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Issue 11 - 11 April 2014

Happy Easter to you all

The next newsletter will be published on 24 April 2014


Selected Articles - New England Journal of Medicine

1. The Road toward Fully Transparent Medical Records 
Walker, Jan, RN, MBA; Darer, Jonathan D, MD, MPH; Elmore, Joann G, MD, MPH; Delbanco, Tom, MD. The New England Journal of Medicine 370.1 (Jan 2, 2014): 6-8
Patients who were given access to their physicians' notes reported having better recall and understanding of their care plans, feeling more in control of their health care, and adhering better to medication regimens. Doctors reported little effect on their work lives

2. Distracted Driving and Risk of Road Crashes among Novice and Experienced Drivers 
Klauer, Sheila G; Guo, Feng; Simons-Morton, Bruce G; Ouimet, Marie Claude; Lee, Suzanne E; et al. The New England Journal of Medicine 370.1 (Jan 2, 2014): 54-9.
Distracted driving attributable to the performance of secondary tasks is a major cause of motor vehicle crashes both among teenagers who are novice drivers and among adults who are experienced drivers.We conducted two studies on the relationship between the performance of secondary tasks, including cell-phone use, and the risk of crashes and near-crashes. To facilitate objective assessment, accelerometers, cameras, global positioning systems, and other sensors were installed in the vehicles of 42 newly licensed drivers (16.3 to 17.0 years of age) and 109 adults with more driving experience.
Conclusions: The risk of a crash or near-crash among novice drivers increased with the performance of many secondary tasks, including texting and dialing cell phones. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Highway Traffic Safety Administration.)

3. Global Health: Global Effects of Smoking, of Quitting, and of Taxing Tobacco 
Jha, Prabhat, MD, DPhil; Peto, Richard, FRS.
The New England Journal of Medicine 370.1 (Jan 2, 2014): 60-8.
: Cigarette smoking is a major cause of illness and death. This article reviews both the magnitude of the disease burden from cigarette smoking worldwide and strategies to limit smoking.

4. Papillomatosis Cutis Lymphostatica 
Kasper, Romano Silvio, MD; Nobbe, Stephan, MD.
The New England Journal of Medicine 370.1 (Jan 2, 2014): 69-69.
An 88-year-old man presented with a 7-year history of asymptomatic, enlarging papules on his feet and toes. He had a 30-year history of chronic venous insufficiency and chronic leg edema

Selected Articles - The Journal for Nurse Practitioners

5. Using the Latest Evidence to Manage Hypertension 
By Davis, Leslie L.
The Journal for Nurse Practitioners 9.10 (Nov 2013): 621-628
: Hypertension (HTN) is a chronic condition that is frequently the precursor to cardiovascular and metabolic conditions. This article reviews the current literature on the management of HTN in adults, including diagnosis, determination of treatment goals, implementation of treatment regimens, and differentiation between difficult-to-treat and truly resistant HTN. Information is summarized about how nurse practitioners can empower patients to use home blood pressure monitoring.

6. Managing Patients With Heart Failure 
By Bowers, Margaret T.
The Journal for Nurse Practitioners 9.10 (Nov 2013): 634-642
Adults with chronic heart failure (HF) are living longer. Thus, management of symptom exacerbation related to this chronic illness is paramount to improving quality of life and reducing hospitalizations. This article provides key recommendations for nurse practitioners from the 2013 American College of Cardiology Foundation/American Heart Association guideline for how to effectively manage patients with HF, including a review of the major classes of medications to treat chronic HF. The article concludes with a brief discussion of selected areas of new research.

7. Contemporary Management of Atrial Fibrillation 
By Davis, Leslie L.
The Journal for Nurse Practitioners 9.10 (Nov 2013): 643-652
Nurse practitioners (NPs) frequently treat adults with atrial fibrillation. With new oral antithrombotic agents available, NPs need to be knowledgeable of treatment options to prevent stroke and systemic emboli. This article reviews the latest American College of Cardiology Foundation/American Heart Association guideline on the management of atrial fibrillation. Emphasis is placed on the changing landscape of pharmacological agents. Use of guideline-directed medical therapy will ultimately improve patients' quality of life and prevent stroke and premature death.

