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Program Overview
Learning Objectives
Target Audience
Credit Designation

Activity overview/background

This curriculum is designed to help local dialysis programs develop effective ambulatory peritoneal dialysis programs in low-resource settings. 

Estimated time to complete this activity 

Each Module: 30min-1hr | Entire Curriculum: 10 hours

Target Audience 

Nursing officers/nurses: Trained in general care of patients with and without kidney disease. Formal training in kidney medicine not required.
Medical officers/physicians: Having completed medical school and residency or other practical training in general medicine. Formal training in kidney medicine not required.
Nephrologists/kidney physicians: Physicians who have completed advanced training in kidney medicine.
Healthcare assistants: Individuals with minimal or no formal medical training who assist in the organization and care of patients. 

 

Learning Objectives:

See next tab. 

 

Disclosures

None

 

Components of the activity and Method of Participation

The accredited activity contains the following modules to be completed:
- 1 Pre-Assessment Test

- 10 Video Modules with Post-Quizzes

- 1 Post-Test Final Evaluation

e-Curriculum Facilitators:

Dr. Anjali Saxena
Dr. Anjali Bhatt Saxena, MD is a Clinical Associate Professor of Medicine at Stanford University School of Medicine and Director of Peritoneal Dialysis at the Santa Clara Valley Medical Center (SCVMC) in San Jose, California. Dr. Saxena completed her Bachelors of Science degree at Duke University, received her MD from Wake Forest University, Winston-Salem, North Carolina, and completed both her residency and postdoctoral Nephrology fellowship at Stanford University.
She assumed the role of Treasurer for the International Society for Peritoneal Dialysis (ISPD) in January 2017, and is President of the North American Chapter of the ISPD. She is committed to providing education and support for home dialysis therapies locally, nationally, and internationally. Dr. Saxena is heavily involved in teaching, both in her faculty role in the Stanford Nephrology Fellowship Program (where she serves as site director for Nephrology Fellowship Education), and on many other levels as she educates medical students, interns, residents and practicing Nephrologists. She has been a key faculty member of the Home Dialysis University Program, jointly sponsored by ISPD and Wake Forest University, since 2007 and has delivered numerous invited lectures at meetings such as ASN-Kidney Week, the Annual Dialysis Conference, and ISPD conferences. She has peer-reviewed publications in the areas of clinical peritoneal dialysis and renal pathophysiology.
Dr. Saxena is board certified in Nephrology and her clinical practice involves the chronic care of over 100 HD and PD patients, and several hundred CKD  patients. As Director of Peritoneal Dialysis at the independent dialysis unit at SCVMC since 2004, she has led the clinic to achieve at least 10% growth yearly.

Robert Rope: 
Rob Rope is a nephrology research fellow at Stanford University with a focus on medical education. His projects include primary care education in CKD, needs assessments in nephrology education, assessing the educational value of consultation, and curriculum development in nephrology. Starting Summer, 2017 he will join the nephrology faculty at Oregon Health and Science University in Portland, OR where he completed medical school and residency. Outside of medicine he attempts to cultivate interest in politics, biking, and the outdoors. 

Shuchi Anand:
Shuchi Anand is an instructor in Internal Medicine-Nephrology at Stanford University. She completed her nephrology fellowship and a Masters in Clinical Epidemiology at Stanford University. Dr. Anand has a K-23 award on the epidemiology and management of CKD in South Asians. She is an organizing member of the International Consortium of CKDu Collaborators and a board member on the North America and Carribean Regional Board of the ISN. She is also the director of the Stanford University nephrology rotation for medical students and residents. 

Accreditation
If you choose to complete this session in accredited mode, you will be prompted to complete all the components of the module in sequential order (Pre-Test, 10 learning modules in any order).

 

You can complete each component in several sittings but you cannot skip any portion of the activity without completing the previous one.


You must obtain a minimum score of 70% in the post-test in order to complete the activity and claim a certificate of completion.

