Staff satisfaction with the RHH Subcutaneous Insulin Chart

Neroli Newlyn

Centre for Education and Research, Royal Hobart Hospital

Abstract:

Insulin is one of the most self-reported medication errors within the Tasmanian Health Service, Safety Learning and Reporting System (Health Round Table 2019) and due to the high risk nature of insulin and insulin prescribing, The Australian Commission on Safety and Quality in Health Care developed a national insulin chart designed to incorporate best practice clinical guidelines to assist with accurate interpretation of Blood Glucose Levels(BGLs)  and subcutaneous insulin orders (Australian Commission on Safety and Quality in Health Care 2017, p.4).

In July 2019, an adapted version of this chart was implemented within the Royal Hobart Hospital (RHH) and interim staff satisfaction has been measured in nurses and prescribers (n=34) who are using the RHH Subcutaneous Insulin Chart (SCIC). Results of the survey show a 70% increase in staff satisfaction since the chart was first implemented. Overall staff prefer that BGLs and insulin orders are on the one page and that BGL trends are now easier to see. There is also dissatisfaction with the chart as insulin orders are often incomplete and prescribers are now called more often.

This small survey shows that overall staff are satisfied with the RHH SCIC and that the chart is an improvement on previous documentation systems. However, incomplete insulin orders are of a concern and will need to be investigated further. A larger staff survey is planned for December and will coincide with a hospital wide chart audit.


Biography:

Neroli Newlyn is a Nurse Practitioner in Diabetes working within Diabetes Education at the Royal Hobart Hospital. Her areas of interest include chronic and complex disease management, hospital avoidance programs and models of care which has seen her publish and present work both nationally and internationally.

Growing our own: A survey of midwifery stakeholders ‘experiences of an online midwifery entry to practice program

Elizabeth Rigg, Debra Clay1, Francine Douce

1University of Southern Queensland, Australia, 2Launceston General Hospital, Launceston, Australia

Abstract:

Background:
Literature highlights that midwifery is experiencing global workforce shortages. This is expected to worsen in Australia as its maternity workforce ages. In Tasmania 70% of the midwifery workforce are over 45 years of age. The education of midwives remains a key strategy to sustainability of a maternity workforce who are inspired for the future. In November 2016, the suspension of locally based midwifery offerings resulted in the Department of Health Tasmania, entering a service agreement with the University of Southern Queensland (USQ) to provide an online Bachelor of Midwifery (Graduate Entry) program supported by local clinical placements.

Aim:
Explore the effectiveness and sustainability of an online Bachelor of Midwifery (Graduate Entry) program for Tasmania from the perspective of stakeholders.

Methods:
This was a mixture methods study. Data was collected via an online survey and in-depth interviews. The Statistical Package for Social Science (SPSS) was used to analyse survey data. Open ended questions and interviews were analysed using a combination of content and thematic analysis.

Findings:
The findings of an online survey undertaken by maternity service providers at five separate sites in Tasmania will be presented to answer the research question: What is the experience, satisfaction and perception of Tasmanian service providers of the USQ online Bachelor of Midwifery (GE) program?


Biography:

Mrs Elizabeth Rigg RN, RM, BLMPrimary, MaMid PhD Student

Elizabeth is the Director of Midwifery at the University of Southern Queensland.  She has published several peer reviewed journal articles, including a book chapter in “Birthing outside the System: The Canary in the Coal Mine”. Her thesis is titled: “The role, practice and training of unregulated birth workers in Australia.

When research doesn’t provide the results you were hoping for, but the learnings are more than you expected

Associate Professor Melanie Greenwood1, Dr Karen Ford1,2, Mrs Cindy Weatherburn1,3, Ms  Meredith Eberle3, Erin McLeod2

1School Of Nursing, University of Tasmania, Hobart, Australia, 2THS-South, Hobart, Australia, 3Royal Hobart Hospital, Hobart, Australia

Abstract:

Partnering with consumers to design and evaluate care can provide mutually beneficial outcomes. However sometimes research projects to evaluate care do not go as planned. When this happens, there are still significant learnings, for the research team and also for the broader research community. Reporting such instances is important to grow knowledge and understandings around the conduct of consumer related research.

We undertook an ethics approved study to explore patients’ and their carers experiences of clinical deterioration from the perspectives of hospitalised patients who experienced unexpected deterioration. Management of acutely ill hospitalised patients is an important health priority internationally with the potential to significantly reduce patient harm. The early recognition and management of patient deterioration is part of this. Despite the introduction of safety solutions including early warning scores and critical care outreach teams, patients continue to suffer harm, including avoidable deaths.

