September 2024
Allied Health Professions Day Stronger Together
October 14 was Allied Health Professions Day, a day we recognise and celebrate our allied health colleagues across the district. At lunch time allied health enjoyed a stretch and move class. Ryde Physiotherapy team was the winner of the NSLHD Allied Health Professions Day “Race around the world” competition. This year’s theme: Stronger Together, highlights the benefits of multidisciplinary team-based care. This is reflective of the remarkable support our allied health staff provide to ensure we deliver holistic care to our community. The expert assessment and treatment of our social workers, dietitians, speech pathologists, pharmacists, radiographers, occupational therapists, physiotherapists, psychologists, podiatrists and orthotists, improve the lives and health outcomes of all patients. On this Allied Health Professions Day, Anna Butcher, Allied Health Manager acknowledged the vital contributions that Allied Health Clinicians and Allied Health Assistants make to clinical excellence, teamwork, patient care, leadership and culture at Ryde Hospital every day. They truly embody this year’s theme: #strongertogether. “I am proud of the continued dedication of all to quality improvement and research, with several clinical trials being led by Ryde Allied Health currently” said Anna. Ryde encourages anyone to make use of the Allied Health Professionals Day Compliment Card and let their allied health colleagues know, how they make a difference, in millions of ways, to patients and staff alike.
General Manager’s Message I am absolutely delighted to be back at Ryde and in the thick of redevelopment once again Thank you to everyone for the very warm welcome and I am most impressed with the work that has gone on in the year and half I have been at RNSH and NSLHD. Buildings have vanished, amazing work is happening on the very clever interim arrangements and the transition towards a new Ryde Hospital is well underway. The dreams and plans of the last few years are becoming a reality which is wonderful. There will be much happening in the next few months to get us in a good place including several ward movements Ward 2 to GR5 (Ward 5) Ward 3 to Trigg house (Ward 6) and ICU to the interim ICU while waiting, plus all the other bits and pieces to make the place keep safe and
operating. The redevelopment team will keep you fully informed as these changes occur, and I know we will all make it work the best we can for our patients until the new building is complete. Keep an eye out for the staff videos. In the meantime, Accreditation is on the horizon and we wait each week to get the call for the Short Notice Assessment (48 hours’ notice) which we know will be very soon. I am sure everyone is prepared, and we had a great response to the Tidy Wards and Departments competition last Thursday with Ward 8 being the winners. We now just have to keep on top of it! Please feel free when the assessors are in your area to be proactive and show off the great work you do every day – don’t wait to be asked rather present them with your highlight and tell them about it Finally I would like to thank and congratulate all the Allied Health Professionals who work at Ryde as we celebrated Allied Health Professionals Day this month. They do a fantastic job for all our patients and are key members of the Ryde Hospital team.
Contents Allied Health Professions Day General Manager’s Message
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Carers’ Week Spiritual Care
12 12 13 14 14 15 15 16 17 17 18 19
2 3 4 5 6 6 7 8 9
Redevelopment News Quality & Safety Corner
Graduate Certificate Clinical Redesign Program
Healthy Food & Drink Audit
Thank You Letters
Multicultural Lunch
Nursing News
Library Update
Risky Business (EDAR)
Management Opportunity
Occupational Therapy Day Unsigned Documentation Multilingual Medication List
Beautiful Ward/Dept Competition
Welcome to Ryde
Just for Fun Photo Gallery Noticeboard
Allied Health News
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Drug Burden Index Medication Review
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Newsletter is for Ryde Hospital Staff by Ryde Hospital Staff. Please email items of interest to: Catherine.jones3@health.nsw.gov.au
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Redevelopment News Managing change and your wellbeing during the redevelopment With the redevelopment well underway, there are a range of support resources for staff to use to help manage the change process. The NSLHD Practice Development Team will be involved in providing coaching, mentoring and reflective practice activities to ensure there is a support system in place during the changes. Practice Development Nurse Manager Brian Julien said that while change brings some uncertainty, his team will be on hand to help staff. “The key thing to remember is that you're not alone in this journey,” he said. “Keep in mind that you do have some great professionals on the site that will be there for you to help answer some questions, facilitate any responses that you need to get and alleviate some of those anxieties and fears.” Watch the video of Brian and fellow nurse manager Tracy Samuel discuss their approach to change and wellbeing here. Construction progress
Construction of the new interim intensive care unit (ICU) and kitchen has taken shape, with walls now built, providing a clear vision of how the services will look. Staff will have noticed the progress made on both the new sites, which will house the kitchen and ICU for the life of the redevelopment, to ensure there is continuity of high-quality care to patients. Change Manager Jaimie Shields said preparations were in place for one of the first decants with ward three moving to Trigg House in late November.
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Quality & Safety Corner SABSI What is a SABSI and how does it harm our patients?
A SABSI, or Staphylococcus Aureus Bloodstream Infection, is a significant health care associated complication which can result in significant harm to a patient. It can also lead to an increased length of stay while a patient completes a course of antibiotic therapy. At Ryde Hospital we have recently undertaken several SABSI investigation to better understand how these infections are occurring, and importantly what we can do to prevent future infections. A feature of all these investigations has been the overall poor documentation of PIVC (Peripheral Intravenous Cannula) insertion and maintenance. There are significant gaps in the documentation recorded from lack of details around what and when PIVCs are inserted, to who they are inserted by and if aseptic technique is used. There is also a consistent lack of clarity around where the PVC is situated with a recent investigation finding that the same PIVC was variously described as placed in the wrist, hand and arm!
