5 ways to re-energise on a night shift

For many nurses and midwives working night shifts, it can be challenging to keep energy levels up and remain mentally alert. The ANMJ suggest five ways to re-energise and combat night shift fatigue here.

                                                          source: ANMJ

Recent article from Critical Care Medicine on the dangers of medication errors in the transition of care

Evaluation of medication errors at the transition of care from an ICU to non-ICU location

Tully AP, Hammond DA, Li C, Jarrell AS, Kruer RM 

Critical Care Medicine. 2019;47(4):543-9.

Transitions of care are a known source of risk. These are points where there can be a failure to communicate important information, failure to adequately transfer or hand over care of a patient between individuals, teams, units or services. This study looked at the specific issue of medication errors for patients transferred from intensive care units (ICUs). The study was a 7-day point prevalence study that encompassed 958 patients who were transferred from an ICU to a non-ICU location in a group of hospitals (34 in the USA and 2 in the Netherlands).

Source: Waitemata District Health Board website

The authors report that 450 patients (45.7%) had a medication error occur during transition of care. Further, among those patients who experienced a medication error, an average of 1.88 errors per patient occurred. The most common types of errors were continuation of medication with ICU-only indication (28.4%), untreated condition (19.4%), and pharmacotherapy without indication (11.9%). Seventy-five percent of errors reached the patient but did not cause harm. Renal replacement therapy during ICU stay and number of medications ordered following transfer were identified as factors associated with occurrence of error. Orders for anti-infective, hematologic agents, and IV fluids, electrolytes, or diuretics at transition of care were associated with an increased odds of error. Factors associated with decreased odds of error included daily patient care rounds in the ICU and orders discontinued and rewritten at the time of transfer from the ICU.

Request the article through the Library Website

Have you checked your immunisation history?

Australians are being encouraged to check their immunisation history as the country reaches a five year high in measles cases.

Australia was declared measles-free just five years ago, with due diligence and high vaccination rates holding the virus at bay. There have been 92 confirmed cases of measles nationally this year in early April, compared to an annual total of 103 for 2018, and 81 for 2017.

Because measles is so highly infectious, outbreaks occasionally happen when people travelling overseas catch the virus and bring it back into Australia. Globally there are hundreds of thousand of cases of measles and tens of thousand of deaths.

The measles virus is so contagious that in areas where vaccination rates are not very high - over 90%, there is a high risk of measles once more becoming a threat to the Australian community. Currently that is what is now happening around the world.

(Centres for Disease Control)

A sharp increase in measles cases has prompted Government immunisation warnings. On Monday, Health Minister Greg Hunt urged all Australians to check their measles immunisation history and book in for a catch-up vaccination if necessary. "In particular, any individual planning to go overseas and those born between 1966 and 1994 are at higher risk and should be take action to protect themselves and their community," Mr Hunt said.

For more on this serious health issue you can read more on ABC News

Chlorhexidine bathing: No benefit in non-critical care units

No benefit of chlorhexidine bathing in non-critical care units
Mimoz O, Guenezan J
The Lancet. 2019;393(10177):1179-80.

Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial
Huang SS, Septimus E, Kleinman K, Moody J, Hickok J, Heim L, et al
The Lancet. 2019;393(10177):1205-15.

Mimoz and Guenezan's commentary on the article by Huang, observes that universal decolonisation has been advocated as a way to reduce health-care-associated infections and limit the transmission of multidrug-resistant organisms. The commonplace strategy has been bathing patients with chlorhexidine (a broad-spectrum antiseptic). This practice has been increasingly used in intensive care units (ICUs) globally. The efficacy of chlorhexidine baths has varied across different trials, with the greatest benefit seen among patients with the greatest risk of infection and few studies have examined the effect of this practice outside ICUs, in lower infection risk venues, and the findings have not been consistent.

Source: Critical Care stock

Huang et al report on the ABATE Infection trial that endeavored to evaluate the use of chlorhexidine bathing in non-critical-care settings. This trial was a cluster-randomised trial involving 53 hospitals and had a 12-month baseline period, a 2-month phase-in period, and a 21-month intervention period. The trial found little difference across the three periods, leading them to find that ‘Decolonisation with universal chlorhexidine bathing and targeted mupirocin for MRSA carriers did not significantly reduce multidrug-resistant organisms in non-critical-care patients.’

Contact the Library for a copy of the article and commentary or use your CIAP log in.

Hastings Macleay Clinical Network - New Books List

Recent systematic review on falls and delirium

Falls and delirium are relatively common – and can have serious consequences for the elderly. This recent study reports on a systematic review about the association between falls and delirium in older people (aged 65 years or older). The review results ‘suggest that falls and delirium are inextricably linked’. The authors propose that this indicated ‘a need to further refine fall risk assessment tools and protocols to specifically include delirium for consideration as a risk factor’.

Source: https://betterhealthwhileaging.net

If you work with the aged you'll be interested in this article. 

The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review
Sillner AY, Holle CL, Rudolph JL
Clinics in Geriatric Medicine. 2019 [epub].

Please request it from your network Library service

When hospitals lead to harm: Opioid year of action

This year there will be more than 2.5 million surgeries in Australia. The prescribing, administration and dispensing of opioids will follow many of these procedures.

Due to unrealistic expectations of pain management, overprescribing and lack of evidence-based educational programs for health professionals, use will grow into dependence and harm for some people.

Since the inaugural multidisciplinary and collaborative Medicines Leadership Forum in Canberra in July 2018 framed the issue of hospital-initiated opioid harm from a pharmacy perspective, SHPA has released a landmark report detailing the problems Australia faces, and solutions that could help turn the tide.

