Mrs Nadine Tinsley1
1Renal Home Therapies, Royal Darwin Hospital, Darwin, Australia
Top End Renal Home Therapies Team look after Peritoneal Dialysis (PD) patients in the Top End, which consists of an area of 245,000km2. The logistics of arranging PD stock to be delivered to remote locations can be quite hair raising. The considerations are our distance, temperature, wet season and cyclones. How do we think outside the square to get things done in such a large area of land?
In a single centre, the KPI of the length of time it took for PD stock to be packaged and delivered from provider to patient and the amount of stock required was reviewed. Quantitative amounts were reviewed to assess the level of stock, lead times and emergencies. Qualitative feedback from patients and remote clinic staff was received and reviewed to improve the service.
This resulted in adjustment of transport lead times, type of transport, communication between transport provider and patients and amount of stock for different seasons and emergencies.
Our patients’ stock travels 3032km by road from Adelaide to Darwin, then it travels out to remote communities by road or barge up to a further distance of 480nm barge for Nhulunbuy patients. Sometimes stock is in transit for 3 weeks. By reviewing the KPI service was improved to ensure that patients received their stock within the most appropriate time possible with improved communication to the patient about delivery and any delays, without running out.
Nadine has been a nurse with the Top End Renal Service for 8.5 years. She has always had a passion for PD, however has worked across the renal spectrum, as inpatient renal ward nurse, haemodialysis hospital and satellite, transplant and now peritoneal dialysis. Nadine believes that providing education to CKD patients, general public and clinical staff has contributed to the increased uptake of PD in the Top End. With the centralisation of the Renal Home Therapies Service in the Top End, there has been an increase of home therapies. Now is the time to see how we can improve further.