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Issue 9 - 16 March 2015

Nurses’ reported use of standing orders in primary health care settings
Authors: Jill A. Wilkinson
Year of Publication: 2015
Source: Journal of Primary Health Care, 7(1), 34-41
Abstract:  The authors report the results of a self-reported survey of 231 registered nurses who work in primary health care (PHC) settings and use standing orders in their practice, which investigated their use of standing orders. They conclude from the results that "standing orders are used extensively in PHC settings. The conditions nurses are involved in treating are usually already

This article is available to read in free full text at:

Articles – Medication Management/Prescribing

1. General practitioners? perceptions on home medicines reviews: a qualitative analysis.
By Amrith Kaur Dhillon, Hendrika Laetitia Hattingh, Andrew Stafford, and Kreshnik Hoti.
BMC Family Practice. 16 (Feb. 7, 2015) p16. Word Count: 3040.
: There is an increasingly high prevalence of medication-related problems (MRP) in the Australian primary health care setting [1]-[5]. The government has therefore implemented a number of interventions to improve medication management services. Home Medicines Reviews (HMR) has been in place since 2001, introduced to improve quality use of medicines [6]. It is a collaborative medication review service that involves a referral from a general practitioner (GP) to a community pharmacy or an accredited pharmacist. The aim is to facilitate community-based patients medication therapy and minimise the prevalence of MRPs.

2. Outcomes of expanded use of clinical pharmacist practitioners in addition to team-based care in a community health system intensive care unit.
By Elizabeth Michalets, Julie Creger, and William R. Shillinglaw.
American Journal of Health-System Pharmacy. 72.1 (Jan. 1, 2015) p47. 
Word Count: 4694.
: Clinical and cost benefits achieved through expanded use of state-licensed clinical pharmacist practitioners (CPPs) with prescribing authority on a critical care team are reported.
Methods. A retrospective pre-post analysis was conducted to evaluate patient care outcomes and cost savings during one-year periods before and after the number of CPPs on a North Carolina community health system's neurotrauma intensive care unit (NTICU) team was increased from one to three. Outcomes assessed included the number and types of medication management encounters, estimated cost savings, and the rate of preventable adverse drug events (ADEs) with expanded use of CPPs.

3. Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study.
By Bjoerg O. Simonsen, Gro K. Daehlin, Inger Johansson, and Per G. Farup.
BMC Health Services Research. 14 (Nov. 21, 2014) p580. Word Count: 5442
: Adverse events frequently involve medication errors, and they accounted for 19% of the events reported in Norway in 2013. The events are often categorized as prescription errors made by physicians or management errors made by nurses. A common notion has been that the nurses? involvement in medication management is quite simple: giving the Right patient the Right drug in the Right dose and Right administration form at the Right time.

4. Patient perspectives on having multiple versus single prescribers of chronic disease medications: results of a qualitative study in a veteran population.
By Corrine I. Voils, Betsy Sleath, and Matthew L. Maciejewski.
BMC Health Services Research. 14 (Oct. 25, 2014) p490. Word Count: 3750
Patients with multiple chronic conditions (MCC) often have complex medication regimens, which can increase their risk for medication side effects or interactions. Additionally, MCC patients typically see multiple providers and prescribers, which can complicate care coordination and medication management Medication management and medication reconciliation in the context of hospital discharge has been studied extensively. Less is known about coordination of medications in the outpatient setting. Care coordination, medication coordination, and regimen optimization may be optimal if patients obtained outpatient care from a single provider or single care team. 

5. Perspectives of carers on medication management in dementia: lessons from collaboratively developing a research proposal.
By Fiona Poland, Sarah Mapes, Hilary Pinnock, Cornelius Katona, Susanne Sorensen, Chris Fox,, et al.
BMC Research Notes. 7 (July 21, 2014) p463. Word Count: 6188.
The prevalence of dementia is growing rapidly; in the UK 700,000 people currently live with dementia and this is predicted to double over the next 30?years. As the condition progresses, people with dementia are increasingly less able to care for themselves making the role of family carers especially important for supporting them to continue to live in the community.

