DArcy Photography Leanne Beagley 070 cropped and resized2

Western Victorian Practice Nurse Study:
a bid to better understand practice nursing in the PHN

Deloitte Consulting recently released a report on the Australian nursing workforce. It predicts an increasing demand, expanded roles and higher pay for nurses. Within western Victoria we are already experiencing some concerns about the general practice workforce and the difficulties of succession planning for GPs planning to retire. What is the situation for practice nursing in our region?

The Western Victorian Practice Nurse project, funded by the Western Alliance, is setting out to explore these issues. The study is run by a research team from the School of Nursing at Federation University, the Deakin School of Medicine, the Western Victoria PHN and the Australian Primary Health Care Nurses Association. It will survey every practice nurse in our region in an effort to identify if we may be developing a shortfall in our practice nursing workforce.

Other planned outcomes include an analysis of what practice nurses currently do and the tasks that GPs, nurses and patients feel practice nurses could appropriately do in the future to better support patients and GPs in improving our regional health status.

Nurses throughout western Victoria will shortly be receiving this survey. The information will be vital to identify how practice nurses might be best supported.

For more information please contact (Deakin University) Chief Investigator Professor Gerard Gill.

Dr Leanne Beagley, Chief Executive Officer & Chair, Victorian PHN Alliance

General

New back pain recommendations
ePIP – Shared Health Summary upload targets
Confirmed measles case in Melbourne
Hepatitis A information for homeless rough sleepers
Ambulance Victoria Care Plans
Codeine Rescheduling Webinar
Influenza Webinar
Number 1 Fertility introduction
Mending Hearts: comprehensive cardiology update
Australian Primary Health Care Nurses Association's 10th annual conference:
'Nurseforce for the Future'
Newborn Behavioural Observations workshop

Geelong Otway

Nurse Practitioner Scholarships: apply by Friday
HealthPathways update
Automated External Defibrillator registered
Child and Adolescent Mental Health Service and Child and Youth Triage: new location
Immunisation providers meeting
Wound Closure and Suturing workshop

Great South Coast

HealthPathways update
Upper Limb Management for Neurological Patients workshop
Vestibular Rehabilitation introductory course
Immunisation providers meeting

Wimmera Grampians

HealthPathways update
Understanding Disability in Culturally and Linguistically Diverse Communities:
Training for Mainstream Services
Domestic violence awareness session

General 

New back pain recommendations

Western Victoria PHN logo

Back pain in Australia is reported to be as high as 80 per cent of the population, with one in ten of those suffering experiencing significant activity limitations.

Traditionally, medications such as opioids, benzodiazepines, pregabalin and gabapentin have been prescribed to treat back pain. However, in light of prescription drug overdoses increasing and changes in codeine regulations, new recommendations have recently been released regarding the treatment of back pain with benzodiazepines and opioids.

There is little evidence to support opioids being an effective treatment for chronic non-cancer pain (CNCP), including back pain. In fact, opioid use in CNCP has been shown to increase distress, unemployment, lower activity rates, and poor self-rated health and overall reduce quality of life. It is now recommended opioids should not be prescribed as a first choice for patients with CNCP. If after a trial period using non-opioid medication unsuccessfully, opioids should not be prescribed alone as an analgesic. Instead, they should be prescribed in conjunction with non-drug therapies, including physio therapy and psychotherapy, which aid in promoting functional restoration while reducing distress.

Opioid prescription for CNCP should cease if there has been no demonstrable improvement in functionality. There should also be periodic attempts in dosing reduction and screening for long-term harms associated with opioid prescription. It is crucial to ensure prior to prescribing that a comprehensive assessment of the patient has been undertaken as well as creating a ‘contract’ with the patient that will include a criteria for functional improvement and rules around use and cessation.

Due to regulatory requirements there should only be one single prescriber and a ‘deputy’ prescriber who take the responsibility for opioid prescription.

Benzodiazepines have been commonly prescribed as ‘muscle relaxants’ to treat back pain in Australia. However, there are no studies supporting the use of benzodiazepines in treating acute or chronic back pain, in addition to or instead of anti-inflammatory medication. Furthermore, the risks appear to outweigh the benefits of benzodiazepine prescription for back pain which include, abuse, addiction, tolerance and overdose. Accidental overdose from pharmaceutical opioids remains the highest in the 30-49 age bracket, although deaths in the older age ranges still remains extremely high.

