Nursing & Midwifery News – February 2022

From Shane

Public health services in metropolitan Melbourne and regional Victoria remain in a Pandemic Code Brown, and whilst things remain challenging I am so pleased that we have seen significant improvements in our workforce status and COVID demand over the past couple of weeks.

Whilst there is a risk of furlough numbers increasing again following the return of schools, I am confident that with the number of new staff starting over the coming weeks, including our new graduates and new post-graduate course students; we have left the worst of this Omicron wave behind us.

Western Health nurses and midwives have been simply phenomenal – thank you!

It is integral that all of us are protected against all variants of COVID. Unfortunately we still have a large number of our nurses and midwives that have yet to take up the opportunity to have the third COVID vaccine dose. There is a mandatory requirement for all healthcare workers to receive this third dose, however this aside – I really just don’t want to see any of my nursing and midwifery colleagues getting seriously unwell from this dreadful virus.

Omicron is only ‘milder’ because vaccination rates in the Australian population are high, and the Delta variant is still circulating in Australia. We know that catching the Omicron infection only gives people short-lived natural immunity, and the protection you get from a booster dose far outweighs this. You want the vaccine, not the virus.

I also want to ensure that all of our nurses and midwives can continue to work and are free from the stress that mandatory deadlines can invoke. The deadline for many of our nurses and midwives to have the third dose under the Pandemic Orders is 12 February, which is this week! If you have yet to get your third dose, I urge you to please get your booster today. Anyone can walk-in to any vaccination centre to get their booster – no appointment is necessary.

If you have had your booster elsewhere and have yet to let us know, please email to covidvaccination@wh.org.au your name (as it appears on your payslip), your employee number and attach your Vaccination Record (available from Medicare Online).

If you have a medical exemption, please do not delay in getting your evidence of this to your manager.

It is important that we continue to look after ourselves and each other. We will have all had adrenaline on board over the past weeks, and it is often after a crisis starts to ease that the impacts of any trauma can start to become apparent. Kindness to ourselves, our colleagues and our loved ones is paramount. Please keep an eye out for each other, and if you feel that you or a colleague would benefit from some support – please don’t delay in seeking that assistance. Western Health has a number of well-being and fatigue management initiatives and services in place for our nurses and midwives, and they are there to ensure that we all come out of the other end of this crisis strong, well and with a positive outlook.

It has been a tough start to the year, but at Western Health we have done it well and worked together to overcome huge obstacles. Our nurses and midwives have been an integral part of our efforts – we are there 24/7 across the entire healthcare journey and in all facets of the response. The influence of our professions on the health outcomes of our community is immeasurable. I hope that each and every one of you is feeling enormously proud of yourselves – as I am incredibly proud of being a part of the Western Health nursing and midwifery team.

Shane Crowe
Executive Director, Nursing & Midwifery

Pandemic Respond Brown update

Our response to the COVID surge has been thankfully decreasing over the past couple of weeks, with improvements in all areas:

Activity:

• 57 COVID positive inpatients (from 118 three weeks ago)
• 1 COVID positive ICU patients (from 6 three weeks ago)
• 176 COVID positive patients being actively managed by Western Health in the community (down from 475 three weeks ago).

Staffing:

Whilst things remain very challenging, it is pleasing to see our staffing situation improve over the past couple of weeks in our acute and subacute wards, ICUs and EDs.

The number of staff on personal leave and furloughed has continued to drop. We have 131 furloughed staff (from 685 three weeks ago), which means that now our wards and departments are now back to their pre-surge staffing levels most of the time – with the additional RUSONs in place on top of our improved nursing numbers. Our night shifts continue to be challenging, an we still have a number of points of care closed to support the staffing challenges in our EDs.

Things continue to be challenging in our Maternity Services, are we are incredibly busy despite improving staffing numbers. We have a number of Maternal Child Health services staff commencing this week to be able to free up our midwives that are currently working in domiciliary services to be able to support inpatient services.

We aren’t out of the woods yet – the Pandemic Code Brown remain in force and the prevalence of COVID in the community remains high. We are closely watching the impact of schools returning over the coming weeks, as this could cause staff furlough numbers increasing.

We are really looking forward to our new graduate nurses and midwives and postgraduate course students joining our teams, which will further increase our staffing numbers and provide some relief to our nurses and midwives that have been working extra hours and doing double shifts and overtime when it was needed.

