BACKGROUND: This study aimed to develop a structured retraining program for peritoneal dialysis nurses using the ADDIE model, emphasizing clinical nursing expert orientation and job competency to facilitate their transition toward expert-level practice. METHODS: From May 1, 2023, to September 30, 2025, the research team followed the five stages of the ADDIE model to assess training needs, learner characteristics, and available resources for retraining peritoneal dialysis specialist nurses. Based on these findings, training modules, content, formats, and assessment strategies were systematically designed, and a preliminary training framework was developed. Twenty-two experts in peritoneal dialysis participated in two rounds of Delphi consultations to refine and finalize the program. The finalized retraining program was subsequently implemented and evaluated among 36 nurses who had obtained the Zhejiang Province Peritoneal Dialysis Nursing Specialist Certificate. RESULTS: The final retraining program comprised 11 modules and 38 topics, including 28 theoretical and 10 practical sessions. Nurses reported high satisfaction scores: 4.74 (4.61, 5.00) during the formative evaluation and 5.00 (4.00, 5.00) during the summative evaluation. By September 2025, 88.89% of participants had progressed to the level of clinical experts. Following the retraining program, nurses demonstrated significant improvements in theoretical examination scores (mean 89.31 ± 6.21, P < 0.001), and the number of independent clinics increased from 13 to 33. Academic productivity and professional engagement, including scientific publications, consultations, lectures, and leadership activities, also increased significantly (P < 0.001). At the peritoneal dialysis center, rates of peritonitis and catheter-related infections declined significantly (all P < 0.001). Further, achievement rates for serum albumin, hemoglobin, serum phosphorus, Kt/V, Ccr, and TOT targets improved significantly (all P < 0.001). CONCLUSIONS: The retraining and utilization program for peritoneal dialysis specialist nurses developed in this study is systematic, reliable, and innovative. By emphasizing both practical competencies and professional development, the program aligns closely with clinical demands while enhancing nurses' intrinsic motivation. Participants' feedback indicated strong acceptance and positive evaluation of the retraining program.
He et al. (2026) studied this question.