Pregabalin and gabapentin have been prescribed to treat back pain, however, new recommendations include avoid prescribing these medications unless the patient meets the full criteria for neuropathic pain. The IASP definition of neuropathic pain requires demonstration of a lesion or disease of the somatosensory system. Descriptors that may suggest neuropathic pain are painful cold, burning, and so on. It is important to note that these symptoms alone do not meet the criteria for neuropathic pain. As with all pharmacotherapy treatment, if prescribing pregablin or gabapentin, improvement indicators such as emotional and cognitive functioning, activity levels, sleep quality, side effects and overall quality of life should be closely monitored.

Visit Choosing Wisely Australia for further information regarding these new back pain recommendations. Western Victoria PHN has developed a number of Healthpathways to support pain management opioid prescription in both the acute and chronic pain setting and information relating to:

  • Chronic pain
  • Low back pain in adults
  • Opioid dependence
  • Codeine misuse and dependence
  • Opioid replacement therapy.

For more information or assistance contact:

Geelong region
Pene Wood email or telephone 5222 080
Hannah Buttigieg email or telephone 5222 0800

Warrnambool region
Amy Collins email or telephone 5564 5888
Raj Samrai email or telephone 5564 5827

Ballarat, Ararat and Horsham regions
Jacqueline Keevins email or telephone 5338 0511

Please join our online forum to discuss with your peers and colleagues your issues with patients displaying drug seeking behaviour or any other issues you have with prescribing opioids, pain and dependence.

ePIP – Shared Health Summary upload targets

Department of Health

The current PIP quarter ends Friday 30 April 2018. Accordingly, the department advises practitioners registered for the eHealth PIP incentive to check that they are on track for the number of Shared Health Summary (SHS) uploads required for their practice.

The department advises that practitioners need to upload 0.5% of practice SWPE (standard whole patient equivalent) of the previous PIP quarter, which may be found at the bottom of the front page of your last statement or on HPOS (example: SWPE 2,500 = 13 shared health summaries uploaded). Please contact your designated primary care consultant if you’re unsure how to calculate the number of SHSs required to be uploaded.

Practitioners can check how many SHSs have been uploaded by:

The department recommends that if you’re not going to reach your target of required SHS uploads, you will need to withdraw from the eHealth PIP incentive online. The department is aware of audits being performed and where there has been non-compliance to the eHealth PIP incentive, practices may be asked to return ePIP funds paid.

Contact PIP for advice specific to your practice online, by email or telephone 1800 222 032 (8.30am to 5pm, Monday to Friday, Australian Central Standard Time).

Victoria State Gov logo

Confirmed measles case in Melbourne

There has been one additional confirmed case of measles in Melbourne which may be linked to a previously reported case from March 2018. This takes the number of measles cases confirmed since early March 2018 to 14 in total.

The list included in the alert outlines additional sites where the latest case may have been infectious with measles. Susceptible patients who attended these sites at the dates and times specified should continue to look out for measles until up to 18 days after their exposure.

Read more

Hepatitis A information for homeless rough sleepers

Victoria's Department of Health and Human Services has announced a public campaign to provide information about hepatitis A and the availability of its associated vaccine. Rough sleepers are now able to access the vaccine after evidence has emerged that they are at an increased risk of developing the acute infection. 

Importantly, the guide has been developed so it can be shared with members of the public and others who do not have a medical background.

Please see the Important health information for homeless rough sleepers guide for full details.

Ambulance Victoria Care Plans

Ambulance Victoria

Ambulance Victoria's (AV) Referral Service plans to telephone GPs regarding the development of patients' AV Care Plans. GPs may be asked to share information about patients, including medical history, medications, pathology and ongoing medical treatments to assist Ambulance Victoria help inform the development of the AV Care Plans.

The plans are tailored for patients who are frequent callers to Ambulance Victoria requesting emergency ambulance attendance, where alternative community care providers or self-care advice is more appropriate.

For more information, please see the attached flyer.

Codeine Rescheduling Webinar 

ACRRM

The Australian College of Rural and Remote Medicine's latest webinar tomorrow, will focus on options for the management of pain, and opiate replacement in chronic disease and palliative care patients. A panel of rural health professionals including GPs, a pharmacist and specialists in pain management and palliative care will host a Q&A forum and consider health professionals' options since codeine was rescheduled.

The 90 minute webinar is open to all health professionals and consumers, and will be of particular benefit to those with a rural and remote focus. All questions are welcome, in particular around options for the management of pain in chronic disease and palliative care, and options for opiate replacement in these circumstances: please email questions to the panel in advance of the webinar.

