News bulletin 27 November

on 27 November

Welcome to the College of Nurses – News Update.
No. 180, Wednesday 27 November 2013 

From NZ media this week

Medicines Amendment Bill passes final reading
Associate Minister of Health Todd McClay welcomed the passing of the Medicines Amendment Bill 2011. The Bill streamlines the current Medicines Act 1981 and is an interim measure until such time as the Therapeutic Products and Medicines Bill is passed. 

Nurses cleared to prescribe drugs

Some nurses and optometrists will be able to hand out medication following a law change today.

Baby robot delivers lifelike lessons for hospital staff
A newborn robot that can turn limp and even blue is helping train doctors and midwives. The simulator baby has monitors to measure its breathing and heart rate. It has a lifelike pulse and it can hiccup

Broken bones top list of adverse events in hospitals
Broken bones from falls accounted for more than half of the 489 serious adverse events suffered by patients in hospitals and other health providers during the past 12 months.

Wider reporting of adverse health events welcomed
Associate Minister of Health Jo Goodhew today welcomed the broadening of reporting of serious adverse events (SAEs) to include some private providers and other non-DHB organisations. 

Counting cost of hospital errors

Rise of 21% in number of adverse events reported put down to greater willingness to learn from mistakes 

Patients suffer when staffing levels are insufficient - NZNO
The New Zealand Nurses Organisation (NZNO) says the Serious Adverse Events report released today is a good way of learning from mistakes to improve the overall safety of healthcare delivery in New Zealand. The report demonstrates that there must be the right number of skilled and qualified nursing staff on duty at all times to prevent patients dying or suffering a serious adverse event while in hospital.

Wanganui Hospital welcomes ‘eye-catching’ Patient status at a glance boards

Whanganui District Health Board (WDHB) director of nursing Sandy Blake's push to have 'eye-catching' Patient status at a glance boards installed beside every patient's bed became a reality this week in Wanganui Hospital's Medical Ward. 

Nursing body says child health report gets it right
The New Zealand Nurses Organisation (NZNO) thanks the Health Select committee for its inquiry into improving child health outcomes and preventing child abuse.

Elderly won't suffer from investment in youth health - committee head

Investing more of New Zealand's health dollar in young Kiwis will not result in shortcomings for the elderly, the head of a parliamentary committee into child health says.

Child healthcare 'pays off' later

The National MP who heads the health select committee is calling on his own Government for "leadership" on its child healthcare recommendations.

Big shakeup coming for Chch hospitals

New Zealand's private healthcare system is set to be shaken up by the imminent arrival of a new hospital in Christchurch. 

Call to measure unmet health need

Unmet need has become "the elephant in the room" and Canterbury's health sector is calling for the Government to start measuring it. 

System failing offenders with alcohol-related brain disability - judge

Thousands of people may be ending up on the wrong side of the law due to an alcohol-related brain disability caused before birth, a New Zealand judge says.

Severe tooth decay affecting Kiwi kids

About 13 per cent of the country's 5-year-olds have such poor oral health it affects their eating, sleeping and school work, an oral health expert says. 

Aged care

Lifting the lid on NZ's rest homes

Some facilities likened to chicken farms over shortfalls in aged care.A Herald investigation of rest homes - where a greater proportion of elderly people die than in 12 other developed countries - has found that although most care is at least adequate, some reflects major failings. 

Inside our rest homes: What's really going on in rest homes

Older people are more likely to end up in retirement facilities in New Zealand than in any other country. In the first of a five-part investigation, Simon Collins and Martin Johnston examine the standard of our care for the aged.

Rest-home audits can be viewed by public

Public access to rest-home audits will be available from today, with the introduction of a new website.

Inside our rest homes: Scabies outbreak lasted 9 months
DHB report on probe into rest home after caregiver complained says mite infestation inadequately managed. 

Inside our rest homes: Retirement centres aim for top dollar to help fund care
Today the Health Ministry starts posting full audits of rest home care online. In the second of a five-part series, Simon Collins and Martin Johnston examine the peculiar business model for our 32,000 old people in care. 

