Safe Clinical Handover Program in NSW

The Safe Clinical Handover Program within NSW Hospitals has been expanded to include two new projects:

• JMO Clinical handover - Improving patient safety through consistent and quality clinical handover at all shift changes for Junior Medical Officers (JMOs). Includes the JMO handover Toolkit.


• GP/Facility handover - The conceptualised GP/Facility clinical handover project aims to improve transfer of clinical information in both directions between acute facilities and General Practice.

You can read more on the ARCHI website. The Australian Resource Centre for Healthcare Innovations (ARCHI) is a unique national information and networking service for health professionals.

Comparison of people with ABI living in two accommodation settings: shared supported accommodation and residential aged care

Young Australians with an acquired brain injury are more disconnected from their communities when living in aged care nursing homes than group homes according to this research. People with severe acquired brain injury (ABI) often require high and ongoing levels of paid support, which is sometimes provided within a shared supported accommodation service However a large percentage of people with ABI still live in aged care facilities.

Findings of the study have been published in the journal Brain Impairment. You can read the full text here.

VTE Prevention Resources

New resources for clinicians and patients to support the implementation of recommendations from the 2009 Clinical Practice Guideline for the Prevention of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Australian Hospitals are now available from the NHMRC website. The guideline provides practical, evidence-based recommendations for the prevention of VTE in adult surgical and medical patients and pregnant women admitted to Australian metropolitan, regional and rural hospitals.

NHMRC new guideline

NHMRC has recently approved Clinical Practice Guidelines on Magnesium Sulphate Prior to Preterm Birth for Neuroprotection of the Fetus, Infant and Child that was developed by the Australian Research Centre for the Health of Women and Babies (ARCH).

Vitamin D supplementation for improving bone mineral density in children

Osteoporosis is a condition where bones are weak and brittle, and break or fracture easily, as a result of both less bone and poor bone quality. One way to prevent osteoporosis in later life is to build stronger bones when young. Vitamin D plays an important role in improving the body's absorption of calcium from food, reducing the loss of calcium from the body and promoting calcium deposition to improve the quantity of bone developed.
The authors of a recent Cochrane Review set out to determine the effectiveness of vitamin D supplementation for improving bone mineral density in children. The meta-analysis used data from six studies, including 884 participants ranging in age from eight to 17 years.

You can read the full review here.

Craniofacial Abnormalities

Medline Plus has recently created a new health topic page on Craniofacial Abnormalities. These health topics are created by the National Library of Medicine's National Insitute of Health.

MedlinePlus offers a free email subscription service that allows you to receive alerts by email when new information is available on any of the hundreds of health topics.

Aged care in Australia - draft report

The Australian Government's Productivity Commission has just released its draft report, Caring for Older Australians. There is a need to cater for a predicted 3.6 million people by 2050 and submissions close on 21 March 2011. Problems with current funding structures, the availability and cost of aged care accommodation, inconsistency of policy and the need for more effective end of life care are highlighted and recommendations are made.

ABC Radio National has available a podcast interview with National Seniors Australia CEO, Michael O'Neil, where he discusses the reaction to the report. Also read an opinion piece by Scott Stephens in The Drum, where he states that the report is "an extraordinary and long-overdue document that, if implemented, will go a long way toward rectifying the myriad injustices and forms of institutional and economic abuse to which our elderly are subjected in the final years of their lives."

Medical ethics in history

ABC Radio National's Health Report recently aired a fascinating program entitled, Lack of medical ethics - from the 19th century to Nazi Germany. Paul Weindling, the Wellcome Trust Professor of the History of Medicine at Oxford Brookes University, discussed how before the 19th Century, the term "medical ethics" really meant professional courtesy - how doctors related to each other. He went on to describe the origins of modern bioethics and explained that what went on in Nazi Germany and the concentration camps didn't come out of the blue - it was an extension of longstanding medical practices in countries like Britain and the United States, taken to inhuman extremes.
You can listen to the podcast or read the transcript at the Health Report site.

