Contact any of the following
for Further Jen Udy Judy
Harris Margaret Hearn Rachael Sullivan Merryll Frear Cherry Waldron Chris Tipa Julie Palmer
|
|
Blessing/Welcome
Apologies
Previous Minutes
Matters Arising
General Business
Report from Cherry Waldron
Nursing Rep on KCI Board
NIL Report
Open Forum—Dept News/Panui
Facilitation of next meeting
7th December 2005
In this Month's Newsletter
Page 1
Nursing Group contact details
Agenda
Quote
Page 2
Minutes of the Nurse Project Meeting held 7 September 2005
Following Pages
Reports from June Henwood & Cherry Waldron (if available)
Previous Minutes
MINUTES OF THE NURSE PROJECT MEETING HELD ON WEDNESDAY, 5th OCT 2005
AT 12.15, CONFERENCE ROOM, COMMUNITY HEALTH, DARGAVILLE HOSPITAL
Present: Cherry Waldron, Julie Palmer, Julie Robertson, Jen Udy, Judy Harris, Zoe Tipa, Chris Tipa, Marion McCahon, Pam Baldwin, Rhonda Zeilinski, Margaret Hearn, Raewyn Fowlie
Apologies: June Henwood, Raey Stainton, Marilyn Archibald, Celeste Sherman, Merryll Frear.
Blessing of kai: by Julie – everyone complimented the chef on the plated lunch.
Previous Minutes: Amend to include that Rhonda Zeilinski was in attendance.
Matters Arising:
Pauline Cook found her visit very interesting and got a strong sense of PHC Nursing in Northland.
Aura has commenced in the joint Co-ordinator/Mental Health position at Te Ha. She is still in orientation phase and will be invited to talk at this forum in the future.
Business:
Presentation by Rhonda Zeilinski:
The presentation was on the Kaipara Maori Advanced Nurse Practice Service and included an overview of the history behind the funding and information on the establishment and implementation of the new role. Feedback welcome. Handouts on recruitment information were distributed. Other information forums are being scheduled.
Discussion revealed that the positions are to be based with iwi providers, but do not have to be internal appointments, nor do the nurses need to be Maori. Some nurses expressed frustration that misinformation led to disappointment re eligibility. Chris commented that NPHO’s had approached MAPO questioning why the funding did not come via PHO’s., with a response that MAPO considered PHO involvement as another governance layer. However, all agreed that MAPO should be congratulated on securing the funding for the initiative.
Contact Rhonda for more details on the position.
Nursing Rep Report: by Cherry Waldron:
SIA Pharmacy Fund - Cherry suggested that nurses remember to suggest to GP’s to write SIA fund on scripts if they feel that pts will not pick them up because of cost. The other issue around scripts is that those written by secondary providers (i.e. hospitals, outpatients) are charged at a higher co-payment than those from the PHO ($15 vs $3 – average). Derek will write scripts for patients being discharged by changing to the DMC programme on the computer. DMC often re-write other hospital and specialist scripts but this is a burden on GP’s time. Other patients just will not pick up the script or will wait until they have saved enough to pay for it. NPHO’s brought this issue up with the DHB about 6 months ago. Their response was that current funding only allowed for PHC scripts to be subsidised.
It was decided that statistics and case studies should be collected over the next month, with a report collated to highlight the issue to DHB management and then the Board. Data from OP’s, Ward, Pharmacy, DMC to be assembled. (Julie to co-ordinate?)
Shuttle/Bus Services - KCHT now subsidise pts to travel to Whangarei for appts via the bus service, freeing the shuttle for wider use within the Kaipara area.
PHONZ – NPHO’s now has representation on the PSAAPG through a PHO New Zealand delegate. Contact Cherry or Chris Tipa if you would like more details.
Open Forum/Panui:
Please be aware that local Mental Health rehab through Rehabworx is under threat of being closed, with clients being transferred daily to Whangarei. A meeting in the Conference room has been scheduled with Northcare Trust and other stakeholders on Oct 15th. Chris Tipa facilitating.
Eat Yourself Well Programme – Pam Baldwin has 10 places in this subsidised (free) 5 week programme for people with known financial hardship. Includes supermarket tours, cooking etc and is based up at the High School. Commences 14th November.
Please make referrals to her before October 20th, or send her an email.
Meeting Closed: at 1.50
Next Meeting: Wednesday 2nd November 2005, Conference Room, Community Health, Dargaville Hospital. – Lunch provided.
