Nursing & Midwifery News – January 2023

From Shane

Happy new year, and I hope you all have had a very happy festive season and have had a chance to catch up with family and friends.

As we enter into 2023, the plateau of the latest COVID surge has been flat and long. There is now 12 COVID variants active in Melbourne, and the parties and social get-togethers that have occurred throughout the festive season has meant that this wave has lasted longer than initially predicted. Unfortunately, the sensitivity of the Rapid Antigen Tests (RAT) on people that have COVID but are asymptomatic is not very high. If you know you have been a close contact and are asymptomatic, a negative RAT may be giving you false reassurance. I urge you to monitor for any signs of symptoms – no matter how mild, and if you are unwell for the safety of your patients, colleagues and our visitors please do not come to work.

It promises to be another big year at Western Health, with a number of milestone projects planned to be delivered this year – as well as accreditation. The good news is that most of you will not be directly impacted by most of these changes, and you will be able to continue to focus on what is important – the provision of Best Care to our community.

We are due to undertake accreditation in the second half of 2023. We last underwent accreditation at Western Health in 2020 – in fact it was the week before COVID was declared a pandemic. There have been a number of changes to the accreditation process since then, which includes:

• accreditation now being a short-notice assessment instead of a planned event. This is positive, as it means that the surveyors will get to see us how we really are as we undertake our ‘business as usual’. It does mean that we will only get 3 working days notice of when the surveyors are going to arrive.
• the surveyors will spend much more time on our clinical wards and departments.
• our new mental health services will be included in the assessment.
• our evidence of compliance needs to be more evident and accessible than previously required.

There is a lot of work happening behind the scenes ensuring that we are ready for these changes, and I have every confidence that we will shine. We passed accreditation with sterling results in 2020, so we have already done this, and we have continued to improve! I think it will be an opportunity for us to show Best Care in action and what great work we do. Information will start coming out over the coming weeks and months on things that you can do to ensure that you feel ready.

I strongly encourage you all to undertake the 10-week Patient Assessment education program that is being released this month. No matter how experienced you are, a refresher on how to undertake a best-practice assessment of your patient never goes astray. We all know that patient assessment informs all elements of care-planning, nursing and midwifery interventions and appropriate referrals to other disciplines. It is the foundation of Best Care, so this is a great opportunity to make sure that you are being your best.

Additionally, this year we will:

• become a designated mental health service from 1 July 2023, going from having no mental health beds to becoming the second largest mental health service in Victoria. Paula Stephenson and her team are busy undertaking the work to ensure that we are ready for this significant change.
• open the new mental health beds being constructed at Sunshine Hospital.
• implement initiatives to meet the requirements of the new Mental Health & Wellbeing Act.
• go-live with Phase 2.1 of the electronic medical record implementation, which will see a significant expansion of our EMR to include maternity, paediatrics and neonates, critical care, Emergency Departments, cancer services, perioperative services, specialist clinics and our community-based services. Our CEO Russell Harrison recently announced that the go-live will occur in July 2023 after we successfully exited User Acceptance Testing of the new system.
• implement a new rostering product to replace the ageing RosterOn in late 2023.
• develop up the Functional Brief for the new Melton Hospital, which will inform what the new facility will include and how it will operate.
• commence construction on the new Point Cook Community Hospital.
• commence construction on the expansion to Sunbury to allow it to become a Community Hospital.

We have amazing people at Western Health, and we are attracting the best and brightest. The nursing and midwifery workforce at Western Health is looking very strong for 2023, and we will continue to strive to optimise our position as an employer of choice for nurses and midwives.

With your continued commitment, we are in an incredibly strong position to deliver all of the above and more.  I look forward to working with you all in 2023 to achieve great things.

Shane Crowe
Executive Director, Nursing & Midwifery

Patient Assessment education program

After a successful pilot in the EMA division and then evaluation and improvement, the patient assessment education program will be launched organisation-wide in ward areas on 16 January 2023. The program consists of WeLearn mini-modules and associated bedside education facilitated by clinical nurse educators (CNEs) and clinical support nurses (CSNs).

The modules are:

• Pre-evaluation and Introduction to Patient Assessment
• CNS and Neurovascular
• CVS and Respiratory
• GIT and Renal
• Skin Integrity and ADLs/Safety
• Post-evaluation upon completion

The modules will be released every 2-3 weeks and CNEs and CSNs will be providing education and support around these skills. This program will run for 10 weeks and is a great opportunity for all nursing staff at Western Health to participate as the bedside education and support will be targeted at individual skill levels. This is the beginning of an increase in targeted bedside education and there will be further programs to come which will be tailored to the needs of clinical areas.

If you have any questions please discuss with your ward educator.

