Visits

The Centre was visited by Mr Hiroshi Okazaki, Ph D, director of the Kyowa Kirin and his team on 18 January, 2011. The Koywa Kirin was the ditributor of Aransep and Rengel in Hong Kong

Staff training and clinical Audits      

Since the Centre is a Satellite Centre, the staff is trained in cardiac resuscitation to cater for the heart emergencies.  Our Centre is the first satellite centre to be equipped with the AED (automatic external defibrillator) and laryngeal mask airway.

As our Continuous Quality Improvement initiative, we had regular clinical audits. The latest one was carried on Secondary Hyperparthyroidism

Clinical Audit on Secondary Hyperparathyroidism (SHPT)

This is a standards-based clinical audit on the management of SHPT in the renal patient undergoing regular haemodialysis in the Integrated Dialysis Facilities.   This clinical audit showed that in our Centre

• The average phosphate level was only slightly raised but 7 patients had abnormal result.  This was consistent with the clinical observation that the
• phosphate level was much more difficult to control than the calcium level.
• Only 6 out of 13 patients had elevated iPTH level.  This compared unfavourably with studies in other Centres in which over 80% of patients with end-stage renal failure has abnormal iPTH level. 

The full clinical audit report on SHPT can be viewed by clicking 'report on SPHT' on the left hand panel.

   The following clinical audit report was performed by a nurse intern, Ms Grace Ho, during her summer vacation.

2007 Clinical Audit of the Integrated Dialysis Facilities.

            The Integrated Dialysis Facilities carried out an internal clinical audit in July, 2006 as a part of the bench-marking process.  In the month of July 2006, the IDF hosted a total of 22 haemodialysis patients, including 2 tourist patients. The candidates selected for this clinical audit must fall under two categories: (1) the subject must be a local patient and (2) he / she must have received treatment at IDF for a continuous period of over three months.

As of the audit of July 2006, 12 patients fulfill the above requirements. The male to female ratio of this population is 2:1 with an average age of 73.75 ± 14.28, and 9 (or 75%) of these patients are diabetic. Eleven patients (91.7%) dialyzed with arteriovenous (AV) fistulae, one patient was on AV graft, and none used permanent catheters. Over 77% of the patients had an Hb level higher than 10g/dL, which is granted satisfactory, and all of them were given erythropoietin (EPO) supplements. The adequacy of haemodialysis is rated using URR (urea reduction rate) and Kt/V (Watson’s formula). In the latest audit, the URR is 0.74 ± 0.07 and the Kt/V value is 1.60 ± 0.23. However, the Ca*PO₄ value is rather high, where just over 50% of the patients have a value less than four. This may be accounted for due to the low percentage of patients receiving an adequate amount of dialysis per week. In July 2006, only 4 out of the 12 examined patients received three dialyses per week, and this is the highest number compared to previous audits.

            In order to create an effective and informative clinical audit, data collection and observation is incorporated into the daily routine at IDF. This exercise is done on every first and seventh month of the year, and a total of three data sets have been collected since July 2005. On the three rounds of examination, there is a steady trend on the increase of weekly Kt/V. This rise may be explained by the increase percentage of patients receiving 3 dialyses / week.

            The Integrated Dialysis Facilities is also popular amongst tourist patients who require renal care during their visits to Hong Kong. Patients from 14 different countries had received treatment from IDF.

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Acknowledgement:  This clinical audit was performed by Ms Grace Ho, a nursing student doing her clinical internship in the IDF.

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