CLINICAL AUDIT : COMPLIANCE TO GUIDELINES ON MANAGEMENT OF PERITONITIS AMONG PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) CY YUNG, MKF LEE, TH KWAN, TC AU, ML SZETO. Department of Medicine, Tuen Mun Hospital. Background: Peritonitis is the leading cause of hospitalization among CAPD patients. It has been the major reason for transfer to hemodialysis and catheter loss. Hence, prompt and effective management on CAPD-related peritonitis is of utmost importance. Aim: To assess the compliance rate to treatment guidelines on CAPD-related peritonitis. Standard statement : Patient with CAPD-related peritonitis should receive standard treatment established by the renal unit. Methods: The Peritonitis Treatment Protocol was jointly validated by renal physicians and nurses. It was based on recommendations on CAPD-related peritonitis implemented by international authority. A self-developed chart, which contains 9 items for evaluation, was used as the audit form. The 9 items were the essential steps involved in the management of CAPD-related peritonitis. Results: 25 patients were enrolled between March and May 2000. The overall compliance rate was 86%. The item with the lowest compliance rate was the prescription of loading dose of cephazolin, one of the 2 empirical antibiotics used. One patient was given a wrong dose while the other was given another cephalosporin. In 3 patients, no cephalosporins was given; instead they were given vancomycin without any accountable reason. Other items of low compliance rates included failure to give heparin and to change transfer set. Improvement measures were implemented to enhance the compliance rate, namely: (I) the importance of adherence to the Peritonitis Treatment Protocol was emphasized at the departmental meeting; (ii) poster was put up at each medical ward as note of reminder; (iii) the nursing staff of medical wards were educated about the Peritonitis Treatment Protocol by the nurse specialist. Re- audit was carried out from June to July 2000 and 28 patients were enrolled. The overall compliance rate has now reached 98%. Conclusion: The adoption of a uniform peritonitis treatment protocol will ensure proper and standardized management among CAPD population. This plays a key role in the context of continued quality improvement and maintenance of quality patient care.