Nurse Liaison Group

Apologies :

Marion Clark, Nursing Council of NZ
Barry Ayling, Nursing Council of NZ
Suzanne Rolls, NZ Nurses Organisation
Marguerite Besier, Occupational Nurses Association
Pip Rutherford, College of Nurses , Aotearoa
Linda Brown, Rural Nurse Network
Mark Jones, Ministry of Health
Bernadette Heaphy, College of Practice Nurses
Margaret Macky, ACC
Anne O'Connell, ACC
Glenda Foster, ACC
Kelly Chal, ACC

1. Attendance

• It is noted that due to extreme weather conditions some members of the group were unable to attend this meeting as their means of travel was impacted. Mark Jones' and Bernadette Heaphy's flights were cancelled/delayed.
• Kate Chong introduced herself as the new Programme Manager; she has recently joined ACC and has responsibility for the various nursing portfolios. Kate has a background in health, having trained as a physiotherapist. She has worked in New Zealand , England and the United States , in both clinician and line manager roles.

2. Minutes from last meeting and matters arising

• Chrissie confirmed that the table of results and questions were completed and forwarded to Pip Rutherford.
• A hard copy of Anne O'Connell's ILO Convention 17 presentation was made available. For those not present, hard copies are available on request.
• Nursing Assessments –neither Glenda Foster nor Kelly Chal were able to be present at this meeting; it was suggested that Kitty could make email contact directly with Glenda.
• Kitty suggested that there should be a procedure in place that when a patient has had a certain number of treatments there should be an assessment that takes place to determine if the patients needs and goals are being met. Chrissie said that it was ACC preference that an assessment should take place, but there was not always the necessary resource available.

3. Nursing Treatment Profiles

The treatment profiles were returned to ACC at the end of April 06 after being peer reviewed by the College of Nurses , Aotearoa. It has been noted some of the information in the treatment profiles is of a basic first aid level that would not be thought necessary for a Registered Nurse holding a current APC – Both Kitty and Sharon agreed. As this information is currently included in the document, making a bulky document of over 300 pages. Final editing will be by Margaret Macky, Branch Medical Advisor, making the document more user friendly.

The ACC Acupuncture Treatment Profiles have recently been released and Kate brought one to the meeting as an example of how the Nursing Treatment Profile will look.

Kitty and Sharon both agreed that the layout is simple and effective making it easy to read and digest.

A final draft of this profile should be available at the next meeting. Once the final draft has been signed off, ACC will then have the profile published and bound. Ideally, it would be great to have a launch of the profile – this would be appropriate around October or November of this year.

4. Pain Management – Linda Shepherd

Linda Shepherd attended the meeting and provided an overview of the Pain Management Group (PMG).

The PMG representatives were nominated by their respective professional bodies. Linda said strict criteria were developed for joining this group. Linda has found that participants within the group have a high level of expertise and passion which was excellent and the group will continue to meet.

They have looked at service evaluation and have identified some issues and gaps in the service delivery.

A handout of the Chronic Pain Questionnaire (a screening tool) was handed out. The PMG are looking into ways of identifying “at risk claimants” and how to intervene.

The questionnaire is an excellent tool that is used internationally. It is designed to be used approximately 6 weeks after initial treatment and can also help to determine where the pain is coming from the enable the correct referrals e.g. Occupational therapist, Physiotherapist, Clinical Psychologist etc

This can be found on the ACC website:

www.acc.co.nz / For Providers/ Resources/ Clinical Guidelines/ Acute Back Pain Questionnaire

Linda advised that ACC is on the path to enabling the use of this tool online – this will mean that you are able to complete the questionnaire online and then hit “Submit”. The programme will then make some calculations and then advise of the next appropriate step to be taken.

The team has also been looking at the Qualifications of Health Providers and ensuring that the right providers are giving the right service.

Kitty asked:

Q If there is no service provider in the area where the assessment takes place, can the patient/claimant be referred out of that area?

A At this stage, some providers are actually travelling to the patients/claimants

Contracted providers are getting six weeks of training in Pain Management. It has been identified that non-contract providers need to be educated in Pain Management also and this is hopefully to happen from July 2006 to July 2007.

Chrissie suggested that it may be useful to have Linda attend the Nurse Liaison Group Meeting to provide information and feedback from the PMG meetings – the table agreed that this was a good idea.

5. Payment/Contracts

Anne O'Connell had discussed options and processes re acknowledging Nurse Practitioners at the previous meeting.

If ACC were to contract with Nurse Practitioners the roles would need to be specific; ACC would need to know what work is being done and in what type of environment for example:

•  wound care

•  pain management

•  primary care practitioner

•  return to work

A pricing evaluation would need to be undertaken.

There is a specific process with setting up a new contract, and does require intensive resources. This could be a possibility for the future however this is resource dependent.

It would be useful if the Nursing Profession provides ACC with information re specific clinical areas where Nurse Practitioners are working with ACC.

Kitty noted that Nurse Practitioners generally hold the role of educators and clinical administrators monitoring, assessing and coaching others .

6. Additional Topic(s)

ACC45s

Sharon raised a query about ACC45's, who has the authority to sign them off? Clinical Nurse Specialists?

Chrissie confirmed that an individual needs to be a registered provider to enable them the authority to sign off ACC45's. Registered Nurses are able to register as Treatment Providers and are then able to complete and file ACC45s – this includes those working in the ED setting. There are also instances where Community nurses will need to be registered to enable them to provide treatment in a clinic setting – if a full course of treatment is provided in this environment it needs to be claimed under regulations – not the Community Nursing contract.

OHN Pilot-

A proposal is being develop but in the very early stages. Potentially are looking at the pilot in one or two locations. At the moment, ACC is ‘back to basics” and any new initiatives are on hold.

Discharge Planning

Kitty and Sharon both discussed the need for effective and early planning for claimants who would be supported in the community.

Chrissie informed them that Ruth Taka, DHB liaison person for ACC, has been working with DHB's developing discharge guidelines and suggested that Ruth be invited to speak to the group.

This information can be found on ACC's website: www.acc.co.nz .

Next Meeting is scheduled for the 4 th September.

To invite to the meeting

•  Teresa Sullivan regarding “Treatment Injury- Harm Report and Patient Safety Update”

•  Linda Shepherd

•  Ruth Taka re Discharge Guidelines

•  Glenda Foster/Kelly Chal regarding Social Vocational assessments

Kitty Turner indicated that this may be her last NLG meeting as she has held this position for two years. Chrissie thanked Kitty her commitment and contribution to the NLG meeting. Kitty will confirm if this was her last NLG meeting.

Other item for the next meeting

•  Nursing treatment profiles update