How to Successfully Train the Physically Impaired Patient to Perform Peritoneal Dialysis
Jeannine Farina MSN, RN, CNN Baxter Healthcare Corporation McGaw Park, IL
Considerations for the Visually Impaired
Practice Problem
 Patient physical impairment may preclude the
healthcare team from considering peritoneal
dialysis (PD) as a viable renal replacement
therapy option.
 Increase practice time and extend training time for visually impaired patients.
 Provide handouts in black and white with enlarged type to heighten visibility.
 Enhance contrast between the object and its surroundings--add contrasting tape on the cycler handle to make it more visible (Figure A).
 Use a tape recorder to speak out the procedure for the patient to take home since they may not be able to read the procedure manual/guide.
Objective
 To empower the PD nurse with the knowledge of a
variety of tools and resources available to enable
the physically impaired patient to successively
perform PD.
 Be aware of the lighting in the training room. Open or close curtains or blinds to provide more light and decrease glare.
 Change the work surface to a matte or dull top, such as a tablecloth, as glare can further reduce vision and cause eye fatigue.
Figure A
 When making connections, use color contrast to enhance differences and depth perception.
 Encourage patients to make the connections vertically in front of them at an angle versus horizontally (or parallel) to their chest. This also helps with depth perception issues.
 Keep your voice at a normal level unless the visually impaired patient also has a hearing impairment.
 Include family and friend involvement to increase success of performing PD at home.
Products for the Hearing
Impaired
 Vibration device for the APD patient are available
along with other devices for the hearing impaired:
www.hearmore.com
Product for the Dexterity
Impaired
 Obtain talking blood glucose monitor, blood pressure monitor, watch, and weight scale.
 Instruct patient to call PD nurse for any development of abdominal pain since unable to evaluate effluent.
 Lighthouse for the Blind has services and special aids for people who are visually impaired: 1-800-829-0500 or www.lighthouse.org.
 Shoplowvision.com: variety of aids including different types of magnifying devices.
 National Federation for the Blind: aids, assistive devices, diabetes articles and books in Braille at www.nfb.org.
 A hands-free magnifier with a battery operated light can help when making connections (Figure B). Available at most craft stores.
A “Three Finger
Approach” to Make a
PD Connection for the
Visually Impaired
Additional Resources for the
Physically Impaired
 Maxi Aids (1-800-522-6294) has products for the
arthritic , blind, hearing, physical, and visually
impaired.
Carolyn's Low Vision Products:
As per Figure C, the patient
secures the dialysate tubing on the
edge of a table by using a specially
designed clip. Then removing the
cap of their transfer set and holding
the transfer set in one hand, the
patient reaches back to the work
table to remove the dialysate tubing
from the clip, and using a “three
finger approach” the connection is
completed in sterile fashion.
Bentley, ML. Keep it simple! A touch
technique PD procedure for the blind and
visually impaired. CAANT 2001; II: 32-34.
Figure B
(800) 648-2266
www.carolynscatalog.com
A free mail order catalog featuring over 700
items for hearing and visually impaired people.
Conclusions and Clinical
Implications
Guest, S. The Handbook of Peritoneal Dialysis. 2010: 212-213. Used with permission.
Figure C
Baxter and EZ-Aide are trademarks of Baxter International, Inc. Other trademarks or products appearing hearin are the
property of their respective owners.
 By providing an overview of the resources and
tools to the PD nurse, the physical impaired
patient can now be considered a candidate to
perform PD. This, in turn, can result in long
term success on PD.