Patients’ and carers’ involvement in the early recognition of deterioration are possible ways that healthcare consumers might contribute to their own care and safety. Little is known about the experiences of patients who become acutely unwell and their relatives. Our study hoped the experiences of patients and carers could inform strategies to address the issue.

However, we found recruitment to our study to be very difficult – people’s illness trajectory, their ability to engage with us following discharge from hospital, their cognition and memory all impacted upon their participation in the study, despite their initial agreeance. We would like to present the difficulties and learnings from our study.


Biography:

Karen is Assistant Director of Nursing, Research and Practice Development, THS-South. Karen is an experienced health researcher, including in the areas of patients’ experiences of care, participatory research, acute and chronic illness and she supervises several PhD and higher degree candidates. A feature of Karen’s research is growing research capacity of beginning/early career researchers.

Melanie is Director of Postgraduate Courses at the University of Tasmania and has a long history of working with staff in the THS. Her research interests are in recognition and response to physiological deterioration and she played a lead role in establishing the MET system at the Royal Hobart Hospital.

Research for practice and practising research

Dr Karen Ford1

1THS-S, Hobart, Australia, 2School of Nursing University of Tasmania, Hobart, Australia

Abstract:

Nursing and midwifery research expands the evidence base for practice and improves patient outcomes. The integral importance of research to nursing and midwifery is outlined in the Nursing and Midwifery Board of Australia standards for nursing and midwifery practice. The standards identify the requirements the professions have for using the best available evidence, that includes research findings for safe quality practice and for the active contribution to quality improvement and research.

If research is so important to nursing and midwifery and quality outcomes for practice, why is it that we often find the idea of engaging in research tricky, daunting and difficult? But it doesn’t have to be this way. The paper considers the opportunities for involvement in nursing and midwifery research and how research can be incorporated into practice. The presentation presents snapshots of a range of different research projects to provide exemplars of individual and team participation in research, including translational work, evidence based inquiry and quality improvement activities.

When it comes to beginning research, it’s a bit like eating an elephant really – one bite at a time.

References

Midwife standards for practice | Nursing and Midwifery Board of Australia October 2018

Registered nurses standards for practice | Nursing and Midwifery Board of Australia June 2016


Biography:

Dr Karen Ford: Karen is Assistant Director of Nursing, Research and Practice Development, THS-South. Karen is an experienced health researcher, including in the areas of patients’ experiences of care, participatory research, acute and chronic illness and she supervises several PhD and higher degree candidates. A feature of Karen’s research is growing research capacity of beginning/early career researchers.

How the last 20 years has changed the Tasmanian nursing and midwifery workforce – and where the next 20 years could take us

Mrs Stephanie Haines1

1Department of Health, Tasmania, Hobart, Australia

Abstract:

Introduction:
Tasmania has more than the national number of nurses and midwives per capita, but fewer than some other jurisdictions, highlighting differences in the way services are provided; and how and where nurses and midwives work. The nursing and midwifery workforce has also changed significantly over the last 20 years, as population has grown and society has embraced technological change and improved practices.

Method:
Data describing the nursing and midwifery workforce has progressed from basic census information collected once each five years to annual data derived directly from respondents at re-registration through the National Health Workforce Data Set.  Patterns of registration, entry and exit, areas of work, age, average hours, and regional distribution are emerging. These patterns illustrate change already at work in Tasmania’s public and private sectors, as well as indicating areas where change may be needed to better align the workforce with the changing health needs of the people of Tasmania.

Conclusion:
The certainty of workforce change brings challenges and opportunities for individual nurses and midwives in the evolving work environment, as well as for leaders seeking to align services with Tasmania’s needs.  Workforce information can inform systemic and individual plans for change, and benefit from monitoring workplace change as it is implemented, particularly where changes to service models are expected to change the way nurses and midwives work.  So much has changed for the better in the last 20 years.  Where will our nursing and midwifery workforce take us in the next 20?


Biography:

Stephanie’s interest in the health workforce pre-dates her qualification as an RN by 20 years.  Starting out in Western Australia implementing rostering and human resource systems for regional health services, Stephanie has continued to be involved with workforce planning for health professions since.  She graduated as an RN in 2015, enjoyed her transition to practice year at the Royal Hobart Hospital, and currently works very part time as a practice nurse in a GP practice – mostly focussed on immunisation and chronic disease management.  Stephanie also works in a long term workforce planning role with the Department of Health, Tasmania.