Report From June Henwood
National Nursing Centres Consortium in partnership with the University of New Mexico School of Nursing and the National Network for Nurse –Managed Health Centres Presented:
Best Practices in Nurse-Managed Health Centres –Eliminating Health Disparities.
Conference Held in Albuquerque New Mexico.
October 9-11th 2005.
This conference attended by 8 Northland Iwi, NDHB and MAPO representatives, was as a direct response to the visit of Tine Hansen-Turton earlier this year when she visited New Zealand in her capacity of Executive Director of the National Nursing Centre Consortium. She gave motivating sessions about the establishment, development and how to ensure sustainability in establishing nurse lead centres of excellence . She invited participation to the American National Conference. This Challenge was taken up and we took the opportunity to not only attend the conference but present a workshop on Nurse led initiatives in Northland and also visited two Nurse Led Health Centres.
1st Visit UCSF Valencia Health Services. Paediatric and Adolescent Health Care in
San Francisco—Staffed by Nurse Practitioners
This Centre provides services mostly to the poor who are uninsured running programs for pregnant women and children from birth to five.
They provide:
One on one , 90 minute weekly parenting skills and educational home visits
Parent-child play groups twice monthly for socialisation.
Health, education and nutrition curriculum’s and family services
All paper files.
All staff bilingual.
2nd visit was a Tour of the University of New Mexico Health Centre
by Dr Ken Millar, Dean and Professor of the University
This clinic focussed on Family Health as well and here we found the rates of immunisation were as high as 80%. One has to ask how this can be when the population are all uninsured and often illegal immigrants of Hispanic and Latino origin with poor command of English. The results were attributed to a variety of strategies:
Home visiting and immunisation
Weeks devoted to catch up imms where flyers are put in shops public places and letter box drops.
Key people identified and trained as Community Health workers. These workers phone or Text clients the night before all appointments.
Most immigrants who are uninsured take the opportunity to safeguard their children against diseases as they can’t afford to be ill.
Training Nurse Practitioners for intensive home visiting.
A Paediatrician is attached to the service—but is not always there.
Files all electronic.
Translation services available by phone.
The conference included two and a half days of motivational workshopping that this small record cannot do justice too. Some of the major themes that came from the conference, for me , were:
As Northland and ultimately New Zealand embarks on developing the role of Nurse Practitioners within the health system, we can benefit from this conference and learn from our American colleagues who have 20+ years of experience. The same health disparities as experienced in NZ were identified by all the speakers. Diabetes, Hypertension, Heart Disease, Asthma Respiratory Disease, Obesity etc.
Develop clear guidelines and criteria for Nurse Practioner’s to claim on a fee for service model. One of the main issues in billing and coding services in America was that the intensity of the consultation that was delivered by NP was not given the true $value as their systems had been developed from Physician consults. Compare apples with apples and not confuse the Medical model with a nursing model.
True partnerships need to be developed between Health Providers and Education. It is imperative to develop and foster relationships with Universities in New Zealand to enhance the NP role. NP’s can receive quality clinical experience in Nurse lead centres and the university can fund, resource, develop and support Nurse led centres to maximise the delivery of care to clients in the community improving health outcomes .
Clinical Nurses need to be proactive at the MOH level, ensuring that we are involved at policy development level supporting and directing the establishment of this new role.
Develop close community relationships.
Know the population and what their particular needs are and involve them in the development of services.
Preventative health is the way for the future in Philadelphia; some of the programs being delivered include reduction of obesity, improving nutrition and decreasing the incidence of smoking in pregnant women. Investment today will change the health status of the future.
Importance of effective data collection and the evaluation of services provided. Work closely with the funder to establish data collection methods that reflect services delivered and support quality and strategic planning for the future.
Continuous Quality Improvement planning with the focus on people as a valuable resource, quality data systems and time. Harness knowledge, skills, leaders and perspectives.
This was an extremely valuable experience to not only go overseas to learn from that country’s experiences, but also to travel with 7 other colleagues who were involved in a regional pilot scheme to develop the NP role in Northland. Relationships were developed between the funders, co-funders, providers and at all levels of service delivery including Clinical Managers, Registered Nurses, Nurse Practitioners and General Practitioner. These relationships will be crucial to the success of this project.
I am happy to share resources with everyone and look forward to sharing knowledge gained with you all. I want to thank all those who were part of making this educational opportunity happen for me.
June Henwood.