Extension to night shift meal program

In recognition of the challenges that the current COVID surge is having on healthcare workers, the Department of Health has extended the program providing access to free meals/refreshments to healthcare workers, prioritising those working night shifts or double shifts by one month.

The program was due to cease on 31 December 2022 and it has now been extended until 31 January 2023.

At Western Health, access to meals will continue in the same way as it has been operating over 2022 through until 31 January 2023.

2023 Leadership Programs

Please see details below of the Western Health Nursing & Midwifery Leadership Programs being offered in 2023:

Transforming Leadership Capability (TLC)
A 4-day Program for Nurse and Midwife Unit Managers, sponsored by the Executive Director of Nursing and Midwifery. Nominations for this program need to be supported by the relevant Director of Nursing & Midwifery and need to be sent to NursingMidwiferyLeadershipPrograms@wh.org.au by Friday 13 January 2023.

Unit Manager Masterclasses (UMMC)
A 2-hour monthly online workshop to enhance the knowledge and skills required to effectively lead and manage in these evolving environments.

Advancing Frontline Leadership (AFL)
A 5-day Program for Associate Nurse and Midwife Unit Managers designed to meet the emerging needs of this key group of leaders. Sponsored by the Executive Director of Nursing and Midwifery. Nominations for this program need to be supported by the relevant Director of Nursing & Midwifery and need to be sent to NursingMidwiferyLeadershipPrograms@wh.org.au by Friday 13 January 2023.

Clinical Nurse & Midwifery Consultants Program (CNMC)
A regular opportunity for this key stakeholder group to come together, share stories and enhance their knowledge of best practice leadership.

Nurse Practitioner Program (NP)
A regular opportunity for this key stakeholder group to come together, share stories and enhance their knowledge of best practice leadership.

Please email NursingMidwiferyLeadershipPrograms@wh.org.au for further details.

Nursing & Midwifery Excellence Awards 2022

On 15 December 2022 a COVID safe audience in the Sunshine Hospital Auditorium and many people on livestream joined us to bestow our Nursing & Midwifery Excellence Awards for 2022.

We have approximately 5,000 nurses and midwives, and every single one has played an important and tangible role in providing Best Care. The Nursing & Midwifery Excellence Awards are a way for us to celebrate all of our nurses and midwives, with a focus on those that have been nominated to be recognised by their peers.

The number and caliber of the nominations received this year has been nothing short of inspirational, and it was a pleasure to be part of this event to showcase some of the incredible achievements and contributions of our nurses and midwives.

Jess takes out Mavis Mitchell Scholarship

The Mavis Mitchell Memorial Scholarship is an award granted to provide funding to enable and assist eligible nurses and midwives to undertake a service improvement, a quality project or research into an area that is beneficial to our patients/women or to the community served by Western Health.

The scholarship honours the memory of Mavis J Mitchell who was the first Matron of Western Hospital.

In 2022 this prestigious scholarship was awarded on 15 December to Jessica Hughes (Lactation Services Team Leader, JKWC).

The scholarship will provide Jess with the opportunity to undertake a two-week international study tour visiting health care facilities and universities in Europe and Croatia to gain perspective that promote, protect and support breastfeeding success.

The tour will evaluate breastfeeding practices in several European maternity health care facilities and universities by examining how the World Health Organization (WHO) and The Untied Nation Children’s Fund (UNICEF) Baby Friendly Health Initiative (BFHI) accreditation influences breastfeeding practices.

The study tour will also include attendance at the Academy of Breastfeeding Medicine European Regional Conference in Croatia, enabling the opportunity to attain new knowledge and skills, as well as network with other international lactation professionals.

The award was presented to Jess by Robyn Peel (Director of Education) and Lisa Gatzonis (DONM Workforce).

Congratulations Jess!

Tanya Farrell joining Western Health leadership team

Western Health is delighted to announce the appointment of Adjunct Professor Tanya Farrell (she/her) to the role of Director of Maternity Services.

Tanya Farrell is a midwife and a nurse and comes to Western Health with extensive experience, expertise and leadership within maternity at a Victorian and national level, and a proven track record of an ongoing commitment to improving the care of women and babies. Tanya is joining Western Health with a desire to move closer to where care is provided to support and lead a maternity service and its nurses and midwives during a time of rapid growth and reform.

Tanya is currently the Senior Maternity Adviser for Victoria at Safer Care Victoria (SCV), a role that she has held since 2018. During this period Tanya has also spent time as the Acting Chief Nursing and Midwifery Officer for Victoria. Previous to this Tanya was the Executive Director of Midwifery and Nursing at the Royal Women’s Hospital.

Tanya is the current Chair of the Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM) and is the first midwife to hold this role in the council’s 70 year history. We are thrilled that Tanya will retain this role whilst she is part of the Western Health team. Tanya is also an Adjunct Professor in Nursing and Midwifery at La Trobe University and was recently awarded an Honorary Doctorate in Public Health by La Trobe University.