We are also actively recruiting large numbers of additional RUSONs and RUSOMs to join our teams, as many of our current RUSON/Ms will be commencing their graduate years soon.

Healthcare workers continue to be exempt from close contact quarantine requirements in order to attend work (as long as certain conditions are met) to prevent significant risk to safe service delivery.

Shutting the door on COVID-19

As COVID-19 has become more prevalent in the community through the Omicron variant wave, unfortunately the risk of patient to patient transmission has also increased.

Currently it is not unusual for a patient to have a negative rapid antigen test (RAT) pre-admission or early in their admission, and then be diagnosed with COVID-19 during their hospital stay.

There are a couple of key things that nurses and midwives can do to significantly decrease the risk of transmission occurring between patients or from patient to staff member:

Close doors wherever possible:

When clinically possible, whilst weighing up all risks associated with a patient, closing the doors to patient rooms (whether they are diagnosed COVID positive or not) is a great way to stop COVID-19. As we are all aware COVID-19 is spread via airborne particles and droplets, and barriers like doors help to prevent the virus from going from one room to another.

Air purifiers:

Western Health has a large fleet of air purifiers. When used properly, air purifiers can help reduce airborne contaminants including viruses in a building or small space. By itself, air purification is not enough to protect people from COVID-19 – but when used along with other best practices implemented at Western Health, including social distancing and mask wearing, air purification is an important part of our plan to reduce the potential for airborne transmission of COVID-19 indoors.

To allow the air purifiers to work properly, please leave them on 24/7 and turned up to the maximum setting, and do not move them from the preferred location. If a patient has required an air purifier during their admission, please ensure it is returned after their discharge so that it can be used elsewhere.

Use of masks with patients and visitors:

Western Health has changed to KF94 masks for our patients and visitors. These masks are new to Australian healthcare and have passed Australian standards. The “KF” in KF94 stands for “Korean filter,” and the “94” indicates a 94 percent filtration efficacy. These masks combine elements of an N95 mask with those of a surgical mask, contouring close to the face with an adjustable band around the bridge of the nose. Most people find taht they fit well and they tend to be well tolerated as the tent-like shape creates a little pocket of extra space between your mouth and the mask.

Ensuring that your patients wear the KF94 masks when clinically possible is another important layer of protection.

Mandatory third dose COVID Vaccine deadline only days away

An urgent reminder that the first deadline for the mandatory third dose of a COVID vaccine is rapidly approaching. For healthcare workers who:

• were eligible to receive the COVID Vaccination booster on 12 January 2022 must have received their third dose by 12 February 2022, and
• become eligible to receive the COVID Vaccination booster after 12 January 2022 must have received their third dose by 29 March 2022.

The mandatory vaccination requirement will not apply to workers who have a valid medical exemption.

It is vital that all staff have a plan in place by their due date to either:

1. Have the third dose at a Western Health vaccination site, or
2. Supply evidence of having received the third dose elsewhere, or
3. Supply evidence of having a medical exemption.

Unfortunately we still have a large number of our nurses and midwives that have yet to do any of these 3 things – so we need you to please act now.

Evidence of third dose:

Western Health will have evidence of dose dates for all vaccinations administered at a Western Health vaccination centre. No action is required if you have received your third dose at a Western Health operated site.

If you have received your third dose at a location other that a Western Health vaccination site, you must email COVIDVaccination@wh.org.au your:

• Immunisation History Statement from Medicare Online, and
• Name (as it appears on their pay slip) and their employee number.

Please do not send your COVID vaccination certificate as evidence, as this currently does not show details of third dose and therefore is not adequate evidence.

Medical Exemption:

As the rate of COVID within the community has been high over the past couple of months, there will likely be a high number of our staff that are unclear on whether they should get the vaccine or get a temporary medical exemption.

You may receive a medical exemption if you are unable to be vaccinated because you:

• have a medical contraindication to all COVID-19 vaccines available for use in Australia, or
• have an acute medical condition such as undergoing major surgery or hospital admission for a serious illness, including COVID-19 infection where vaccination can be deferred for up to 4 months after the infection (or earlier if the medical practitioner specifies an earlier date).

These medical exemptions are determined by ATAGI clinical guidance.

Whilst you may have an exemption of up to 4 months after having COVID disease, the latest clinical advice is that people can safely receive a dose of a COVID vaccine after all of their symptoms have subsided and they are well. Western Health strongly encourages our staff to get your third dose as soon as you are able, to ensure that you are fully protected against all COVID variants.