Impact of dementia educational intervention on attitudes/practices of early career nurses

Mrs Helen Gulliver1,2

1Tasmanian Health Service – Launceston General Hospital, West Launceston, AU, 2Wicking Dementia Research and Education Centre, Hobart, AU

Abstract:

The Wicking Dementia Research and Education Centre (WDREC) has developed a massive open on-line course, Understanding Dementia (UDMOOC), to provide accessible and evidence-based education to a broad range of people, regardless of educational background. Since 2013, 55,000 people from more than 180 countries have enrolled in the UDMOOC.  WDREC impact  studies have established that completion of the course has a demonstrable impact on participant dementia knowledge.  Helen Gulliver’s PhD research is interested in the impact of the UDMOOC  for early career acute care nurses.  Some areas of particular interest to be considered during Helen’s research are whether this educational intervention can contribute to change in nurse attitudes towards people living with dementia; or  whether initial increase in dementia knowledge and change to dementia-care nursing practice (if identified) are sustained over time.

As we advance towards a future where a projected 600 000 Australians will be living with dementia, Helen’s research will  contribute to understandings of ‘what works’ in dementia education, particularly in an acute setting where it is recognised that complex and multi-faceted factors influence why and how nurses prioritise and value the care they provide.  Research into this area is still in its infancy and education via the UDMOOC is one intervention which might assist with meeting the associated future challenges and expectations of acute-sector dementia care.


Biography:

Helen Gulliver is a Registered Nurse and Clinical Nurse Educator for Transition to Practice at the Launceston General Hospital.    In this role she works within a team  to recruit, support and educate first year and early career nurses.  Helen is also a PhD candidate with Wicking Dementia Research and Education Centre.  Helen’s PhD research is exploring the outcomes for early career nurses who are working in an acute care facility and who have completed an existing on-line dementia education course, the Understanding Dementia Massive On-line Course (or UDMOOC).

An examination of influences on women’s mental wellbeing after childbirth in Tasmania: implications for future policy and practice

Ms Sarah Young1, Professor Steven Campbell1, Dr Mai Frandsen1, Dr Carey Mather1

1University Of Tasmania, Launceston, Australia

Abstract:

Women’s needs after childbirth are varied and numerous, and the weeks and months following birth are crucial for both mother and baby. Research has shown that many women experience emotional issues after childbirth, and some of these complications may persist for a prolonged time period. The trickle-down effects of mothers who do not feel mentally well are significant, as reduced mental wellbeing is associated with poor health outcomes for their babies and families. Despite these ramifications, the postnatal period is often ‘eclipsed’ by the attention paid to the antenatal and intrapartum periods, and the health needs of postnatal women are often not addressed in practice or research. While a considerable volume of work has focused on postnatal depression, only 12-13% of women fall into this diagnostic category, and there is a lack of research examining the postnatal mental wellbeing of the remaining majority. To gain a better understanding of what influences new mothers’ ability to cope, a longitudinal, phenomenologically-informed study was conducted in northern Tasmania. A series of four in-depth interviews with 13 first-time mothers were undertaken over the course of their childbearing year to improve understanding of mental wellbeing during this important time. Tasmania is lacking a comprehensive program of care for women in the postnatal period. This research will contribute to the development of innovative, informed policies to provide improved emotional support to future first time mothers.


Biography:

Sarah Young is a PhD candidate in the School of Nursing at the University of Tasmania. Her areas of interest include women’s health in general, and in particular, the mental wellbeing of new mothers.

Personality traits, staff attitudes and their association with absenteeism and presenteeism in public sector hospital nurses in Hobart, Tasmania

Mr Colin Banks1, Dr Sue Pearson2

1THS-S, Hobart, AU, 2UTAS, Hobart, AU

Abstract:

Absenteeism and presenteeism in the healthcare environment has been shown to have significant negative impacts on individuals, departments and organisations. As the largest professional group within healthcare settings, the negative impacts in nursing include poor work performance, decreased perceptions of own health, poorer patient safety, reduced or no productivity and a significant economic burden.

Predisposing factors linked to both attendance dynamics include the individual’s physical and mental health status, workplace culture, work characteristics such as job security, work overload, social factors, individual and team attitudes, workplace policies, age and gender. Individual nurse’s personality traits and attitudes may also have an impact on absenteeism and presenteeism.

Thus the aim of my study was to examine the association between individual personality traits (using the five-factor model) and attitudes to absenteeism and presenteeism in public sector nurses in southern Tasmania. I will present the findings of my Masters thesis, discuss the implications for nursing practice and opportunities for future research.


Biography:

Colin Banks. Acting EDON THS-South.

I trained in the UK and have been a Registered Nurse for 22 years mainly specialising in Renal Dialysis. For the past 10 years I have worked in nursing management roles, firstly as Nurse Unit Manager, ADON and currently as the Acting EDON for THS-S. I completed my Master of Management and Leadership in 2018.

Hobart has been home for the past 15 years so I’m probably as close to being a local as I’ll ever be. I live here with my wife and young family.