17 May 2018

Child visits to emergency departments for mental health issues triple

Australian children receive mental health care from a variety of community-based organisations, but recently it has been noted that an increasing number of children and young people are presenting to emergency departments (EDs) with mental health problems. It appears that current mental health services are failing to provide alternatives to emergency departments for adolescents in crisis.

Hiscock, H., Neely, R. J., Lei, S., & Freed, G. (2018). Paediatric mental and physical health presentations to emergency departments, Victoria, 2008-15. Medical journal of Australia, 208 (80, 343-348

You can also read the editorial on this topic in the same issue for free:
Sawyer, S. M., & Patton, G. C. (2018). Why are so many more adolescents presenting to our emergency departments with mental health problems?. The Medical Journal of Australia, 208(8), 339-340.  

Transformational change in health and care

This recent Kings Fund report offers insights to help strengthen transformation efforts by looking at four sites in the UK that have been recognised as successful transformation initiatives.
The stories of Bromley by Bow, Birmingham, Northumbria and Buurtzorg illustrate that transformation is multi-layered, messy, fluid and emergent. It is not merely about changing how a service operates, but also about shifting mindsets, changing relationships and re-distributing power.
The report shows the power of staff and communities to drive transformation: the importance of giving people time and space to think through the purpose of transformation; to understand the struggles and worries they face; to offer support instead of demanding change with no time to prepare or engage.

Transformational change in health and care: Reports from the field. 2018 

Depression During and After Pregnancy

Many women experience depression during and after pregnancy, and it’s important to learn the symptoms of depression and to seek treatment if needed. Some people may experience a few symptoms, and others might experience many. How often symptoms occur, how long they last, and how intense they may feel can be different for each person.
The Center for Disease Control and Prevention (CDC) has released a feature article with information about maternal depression and treatment.  

Trends in hospitalised injury due to falls in older people 2002-03 to 2014-15

This report focuses on trends in fall-related hospital care for people aged 65 and over from 2002-03 to 2014-15. Age-standardised rates of hospitalised fall injury cases increased over the period 2002-03 to 2014-15 for both men (3% per year) and women (2%). There was a decrease in the rate of hip fractures due to falls (-2% per year) between 2002-03 and 2014-15. In contrast, falls resulting in head injuries increased at a particularly high rate (7% per year).

Trends in hospitalised injury due to falls in older people 2002–03 to 2014–15 

26 April 2018

My Health Record Guidelines for Pharmacists

The My Health Record provides electronic access to a patient’s key health information including medicines, allergies, medical conditions and test results, and supports improvements in the safety, quality and efficiency of Australia’s healthcare system.
A pharmacist’s contribution to medication safety and quality use of medicines will be enhanced by their ability to access a patient’s My Health Record. These new guidelines are intended to help increase the number of pharmacists using My Health Record.

My Health Record Guidelines for Pharmacists. Pharmaceutical Society of Australia Ltd., 2017. 

Alcohol & Breastfeeding Web Page

Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns.
The Centers for Disease Control and Prevention (CDC) recently launched a new web page to better inform health care providers and nursing mothers,to provide guidance on consuming alcohol while breastfeeding.

Alcohol and Other Drug Treatment Services in Australia

The report Alcohol and Other Drug Treatment Services in Australia 2016–17: key findings, shows that over 127,000 Australians received drug or alcohol treatment in 2016–17, equating to around 1 in every 170 people. The fastest growing treatment area is for amphetamine use, which has more than doubled over the last 10 years—in 2007–08.
The report from AIHW also shows that Aboriginal and Torres Strait Islander Australians were overrepresented among clients. Despite only comprising 2.7% of the Australian population (10 years and over), 1 in 7 clients (15%) receiving drug or alcohol treatment services were Indigenous.

