Introduction:

A dedicated group of nurses in SGH provide peritoneal dialysis (PD) care for patients across the hospital. For these nurses, ergonomics at work is a challenge for the following reasons:

1. For patients on APD, their dialysis effluent can be as much as 15-20 kg

2. Nurses have to carry the bags onto a higher surface top before draining the effluent away

3. Repetitive movements involving the above may cause a strain on the nurses’ back

4. Being an open system, there is a potential for splashes and spillage during drainage

Method:

A multidisciplinary team (involving PD nurses, renal APN, engineer, infection prevention nurses, safety officer, environmental services experts) was formed to address the issue.

The team looked into ways to eliminate the need for nurses to lift/carry the heavy load. Cross referencing to other industries for potential solutions was also done.

The team adopted the Plan-Do-Check-Act method for project management and execution.

Results:

A peristaltic pump was installed in the dirty utility room of the pilot ward. Silicon tubings were used to connect the pump to the drainage bags. The pump was able to drain away 15 litres of effluent in less than 12 minutes. The tubing is flushed with water after every use, and flushed with an antiseptic solution once a day. The solution fulfilled the requirements from an infection prevention perspective (no more spillages; splashes); ergonomics (no more lifting); and environmental concerns (the pump and tubings are easy to maintain and wiped down).

Conclusion:

With an increased demand for renal nurses, it is important for nurse leaders to explore ways to improve the professional quality of life of this group of nurses.