6. Do practice nurses have the knowledge to provide diabetes self-management education?.
By Margaret Hollis, Karen Glaister, and Jennifer Anne Lapsley.
Contemporary Nurse. 46.2 (Feb. 2014) p234. Word Count: 4328.
:  Practice nurses are ideally positioned to provide key aspects of self-management education to a large majority of people with diabetes within a primary care setting. However, practice nurses have seldom had comprehensive training in this field and consequently their role may have limitations. A study was designed to determine the diabetes related knowledge levels of practice nurses in a regional/rural setting in Australia.

7. Improving medication management after a hospitalization with pharmacist home visits and electronic personal health records: an observational study.
By Stephen Jon Kogut, Elaina Goldstein, Camille Charbonneau, Anita Jackson, and Gail Patry.
Drug, Healthcare and Patient Safety. 6 (Annual 2014) p1. Word Count: 3286.
: Background: Substantial opportunity exists to improve medication management in the period following a hospital discharge. The objective of this study was to assess and improve medication management during care transitions through pharmacist home visits and the use of an electronic personal health record (ePHR) system.
Methods: Recently discharged patients aged 50 years or older and having a chronic medical condition were offered the opportunity to meet with a pharmacist in the home setting to review medication instructions and receive a demonstration of an ePHR system. Patients agreeable to using the ePHR system were offered pharmacist support with setting up the ePHR system, having emphasis on documenting and reviewing medication regimens. Medication-related problems identified by the pharmacist during the visit were categorized according to ePHR use and by other characteristics.

8. Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care - a systematic review.
By Cheryl LL. Carling, Ingvild Kirkehei, Therese Kristine Dalsbo, and Elizabeth Paulsen.
BMC Medical Informatics and Decision Making. 13 (Dec. 5, 2013) p133. 
Word Count: 7050.
: E-prescribing or the e-prescription (e-Rx) is defined in the Center for Medicare and Medicaid Services final rule as  the transmission, using electronic media, of prescription or prescription-related information between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary, including an e-prescribing network?.

Articles – Evidence-Based Practrice

9. Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation.
By Gregory A. Aarons, Mark G. Ehrhart, Lauren R. Farahnak, and Michael S. Hurlburt.
Implementation Science. 10 (Jan. 16, 2015) p11. Word Count: 8215.
: The implementation of evidence-based practices (EBPs) is important for health and allied health organizations and providers.   Leaders can impact the capacity to foster change and innovation, and the role of first-level leaders?those who supervise individuals providing direct services is particularly critical to organizational effectiveness. First-level leaders are in a position to facilitate EBP implementation and may often be promoted based on clinical expertise with little support or training in effective leadership of workplace change efforts such as EBP implementation.

10. Using evidence-based practice to move beyond doing things the way we have always done them.
By Debra J. Hain and Tamara M. Kear.
Nephrology Nursing Journal. 42.1 (January-February 2015) p11. Word Count: 6106.
: Contemporary health care demands better care for individuals with kidney disease. In the quest for the Triple Aim of health care--improving the experience of care, improving the health of populations, and reducing per capita costs of health care--nephrology nurses can no longer afford to practice the way we have always done. Instead, it is critical to consider the best available evidence, personal expertise, and patient/family preference when engaging in clinical decision-making. This article provides the steps to develop an evidence-based project to address a clinical problem.

11. A modified evidence-based practice- knowledge, attitudes, behaviour and decisions/outcomes questionnaire is valid across multiple professions involved in pain management.
By Qiyun Shi, Bert M. Chesworth, Mary Law, R Brian Haynes, and Joy C. MacDermid.
BMC Medical Education. 14 (Dec. 14, 2014) p263. Word Count: 4569.
: Evidence-based practice (EBP) is defined as the integration of the best research evidence with patients? interests and clinical circumstances in decision making. As EBP is associated with improved clinical decision-making and patient care, health professional organizations have advocated for increased training in EBP for all health care professionals at all levels of education. Understanding how EBP is understood and implemented across different health professionals can identify educational needs and outcomes, and predict where new research evidence is more likely to be implemented. As such, a validated and reliable instrument is required to evaluate an individuals perceptions of EBP.

12. Population-level cost-effectiveness of implementing evidence-based practices into routine care.
By  John C. Fortney, Jeffrey M. Pyne, and James F. Burgess, Jr.
Health Services Research. 49.6 (Dec. 2014) p1832. Word Count: 6280.
: The objective of this research was to apply a new methodology (population-level cost-effectiveness analysis) to determine the value of implementing an evidence-based practice in routine care.

13. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS).
By Mark G. Ehrhart, Gregory A. Aarons, and Lauren R. Farahnak.
Implementation Science. 9 (Oct. 23, 2014) p157. Word Count: 7550.
: There is an implementation science gap in the development and availability of practical, reliable, and valid measures to assess constructs likely to impact effective implementation of evidence-based health-care innovations. One area in need of further attention is the development of targeted and psychometrically sound measures of organizational context for implementation. This study describes the development of a measure of strategic organizational climate for EBP implementation, which can be used to support appropriate pre-assessment of organizational context and the development of strategies to accelerate effective implementation

Journal - Table of Contents

14. From American Journal of Nursing, Vol 115, No. 2, February 2015
. Editorial: All Together Now [Why the future of nursing matters to all nurses]
14B. Nursing in the Era of Mass Incarceration [Associated health inequalities extend well beyond prison and jail cells]
14C. Bachelor's Degrees Not Only Save Lives, They Save Hospitals Money
14D. Laundry Detergent Pods Pose a Dangerous Poisoning Risk for Children
14E. Combating Alarm Fatigue
14F. U.S. Bicyclist Deaths in Motor Vehicle Accidents Increase Dramatically
14G. To Eat Fish or Not to Eat Fish
14H. CE: Original Research: Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis
14I.  CE Test Hours: Hospital System Barriers to Rapid Response Team Activation: A Cognitive Work Analysis
CE: Long-Term Outcomes After Repair of Congenital Heart Defects: Part 2
14K.  CE Test Hours: Long-Term Outcomes After Repair of Congenital Heart Defects: Part 2
14L. A Bold New Vision for America's Health Care System [The Future of Nursing report becomes a catalyst for change]
14M. Better Type 2 Diabetes Self-Management Using Paired Testing and Remote Monitoring
. Charlotte Rhone: Nurse, Welfare Worker, and Entrepreneur
14O. Swabbing Tubby [Family caregiving can be trying on many levels, but a little levity may help]


15. Māori Concepts of Health Promotion: traditional and cultural approaches to health and wellbeing
     Friday 24 April, 2015
Time:     9.30am - 3.30pm
Location: Taupo
Venue:   Waiora Community House, 129 Spa Road, Taupo 3351
Register online by clicking here

16. Certificate of Achievement in Introducing Health Promotion
Date:                     BLOCK ONE:       24-27 March, 2015
                                BLOCK TWO:      21-24 April, 2015
Time:                     8.30am – 4.30pm each day.
Venue: Pelorus Sports Trust House, Waiwhetu Room
                                93 Hutt Park Rd, Seaview
More information:

News – National

17. Health board coy on sugary drinks policy
By Vaughan Elder on Fri, 13 Mar 2015
The Southern District Health Board is developing a policy on the sale of sugary drinks on its premises, but won't say whether a ban is being considered

18. The addictive white powder that's killing you
Stuff - March 13 2015
It's official. I'm an addict. There is a white substance I've been relying on for a few years now that picks me up and gives me a kick a few times each day. The only problem is while it picks me up, it also crashes me down - hard. A few months ago I knew it was time to stop, I realised the white stuff was no longer my friend. It was time to have "that" chat. It was time to break up with sugar. You see, I should know all about the perils of sugar – I have a degree in exercise physiology and I also run a health and wellbeing company teaching people how to eat healthily

19. Prostate cancer a greater risk to Aussies than other men – study
NZ Herald -  Wednesday Mar 11, 2015
Australian men have a higher chance of dying from prostate cancer than Americans and Canadians, a new study shows. Published in the World Journal of Urology, the study examined prostate cancer trends in Australia, England, Canada and the US between 1994 and 2010. It found mortality rates were highest in Australia and England in 2010.

News – international

20. Women on the Pill face increased risk of Crohn's disease
The Telegraph – 15 March 2015
New study of 230,000 women suggests women may be three times as likely to develop the bowel condition if they are on the Pill and have high-risk genetics

21. Patients are 'dying in hospital because they fear leaving bills to pay'
The Telegraph – 15 March 2015
MPs are calling for free social care for the terminally-ill, amid warnings that patients who want to die at home are forced into hospital because of a fear of leaving bills for their families to pay

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