February 14, 2025
SINGAPORE – In 2016, the National Kidney Foundation (NKF) introduced overnight dialysis at some of its centres as research showed that certain patients benefit from it.
The longer dialysis duration – about six to seven hours instead of four hours during the day – removes larger toxins. Since the process takes place while patients sleep, they can use their daytime hours for work and family commitments.
But NKF found that involuntary arm movements during sleep caused the metal needles used for dialysis to shift out of place, leading to patients experiencing pain and causing alarm.
The dialysis process then had to be paused while a nurse checked on the patient and adjusted the needle. In extreme cases, the needle could puncture the blood vessel it was inserted into, causing bleeding or swelling of the arm, which might require hospitalisation.
As a result, 30 per cent of patients on overnight dialysis dropped out, NKF chief nurse Pauline Tan said.
To overcome this issue, Ms Tan applied what she learnt from her 10 years working in Calgary, Canada, where plastic cannulas – thin tubes inserted into the body – are used for dialysis. The flexibility of the tubes reduces the risk of damaging blood vessels.
Ms Tan led a team of six to teach other nurses how to use the cannulas in a six-month trial between 2022 and 2023 at two NKF dialysis centres.
The trial found that 63 per cent of patients reported less pain, while 85 per cent felt less anxiety over moving in their sleep during dialysis.
On Feb 13, Ms Tan’s team was one of four healthcare teams that received awards at the 16th Singapore Health Quality Service Awards.
SingHealth, one of Singapore’s three public healthcare clusters, has organised the awards since 2011 to recognise the efforts of healthcare workers in improving patient safety and outcomes.
Ms Tan said she was happy they were able to enhance patient care, improve their comfort and ensure their safety, adding that she is grateful her team received the award.
Besides the 47 patients now undergoing overnight dialysis, NKF plans to use plastic cannulas for kidney patients with dementia from July.
Ms Tan noted that plastic cannulas are 10 times more expensive than conventional metal needles. But she hopes that wider use will bring down costs, making them accessible to all dialysis patients.
“We hope that in the future, this will be the gold standard,” she said.
In 2025, more than 4,700 awards were presented to healthcare professionals and teams from 45 public and private healthcare institutions and community care organisations, at a ceremony held at the National University of Singapore’s University Cultural Centre on Feb 13.
The team was one of four healthcare teams that received awards at the 16th Singapore Health Quality Service Awards held at NUS’ University Cultural Centre on Feb 13. PHOTO: THE STRAITS TIMES
President Tharman Shanmugaratnam, the event’s guest of honour, presented the awards, including 14 Superstar awards such as the Exemplar Leader and Exemplar Professional awards, given to those in the clinician, nursing, allied health and pharmacy categories.
Speaking at the event, SingHealth chief executive Ng Wai Hoe highlighted the “far-reaching impact” of healthcare professionals in tackling the challenges of Singapore’s rapidly ageing population, particularly in encouraging patients to take charge of their own health.
“Today, healthcare professionals partner with patients, involving them in care plan discussions to understand their health goals, much like a coach who provides the guidance, expertise and strategy for an athlete,” he said.