DHB specific

DHB cooperation yields little - report
The Auditor-General has released a report critical of district health boards' efforts to work together in order to save money and improve treatment.

More time released back to patient care
Many patients at Waikato DHB are experiencing a near 30 per cent increase in direct care-time thanks to the Releasing Time to Care -The Productive Ward programme 

Mental health 

Youth suicide: Web-based therapy could be the breakthrough

New web-based therapy programmes aimed at teenagers could be the breakthrough in curbing the country's alarming youth suicide rate, a researcher says. 

Public health

Superbug epidemic unlikely in New Zealand, health experts say

People should not fear a superbug epidemic following a recent death, experts say, as there are strict procedures in place to prevent a widespread outbreak.

Growing concern over rise of whooping cough rates

A Whangarei mum is urging pregnant women to get a whooping cough vaccination after her baby daughter developed the potentially deadly disease shortly after birth and spent her first nine weeks in hospital.

New vaccines proposed

Wanganui children could soon get protection from rotavirus and chicken pox if funding for vaccines is approved - cutting the number of child hospitalisations each year.

Social health

Teen pregnancy is growing concernNearly one-in-10 Kiwi babies are born to women aged under 20 years of age.A parliamentary health committee found New Zealand has the third-highest teenage pregnancy rate among high-income OECD countries, trailing only the United States and Chile.

International media

RN education, experience linked to peds cardiac surgery outcomes

Nursing education and experience significantly affect outcomes for pediatric patients undergoing cardiac surgery, according to a study. 

Nurse researcher studies moral distress in ICU for burn patients

Researchers at Loyola University Medical Center in Maywood, Ill., have published a study of emotional and psychological anguish, known as moral distress, experienced by nurses in an ICU for burn patients. 

RCN: 'Better relationships with cleaning staff needed'

Improved relationships between nurses and cleaning staff could improve patient care, a report has claimed. 

Full report: 

Sounding the alarm
Patients and their families often say they can’t wait to get home so they can finally get some rest — in part because of all the beeps and buzzes coming from IV machines, cardiac monitors and other medical equipment. That cacophony of sounds also can have a negative effect on nurses and other health care professionals — a phenomenon known as “alarm fatigue” caused by sensory overload. 

Using Good Design To Eliminate Medical Errors

Nurses Eliminate Pressure Ulcers in Premature Infants
Infants born prematurely are at a significantly increased risk for pressure ulcers, yet nurses at one hospital have been able to eliminate this threat for patients in the hospital’s neonatal intensive care unit. 

While Google Glass may be occupying a lot of the spotlight on wearable tech at the moment, particularly when it comes to headsets, other companies are quietly innovating away in the same space. Evena Medical, for example, which today revealed hardware (based on Epson smart glasses) that lets nurses and medical technicians literally see through a patient's skin to the vascular system underneath--in real time.  

Involving Patients in Nurses' Shift Change Reduces Medical Errors, Satisfies Patients
At shift change, incoming and outgoing nurses transfer accountability by exchanging information about the patients under their charge. Called bedside handover, this process empowers patients and allows them to become active partners in their own care. 

Francis report on Mid Staffs: government accepts recommendations
Plans announced to make the NHS more open, more accountable and more focused on safety and compassion.

Articles of interest

A view from the outside: nurses' clinical decision making in the twenty first century

The purpose of this paper is to highlight some observations of clinical decision making processes made by culturally and linguistically diverse nurses (CALD), in relation to elderly patients in particular. It will explore some of the potentially serious professional and legal implications for nurses when there is an over reliance on experiential knowledge and routine tasks without mindful application of evidence and consideration of the ethico-legal imperatives. 

Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents 
by Jennifer C. Hunter, Jane E. Yang, Adam W. Crawley, Laura Biesiadecki, Tomás J. Aragón
As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. 

Moral Distress Among Healthcare Professionals at a Health System 
JONA's Healthcare Law, Ethics, and Regulation, 
July/September 2013
ABSTRACT: Moral distress is increasingly recognized as a problem affecting healthcare professionals. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even leaving the profession. Using the 21-Moral Distress Scale-Revised to assess moral distress, 323 surveys were received from 5 healthcare disciplines. The overall results showed that all disciplines experienced moderate to high actual moral distress, related to similar and/or different patient care situations. 