If you are seeking a temporary medical exemption, your doctor will need to update your record on the Australian Immunisation Register to show that you have a medical exemption. Under the current Pandemic Order you can no longer use a medical certificate or letter as evidence of COVID-19 vaccination exemption. Once the your exemption has been processed, you can download your COVID-19 digital certificate which will show the duration of the medical exemption.

You then need to provide a copy of the COVID-19 digital certificate to your manager, who will arrange for Western Health’s systems to be updated.

As the time frames are now very tight, please act urgently to ensure that you will be able to continue to work after the deadlines.

Congratulations to our graduating RUSONs and RUSOMs

Over the past year a large number of our Registered Undergraduate Students of Nursing (RUSONs) and Registered Undergraduate Students of Midwifery (RUSOMs) have been incredibly busy juggling working at Western Health and their final year of their undergraduate program. They have made a remarkable impact, supporting our nurses and midwives to provide Best Care to our patients, women and babies through an incredibly challenging year.

Well these amazing people have recently graduated, and are now Registered Nurses and Registered Midwives. Congratulations and welcome to the best professions in the world! A significant number of our final year RUSONs and RUSOMs aren’t going anywhere, with them commencing their graduate program with us shortly. To those people – great choice! We are so pleased to have you stay part of the Western Health team, and we are looking forward to supporting you to make a successful transition and commence a long and fulfilling career with us.

For those that are commencing a graduate program elsewhere, thank you and good luck in your career. We may see you back with us one day!

Surge Support Allowance extended

On Wednesday 2 February 2022 the Department of Health announced that the Hospital Surge Support Allowance has been extended and it will now conclude on 31 March 2022.

The Allowance has been continued to support healthcare workers who are providing direct, patient‑facing care in key priority areas during this ongoing pandemic period.

Eligibility for payment of the Allowance to public healthcare workers remains the same, so nurses and midwives that are already receiving the Hospital Surge Support Allowance will automatically continue to receive it for this extended period.

Clinical Assessment Tool temporarily simplified

In response to feedback from health services regarding the current challenges associated with the assessment of nursing students on clinical placement, a modified student clinical assessment tool has been developed (based upon the current Australian Nursing Standards Assessment tool [ANSAT]). This slightly simpler tool is designed to assist staff less familiar with student assessment and help alleviate pressures for health services during this peak COVID period.

The Australian Nursing and Midwifery Accreditation Council has agreed to use of the modified tool for a limited period for those education providers who are currently using the ANSAT. This will be used for all students expect those from Deakin University.

The principles for application of the modified tool are:

• Written feedback will be provided under each Standard by exception, however must be completed if/when a student scores 1 or 2 in any assessable item.
• A formative assessment is only required to be undertaken on placements greater than 2 weeks in length.
• Regardless of length of clinical placement a formative assessment is undertaken on students that are repeating a placement or had prior issues on placement as advised by the education provider.
• The amended ANSAT will be utilised for a 6-week period commencing Monday 7 February 2022.

Western Health’s Centre for Education will liaise with our Preceptors regarding implementation of the new assessment tool.

Thank you for your ongoing commitment and support for student clinical placements during these challenging times.

Anie takes out the Mavis Mitchell Award

Mavis J Mitchell was the first Matron for Western Health. A Nursing and Midwifery Scholarship honouring her has been in place since 2 June, 1990. The intention of this scholarship is to encourage and support Nurses and Midwives to engage in research and service improvements across Western Health.

The 2021 Western Health Mavis Mitchell Scholarship Award ($5,000) has been awarded to Anie Edwards (Infection Prevention – pictured right with Shane Crowe) to research “nurses’ use of P2/N95 masks during the COVID- 19 pandemic: experiences and perceptions of nurses with adverse effects”.

Thanks to all nurses and midwives who took the time to submit an application for their commitment to research and continually improving our services.

Congratulations to Anie on this achievement, and we all look forward to seeing the findings of her important research.

Post-graduate Scholarships for Nurses and Midwives 2022

A reminder that applications for post-graduate scholarships for nurses and midwives are closing soon.

Each year Western Health offers significant financial support for our nurses and midwives to undertake post-graduate education to further their own professional development.  If ever there was a year to study, 2022 is it! We have more funds than ever before to support post-graduate scholarships, and so many post-graduate course options available. This year we are introducing new Tippet Trust Scholarships too, which is additional funding on top of our other funding sources. We are looking forward to being generous! No matter where you work, we have a post-graduate course available for you – from ICU, cardiac and emergency, to general medical, general surgical, rehabilitation, peri-operative, cancer, renal, neuroscience  and more!

