Nursing care is a vital component of the safe and quality healthcare services provided by the National Kidney and Transplant Institute.

Following the primary nursing model of delivery of care, nursing at NKTI is scientifically-based, and requires critical thinking and decision making towards a holistic definitive course of action and care. It is relational and makes use of the interpersonal and communication skills to manage different human responses to illness; and it underlines the nurses’ accountability and the multi-faceted needs of the patients we serve.

As the constant companion of patients in every step of the way, whether at the bedside or at the outpatient, nurses play a critical role in achieving better patient outcomes. As such, nurses at NKTI assume a variety of roles in practice, education, leadership, quality improvement and research. They function within all levels of the organization from the front-liners in patient care, to administrative leadership, to the executive level. They, together with able allied health professionals (medical services technicians, nursing attendants, clerks), make up the NKTI Nursing Services Department.

Vision
Imbued with compassion, professionalism and excellence, we shall be the role model in the entire nursing profession and its allied health care services, globally recognized in the delivery of effective and efficient quality care to everyone we serve.
 
Mission
We are dedicated to serve and share our expertise to everyone with integrity and with partiality to none.

Core Values

• Competence & Compassion

• Timeliness

•  Accountability

• Empowerment

• Respect & Integrity

• Innovation

Goals

1. Patient Care
   Provide individualized quality patient care using the nursing process to meet patient care needs from admission to home management.
   
   
2. Education
   Establish a continual program in quality training and education to provide the staff with the cutting edge knowledge, skills and values to effectively and efficiently care and interact with the patients.
   
   
3. Continuous Quality Improvement
   Review, evaluate and revise processes and practices, to achieve best outcomes.
   
   
4. Research
   Develop and implement research-based strategies on identified patient care needs and job performance needs.
   
   
5. Leadership
   To provide competent, responsible, and accountable leadership aimed at developing and sustaining a creative and positive culture and milieu for professional nurses and support staff.

Structural Organization

Under the leadership of the Director for Nursing Services, the Nursing Services Department is composed of the following divisions and committees:

• Clinical Division
• Critical Division
• Institute of Advanced Nursing and Allied Health Professions (IANAHP)
• Central Supply and Sterilization Unit (CSSU)
• Patient Safety Committee
• Pastoral Care Committee

Clinical Division

The Clinical Division is composed of 12 in-patient care areas or wards that house the Institute’s admitted patients; and the Out Patient Services which caters to the out-patient consultation needs of our service patients.

The Out-patient Services is open from Mondays-Fridays except holidays, from 8AM-5PM with the following clinic schedules:

Critical Division

Under the Critical Division are nurses and allied health professionals providing specialized care in the different specialty areas in the Institute namely:

• Emergency Room Unit
• Hemodialysis Unit
• Intensive Care Unit/Intermediate Care Unit
• Operating Room-Recovery Room Complex
• Peritoneal Dialysis Unit and CAPD Clinic
• Cardiovascular Catheterization and Radiology Unit
• Medical Oncology Unit
• Ambulatory and Endoscopy Center (includes Endoscopy, Lithotripsy, and Urodynamics)
• Other Areas: Nursing staff assigned at the Palliative Care Unit, Liver Care Center, Breast Center, Human Organ Preservation Effort, iVasc, Cardiology Laboratory, Occupational Health and Wellness Clinic, and Infection Control Committee

Cardiovascular Catheterization and Radiology Unit

The Cardiovascular Catheterization and Radiology Unit is a highly specialized facility located at the 2^nd floor of the NKTI Diagnostic Center that provides valuable digital angiography of the heart and the entire cardiovascular system, as well as cardiac and radiologic interventional procedures.

It utilizes top of the line facilities in delivering its services which include the following:

1. Interventional Cardiology - Coronary Angiography, Percutaneous Transluminal Coronary Angioplasty (PTCA), Temporary & Permanent Pacemaker Insertion, Implantable Automated Cardioverter and Defibrillator (IACD), Valvuloplasty, Pericardiocentesis, Hemodynamic Study, and Intraaortic Balloon Pump Insertion.
2. Peripheral and Vascular Intervention - Peripheral & Renal Angiography, Peripheral Angioplasty, Carotid and Renal Stenting, IVC Filter Insertion, Endovascular Repair of Aneurysm (EVAR) and Thoracovascular Repair of Aneurysm (TVAR).
3. Interventional Radiology– Gastrointestinal/Renal/Pulmonary Embolization, TACE and Cerebral Angiography.

The CCRU is open from 7:00AM to 5:00 PM from Monday to Friday. For emergency cases, the CCRU is available 24 hours per day, 7 days a week. At present, scheduling of elective cases on regular slot shall be on a First Come, First Served basis.

Institute of Advanced Nursing and Allied Health Professions (IANAHP)

The IANAHP is the training arm of the Nursing Services Department that is committed to providing high quality, comprehensive, and cost effective education and training programs to nurses and allied health professionals. It aims and endeavors to continually improve their method and system of education to promote the highest standard of the nursing profession and other health courses.

It offers contemporary postgraduate courses, continuing professional education programs, and staff competency development programs to nurses and allied health professionals within and beyond NKTI.

