Welcome to the Zulu Kingdom, KwaZulu-Natal

Disabled Tourists - Help Available in the Zulu Kingdom

Tourism KwaZulu-Natal recently launched a Disabled Tourism Strategy which aims both to ensure that the province's tourism facilities become more disabled tourist friendly, and also to alert tourists with disabilities that KwaZulu- Natal is both aware of the problems involved in travelling if one is disabled, as well as of a variety of help measures. In line with the strategy, the following information from National Renal Care is offered.

Established in 1995, National Renal Care is a wholly South African owned company and is the only private dialysis therapy provider in SA that has a national network of units with a presence in every major center throughout the country (44 units to date).

Driven by a vision to be recognized as the premier Total Kidney Disease management organization in South Africa and the first choice service provider for all funders and patients in the country, NRC strives to provide optimal care to all patients in its care. This quest is fulfilled by a determination to deliver consistently high quality, holistic care to patients, achieved by keeping pace with technological innovations and working collaboratively with medical professionals and scientists to advance renal medicine.

NRC Offers the full spectrum of dialysis treatments, namely: · Healthy Start Clinic: Unique to NRC The Healthy Start Clinic is a lifestyle management program for patients with end stage kidney disease and patients at risk of developing end stage renal disease. These patients include diabetics, patients with hypertension, patients with a family history kidney disease and patients with compromised kidney function.

The primary aims of the programme are to help the patient remain as healthy as possible while simultaneously retaining a high quality of life. Preventative strategies include early detection and treatment, meticulous hypertension control, strict glycaemic control, anemia management and appropriate dietary and lifestyle changes. Patient and family education and psychosocial counseling play a key role. Where dialysis is unavoidable the programme helps to prepare the patient for treatment and improves patient outcomes while reducing costs. Dialysis access is gained early to ensure optimum use and efficiency of such access.



· Are you at risk: – A screening programme that forms part of the Healthy Start Clinic, the “Are you at risk?” initiative uses a finger-prick blood test similar to a glucose test to measure a patient’s plasma creatinine and then calculate the kidney function. Once this is determined, patients can be managed appropriately, based on their kidney function.

· Chronic haemodialysis – All NRC dialysis units offer bicarbonate dialysis, a range of biocompatible membranes with flexible dialysis shifts to meet the patient’s lifestyle. Quality is assured through adherence to national and international protocols as well as measurement of dialysis efficiency (KT/V). A comprehensive home haemodialysis programme is also available, including training and home visits. · Peritoneal haemodialysis – Both Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD) are offered. A complete home visit and delivery service is offered, including delivery of disposables locally and internationally. To ensure the most efficient peritoneal dialysis prescription is administered, all patients undergo annual Peritoneal Dialysis Equilibration Prescription tests (PET). · Acute dialysis – A fully comprehensive mobile acute dialysis service is offered, manned by staff on 24-hour call. The range of services includes haemodialysis, peritoneal dialysis, continuous therapies for unstable patients, plasma filtration therapy and blood exchange.

In addition to offering the full range of dialysis treatments, NRC also offers a range of services that add measurable value to patients, including:

· Nutritional guidelines – NRC has developed a training manual to educate dieticians and NRC staff countrywide on the nutritional needs of patients with kidney disease. · Patient and family education – All patients treated by NRC, and their family members, are introduced to the world of kidney disease via the distributing of information regarding kidney disease, treatment modalities and other pertinent details (such as nutrition and exercise to optimize health).





· Patient support – NRC encourages and helps form support groups for patients and their families. Newsletters are distributed regularly by each of the NRC dialysis units, detailing parochial news and including articles of interest regarding kidney disease · Medical aid assistance – Drawing on the close relationships nurtured with South Africa’s medical aid schemes over the years, NRC negotiates with funders on behalf of members to motivate the associated cists and to establish rates for this cost. NRC is well positioned to help patients choose the best healthcare option so as to get the optimum benefit from their medical insurance. In addition NRC complies quarterly reports on each patient and submits these to their respective medical aids, supplying detailed information on clinical outcomes.