All Western Health nurses and midwives are eligible to apply for financial assistance relating to post-graduate study in a nursing or midwifery field, or an education or business stream directly related to nursing and midwifery.

Applications will close on 25 February 2022. Further details, requirements and application forms will be released on Western Health’s internet site.

Health-e Workforce Solutions now integrated with RosterOn

RosterOn integration to upload staff names from your rosters into Health-e Workforce Solutions (HeWS) in now live in the system.

What this means is:

• When viewing your department ‘request staff’ screen, you will notice a few changes
  • The number of people icons for each shift will be a reflection of your rostered staff (at time of data upload)
  • When hovering over the icons, you will see staff name and details
  • You will need to enter your actual bed numbers for each shift, as this will generate an automatic calculation of ratio’s based on rostered and requested staff
  • You will need to ensure that a staff member has been identified as ’In-charge’ to ensure ratio calculations are correct for those shifts where In-charge are not allocated patients
• When requesting staff replacement, the request screens will be different – see attached information guide on what this will look like and how you need to action requests
• All this information will be displayed in the timeline screen and overview screen as well

What this means for the organisation is:

• Opportunity for improved daily allocation of supplementary staff based on in-time accurate staffing information
• Centralised snapshot of nursing and midwifery workforce with overview of staffing requirements, skill types and ratios for all areas
• Ability to generate reports to reflect historic staffing levels and ratios

The nurse or midwife in charge will now also need to enter and review bed numbers in the ‘request staff’ screen to reflect number of beds open for admissions.

Of great importance to know and remember – As the ‘upload’ of RosterOn information will occur only once a day overnight – the HeWS data is a ‘point in time’ capture of rosters and is NOT live information. So your source of truth for your rosters will always remain as the RosterOn platform.

For more information view the HeWS-Roster-On Integration quick reference guide.

If you have any questions or concerns, please make contact with either Michelle Read or Lisa Gatzonis in the Nursing & Midwifery Workforce Unit.

Safe Care needs You!

Western Health’s Safe Care Committee is seeking expressions of interest from nurses interested in contributing to the committee as a member for 2022.

Safe Care Committee Purpose and Role: To provide leadership and direction for reviewing, monitoring and evaluating all matters related to the provision of Safe Care across Western Health, as assigned by the Best Care steering committee.

National Quality and Safety (NSQHS) Standards aligned/reporting to Safe Care Committee:

• Infection Prevention
• Medication Safety
• Deteriorating Patient
• Blood Management Committee

The Safe Care Committee reports to the Western Health Best Care Steering Committee.

Safe Care Committee Charter: Charter Link

Safe Care Committee Membership: The committee is co-chaired by the Chief Medical Officer and a nominated Senior Clinician (Clinical Service Director). Membership includes aligned Standard Committee chairs, Divisional Director, Director of Nursing, Surgical Leadership, Clinical Informatics, Education and Consumer representatives.

Consumer Participation: In line with Western Health’s Patient First approach, consumer representation on the Safe Care Committee is essential in ensuring consumers are engaged in systems that support the provision of Safe Care.

Membership requirements: The Safe Care Committee meets 4-5.30pm on the first Tuesday of each month. Members unable to attend meetings are requested to coordinate a proxy to attend in their absence.

A shared appointment between two Nursing Staff would be considered.

Expressions of Interest: Submission of a brief emailed EOI to william.osullivan@wh.org.au addressing:

1. Why you are interested in participating in the Safe Care Committee?
2. Any relevant experience aligned to the provision of Safe Care and the Safe Care Committee?

Please submit EOI by Friday 18 February 2022.

For further queries, please contact either Nicole Davies, DONM (Nicole.davies@wh.org.au) or Kylie Fisher, Intensive Care & Critical Care Outreach Operations Manager (kylie.fisher@wh.org.au).

Benchmarking Best Care

The latest benchmark reports from the Health Roundtable that go up to September 2021 have recently been released, that show how our delivery of Best Care compares to other health services across Australasia.

In our continuing series looking at nursing and midwifery key performance indicators, this month we will look at how we perform in the area of falls.

Falls:

Sunshine Hospital

Look at the amazing drop in falls resulting in a fracture or intracranial haemorrhage per 10,000 episodes of care at Sunshine Hospital in the period of July to September 2021! This is a fantastic result.