Each year, the IANAHP provides a diverse offering of both short-term and long-term courses which include Department of Health recognized modules under the Nurse Certification Program. Listed below are the list of long-term courses offered including the requirements and other information:

The IANAHP also offers Continuous Quality Improvement and Research Workshops, as well as seminars and trainings open for nurses and allied health professionals. See Annual Schedule of Long Courses, and Monthly Training Calendar.

E3N Care Program

One of the innovations of the NKTI Nursing Services Department to improve its delivery of care is the E3N or Effective, Efficient, and Equitable Nursing Care Program, which encompasses the different innovations and strategies initiated to address and reduce the occurrence of patient-related incidents. Under this program, incidents are thoroughly investigated, root causes are analyzed, and corrective and preventive actions are instituted, towards improving the overall quality of care particularly in the following key performance indicators and goals:

• Reduce Medication Variance;
• Reduce Patient Fall;
• Reduce Healthcare-Associated Pressure Ulcers;
• Reduce Healthcare-Associated Burn Injuries;
• Reduce Blood Transfusion-related Errors;
• Reduce Patient Complaints;
• Reduce Diagnostic Test-related Errors; and
• Reduce Injuries related to Medical Equipment.

Continuous Quality Improvement Initiatives from the Rank and File Nursing Staff

Since 2010, the Nursing Services Department has been actively involved in Continuous Quality Improvement (CQI) Initiatives as it seeks to constantly improve patient experience and outcomes, by developing a quality improvement culture among its staff.

Annually, the Department conducts CQI workshops and CQI Study Presentation Contest, which serves as a venue for the rank-and-file staff to showcase their CQI projects aimed at improving patient care, efficiency of processes, and work systems in general for the benefit of both the patients and the healthcare workers.

Many of these projects have formed basis for the creation or revision of departmental policies and some have been given recognition not only within the Department but also by the Philippine Society or Quality in Healthcare (PSQUA).

Listed below are a few of these notable CQI projects:

• “Appropriate Charging of Oxygen Consumption: A CQI Approach to Strict Implementation of the Institute’s Protocol” (2010)
• “iReport: Improving the Quality of Written Reports on Patient-related Incidents” (2011)
• “ZipVap: Decreasing the Incidence of Ventilator-Associated Pneumonia (VAP) in the ICU-IMCU” (2012)
• “iTurn: Improving the Turnaround Time of Patient-related Incident Reports” (2012)
• “Shoot the Bugs! Strategies that work in Reducing Methicillin-Resistant Staphylococcus aureus (MRSA) in the Hemodialysis Setting” (2013)
• “Sore Rangers: Decreasing the Incidence of Pressure Ulcer in the ICU and IMCU” (2014)
• “HE^LP B C SILA!: Reducing the Probability of Cross Infection Between Hepatitis B/C Positive and Non-Hepatitis B/C Patients When Dialyzed in a Non-Hepatitis B/C Machine” (2014)

As the Institute pursues the part of providing the highest possible quality of healthcare for all, the Nursing Services Department shall also press on in improving its own systems and services, and shall lead in the promotion of Continuous Quality Improvement within and beyond NKTI.

Nursing Services Department’s involvement in Research

Keeping true to the goals of the Department, the Nursing Services Department conducts research workshops and colloquiums aimed to develop and foster interest and involvement of nurses in Research.

To achieve this end, a series of lectures on the Principles of Research in the form of 6-8 sessionsare given to nurses and allied health professionals from March to May. These sessions are complimented by colloquiums and contests that are usually held every October.

Completed research papers are entered into separate research forums and presentations both within the Institute and outside NKTI. Among these completed research papers are:

1. Correlation of Standardized Communication Model Workshop to the Variances in the Delivery of Care to the Patients in a Specialty Tertiary Center
2. The Trends and Causes of Medication Variances in a Tertiary Specialty Center: A Descriptive Study
3. Use of Patient Reminder Boards: A Survey of Patient Perception and Recommendation
4. Reducing Methycillin Resistant Staphylococcus Aureus (MRSA) in the Hemodialysis Unit
5. Impact of the Medication Safety Program to Interruptions and Medication Errors during the Medication Management Process among selected clinical units of the National Kidney and Transplant Institute

Medication safety program (MSP)

In the year 2014, the Nursing Services Department conducted a pilot study concerning Medication Errors in the Clinical Units (Wards) entitled “Impact of the Medication Safety Program to Interruptions and Medication Errors during the Medication Management Process among selected clinical units of National Kidney and Transplant Institute”.

The Pilot Study was conceptualized in an effort to improve patient safety by addressing medication errors. As identified in a previous study of the Department, interruptions to nurses during medication management can lead to medication errors. This data, augmented with foreign studies, gave birth to the Medication Safety Program.

MSP was implemented for a period of 4 months. It was also continuously monitored through spot checks. Findings after the study period revealed that there was an average over-all reduction of 94% in the number of interruptions experienced by nurses before and during MSP. Additionally, there was 60% reduction in the number of medication errors reported in clinical units as compared to units without MSP.