A recording will be made available after the event.

Date: Thursday 12 April
Time: 7.30pm - 9pm
Venue: Online

Register online.

Influenza Webinar

Immunisation Coalition

The Immunisation Coalition will present its annual update on influenza vaccination for GPs, immunisation nurses, pharmacists, and other immunisation professionals, next week. The webinar will provide the latest information on the 2018 influenza vaccines, including two new enhanced vaccines that will be available for people over 65 years, through the National Immunisation Program (NIP) Schedule.

In addition, an updated quadrivalent influenza vaccines will be available for all adults under 65 years and will be available under the NIP and in the private market. 

Date: Tuesday 17 April
Time: 7pm

Register online.

Number 1 Fertility introduction

Number 1 Fertility

Doctors are invited to meet Number 1 Fertility's Medical Director Dr Lynn Burmeister and Scientific Director Dr Tiki Osianlis at Epworth Geelong. The pair will discuss:

  • Optimising fertility for patients of all ages
  • Investigations to determine underlying causes
  • What you can do to assist your patients 
  • World class IVF in 2018 (acronyms, procedures and processes).

Date: Monday 30 April 
Time: 6.30pm
Venue: Epworth Geelong, 1 Epworth Place, Waurn Ponds

Please RSVP by email before Monday 23 April 2018.

Mending Hearts: comprehensive cardiology update

Cabrini Square

An interactive seminar, developed in consultation with GPs, will present the latest issues, literature, research and best-practice guidelines. A specialist panel will discuss and interpret these topics for real life general practice, and help participants keep up-to-date with emerging therapies in structural and non-structural cardiology.

Date: Saturday 5 May
Time: 8.30am - 5pm
Venue: Auditorium, Cabrini Malvern, Level 2, 183 Wattletree Road, Malvern

For more information please see this flyer.

Australian Primary Health Care Nurses Association's 10th annual conference:
'Nurseforce for the Future'

APNAlogo.155329

The Australian Primary Health Care Nurses Association will host its 10th annual conference next month. The conference will offer tailored professional development for nurses working in primary health care around Australia, including keynote presentations from nurses leading the way, interactive workshops and collaborative sessions from nurses making a difference in the field.

Date: Thursday 10 May - Saturday 12 May
Time: 9am - 5pm (Thursday), 7am - 5pm (Friday), 7am - 5pm (Saturday)
Venue: Brisbane Convention & Exhibition Centre, Corner Merivale and Glenelg Streets, South Brisbane, Queensland

Read more

Newborn Behavioural Observations workshop

Womens Hospital logo

The Royal Women's Hospital Newborn Behavioural Observations (NBO) system is a relationship building tool that the hospital says fosters a positive parent-infant interactive relationship. The hospital asserts that a supportive, nurturing relationship that is sensitive and responsive to the infant’s needs is a sign of parents' successful adaptation to parenting and optimises their infant's neurological and psychological development.

The NBO training program is designed to provide participants with the theoretical foundations and clinical principles necessary to enable them to use the Newborn Behavioural Observations (NBO) system in their clinical practice. Use of the NBO in clinical practice will provide parents with important information about their baby’s remarkable capacities and individuality. It will help parents develop a positive relationship with their newborn child.

The workshop is open to general practitioners, midwives, maternal and child health nurses, paediatricians, neonatologists, obstetricians, social workers, perinatal psychiatrists, infant mental health clinicians and family support workers.

Twilight workshop
Date: Sunday 24 June
Time: 2pm - 6pm
Venue: Ground Floor, The Women's Conference Centre, The Royal Women's Hospital, Corner Grattan Street and Flemington Road, Parkville

Full day workshop
Date: Monday 25 June
Time: 9am - 5pm
Venue: Ground Floor,The Women's Conference Centre, The Royal Women's Hospital, Corner Grattan Street and Flemington Road, Parkville

Attendance at both days is required to attain certification.

Register online.

Geelong Otway

Western Victoria PHN logo

Nurse Practitioner Scholarships: apply by Friday 

Applications for the 'Barwon South West Pharmacotherapy Area Based Network' (PABN) scholarships for nurse practitioners close Friday 14 April.

These scholarships are offered to increase the number and capacity of Nurse Practitioners prescribing Medically Assisted Treatment for Opioid Dependency in the region, which will add significant value to primary care systems.