Selected Articles -  Journal of Community Nursing

8. Why are we stigmatising people with dementia? 
Journal of Community Nursing 28.1 (Jan/Feb 2014): 10-12.
According to the Secretary of State for Health, Jeremy Hunt, there are also massive variations across the country in how long people wait to be seen by a memory service, and if that wasn't bad enough, support provided postdiagnosis (if you are'lucky7 enough to be diagnosed), varies as well. Education and support for healthcare professionals will facilitate advocacy for their patients. Because people involved in the voluntary sector have both professional and personal experience of dementia care, we must not forget that there is a wealth of information there, which needs to be utilised.

9. Ensuring optimum quality of life in community patients with a stoma 
By Burch, Jennie.
Journal of Community Nursing 28.1 (Jan/Feb 2014): 21-22,24,26.
Community nurses are frequently involved in the care of patients after they are discharged from hospital, including many who have undergone stoma-forming surgery. There is evidence that it takes some time to adjust to life with a stoma, with much of this adjustment occurring in the first three months following surgery. During this period, nurses can use their skills to resolve any problems that might occur, helping patients to adapt and improve their quality of life. If community nurses cannot resolve any issues patients may have with their stomas, referral to a specialist such as the local stoma specialist nurse, might be necessary. [PUBLICATION ABSTRACT]

10. Supporting community patients with irritable bowel syndrome (IBS) 
Mason, Isobel.
Journal of Community Nursing 28.1 (Jan/Feb 2014): 28,30,32-33.
: Irritable bowel syndrome (IBS) is associated with a significant impairment of quality of life. Due to the nature of its symptoms, the role of the nurse is central to the care of patients who may have IBS. The often embarrassing symptom profile means that patients may rely on nurses to provide psychological and physical support in helping them to improve their symptoms. In this article, the author discusses the management of patients with irritable IBS, including the optimal delivery of care for patients and the role of community nurses in dealing with this chronic condition. [PUBLICATION ABSTRACT]
selected articles

11. Nutrition in the older person - are we facing a crisis in the community? 
By Willis, Helen. Journal of Community Nursing 28.1 (Jan/Feb 2014): 34,36-38.
Eating well in later life is an essential part of enabling older people to live independently at home for longer. However, with increasing funding cuts to community care services in the context of an ageing society, is enough being done to encourage good nutrition in later life? This article discusses the importance of nutrition for older people and explores how community practitioners are ideally placed to spot the early warning signs of malnutrition and encourage patients to take better care of their diet. [PUBLICATION ABSTRACT]

Articles - Quality Improvement

12. Using complaints to enhance quality improvement: developing an analytical tool
By Sophie Yahui Hsieh.
International Journal of Health Care Quality Assurance 25.5 (2012): 453-61
- This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality.
Design/methodology/approach - PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT).
Findings - The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement.

13. Communities of practice: Quality improvement or research in general practice
By Jiwa, Moyez; Ping-Delfos, Wendy Chan She; Ross, Jackie; Shaw, Tim; Magin, Parker.
Australian Family Physician 40.1/2 (Jan/Feb 2011): 72-5
: A 'communities of practice' (CoP) approach has the potential to address quality improvement issues and facilitate research in general practice by engaging those most intimately involved in delivering services - the health professionals. This article outlines the CoP approach and discusses some of the challenges involved in using this approach to raise standards in general practice and how these challenges might be addressed. General practitioner insight needs to be harnessed in order to develop solutions that are conceived in, and informed by, clinical practice. A CoP approach provides control to the practitioners over selection of the most relevant research question and outcome measure. However, the method is challenging as it requires a focus that is suitable, that motivates the participants, and effective management strategies and resources to support the CoP.

14. Teaching the Quality Improvement Process to Nursing Students
By Dotson, Barbara J; Lewis, Lisa.
Journal of Nursing Education 52.7 (Jul 2013): 398-400.
: During the past decade, there has been increasing emphasis on nurses leading and participating in quality improvement (QI) activities, creating a need for nursing students to learn QI skills. There is minimal information that explains how to teach QI skills or provide nursing students with the opportunity to participate in actual QI projects. Faculty in a prelicensure diploma RN program developed a project that provides an opportunity for senior students to participate in an interdisciplinary team related to the development, planning, and implementation of QI projects in a geriatric setting.

