In the latest statistics of Singapore, stage 5 chronic kidney disease (CKD) patient has already reach to 1730 patients and it has increased twice than the prevalence of 1990. All these CKD patients may require different dialysis modality in future. I defined my program population as who is already stage 5 and may require dialysis sooner or later. The current model of care for decision of dialysis modality in my renal department was still patients’ decision making with recommendation from nephrologists. Although worldwide has recommended that peritoneal dialysis first model, it was still not fully recognized by public. Factors influencing underutilization of PD include …show more content…
APN expanded role included clinical and professional role and responsibilities. For the role of clinical, patients’ assessment and history taking are identified both physical and psychosocial status. Physically assessment included patients’ functional status, uremic symptoms, blood pressure and heart rate control, medical and surgical history, any potential hernia risk or weakness of abdominal wall and patients’ self care ability. Psychosocial included patients’ perception to his/hers disease progress, mental preparation for his disease process and social support from family or friends, financial status and perspectives of dialysis modality. Professional role also included education to the nurses for the perception towards peritoneal dialysis including complications and solutions to troubleshooting to the potential problems. The other component of education included patients self care awareness and disease progress management including fluid, diet and compliance to management. The new model of care empowered patient to play a part of decision-making in the setting of short term and long term