When compared to our peers, we are now great after being red for over 1 year – which means that everyone’s hard work is really paying off – well done to everyone involved.

Well done to our Sunshine Hospital teams. Green is good, so let’s keep working to keep ourselves there!

Congratulations to our Sunshine teams for the marked improvement.

Footscray Hospital

Our Footscray Hospital teams are maintaining the improvement in our falls resulting in a fracture or intracranial haemorrhage per 10,000 episodes that was achieved over the past 12 months.

When compared to our peers, we still remain red so there is continued work and an ongoing focus needed – however the work and effort of everyone is making a real difference!

Keep going Footscray! We are only a tiny bit over amber, and we are confident we can get to green.

We have seen marked improvements in our serious falls rates and falls without injury rates over the past year on all of our sites. What you are doing is making a difference – thank you for your ongoing commitment to keeping our patients safe.

Giant Steps Conference 2022

Discounted tickets are available for Safer Care Victoria’s annual Giant Steps conference. Healthcare workers and consumers can get a 30% discount code to attend GIANT STEPS 2022 in person, bringing the cost down from $700 to $490. The cost of virtual tickets has also been reduced to $320!

The program has recently been released. This two-day conference focuses on healthcare quality and safety, and includes many exciting and inspirational keynote speakers, practical learning, and a myriad of opportunities to network with your colleagues and peers.

Life can be unpredictable, so SCV have given assurance that they will provide full refunds if COVID-19 prevents you from attending.

Click on this link to get the discount code and book your ticket.

Emerging Evidence

The Western Health Library Service is a great source for locating the latest nursing and midwifery related evidence based practice and research.

New articles of interest:

• The impact of covid-19 on psychosocial well-being and learning for Australian nursing and midwifery undergraduate students: a cross-sectional survey. Nurse Education in Practice. 2022: January Full Text  Western Health Author
  
• Proactive rounding: Perspectives and experiences of nurses and midwives working in a large metropolitan hospital. Australian Critical Care. 2021: December. PubMed Link. Request copy  Western Health Author
• Systemic causes of in-hospital intravenous medication errors: A systematic review. Journal of Patient Safety. 2021: December. Full Text
• Barriers to and facilitators of bedside nursing handover: A systematic review and meta-synthesis. Journal of Nursing Care Quality. 2021: Oct-Dec. Full Text
• Systematic review: Nurses’ safety attitudes and their impact on patient outcomes in acute-care hospitals. Nursing Open. 2022: January. Full Text
• Signs and symptoms, apart from vital signs, that trigger nurses’ concerns about deteriorating conditions in hospitalized paediatric patients: A scoping review. Nursing Open. 2022; January. Full Text
• Postoperative delirium screening tools for post-anaesthetic adult patients in non-intensive care units: A systematic review and meta-analysis. Journal of Clinical  Nursing. 2021: December. Full Text
• The contribution of group prenatal care to maternal psychological health outcomes: A systematic review. Women and Birth. 2021: November. Full Text

New Nursing/Midwifery eBook Titles

• Field guide to telehealth and telemedicine for nurse practitioners and other healthcare providers. Springer, 2022.
  Field Guide to Telehealth and Telemedicine outlines step-by-step how to set up and manage a tele-medical practice or incorporate it into an existing one. Chapters include information on workflows, staffing, formats and limitations, online etiquette for an optimal patient experience, legal and safety issues, and essential techniques for assessment and remote care. Numerous tables help identify state-specific limitations and clarify the ins-and-outs of billing and reimbursement for remote visits. Additionally, a section specifically devoted to COVID-19 outlines key considerations regarding care of these patients.
• Clinical nurse leaders beyond the microsystem: a practical guide. Jones & Bartlett Learning, 2022.
  In today’s rapidly changing healthcare landscape, a concise and comprehensive guide focused on preparing advanced clinical nurses to assume a leadership role is critical to improving the quality of patient care. Clinical Nurse Leaders Beyond the Microsystem: A Practical Guide, fourth edition is a core resource for CNLs which imparts the competencies necessary to lead improvement teams, analyse data, and ensure delivery of quality, safety, and value- based care in any healthcare setting.

Off-site or home access to the library eBook titles, require free library membership. If you are not a member you can Join Online. For more information Click on our FAQ page.

Visit the library’s Intranet website, or ring the library to speak with a Librarian: 8395 8036 or 8345 6655. Working from home? Visit the Library Internet site.