Publications and Reports online

Serious Adverse Events Report 2012–13

The Health Quality & Safety Commission has released the 2012–13 report of serious adverse events (SAEs) reported by district health boards (DHBs) and other health providers. 

Children and young people with diabetes. RCN guidance for newly-appointed nurse specialists (PDF 195.1 KB)
Specialist diabetes nurses play a key role in supporting children, young people and their families. Numerous research studies and audits demonstrate the significant impact they can have in achieving good diabetic control and overall management. However, many specialist nurses work in isolation. This guidance sign posts those new to a specialist nurse role to resources and sources of support. It also highlights issues that need to be considered by the individual as well as their employing organisation. 

Supporting children and young people with diabetes: guidance for nurses in schools and early years settings (PDF 335.1 KB)
The RCN is aware of inequality in the care provision for children and young people with diabetes in schools and early years settings. This document outlines the principles that health care professionals and education staff should apply to ensure the needs of children and young people with diabetes are met. The aim is to ensure that children and young people receive appropriate intensive therapies, without prejudicing their health or education.

Developing an effective clinical governance framework for children's acute health care settings (PDF 255.0 KB)
Publication code:
Publication date: 22 October 2013
ISBN: 978-1-908782-84-7
Abstract:This publication, originally published in 2001, and updated by the RCN Children and Young People’s Professional Issues Forum, is designed as a checklist to be used when considering the implantation of a clinical governance framework within children’s acute health care settings. It highlights the principles for implementation and the issues to consider when developing a framework. The publication is aimed at all clinical professionals and managers with responsibility for acute children’s health care services.

Lost in transition. Moving young people between child and adult health services (PDF 196.8 KB)
Children and young people experience many significant transition points between health care services, as well as those between schools, university and other educational settings. All these transitional phases can have an impact on adherence to therapeutic regimes and retention by supportive health care services. This publication is aimed at health professionals who work with children and young people and includes information on the principles of good practice in arranging transitions, keyworkers' roles in transition, young people's involvement and processes and protocols. There are also case studies throughout the publication, along with a list of RCN recommendations to make the transition for children and young people to adult services smoother.

Breaking bad news: supporting parents when they are told of their child's diagnosis (PDF 273.0 KB)
Publication code: 004471
Publication date: 23 October 2013
ISBN: 978-1-908782-60-1
Abstract:Nurses are often in the frontline of supporting children and their families following receipt of bad news. This guidance replaces Supporting parents when they are told of their child’s health disorder or disability (1999) and identifies effective strategies to use when communicating with, or supporting parents and carers, receiving bad news. It also signposts practitioners to quality resources that will support them in their practice.

rom the Ministry of  Health 

Health Literacy and the Prevention and Management of Skin Infections

Health literacy refers to the degree to which people are able to access and understand essential health information in order to make informed and appropriate health decisions. This report focuses on the health literacy experiences among Māori with skin infections.New Zealand has one of the highest rates for childhood skin infections in the western world. It is estimated that 60,000 children visit general practices every year for treatment of skin infections and previous research has shown there is a strong relationship between a person's health literacy and their health status.The report identifies effective health literacy interventions to strengthen the prevention and management of skin infections for Māori children under 15 years of age and includes a set of skin infection resources designed to improve both the health information available to Māori parents/caregivers, and patient/health provider communication. 

New Zealand Framework for Dementia Care
This publication provides DHBs and the health and social support sectors with a guide for developing their dementia care pathways.  The framework has three guiding principles:following a person-centred and people-directed approachproviding accessible, proactive and integrated services that are flexible to meet a variety of needsdeveloping the highest possible standard of care.

The above information has been collated for the College of Nurses Aotearoa (NZ) Inc by Linda Stopforth, SNIPS and is provided on a weekly basis.  It is current as at Tuesday 26 November 2013
If you have any feedback about content - what parts are most useful or what you would like added - please email
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