Quality medical care is the very core of total disease management. At NRC, this is interpreted through various quality initiatives, including

· Dialysis adequacy testing – Dialysis adequacy tests are conducted every three months for haemodialysis patients and bi-annually for peritoneal dialysis, with all costs borne by NRC. · Water quality testing – The quality of the water used is tested with the assistance of the South African Bureau of Standards for endotoxins, bacteria and chemistry. · Adopting international quality guidelines -All NRC units operate under both international and locally accepted guidelines and procedures, using the US Dialysis Outcome Quality Initiative (DOQI) guidelines as a benchmark. · Hepatitis screening – All staff and patients are screened for Hepatitis B, and then immunized to prevent the disease being contracted. · Dedicated Nurse programme – Each staff member is assigned to specific patients to ensure individualized patient care as well as to facilitate early detection of potential problems. To this end, clinical indicators are monitored closely and visits are used as an opportunity to continue patient education regarding their condition. §



· Satisfaction surveys – Patients, doctors and staff are encouraged to give feedback using satisfaction survey forms. This provides NRC with insight into any perceived or real problems and the opportunity to rectify the same.

· Patient forums – Patients are invited to attend bi- annual forums, held in the major centers around the country. These events provide a platform for sharing opinions, airing grievances and offering constructive criticisms.

Importantly, every NRC dialysis unit boasts a representative mix of knowledge and skills, giving patients the benefit of comprehensive expertise. What’s more, acuity levels at NRC’s units are consistently higher than industry averages while the Name Nurse programme ensures dedicated attention is given to every patient.

Ongoing training and skills development initiatives ensure that staff members remain abreast of trends. An internal training programme, co-ordinated by a clinical division is complemented by:

· Sponsoring six NRC nurses to participate in a Renal Nursing Course at the University of Port Elizabeth each year; · Providing practical training opportunities for third-year clinical/renal technology students at SA Technicons; · In-service training on new equipment and techniques; · Developing practice and patient management competencies; · Regular and refresher CPR training; · Encouraging staff to attend national and international conferences on renal disease and its management; and · Offering a staff wellness programme that caters primarily for the emotional, spiritual and mental well being of staff.



Fundamental to NRC’s Total Disease Management philosophy is an ambition to change the treatment of renal disease from the usual reactive crisis driven process to a knowledge- based, pro-active, cost-efficient and effective process that simultaneously ensures an optimal health outcome for the patient. Initiatives in this regard include:

· A detailed patient database – NRC has developed and maintains a national database as a vital patient management tool. The database may be accessed via the Internet by both funders and doctors, the information being available 24 hours a day, seven days a week. Unique to NRC and a first within the South African renal healthcare market, this service provides funders in particular with quality indicators for benchmarking against international and local standards.

· Continuing Medical Education – NRC sponsors regular CMEs on Chronic Kidney Disease with a view to keeping the medical fraternity well versed regarding treatment trends in renal disease.

· Quarterly reports – These are compiled on each patient and submitted to their respective medical funders and doctors, supplying detailed information on the clinical indicators and patient outcomes. The reports include specific blood results, treatment modality, medication, as well as hospitalization and transplant status.

· Research resources – NRCs patient database and quarterly reports provide a powerful research resource, whether from an academic perspective or for clinical trials aimed at improving renal therapies. NRC has conducted and presented a number of research papers at the South African Nephrology congress in 2000,2002 and 2004. Two papers have been awarded best abstract submitted at the above congresses.





· Involvement with renal medicine associations – NRC maintains cordial relationships with renal medicine organizations in South Africa and abroad, using any opportunities that arise to improve the service offering to patients.

NATIONAL RENAL CARE KWAZULU-NATAL

Director: Mrs Wendy Rowbotham

Regional Office: 13 South Ridge Road First Floor Berea, Durban Tel: (031) 202- 8816 Email address: ssing@icon.co.za

St Augustines - Durban Central: (031) 268- 5133/4/5 City Hospital – Durban Central: (031) 309- 1180 Medicross Pinetown – Durban Central : (031) 702-6683 Chatsworth – Durban South: (031) 404- 7939 Isipingo – Durban South: (031) 902-5335 Umhlanga - North Coast: (031) 560- 5760 Victoria - Tongaat : (032) 944-8121 St Annes - Pietersmaritzburg: (033) 345- 0878 Midlands - Pietersmaritzburg (033) 342- 1112 Richards Bay – North Coast: (035) 789- 3957 Margate – South Coast: (039) 317-3981 Ladysmith – Northern KwaZulu-Natal: (036) 631-4400 Natal Acutes 082 574 3665

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