Read more here on Hospital and HealthCare.

New title available at CHHC library Overcoming Opioid Addiction : The Authoritative Medical Guide for Patients, Families, Doctors, and Therapists

** Reminder ** MNCLHD Libraries Needs Assessment Survey

We are carrying out an evaluation of the library’s services, to see if we can improve facilities and services and keep them up to date with staff needs. Thank you for taking the time to fill in this questionnaire; it should only take five – ten minutes of your time. Your answers will be treated with complete confidentiality and will be entirely anonymous. Hardcopies are available in both CHHC and PMBH library. If you have any questions about this questionnaire, please contact 6656 7161 or 5524 2192.

Survey will be open until COB 15th March 2019

Please take our survey here or click on the pic below:

Caesarians increase risk of postnatal depression

A major new study conducted by the University of York, and published in the Journal of Health Economics, provides new evidence that emergency C-sections put new mothers at greater risk of experiencing mental health problems after giving birth.

The study has revealed first-time mothers who give birth via unplanned caesarean section are 15% more likely to experience postnatal depression. Furthermore, the numbers of C-sections performed worldwide have increased dramatically in many developed countries over the past few decades

The author of the study is calling for more mental health support for women whose babies are delivered via emergency caesarean section, or C-section — a surgical procedure usually carried out because of complications during labour.

Read more here at Hospital and Healthcare.

                                                           Source: Hospital and Healthcare

‘Year of the Nurse’ in 2020

Nursing Now, the three-year global campaign aiming to improve health and lift the profile of nursing, has welcomed backing by the World Health Organization (WHO) to designate 2020 the ‘Year of the Nurse’.

“There are 20 million nurses and midwives globally, who make up half of the professional health workforce. This is a wonderful opportunity to show people what an exciting career nursing is and highlight what nurses can do to help achieve health for all.”

Read full article here on ANMJ and more at Nursing Now 

                                                                   Source: ANMJ

Is breakfast the most important meal of the day?

Will eating a good breakfast improve your energy through the day and help you loose weight? Recent research published in the British Medical Journal suggests that this might not be the case. Recommending the inclusion of breakfast to adults seeking weight loss guidance might not be a good plan, as it could have the opposite effect.

"Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials".
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l42 (Published 30 January 2019)Cite this as: BMJ 2019;364:l42

                                                                               www.bmj.com

If you would like to read this article go to your CIAP account (NSW Health employees only) or contact your Librarian for the document to be delivered to your desk-top.

CIAP / MIMs Online and MIMs App : Do you know how to access these vital tools?

NSW Health employees have access to the Clinical Information Access Portal (CIAP) free of charge.

Register for a CIAP account on a NSW Health Department Intranet computer
www.ciap.health.nsw.gov.au

> MY CIAP Account > Register for My CIAP Account
Once you've completed the form you will be sent and e-mail with a verification link which must be used within 24 hours. Once that's done you are ready to use CIAP from anywhere!

Resources include major databases, core journals, medicines information, ebooks and more.

You can use MIMS Online from any networked computer of from your own device when you've registered for your CIAP account. If you use your own device you will need to use data.

There are a range of tools available online that also have applications available for staff to use offline, but one of the most popular is MIMS Australia.

To get the App all you need to do is download the iMIMS from the App Store or MIMS for android from the Google Play Store. Links to these can be found by navigating to the CIAP website as above  and selecting the "Mobile" tab on the top menu.

Then register for an "enterprise token" number from the appropriately named button on the Mobile Resources page on CIAP. Select your device type, enter your email address and follow the prompts. Remember to record your token number.

Open the app on your device and select "Logon (Token Required)" under the enterprise users only section.

Enter your enterprise token number and your app is ready to go.

Need help? See your Network Librarian

MNCLHD Libraries Needs Assessment Survey

We are carrying out an evaluation of the library’s services, to see if we can improve facilities and services and keep them up to date with staff needs. Thank you for taking the time to fill in this questionnaire; it should only take five – ten minutes of your time. Your answers will be treated with complete confidentiality and will be entirely anonymous. Hardcopies are available in both CHHC and PMBH library. If you have any questions about this questionnaire, please contact 6656 7161 or 5524 2192.

Please take our survey here

picture credit: admonsters.com

ScrubUp App helps inexperienced perioperative nurses

Perioperative nurse and ScrubApp inventor Marrianne McGhee has been a registered nurse for over 20 years. Marrianne had not been working as a registered nurse for long when she was asked to scrub for an embolectomy — assisting an experienced, and somewhat intimidating, vascular surgeon to remove a blood clot. The procedure did not go according to plan, leaving the surgeon increasingly frustrated and Marianne feeling very ineffective and unhelpful.

If faced with the same situation now, she would have known the potential risks and would have prepped the theatre accordingly, but is concerned about the ongoing pressures put on junior nurses, who continue to be asked to scrub for cases across surgical specialities they’re unfamiliar with.

Which is why she developed mobile app ScrubUp — as a way to support novice nurses.

Read the full article here on Hospital and Healthcare.

                                                                                                 photo credit: Hospital and Healthcare

AI supports instant diagnosis of top eye disease

Artificial intelligence is being used to support the instant diagnosis of diabetic retinopathy, one of the top causes of blindness, in its earliest stages.

The diabetic-related eye disease is the leading cause of vision loss in adults and its impact is growing worldwide, with 191 million people set to be affected by 2030.
Now a team of Australian–Brazilian researchers led by RMIT University have developed an image-processing algorithm that can automatically detect one of the key signs of the disease, fluid on the retina, with an accuracy rate of 98%.

Read more here at Hospital and Healthcare.