Clinical Nurse Manager
Te Ha O Te Oranga O Ngati Whatua—Mobile Nursing Service
(09) 439 1690
Email-juneh@teha.co.nz
Report from Cherry Waldron
FEEDBACK FROM THE MAORI ASTHMA HUI WHANGAREI/ 11th, 12th, and 13th October.
Attended by Marilyn and Cherry from Te Ha
The Asthma Hui was officially opened by Tariana Turia MP and she spoke of her journey with a diagnosis of asthma. Two very pertinent messages were about being “in control of asthma” rather than “asthma being in control or you” and by taking an opportunity to assist her asthma control with Buteko breathing and achieving very positive results.
Dr Allen Liang, the President of Asthma New Zealand, followed and as usual kept our sides splitting with his canny sense of humour, however on a more serious note, brought home the message that Pharmac needs to be seriously considering whether it is fulfilling the stated goal of “Best Treatment” for all patients. That it appears not to recognise the risk that their policies may be compromising some patients’ health and producing economic disadvantage.
Pharmac responds: On a positive note, that NZ’s hospitalisation rates for Asthma have dropped over the last decade ahead of our Australasian neighbours and many other medications for chronic Respiratory conditions have been added to the subsidized list.
Comprehensive and varied speakers followed the controversial Dr Liang’s concerns by updating the attendees on many other topics:
Smoke free Coalition:
Aims to continue efforts to create smoke free environments.
Promote dangers of second hand smoke,
Work in conjunction with National campaigns.
Dr Wilkinson assisted with “hands on” auscultation practice and knowledge.
Dr Reti relayed the results of a small Ventolin verses Salamol research survey of 37 persons with Asthma.
One outcome exposed was that 83% of the participants had problems with the Salamol inhaler.
Pharmac has appointed Marama Parore-Katene to the new position of Maori Health Manager in response to the Pharmac’s Maori Responsiveness Strategy.
The Strategy has six key aims, including improving Maori representation within Pharmac, improving how Pharmac responds to Maori helath needs and improving information on medicines for Maori.
Marama is also playing a key role in producing a flip chart visual teaching aide for Asthma (currently used by our Asthma Service @ Te Ha) and increasing awareness of cardiovascular risk.
The conference nurses all indicated that Asthma awareness could be helped by producing an up to date visual CD as a useful education tool. This was gratefully accepted as a good project.
The motivational Workshop asked us to practice outside the task orientated domain, to encourage our clients to “keep your eye on the Prize” and to “keep your eye on the Big Picture”.
Dr Child kept our minds on the “worm” as we responded to Best Treatment questions/decisions related to Asthma Case Studies.
Raina Kitchen and Roger Barton tweaked our emotion with photos and a comprehensive account of their time assisting the tsunami victims of Indonesia. One of the problems that was difficult to address was the guilt that the men felt when they were able to save themselves due to their strength i.e. they were able to hold onto the palm trees—when their children and women were washed away.
Spirometry skills were honed with Kevin Ellyett from the respiratory unit, Green Lane.
The highlight of the conference was the power-point presented by Lorraine Stevens on Bx (Bronchiectasis).
Messages:
Keep active to shift the mucous
Dancing is an excellent form of exercise.
Bx action plan is essential for Best Treatment.
Prof. Innes Asher highlighted and introduced the new “Best Practice Evidence Based Guidelines for the Management of Asthma in Children Aged 1 – 15 years”. 2005.Paediatric Society of NZ.
Health of our Children: Wealth of our Nation.
Website: www.PAEDIATRICS.ORG.NZ
The Last message that may be very important to all of us as Health advocates and practioners is:
“If we find out that the patients’ health is in conflict to our ruling bodies, then we must be prepared to do the research, f ind out what the drivers are for the schedule and be prepared to lobby the ruling body in an organized and effective manner”.
Kia Kaha/Keep Strong.
Cherry
Quotation
Nurse Sayings—”Ten Reasons to Become a Nurse”
Pays better than McDonalds (though the hours aren’t as good)
9. Fashionable shoes and sexy uniform
8. Needles—’tis better to give than to receive
7. Confidence in reassuring patients that all bleeding stops ….. Eventually
6. Opportunity to expose yourself to rare, exotic and exciting new diseases
5. Interesting aromas
4. Courteous and infallible doctors who always leave clear orders in perfect handwriting
3. Celebration of holidays with all your friends—at work
2. Comfort in the knowledge that most of your patients survive no matter what you do to them
1. You can drink a pot of coffee and still go to sleep in the morning