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Issue 13 - 30 April 2012

Enjoy FREE access to LWW Nursing Journals
In honour of Nurses' Week 2012, enjoy online access to the current issues of LWW's Nursing journals from May 6 through May 12.


1. Comparing the coding of complications in Queensland and Victorian admitted patient data
By Michel, Jude L, BHIM; Cheng, Diana; Jackson, Terri J, PhD. Australian Health Review. 35 (3), Aug 2011: 245-52
This study aims to examine differences between Queensland and Victorian coding of hospital-acquired conditions and suggest ways to improve the usefulness of these data in the monitoring of patient safety events. The method used in this study is by comparison of depth of coding, and patterns in the coding of ten commonly coded complications of five elective procedures. The authors' findings demonstrate that the coding of complications is more comprehensive in Victoria than in Queensland. It is known that inconsistencies exist between states in routine hospital data quality. Comparative use of patient safety indicators should be viewed with caution until standards are improved across Australia. More exploration of data quality issues is needed to identify areas for improvement
2. Prevalence and prevention of workplace aggression in Australian clinical medical practice
By Hills, Danny J, RN, BN, Grad Cert Mgt, Grad Ce; Joyce, Catherine M, BA, M Psych, PhD; Humphreys, John S, BA, Dip Ed, PhD. Australian Health Review. 35 (3), Aug 2011: 253-61
This study aims to determine the extent of aggression directed towards Australian doctors and the implementation of aggression prevention and minimisation strategies in medical workplaces. Data were obtained from the pilot phase (n=321) of the Medicine in Australia: Balancing Employment and Life survey of the clinical medical workforce in 2010. Descriptive statistics were generated in relation to doctors' experiences of aggression at work in the previous 12 months, and the implementation of workplace aggression prevention and minimisation strategies. Distributions of the outcome variables were evaluated by doctor type and sex. More than 70% of doctors experienced verbal or written aggression and almost a third experienced physical aggression. Higher proportions of hospital non-specialists and specialists-in-training experienced aggression from patients, patient relatives or carers and co-workers. Many Australian doctors experience workplace aggression. The more widespread adoption of measures that support the prevention and minimisation of aggression in medical practice settings appears necessary.

3. Role of Australian primary healthcare organisations (PHCOs) in primary healthcare (PHC) workforce planning: lessons from abroad
By Naccarella, Lucio; Buchan, James; Newton, Bill; Brooks, Peter. Australian Health Review. 35 (3), Aug 2011: 262-6
This study aims to review international experience in order to inform Australian PHC workforce policy on the role of primary healthcare organisations (PHCO/Medicare Locals) in PHC workforce planning. ANZ and UK study tour was conducted by the lead author, involving 29 key informant interviews with regard to PHCOs roles and the effect on PHC workforce planning. Interviews were audio-taped with consent, transcribed and analysed thematically. Emerging themes included: workforce planning is a complex, dynamic, iterative process and key criteria exist for doing workforce planning well; PHCOs lacked a PHC workforce policy framework to do workforce planning; PHCOs lacked authority, power and appropriate funding to do workforce planning; there is a need to align workforce planning with service planning; and a PHC Workforce Planning and Development Benchmarking Database is essential for local planning and evaluating workforce reforms. With the Australian government promoting the role of PHCOs in health system reform, reflections from abroad highlight the key action within PHC and PHCOs required to optimise PHC workforce planning.

4. Paying the right price for pharmaceuticals: a case study of why the comparator matters
By Spinks, Jean M, BPharm, MPH, MHSc(PHP); Richardson, Jeff R J, PhD. Australian Health Review. 35 (3), Aug 2011: 267-72
This article considers the pricing policy for pharmaceuticals in Australia, which is widely seen as having achieved low drug prices. However, compared to New Zealand, the evidence implies that Australia might have improved its performance significantly if it had proactively sought market best pricing. The Australian record suggests that the information sought by authorities may not be sufficient for optimal pricing and that the economic evaluation of pharmaceuticals may be neither necessary nor sufficient for achieving this goal. [PUBLICATION ABSTRACT]

5. Financial incentives and the health workforce
By Scott, Anthony; Connelly, Luke B, BA, MEconSt, PhD. Australian Health Review. 35 (3), Aug 2011: 273-7
Changes to the remuneration of medical practitioners are currently being considered in Australia. In this paper, we provide a discussion of financial incentives in healthcare markets and their effects on health professionals' behaviour. After defining incentives, the paper focuses on the design of incentive schemes for the health workforce. It discusses several issues that should be considered when designing incentives, illustrated with some Australian examples. What are the objectives of the incentive scheme? What types of incentives can be used and under what circumstances? What is the empirical evidence around the effects of incentive schemes? What unintended consequences might exist? The paper concludes with a set of principles around which incentives can be designed. These principles might be used to inform the current debate about revisions to the incentives that are faced by medical practitioners in Australia. [PUBLICATION ABSTRACT]