Australian Health Practitioner Regulation Agency Registered Nurses (Division 1) practicing in the Barwon South West PABN region who are, or wish to, undertake the Masters of Nursing (Nurse Practitioner) course are encouraged to apply. Preference will be given to those nurses already working in AOD service delivery.

Last year’s recipient, Alison Ford, said she wanted to become part of a collaborative health care team that's delivering services in the community to ease the burden of time pressures on GP’s and in effect provide assistance and support to people wishing to decrease their dependence on opioids.

Alison Ford


"The more I work in preventative primary health care, the more I realise the positive impacts it has for individuals and for the health care system at large," Alison said.

How to apply

Please read these Guidelines and Agreement, complete this two-page Application Form and email to pene.wood@westvicphn.com.au by close of business, Friday 14 April 2018. 

Successful applicants will be advised by 28 April 2018.

HealthPathways update

HealthPathways

New on HealthPathways:

  • Post-acute stroke care
  • Thrombocytopenia
  • B12 deficiency
  • Neutrophilia
  • Neurosurgery assessment – acute, non-acute and advice.

Recently reviewed and updated:

  • Irritable bowel syndrome
  • Memory assessment
  • Familial genetic counselling referrals
  • Syphilis.

To stay up to date on recent, locally agreed guidelines see HealthPathways.

Automated External Defibrillator registered

Ambulance Victoria

The Automated External Defibrillator (AED) mounted on the kitchen cupboard near reception (ground floor, Western Victoria Primary Health Network Geelong), has been registered with Ambulance Victoria. The registration supports Ambulance Victoria’s Responding to Cardiac Arrest: A Community Response to a Community Problem campaign.

Now that our AED is registered as ‘Public Access’, a Trusted Responder may be directed to use this during our opening hours. Trusted Responders are verified by Ambulance Victoria, and are bound by a Code of Conduct.

A sticker has been placed on the outside of the AED case confirming registration with Ambulance Victoria. A big thank you to Marg Dempsey for suggesting we take part in the initiative.

Child and Adolescent Mental Health Service and Child and Youth Triage: new location

BarwonHealthlogo.161143

Barwon Health's Child and Adolescent Mental Health Service (CAMHS) and Child and Youth Triage has relocated to Level 1, 131 Myers Street Geelong. To speak with a clinician regarding an existing client, please continue to telephone 4215 8600 and ask for the relevant case manager or duty worker.

All new referrals for CAMHS, Jigsaw and the eating disorder service will continue to be received via Child and Youth Triage by telephone 1300 094 187 and fax 4215 8698.

Please refer patients by telephone where significant risk issues exist.

Immunisation providers meeting

Department of Health and Human Services

The Department of Health and Human Services (DHHS) will convene a meeting of immunisation providers in western Victoria this month. The forum will provide information on policy and project developments, including vaccine changes and new resources. Attendees will also receive an update on Western Victoria Primary Health Network's Immunisation Program Report.

Date: Tuesday 24 April
Time: 9.30am - 1.30pm
Venue: Western Victoria Primary Health Network, Bayside City Plaza, 24 – 36 Fairy Street, Warrnambool 

Please RSVP to Eileen McCormick, DHHS Divisional Public Health Officer.

Participants wishing to attend the meeting via webinar can register online.

Wound Closure and Suturing workshop

Benchmark Logo

A new workshop next month will examine the knowledge and skills required for nurses, general practitioners and relevant allied healthcare workers to safely assess the need for and to perform wound closure in a variety of settings.

The two-day course will cover 

  • Wound assessment
  • Identifying and managing different types of wounds
  • Using localanaesthetic
  • Closure methods and selection of appropriate materials Demonstrations
  • Simulated wound closure
  • Practical techniques and simulated assessment tasks
  • Documentation and follow up and referral.

Date: Thursday 31 May - Friday 1 June
Time: 8.45am - 4.30pm
Venue: Geelong Conference Centre, Adams Court, Eastern Park Gardens, East Geelong

For more information please see this flyer.

Great South Coast

HealthPathways update

HealthPathways

Recently updated with localised information:

  • Pain management programs
  • Q Fever
  • Benzodiazepine withdrawal
  • Alcohol brief intervention
  • Alcohol withdrawal
  • Drug and alcohol assessment and support
  • Pain specialist assessment (non-acute, advice)
  • Cognitive impairment and dementia
  • General medicine referrals – acute, non-acute and advice.

To stay up to date on recent, locally agreed guidelines visit HealthPathways.