Australian doctors' satisfaction with their work

A study published this month in the Medical Journal of Australia looks at the level and determinants of job satisfaction between four groups of Australian doctors: general practitioners, specialists, specialists-in-training, and hospital non-specialists. Australian doctors’ satisfaction with their work: results from the MABEL longitudinal survey of doctors, reports on job satisfaction scores for each group, calculated using data from the longitudinal survey of Australian doctors in clinical practice (Medicine in Australia — Balancing Employment and Life [MABEL]).

85.7% of doctors were moderately or very satisfied with their jobs and there were no differences in job satisfaction between GPs, specialists and specialists-in-training. Hospital non-specialists were the least satisfied compared with GPs. "This is the first national survey of job satisfaction for doctors in Australia and it provides an important baseline to examine the impact of future health care reforms and other policy changes on the job satisfaction of doctors."

MJA 2011; 194 (1): 30-33. Contact your library if you have trouble accessing the full text.

Chronic Care for Aboriginal People Models of Care

Chronic Care for Aboriginal People Model of Care has been published by the NSW Health Clinical Services Redesign Project as a step-by-step guide for health professionals treating Aboriginal people with chronic conditions. Four major diseases are the focus: heart disease, diabetes, chronic lung disease and kidney disease.

The purpose of this document is to highlight the need to move from a traditional approach in health care to a model that considers the special needs of Aboriginal people. Eight fundamental elements were identified as being essential to the model of care for working with chronic disease in Aboriginal communities. They are Identification, Trust, Screening and Assessment, Clinical Indicators, Treatment, Education, Referral and Follow up. The element of "trust" is seen to be the most significant difference between this and other models of care.

Marketing obesity? Junk food, advertising and kids

This paper examines the debate over the importance of foods high in fat, sugar and salt in childhood obesity. It also looks at policy approaches to junk food in a number of countries and consequent actions taken to control or prohibit the influence of advertising. In particular, the paper notes recent Australian government approaches to dealing with this issue

You can read the Research Paper by Dr Rhonda Jolly here.

Disability support services

The number of people using disability support services increased by almost 50% between 2003-04 and 2008-09, according to a report released on January 19 by the Australian Institute of Health and Welfare (AIHW). Each of the five main service types—respite, employment, accommodation support, community support and community access—experienced real increases in total expenditure. The report also describes the service outlets and the uses of these services, including their support needs and informal carer arrangements.
Read or download the report here.

Standards of Medical Care in Diabetes

The American Diabetes Association's annual update of standards of care for diabetes can be read for free in the latest issue of Diabetes Care.

Standards of Medical Care in Diabetes Diabetes Care Jan 1, 2011 (FREE FULL TEXT)

National Teen Drug Usage

The National Drug Strategy Monograph: Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2008, was released by the Acting Minister for Health and Ageing, Mark Butler this week. The Australian Secondary Students Alcohol and Drug Survey, partly funded by the Australian Government, is coordinated by the Cancer Council of Victoria and takes place every three years. This survey took place during the academic school year of 2008, with around 24,000 secondary students aged between 12 and 17 years participating. They were asked about their lifetime and current use of tobacco, alcohol, analgesics, tranquilisers, illicit substances and related behaviour. You can download the report here.

Australian health expenditure

The Australian Institute of Health and Welfare has published a new report "Australian health expenditure by remoteness: a comparison of rural, regional and city health expenditure".
The report looks at selected health services for the financial years 2001-02, 2004-05 and 2006-07 and examines the way these services were delivered across Australia. This analysis was performed using the Australian Standard Geographical Classification System to compare the expenditure and usage rates of the health services by residents of Major Cities, Inner Regional, Outer Regional, Remote and Very Remote areas of Australia. Click here to view the report.

