and minimize potential COVID-19 exposure.
Training a patient for PD takes approximately two half-day visits per week for four weeks. During the height of the COVID-19 pandemic in New York City, we utilized telemedicine visits to reduce the number of patients physically present in the PD unit. With COVID-19 cases rising again, we have seen increased local interest in PD as an alternative to in-center hemodialysis.
We propose to develop and expand existing PD training protocols using telemedicine and videos to teach correct PD techniques. A digital curriculum will be created with PD training nurses demonstrating each training step on video, such as appropriate hand-washing or aseptic connection. During the scheduled telemedicine training visits, patients will demonstrate the technique on a PD apron and receive real-time teaching from the PD training nurse similar to a traditional in-person training visit. The nurse will verify that the patient meets appropriate training milestones prior to moving on to the next step.
All members of the interdisciplinary team can also utilize telemedicine during training to provide counseling regarding nutrition and social concerns. In-person visits will be required to verify training milestones using the patient's catheter and at the conclusion of training to ensure that patients meet all requirements to begin PD at home.
Implementation and adaptability
This novel PD training protocol is a low-cost, reproducible solution that could be rapidly deployed by existing home training units nationwide. Most dialysis centers, clinics, and hospitals already have telemedicine infrastructure in place during COVID-19. Training videos would be made publicly available upon request. The success of this program would provide proof of concept that telemedicine can be used to supplement traditional in-person patient care to promote maximum safety from COVID-19 and improved efficiency of in-person visits. The training schedule can be rapidly disseminated and tailored to each individual organization and patient. Telemedicine visits can be added as needed should patients need more support. Lastly, additional in-person visits will always remain an option, but we believe many PD patients would successfully complete training using the outlined approach.