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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The National Kidney Foundation (NKF) is a non-profit healthcare organisation that provides haemodialysis (HD) for more than 4500 patients in 40 community-based dialysis centres (DC) across Singapore in 2023. 15% of patients were using tunnelled haemodialysis catheters (THC) as their vascular access, with a median of 48 monthly hospital referrals for catheter dysfunction as lytic dwell to restore flow in occluded THC had traditionally been performed in acute hospitals.
This posed a significant burden on the patients, caregivers and the acute hospitals. This study aimed to reduce hospital referrals by implementing a standardised community-based THC lytic dwell protocol.
A phased quality improvement initiative was implemented across NKF DC in collaboration with eight major Singapore hospitals and the National Improvement Unit. The intervention comprised two sequential bundles:
1. Optimising Blood flow, Locking solution, Anticoagulant & Standardising Technique (BLAST)
2. Empowering community dialysis nurses to perform Catheter flow restoration with Lytic dwEll at community diAlysis centRe (CLEAR).
Primary outcome measures included monthly THC dysfunction episodes and hospital referrals. Process measures tracked nurse training completion, whilst safety was monitored through 72-hour post-procedure infective complications.
Over 2.5 years, 402 hospital admissions were averted with an 86.8% procedural success rate. Hospital referrals for THC dysfunction decreased from baseline (48 cases/month) to 34, 11.5, and 19.5 cases at 1 year, 2 years, and 2.5 years respectively, representing reductions of 29.2%, 76.0%, and 59.4%.
A total of 116 community nurses were successfully trained in lytic agent administration. Importantly, no infective complications occurred within 72 hours of community-based lytic dwell procedure.
This multi-centre initiative demonstrates that appropriately trained community dialysis nurses can safely and effectively perform lytic dwell for THC occlusion. The protocol achieved substantial reductions in hospital referrals whilst maintaining patient safety, offering a scalable model for improving dialysis care delivery and reducing healthcare system burden. These findings support feasibility of task-shifting complex procedures to the community setting with appropriate training and protocols.
