Improvement of Inpatient Workflow in Management of Peritoneal Dialysis Patients

Background: In SGH, the model of care in managing PD in-hospital patients have been depending on the PD trained nurses. The current practice of PD nurses managing the in-hospital patients was flagged up for its continued relevance given that there is increasing workload demand based on the current programme’s capacity and also organisation efforts on right sizing exercise and management of current resources to continue in improving care, productivity and efficiency. The project aim to optimize the PD inpatient workflow and improve the efficiency of the inpatient PD nurses

Methodology: Changes were generated using survey data and closed observational methodologies. The team identified the gaps of inefficiency in the workflow in managing the PD in-patient in the hospital and implemented the new changes. A new training course for the ground nurses to upskill them to perform PD therapy for inpatient was initiated. Industrial partners were engaged to assist with a clear instruction sheet for the medical team to refer when managing the PD machine.

Results: There was potential manpower saving of 0.85 FTE (1 FTE = 1940.4hours). With the additional time saved, the PD nurses can value-add by spending time to care for patients with more complex medical conditions, patient education and staff training. Based on the 2 months data collected after the ward nurses has taken over the PD service, there were zero cases of inpatient peritonitis.

Conclusion: These initiatives had provided an opportunity to upskill the nurses and expand their capabilities in caring for the renal patients.