A written order from the attending physician to start CAPDTRAINING should be obtained.

The type of CAPD system should also be stated. (Incase the type of CAPD system is not indicated in the physician’s order sheet, the Supervisor or CAPD Trainor will automatically start the patient on CAPD using the system on deck.)

A written order from the Nephro Fellow assigned to start CAPD TRAINING should be obtained.

An approval slip from the assigned social worker should also be obtained. The approval slip signifies that the patients capable of maintaining Peritoneal Dialysis therapy even at home.

Once approved for CAPD training, the Nephro Fellow assigned will relay names and dates of their admission to our CAPD Trainor.

The type of CAPD system that will be used by the patient is dependent on their financial capability, and the brand of CAPD system that will be used.

The CAPD TRAINING program is done twice a week for all Service Patients . A patient needs to be admitted preferably on a Monday or a Wednesday, patients admitted on a Monday will be discharged on a Wednesday and patients admitted on a Wednesday will bedischarged on a Friday. If a patient is to be admitted beyond the days specified (especially during Saturdays and Sundays) and a bed is available the patient will still be admitted and trained onto CAPD. The PD nurse on duty will have to start the training by allowing patient/relative to observe the procedure. Some reading materials will also be provided to give patient/relatives an idea of the system and the step-by-step procedure, but the CAPD Trainor will provide the actual training and evaluation.

The PD unit can cater up to 3 CAPD patients for training / session, with a total of six patients a week.

The CAPD TRAINING program for pay patients depends on the day the attending physicians ordered the start of training. If the order for CAPD training falls on a weekend, the patient will still be shifted to CAPD and the PD nurse on duty will have to start the training by allowing patient/relative to observe the procedure. Some reading materials will also be provided to give patient/relatives an idea of the system and the step-by-step procedure, but the CAPD Trainor will provide the actual training and evaluation.

Provides a brief lecture on the normal functions of the kidneys. (this will give our patient an idea about their present health status and the reasons why they need to be dialyzed).

Discuss about peritoneal dialysis and its significance.

Discuss the dialysis schedule at home and its flexibility to adopt to the patient’s lifestyle.

A Showcase and Demonstration of the CAPD system to be used by the patient.

Discuss the importance of cleanliness.

Demonstrates proper hand washing to the patient or relatives.

Return demonstration of the CAPD SYSTEM.

Illustrates proper technique in Adding Medications to Dialysis Bags.

Discuss proper recording of dialysis sessions particularly the ultra filtrate for each cycle/exchange.

Discuss common complications of peritoneal dialysis and their immediate action.

Discuss trouble shooting techniques incase of flow problems and the onset of common complications.

Final evaluation in the performance of dialysis procedure.

Final evaluation on the acquired knowledge of patient regarding the topics discussed.

Dietary instructions by dietician.

Issuance of prescriptions, address and telephone numbers where to buy dialysis solutions and make follow-up consultation.

Start CAPD training using 1.0 liter 1.5% PD solution every 2 hours until bedtime with a night dwell of 1.0 liter 4.25% PD solution.

Discharge on 1.5 liter at 4 exchanges daily. (Usual regimen is 1.5% during daytime and 4.25% at night dwell).
Follow-up at CAPD clinic after 1 week on Friday afternoon. (Clinic follow-ups: at least once a month; more frequently if problematic).

Start CAPD training using 1.0 liter PD solution every 2 hours.

Do a nighttime dwell using 1.5 liters PD solution on Day 1.(Observe closely for leakage. If positive for leakage, go back to 1.5 liters).

Discharge OPD follow-up, if with no problem, shift to 2 liter bags at 3 exchanges daily.

During OPD follow-up, if with no problem, shift to 2 liter bags at 3 exchanges daily.

If previously on 1 liter/exchange, convert night-time dwell to 1.5 liter initially.

If previously on 1.5 liter/exchange, convert night-time dwell to 2.0 liter initially.

If no untoward event occurs, use 2 liters on all exchanges.

Discharge patient on 2 liters at 3 exchanges daily.

• Peritonitis: If infection sets in before the start of CAPD training. It is therefore Recommended to treat the infection first and continue IPD temporarily. The treatment of peritonitis usually takes 14days. If dialysate clears up after 3 to 4 days, the patient cannot start on CAPD training immediately but rather perform another IPD session a week after. A total of 2 IPD sessions is suggested before we resume CAPD training.
• Flow Problem: If on CAPD Training but suddenly experienced poor inflow and out flow without any improvement after flushing, the training is deferred temporarily until the problem is resolve by a surgeon.
• Hernia: If any type of hernia develops, CAPD training is terminated and the patient is referred to a Surgeon for assessment.
• No relative to train