 

Goals

1. Assist local providers in developing and improving effective ambulatory peritoneal dialysis programs in low-resource settings.

2. Train local providers – including non-nephrology physicians, nurses, and health care assistants – in the delivery of ambulatory peritoneal dialysis.

3. Assist local providers in the development and implementation of sustainable quality improvement methods to track and improve patient outcomes.

Objectives

1. After completing the video and in-person modules, learners will be able to:

a. Explain the basic physical effects of ESRD and what renal replacement therapy is.

b. Implement appropriate peri-operative catheter care including exit-site and catheter placement planning, catheter selection, and infection-prevention.

c. Recognize catheter malfunctions (ex. poor outflow) and perform appropriate diagnostic testing.

d. Describe the basics of a peritoneal dialysis exchange and how to write peritoneal dialysis prescriptions.

e. Compare the physiology of solute clearance and ultrafiltration through peritoneal dialysis.

f. Recognize states of hypervolemia (ex. hypertension, edema) and ultrafiltration failure as well as prescribe medications to preserve kidney function and maintain euvolemia (ex. diuretics, ACEi/ARBs).

g. Provide appropriate infection prevention methods in patient care (ex. catheter care and prescribing antimicrobial prophylaxis).

h. Complete infection diagnostic testing (ex. peritoneal fluid testing) and prescribe appropriate antibiotics.

i. Recognize and respond to non-infectious peritoneal dialysis complications (e.g., hernias and fluid leaks).

j. Implement evidence-based teaching principles and protocols within in patient training.

 

2. After participating in the curriculum, learners and programs will also be able to:

a. Incorporate quality improvement methods including:

i. Tracking the monthly patient census.

ii. Tracking patient care outcomes for key events (ex. peritonitis, catheter infections, hospitalizations) via event-sheets.

iii. Tracking appropriate monthly patient care information (ex. blood pressure, weight, monthly labs).

b. Adjust patient care protocols to respond to poor patient care outcomes. 

Necessary Program Personnel

  • Nursing officers/nurses: Trained in general care of patients with and without kidney disease. Formal training in kidney medicine not required.
  • Medical officers/physicians: Having completed medical school and residency or other practical training in general medicine. Formal training in kidney medicine not required.
  • Nephrologists/kidney physicians: Physicians who have completed advanced training in kidney medicine.
  • Healthcare assistants: Individuals with minimal or no formal medical training who assist in the organization and care of patients. 

Satisfactory Completion  
Learners must complete an evaluation form to receive a certificate of completion.  If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.

The ISN Academy, made available on https://academy.theisn.org and organized by International Society of Nephrology (ISN), is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists.

Each medical specialist should claim only those credits that he/she actually spent in the educational activity. The EACCME is an institution of the European Union of Medical Specialists (UEMS). Only those e-learning materials that are displayed on the UEMSEACCME website have formally been accredited.
Through an agreement between the European Union of Medical Specialists (UEMS) and the American Medical Association (AMA), physicians may convert EACCME credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME credit to AMA credit can be found at www.ama-assn.org/education/earn-credit-participation-international-activities.

Date of Release
15/03/2019

Date of Expiry
10/01/2021

Pre-Evaluation Quiz
Module 1 - Introduction to Peritoneal Dialysis
Module 2 - Introduction to Peritoneal Dialysis Catheters (Two Videos)
Module 3 - Catheter Complications (Non-infectious)
Module 4 - Basics of Peritoneal Dialysis: Solute Clearance (coming soon)
Module 5 - Basics of Peritoneal Dialysis: Writing PD Prescriptions
Module 6 - Volume Management in Peritoneal Dialysis (two videos)
Module 7 - Infection Prevention in Peritoneal Dialysis
Module 8 - Infection Diagnosis and Management
Module 9 - Non-infectious Complications in Peritoneal Dialysis
Module 10 - Teaching Patients as Adult Learners in Peritoneal Dialysis
Post-Evaluation and Certificate
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