15. A safety and quality improvement initiative in a general practice
By Rutherford, Angela. Australian Family Physician 40.1/2 (Jan/Feb 2011): 30-2.
A general practice in inner city Melbourne (Victoria), committed to ensuring quality standards of clinical care, developed a process for peer review of their doctors' performance. The aim was to ensure that there was a robust and fair process for evaluation of doctor performance from both a safety point of view, and from the perspective of contribution to team based practice. This article describes the process and outcomes of this appraisal process

Journal - Table of Contents

16. From Canadian Nurse, April 2014
An introvert’s take on introversion 
She wasn’t making it easy for me to complete a mental status assessment. However, it was clear that she was not evading my questions but simply being honest. I recognized a fellow introvert.
16B. April is National Oral Health Month [17%: Percentage of Canadians who avoided going to dental professionals in the previous 12 months because of the cost]
16C. CNA Now 
FROM THE CEO Reaching the public How does our national professional association communicate the complexity of the RN role to the public? With a national public awareness advertising campaign, of course
16D Dangerous fallout from angry outbursts 
Temper tantrums are bad for your heart, suggests a study published in the European Heart Journal. Researchers reviewed studies published between 1966 and 2013 in which patients were asked about their mental state before experiencing a cardiovascular event
16E. Environmental effects 
The word environment conjures up so many meanings for me. The weather comes to mind first, naturally. Here in Ottawa, it’s been a challenge getting through the coldest winter we’ve had in 20 years, and I haven’t been able to do much about it
16F. Faith, family and community 
Cindy Cousins is definitely a people person. Whether she’s doing a shift at the Prince Edward Island Cancer Treatment Centre or running her organic farm, it’s day-to-day interactions with friends, family, the community and patients that matter most to her.
16G. Filling a gaping hole in care 
We pride ourselves on universal access to high-quality health care in Canada — that is, unless we’re talking about oral health care.
16H. Hormone therapy and lung cancer survival 
Feeling hormonal could be a good thing, according to recent research published in the Journal of Thoracic Oncology
16I. Household vinegar kills TB 
Grandma always said vinegar will clean almost anything. But recently, researchers were surprised when cultures of drug-resistant tuberculosis bacteria were wiped out after 30 minutes’ exposure to a simple solution of 6 per cent acetic acid — a.k.a. vinegar.
16J. Improving psychological health in the workplace 
“If you walked through a construction site today and saw a person without a hard hat or boots on, you’d be shocked,” Sapna Mahajan says


17. CWNZ Conference 2014
10-12 October 2014
Venue: Auckland, Waipuna Conference Centre

18. The Health Information Privacy Code
This workshop provides participants with an overview of the Health Information Privacy Code and is particularly suited to people employed in the health sector or interfacing with the health sector.
On request the workshop may be extended to discuss privacy and the mental health area specifically.
Time: 9.00 am - 1.00 pm
Fee: $210 (includes GST)
2014 DATES:

  • Wellington

19 Mar, 28 May, 23 July, 24 Sept, 26 Nov

  • Auckland

20 Mar (Full), 29 May, 24 July, 25 Sept, 27 Nov

  • Christchurch

26 Sept
Auckland: Level 13, 51-53 Shortland Street, Auckland
Wellington: Level 4, 109-111 Featherston Street
To register: Ph (04) 474 7590 or email

19. 2014 RACP Future Directions in Health Congress
The premier event of the Royal Australasian College of Physicians and is the largest annual multi-disciplinary internal medicine meeting in Australasia.
Date: 18–21 May 2014
venue: Auckland Convention Centre
More information:

20. 2014 NZNO 9th Gerontology Section Conference
 This will include a stream for health care assistants
Date: November 3rd and 4th
Venue:  Waipuna, Auckland

21. International Indigenous Development Research Conference
Date: Tuesday, 25 November 2014 - Friday, 28 November 2014
The University of Auckland , Auckland
More information:

22. Information Security: what does 'reasonable' look like?
Speaker: David Shaw, Symantec Corporation
When: Monday May 5, 12:00-1:00pm
Where: Thorndon Room, Ground Floor, National Library of NZ
Limited seating (80) – email RSVP no later than 30 April 2014 to
For more information see the flyer on our website at

News - National

23. Online health records to improve patient care
Tony Ryall Release - 7 April 2014

24. Photographers in focus as DHB tightens rules
Last updated 08:48 08/04/2014

News - International

25. Homeopathy dismissed by National Health and Medical Research Council review
Sydney Morning Herald: April 9, 2014
There is no reliable evidence that homeopathy can treat health conditions, a major review of the practice by the National Health and Medical Research Council has concluded


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