As the chair of CCOPMM Tanya oversees the investigation and reporting of all maternal, perinatal, and paediatric mortality and morbidity, provides advice to the Minister for Health, SCV and the Department of Health on strategies to strengthen clinical governance, improve clinical performance and avoid preventable harm in Victoria.

Tanya will commence at Western Health on 6 March 2023, and will report professionally to Shane Crowe and operationally to Wendy Watson. I know that you will join with me in congratulating Tanya on her appointment and will welcome and support her in this important role.

Working with our nurses and midwives to reform rostering

Western Health is working with Safer Care Victoria (SCV), the Department of Health (DH), the Australian Nursing and Midwifery Federation (ANMF) to work with our nurses and midwives to implement an employee centred rostering project. Western Health is one of 3 health services involved in this important project, which aims to address flexibility by creating a set of guidelines that will support more employee centered rostering.

We are committed to working with our front-line nurses and midwives to develop a set of contemporary employee centred roster principles and guidelines that best meet your needs.

The project will address the changing environment nurses and midwives are currently experiencing including the need for flexibility regarding work arrangements, shift allocation, night duty rostering and the importance of professional ongoing development.

The research will involve:

• A detailed preliminary survey
• Multiple co-designed focus groups and workshops to develop the guidelines
• A second survey to ascertain the developed guidelines are suitable and acceptable
• Follow up surveys at six- and twelve-months duration following the introduction of the principles and guidelines to determine how well they are working for nurses, midwives, and health services.

Our aim is to use this data to drive improvement in rosters to formulate rostering principles and guidelines for the nursing and midwifery workforce across Victoria.

Keep an eye out, as it will be commencing early in 2023.

Shark Tank is back in 2023

A leadership experience: from concept to funding

Do you have an idea to improve an element of Best Care? An idea that directly improves efficiencies and aligns with quality improvements and or Western Health strategy?

Be supported through a learning process that takes you from an idea to business case. The program is an opportunity for you to improve an element of care, either through clinical practice or through support services.

The Shark Tank program comprises six workshops and at completion, participants will have the opportunity to pitch their idea to an expert panel including the CEO. Up to $50,000 will be awarded to the successful participant to support their project and best care.

About the Shark Tank Experience:

The Shark Tank experience is a collaborative program between Western Health and Advisory Board. Advisory Board will deliver rich leadership development experiences that elevate and shift leadership attitudes, skills, and behaviors most critical for success on the journey to develop and showcase your innovation.

The program relies heavily on interactive learning techniques including a dynamic mix of facilitated discussions, case studies, simulations, multimedia, application exercises self-evaluations, and role-play. Example themes included in the programme include:

• Not settling for “good enough” and becoming comfortable with appropriate risk-taking
• Engaging with stakeholders
• Shifting perspective and noticing with greater awareness
• Innovating thinking
• Maximising key process metrics
• Self-advocacy
• Managing and engaging others in change
• Communicating with cognitive preference in mind

Is Shark Tank for you?

• You are an active participant in learning and in applying new knowledge
• You have an idea, or concept and a strong desire to improve an element of care
• Your idea aligns with best care framework and /or Western Health Strategy
• You have some experience in implementing change or new initiatives
• You are available as per program dates
• You have evidence of your manger’s support

Dates for your diary:

• 20 February 2023, 9:30am – 4.30pm
• 8 May 2023, 9.30am –4.30pm
• 24 July 2023, 9.30am –4.30pm
• 25 July 2023, 9.30am –4.30pm
• 9 October 2023, 9.30am –4.30pm
• 11 October 2023, 12.00pm-4.30pm

Applications and closing date:

Applications close on Monday 23 January 2023. Please the application form.

Enquiries should be directed to either Anne Wright (email anne.wright@wh.org.au or phone 0403 369 350) or
Melissa Edwards (email Melissa.edwards2@wh.org.au or phone 0497 084 790).

Educational Opportunities

Post-graduate scholarships:

The Department of Health postgraduate nursing and midwifery scholarships are now open for applications.

Nursing and midwifery scholarships are provided to public health services to support registered nurses and midwives to undertake postgraduate study, in areas of clinical practice where there is an identified workforce need.

Nurses and midwives employed in Victorian public health services and undertaking and eligible clinical postgraduate course (commencing 2023 or 2024) will be eligible for a scholarship. The value of this scholarship will cover out of pocket course fees for the post graduate qualification.

Applications close on 10 February 2023. Please send your scholarship application to Robyn Peel:  robyn.peel@wh.org.au

Further information can be found on the post-graduate education internet page.

2023 Courses:

Details of the 2023 education courses will be available soon!

