PATIENT EDUCATION

Ensure PD education program is underway, including the following topics:

• Home dialysis concept
• Basics of PD therapy
• Permanency of catheter until transplantation
• Self-care concept
• Postoperative catheter care
• • Dressing changes following implantation should be restricted to experienced PD staff or trained patients
  • Provide postoperative care instructions and, if applicable, supplies including: soap/alcohol-based hand disinfectants, masks, absorbent dressing (e.g., gauze), tape, and exit-site cleansing agent/skin disinfectant

Review written operative instructions with patient/caregiver:

Preoperative:

• Review catheter placement procedure
• Fast after midnight or at least 8 hours prior to catheter insertion (essential medications are permitted with a sip of water)
• Empty bladder^{1, 3, 5}
• Bowel preparation to evacuate the lower colon in case of previous history of constipation (e.g., polyethylene glycol solution, enema, or a stimulant suppository administered beginning a day or two before the procedure depending on the severity of symptoms)^{1, 3, 5}
• • Avoid using sodium phosphate bowel preps⁸
• Shower or bathe with disinfectant soap on the day of surgery^{1, 3, 5}

Postoperative:

• Keep sterile dressing clean, dry, securely taped for one week unless there is excess drainage or bleeding¹
• Report bleeding, pain, or tenderness immediately
• Report severe cough
• Avoid high intra-abdominal pressure until healed (2 to 6 weeks):
• • Heavy lifting
  • Straining and constipation
  • Pulling with upper extremities during stair climbing
  • No showers until completely healed up to 2 weeks⁵ (2 days in case of embedded catheters)⁷