Standards for the care of children and adolescents

Consensus standards for the care of children and adolescents in Australian health services has been published in the Medical Journal of Australia this week. The Standards were developed by a working group of clinicians, health service providers and consumer advocates and included stakeholder input. Pilot testing was conducted in six metropolitan, regional and rural hospitals. The key outcomes are:

• Rights: The rights of children and adolescents are upheld at all times and they and their families are always treated with respect, sensitivity and dignity.


• Facilities: Children and adolescents are cared for in a safe and appropriate physical environment designed, furnished and decorated to meet their needs & developmental age.


• Equipment: Children and adolescents are cared for utilising equipment that is specifically designed to meet their needs, size and developmental age.


• Staff: Children and adolescents are cared for by staff specifically trained to meet their physical, psychosocial, developmental and cultural needs.

MJA 2011; 194 (2): 78-82

Dangers of tablet splitting

The Journal of Advanced Nursing in it's January 2011 issue includes a study by Charlotte Verrue and others called "Tablet splitting : a common but not so innocent practice."

The study found that nearly a third of the split fragments deviated from recommended dosages by 15 per cent or more, and the authors point out that the practice could have serious clinical consequences for tablets that have a narrow margin between therapeutic and toxic doses.
They are calling on manufacturers to produce greater dose options and liquid alternatives to make the practice unnecessary. Verrue says, “Based on our results, we recommend use of a splitting device when splitting cannot be avoided, for example when the prescribed dose is not commercially available or where there is no alternative formulation, such as a liquid.
“Staff who are responsible for splitting tablets should receive training to enable them to split as accurately as possible. They should also be made aware of the possible clinical consequences of dose deviations."

Journal of Advanced Nursing. 67.1, pp 26-32. (January 2011). DOI: 10.1111/j.1365-2648.2010.05477.x. Article available through CIAP, or consult your health library.

Atlas of Productive Ageing

From the National Seniors Productive Ageing Centre (NSPAC), comes a new website. The Atlas of Productive Ageing provides statistics on the population, health, finance, housing and activity of older Australians. Maps and data are available by state and regional areas and for different age groups.

There's a huge amount of statistical information available here, from levels of education to volunteer workers, to religion and Internet usage.

Top Health Reports 2010

The five most read reports and commentary pieces in the Health area in 2010 include items concerning: primary health care reform; the health impact of Black Saturday; the National Health and Hospitals Network. To read more about these popular items click here.

Tuberculosis Testing

The World Health Organization (WHO) has endorsed a new and novel rapid test for tuberculosis (TB) which could provide an accurate diagnosis for many patients in about 100 minutes compared to current tests that can take up to three to six weeks. TB is a major cause of death and disability in the regions closes to us so it remains a real risk to the Australian community.
World TB expert Warwick Britton from the Centenary Institute in Sydney said: “The current test is over 100 years old now so it poses a major limitation in the early diagnosis of TB, especially in children and those with drug-resistant TB. This new rapid test is a significant breakthrough because it will allow accurate diagnosis within hours rather than the three to six weeks it currently takes to grow the bacterium.”
Go to the WHO Tuberculosis topic page to download fact sheets, guidelines and reports.

Gateways to Evidence that MatterS' (GEMS)

The aim of 'Gateways to Evidence that MatterS' (GEMS) is to provide a summary of recent, Australian and international research concerning children (aged 0-18 years) of parents with a mental illness, their parents and families. While research in this area is growing, there is a lack of evidence based practice when working with families affected by parental mental illness. GEMS is part of Children of Parents with a Mental Illness (COPMI) which provides information for family members across Australia where a parent has a mental illness and for people who care for and work with them.

Infections in pregnancy

2011's BJOG themed issue entitled "Infections in pregnancy" is freely available online until March 31. The articles in this special themed issue of BJOG highlight significant viral, bacterial and microbial infections that complicate pregnancy. The way each one causes damage, and how mothers and fetuses respond (or sometimes fail to respond) is described. Prevention and treatment strategies that are currently available, and priorities for future research, are presented in reviews, commentaries and original research articles.