Resuscitation Mandatory Competencies: 

Sessions have recommenced. In the first instance, can you arrange an assessment with your local instructor or educator. Resus educators are contacting managers to arrange local sessions for individual teams. Dedicated sessions for Bank and Pool Staff along with separate sessions for Nursing and Medical staff are available on WeLearn.

Invasive Lines & Cannulation: 

Advertised dates are now available for Bank-Pool Nursing Staff, Radiology, Medical staff and all ward nursing and midwifery staff. 

January 2023:
23/1/2023: Peripheral Intravenous Cannulation (PIVC) at Sunshine Hospital 

Blood product restrictions

Australian Red Cross Lifeblood Victoria have advised that due to supply shortages of some groups of Red Blood Cells (RBC) especially Group O Rh (D) Negative RBC inventory restrictions are in place. Orders for Group O Rh (D) Neg RBC are now on “MO” meaning all orders will be triaged and approved by a Lifeblood Transfusion Medicine Specialist. Clinical notes including the indication for the transfusion and the prescriber’s contact number needs to be included on request forms.

The Sunshine Hospital laboratory currently has two units of irradiated, CMV Neg, Group O Rh (D) Negative RBC (expiry 2/1/2023) for urgent neonatal transfusion.

As previously advised, in this current situation it may be necessary for the laboratory to issue Group O Rh (D) Positive RBC with Haematologist approval for some patients rather than Group O Rh(D) Negative RBC. It is also critical that samples for pretransfusion testing are taken as early as possible to test and identify the patient’s blood group to enable the issue of Group specific units thus negating the avoidable use of Group O Rh (D) Negative RBC.

Judicious attention to patient blood management for all transfusion decisions for RBC and meticulous attention to the transport and storage of blood products to negate avoidable wastage are always important, but are critical in times of supply shortages such as we are currently experiencing.

Benchmarking Best Care

The latest benchmark reports from the Health Roundtable that go up to September 2022 have recently been released, that show how our delivery of Best Care compares to other health services across Australasia.

Let’s look at how we perform in the area of falls. The following data looks at the rate of falls that result in an intracranial haemorrhage, fractured neck or femur or other fractures.

Falls:

Sunshine Hospital

Unfortunately we had a significant increase in falls resulting in a fracture or intracranial haemorrhage per 10,000 episodes of care at Sunshine Hospital for 3 quarters – however it has dropped significantly in the latest quarter to low amber!

It i great to see this trending downwards – well done Sunshine!

Footscray Hospital

There has also been a big drop in the falls resulting in a fracture or intracranial haemorrhage per 10,000 episodes at Footscray over the past quarter.

Compared to our peers, we still remain red, however it is pleasing that this is nearly back to amber.

Keep going Footscray!

Bacchus Marsh Hospital:

The rates of falls with serious injury at Bacchus Marsh Hospital has dropped again after an isolated spike. Overall, this has been consistently low (zero for the latest quarter). This is a fantastic result.

Well done to our Bacchus Marsh Hospital teams.

Heading towards ERM Phase 2.1 Go-Live

As preparations for the EMR Phase 2.1 Go-Live increase, the Digital Health Learning and Development team will soon be visiting Western

Health’s EMR sites to provide nurses and midwives with training and support information.

The team will hold Training Information Kiosks at designated locations in January and February giving staff an opportunity to visit at a time of their choosing to privately chat about EMR Phase 2.1 training, particularly for new staff. The Training Information Kiosks will run from 12:30pm to 2:00pm on the following days:

Footscray (Outside the security office near main reception)

• January 16^th, 17^th, 19^th, 20^th
• February 6^th, 7^th, 8^th, 9^th, 10^th

Sunshine (Outside the public Pharmacy on the ground floor)

• January 16^th, 17^th, 18^th, 19^th, 20^th
• February 6^th, 7^th, 9^th, 10^th

Williamstown (Ground floor staff breakout area, near courtyard)

• January 18^th
• February 8^th

In addition to the information kiosks, the Digital Health Learning & Development team are currently liaising with NUM’s, MUM’s and unit heads to schedule Ward Walkarounds between 13^th – 17^th and 20^{th –} 24^th February at a suitable time for each area.

This will give nurses and midwives a chance to learn about the upcoming EMR training opportunities, seek assistance with signing up to WeLearn and Super User training, or ask questions about the upcoming EMR Phase 2.1 implementation. As the dates and times for the Ward Walkarounds are confirmed they will be published on the Digital Health information site.

The information kiosks and ward walkarounds were an invaluable training and communications tool during EMR Phase 1, and the Learning and Development team are looking forward to engaging further with staff in the build-up to the EMR Phase 2.1 Go-Live.

For more information, please contact Kristin McCann (Digital Health Deputy Learning and Development Manager) – Kristin.Mccann@wh.org.au.