South West Healthcare

Upper Limb Management for Neurological Patients workshop

South West Healthcare will host a half-day workshop in Warrnambool next month focusing on best practice for upper limb management for neurological patients. Neurosciences physiotherapist Thao Nguyen (The Royal Melbourne Hospital) will facilitate the event, designed to provide physiotherapists and occupational therapists with the opportunity to update skills and theoretical knowledge in the management of the upper limb in neurological patients.

Discussions will cover: 

  • Management Tool for Acute Hemiplegic Shoulders (MTAHS)
  • Strapping
  • Collar and cuff
  • Positioning and stretching
  • Functional electrical stimulation
  • Splinting
  • Serial casting
  • Botulinum toxin
  • Modified constraint induced movement therapy.

Date: Thursday 19 April
Time: 12.15pm - 4.30pm
Venue: South West Healthcare, 25 Ryot Street, Warrnambool

For more information and to register, see this flyer.

Vestibular Rehabilitation introductory course 

South West Healthcare will also present a two-day introductory course on vestibular rehabilitation, in May. The training aims to introduce clinicians to common vestibular disorders such as Benign Paroxysmal Positional Vertigo (BPPV), Vestibular Neuritis/ Labyrinthitis, Ménière's Disease, Bilateral Vestibular Hypofunction, Migraine Associated Dizziness, and central vestibular pathologies.

The course will cover: 

  • Vestibular assessment and differential diagnosis
  • Unilateral vestibular pathology: recovery mechanisms and implications for treatment
  • Audiology Testing
  • Anatomy and Pathophysiology of BPPV
  • Assessment and Management of BPPV
  • Introduction to Central Vestibular Disorders.

Date: Saturday 19 - Sunday 20 May
Time: 8.30am - 4.30pm
Venue: South West Healthcare, 25 Ryot Street, Warrnambool

For more information and to register, see this flyer.

Immunisation providers meeting

Department of Health and Human Services

The Department of Health and Human Services (DHHS) will convene a meeting of immunisation providers in western Victoria this month. The forum will provide information on policy and project developments, including vaccine changes and new resources. Attendees will also receive an update on Western Victoria Primary Health Network's Immunisation Program Report.

Date: Tuesday 24 April
Time: 9.30am - 1.30pm
Venue: Western Victoria Primary Health Network, Bayside City Plaza, 24 – 36 Fairy Street, Warrnambool 

Please RSVP to Eileen McCormick, DHHS Divisional Public Health Officer.

Participants wishing to attend the meeting via webinar can register online.

Wimmera Grampians

HealthPathways update

HealthPathways

New on HealthPathways:

  • Non-acute neurosurgery assessment
  • Cognitive impairment and dementia
  • Acute orthopaedic assessment
  • Non-acute orthopaedic assessment
  • Orthopaedic advice
  • Acute respiratory assessment
  • Non-acute respiratory assessment
  • Respiratory advice.

To stay up to date on recent, locally agreed guidelines visit HealthPathways.

Understanding Disability in Culturally and Linguistically Diverse Communities:
Training for Mainstream Services

ADEC

Action on Disability within Ethnic Communities is hosting training sessions for organisations seeking to improve their service delivery for people living with or caring for someone with a disability from a culturally and linguistically diverse background in the western district.

Places are open to mainstream organisations (non-service providers) from the areas including Corangamite, Glenelg, Hindmarsh, Horsham, Moyne, Northern & Southern Grampians, Warrnambool, West Wimmera and Yarriambiack.

Date: Friday 27 April
Time: 9.15am - 4.30pm
Venue: Wimmera Business Centre 62 Darlot Street, Horsham

For more information please see this flyer.

Domestic violence awareness session

Lifeline logo DV Alert logo

Interactive presentations in Horsham and Stawell will afford participants an opportunity to talk about domestic violence and what they can do to help make a difference. The discussions will help participants:

  • Identify the different signs and forms of abuse that constitute domestic and family violence
  • Familiarise themselves with the Cycle of violence and Duluth wheels – power and control, equality and empowerment
  • Reflect on and share what they can do if they know someone who is experiencing domestic and family violence.

Horsham
Date: Monday 30 April
Time: 1pm -3.15pm
Venue: Wimmera Business Centre Meeting Room 62 Darlot Street Horsham

Register online.

Stawell
Date: Tuesday 1 May
Time: 9.45am - 12pm
Venue: Stawell Health and Community Centre 8-22 Patrick Street Stawell

Register online.