6. Resource allocation and economic evaluation in Australia's healthcare system
By Baghbanian, Abdolvahab; Hughes, Ian; Khavarpour, Freidoon A, BSc, MSc, PhD. Australian Health Review. 35 (3), Aug 2011: 278-83
This paper aims to explore dimensions and varieties of economic evaluations that healthcare decision-makers do or do not use. The authors used a Web-based survey. A total of 91 questionnaires were analysed. Almost all participants were involved in financial resource allocations. Most commonly, participants based their decisions on patient needs, effectiveness of interventions, cost of interventions or overall budgetary effect, and policy directives. Evidence from cost-effectiveness analysis was used by half of the participants. Evidence from health economic evaluations may provide valuable information in some decisions; however, at present, it is not central to many decisions. The study suggests that, for economic evaluation to be helpful in real-life policy decisions, it has to be placed into context -- a context which is complex, political and often resistant to voluntary change.

7. What is a health emergency? The difference in definition and understanding between patients and health professionals
By Morgans, Amee; Burgess, Stephen J, BHthSc, Grad Dip Emerg Health. Australian Health Review 35 (3), Aug 2011: 284-9
Investigations into 'inappropriate' use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient's right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. This paper aims to define a 'health emergency' and compare patient and health professionals perspectives. A sample of 600 emergency department patients were surveyed about a recent health experience and asked to rate their perceived urgency. Differing definitions of a 'health emergency' may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation

8. Shared services arrangement in a decentralising healthcare environment - will it work?
By Arya, Dinesh K, MBBS, MD, DPM, MRCPsych, DM, F. Australian Health Review. 35 (3), Aug 2011: 290-3.
To support implementation of National Health Reform and the National Health and Hospital Network Agreement, changes are being made to the way hospitals and health services are funded and administered across Australia. In New South Wales (NSW), 18 Local Health Networks (soon to be called Local Health Districts) have been established. For each Local Health Network, a Governing Council (soon to be replaced by Health District Board) was also established. Early indication is that the incoming government is committed to strengthening local decision-making and accountability at network or district and hospital level. One of the key stated reason for 'regionalisation' (or development of the three Clinical Support Divisions in NSW was to centralise some support (and possibly clinical) services to ensure that there was no net increase in health bureaucracy (as outlined in the National Health and Hospital Network Agreement).

Journal - Table of Contents

9. From The Dissector, Journal of the Perioperative Nurses College of the New Zealand Nurses Organisation, March 2012, Volume 39, Number 4
Professional voice under the NZNO umbrella
9B. Education Committee reviewing PNC standards
9C. Keynote speakers signed for PNC Conference; Anaesthetic Nurses may continue registration with Nursing Council; Auckland region study day
. Introducing Rob Hawker
9E. Strong nursing support for Vascular Society Meeting
9F. Christchurch Hospital's 'New Nurses Home' demolished
. Adelaide Unplugged MINA Australia National Conference, 2011 [PICC Suturing; Radiology in the field; Digital autopsy; Advances in musculoskeletal procedures; Fistulography & Fistuloplasty; Epileptic brain; Stroke recognition & intervention; Contrast induced nephropathy; Dual energy CT; Reducing radiation dose; Earthquakes & rhabdomylosis; Radiology Nurse Practitioner; Needle phobia; Men's cycle of silence

News - National

10. Agents 'trick' nurses into signing bonds
Stuff - 22/4/2012

Filipino nurses are being lured to New Zealand only to end up bonded in caregiving roles at rest homes, the national nurses' organisation says. More than a quarter of the 46,000 nurses represented by the New Zealand Nurses Organisation were trained overseas, with Filipinos the largest ethnic group.

11. New warnings over superbug cases in NZ
Stuff - 22/4/2012

An antibiotic-resistant "superbug" that has spread to New Zealand could become a significant medical problem unless hospitals remain vigilant. The superbug, dubbed NDM-1 (New Delhi metallo-beta-lactamase 1), is thought to be resistant to nearly every known antibiotic, and appears to have originated in India before spreading across the world

News - International

12. Health ministers warn of 'unsustainable' services
The Age - 28 April 2012
AUSTRALIA'S dependence on imported doctors and nurses - which faces rising international criticism - will continue to grow without reforms in supply and use of local graduates, the first national report on the health workforce says. The report by HealthWorkforce Australia shows in recent years Australia has imported more doctors than it has produced local medical graduates. That is despite endorsement eight years ago by health ministers of the goal of ''national self-sufficiency'' in health workforce supply

13. Health Workforce 2025 [AUSTRALIA]
Health Workforce 2025 (HW2025) provides medium to long-term national workforce planning projections for doctors, nurses and midwives.  HW2025 projects the estimated numbers of professional entry students, postgraduate and specialist trainees that will be required for these professions between 2012 and 2025. It also contains detailed modelling on workforce supply, demand, training and distribution. Recognising the importance of national planning for a sustainable health workforce, the Australian Health Ministers (through the Standing Council on Health) commissioned the Health Workforce 2025 Report. The report identifies a range of policy considerations covering workforce reform, training, immigration and geographical distribution. Health Ministers are working together to consider the options to ensure a more sustainable health workforce to meet the future health needs of the Australian community.
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