Treating Lyme Disease Early

The National Institute for Health and Care Excellence in the UK has published a new guideline on Lyme Disease. The guideline has advice for GPs and specialists on symptoms to look out for, tests to help confirm a diagnosis and what treatments to use. It also calls for more UK research into Lyme disease and the best long-term treatment options. Lyme disease symptoms are common with those of other conditions and so NICE says lab tests can be useful to help confirm a diagnosis. Typical symptoms can include combinations of headache, fever, joint pain or fatigue as well as others that are more specific such as problems with nerves or joints.
Lyme disease. NICE guideline [NG95] Published date:  

03 April 2018

Bedside Burnout: Young Midwives

Nurse Uncut blog tells the story of one midwife who took a 20 year career break only to return to many of the same problems they worked through before. Burnout, too many shifts and not enough  staff, things haven't changed.

Bedside Burnout: Young Midwives With No Life Outside Work. By Nurse Uncut Editor, March 15, 2018.

1 in 20 Australian deaths caused by alcohol and illicit drugs

Alcohol and illicit drug use are serious and complex issues that contribute to substantial illness, disease, injury, and deaths in Australia. This new report from AIHW provides insight into the health impact of alcohol and illicit drug use in Australia;

  • Nearly 5% of all deaths are from alcohol and illicit drug use.    
  • One-third of road traffic injuries due to alcohol use
  • Opioids are the largest contributor to the illicit drug use burden.

Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011, AIHW. 29 March 2018. Cat. no: BOD 19

27 March 2018

Weight, Diet and Physical Activity

The Australian and New Zealand Journal of Public Health has published a full open access issue in early 2018. The issue is divided into sections:
  •  Weight, Diet and Physical Activity
  • Alcohol
  • Infectious and Communicable Disease    
  • Water
  • Cancer

Waiting times in the emergency department for people with acute mental and behavioural conditions

Access block and ED overcrowding have implications for patient safety, and are associated with poor health outcomes and excess mortality and morbidity. Patient access to hospital beds should occur within a reasonable timeframe, that is, in no more than eight hours. When a patient waits in the ED for eight hours or more following assessment and treatment, they are known to be experiencing access block.
On 4 December 2017 a POMAB Snapshot Survey was undertaken to estimate the point-prevalence of mental health access block in Australian and New Zealand public EDs accredited for specialist training by ACEM.   The purpose of this brief report is to present findings from ACEM’s research exploring mental health presentations in hospital emergency departments (EDs).

Waiting times in the emergency department for people with acute mental and behavioural conditions. ACEM 2018

Fetal alcohol spectrum disorder and youth justice

This study, in a representative sample of young people in detention in Western Australia, has documented a high prevalence of FASD and severe neurodevelopmental impairment, the majority of which had not been previously identified. These findings highlight the vulnerability of young people, particularly Aboriginal youth, within the justice system and their significant need for improved diagnosis to identify their strengths and difficulties, and to guide and improve their rehabilitation.

Falls among community-dwelling older people

Falls are common among older people and a leading cause of injury-related hospitalisation. The immediate post-hospitalisation period is a risky time for further falls. This paper explores discharge strategies from the perspectives of older people hospitalised for a fall and liaison nurses assisting people to return home.
Thematic analysis revealed three key themes: ‘falls are not a priority’, ‘information not given, or 
given and not retained’ and ‘reduction in confidence and independence’.

Meyer Claudia, Renehan Emma, Batchelor Frances, Said Catherine, Haines Terry, Elliott Rohan, Goeman Dianne (2017) ‘Falls not a priority’: insights on discharging older people, admitted to hospital for a fall, back to the community. Australian Journal of Primary Health 24, 66-73. [open access] 

Simulation-based education to improve communication skills

Good communication between healthcare professionals and between healthcare professionals and patients is important in delivering high-quality care. Effective communication between healthcare professionals and patients improves patients’ outcomes. Communication failure among healthcare professionals is reported to be the major contributing factor in >50% of ‘never-events’ involving patients.
The evidence found in this study suggests a model for SBE aimed at teaching communication skills that is informed by the current evidence and takes into account the need to collect higher-level outcome data.
Blackmore A, Kasfiki EV, Purva M., Simulation-based education to improve communication skills: a systematic review and identification of current best practice