Other important information is also not being documented, especially around the need for a PIVC to be maintained which should be documented daily by the medical team. Keeping a PIVC in-situ that is not needed significantly increases the risk of harm to a patient. VIP (Visual Infusion Phlebitis) scores should be determined on each nursing shift. These scores, ranging from 0-5, help assess the patency of the PIVC by monitoring for phlebitis. If a score of 2 or more is given the PIVC should be removed. See table below for more information on how to assess a VIP score. The length of time a PIVC should remain in-situ should generally not exceed 72 hours, and documentation of removal of a cannula is also an important component of the health care record. For more information on placing and maintain PIVCs please review the NSLHD Adult Peripheral Intravenous Cannula Insertion and Management Procedure or to refresh your knowledge on this important clinical skills view the RNSH video using the following link Cannulation - RNS on Vimeo
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Thank You Letters Emergency Department
My dad is turning 87 and for the first time in his life he has admitted to his family that he is struggling with his mental health. On Tuesday evening his experience of struggling for breath led to us presenting at emergency. He was x-rayed to eliminate concerns, he was treated with patience, kindness and care by triage staff, lovely reception staff and by the doctor. The ED was not particularly busy and I think we were there about 3 hours. I followed up by making an appointment with his doctor for later in the week. However, the following evening dad called me in a state of extreme distress and I could tell that he was having a panic attack, so we returned to emergency. He was triaged with high blood pressure, but the department was busy so there was a long wait. Because he was in a state of anxiety he wanted to leave, (he was worried that he was impacting my chance of work the next day) and after checking his blood pressure again, there must have been a miscommunication with triage as his name was taken off the list to be seen by the doctor. Gradually the waiting room emptied and after 6 hours, reception staff explained to us there must have been a mistake and made sure he was seen by a doctor. We want to stress, that despite this, my dad and I are extremely grateful for the respectful, patient and thorough treatment my dad received. We are particularly grateful for the patience of Dr Josephine Atalifo who gave dad the time he needed to explain how he was feeling, and to asking the right questions for him to feel safe to discuss his mental health which he has not done before - at the end of a shift at 6am. In short, thank you. Tonight, my dad is feeling the medication is working and he is not fearful of a night of ruminating and distress. He is grateful that this downward spiral he has been experiencing has shifted and is feeling more positive. So much so, that he did not want to answer the survey he was sent, because he did not feel it would give him the chance to truly reflect how appreciative he is. Ward 2 1. Just wanted to touch base regarding 2 Nurses on Ward 2. Big shout out to Mel and Lucy. The care they took for a dementia patient across from my dad was just superb. They both listened to her whilst they tended to her needs whilst I have seen others just nod and walk off these two ladies had a great conversation with her was just beautiful. They then joked with dad and put a big smile on his face. Thank you, ladies, for your empathy and quality care for the patients especially the elderly. 2. Just wanted to reach out to the Nursing Unit Manager of Ryde Hospital Ward 2 in regard to a Nurse who cared for my dad. The care and compassion shown by this nurse goes above and beyond. The nurse was happy to listen to me and my concerns and showed such a caring nature to not only my dad but all patients I witnessed it was a true credit to her. Thank you. Ward 3 All the staff on ward 3 during my stay were absolutely incredible and all the medical staff involved in my surgery were fantastic at giving me all the information and reassurances, I felt very safe in their care and there treatment was above what I expected. One particular night a nurse went above and beyond for my care, especially post surgery she took my pain complaints seriously and did everything she could to keep me comfortable. It made the experience so much easier with such a caring and responsive nurse I feel very lucky to have been taken care of so well. Although surgery is never an experience I wanted the medical care provided to me was exceptional by everyone involved and I can't praise the team high enough for all their efforts but I will forever be so grateful to have had this happen whilst they were all there.
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Nursing News Person Centred Showcase
At the Person Centred Care showcase, Ryde had 2 oral presentations, one from Sta from ICU on the springboard to success program. Our other oral presentation was from a consumer Gillian who presented her stroke journey, as well as 4 poster presentations.
Risky Business Eating & Drinking with
Acknowledged Risk (EDAR) Sarah Drake, Catherine Pash, Bianca Italiano, Dr Linda Xu, Jeanette Carey, Barabara Scott & Dr Therese Nguyen provided a multidisciplinary presentation about the Risky Business of EDAR.
Dysphagia (swallowing difficulty) can lead to food/fluid entering lungs (aspiration). Despite dysphagia, many patients choose to eat and drink for quality of life, accepting risks of illness or death. “Eating and Drinking with Acknowledged Risk” (EDAR, a.k.a. “risk feeding” or “comfort feeding”), can be a complex process for patients and clinicians, primarily due to lack of clinician knowledge, education and standardised procedures. The Risky Business project at Ryde Hospital aimed to determine current practices at Ryde Hospital around EDAR and effects on 1) patient health outcomes and experience; 2) clinician knowledge and confidence and 3) health service efficiency. A secondary aim was to develop a standardised protocol for the multidisciplinary team to implement for patients considering EDAR.
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Occupational Therapy Day Celebrating OT In October we celebrated Occupational Therapy week (21- 27 October 2024). Across the world the profession celebrates on 27 th October. This year’s theme reflects the important role of the profession to facilitate the ability of individuals, communities and populations to participate in the activities that they want, need or are expected to do in their daily lives. Here at Ryde hospital Occupational Therapists work across the site in Acute Care, Rehabilitation and the Community. One of our team reflected; “Occupational therapy is truly holistic. We help people at all ages, at all stages of life. I’m proud to be able to work with OTs across the district to improve the lives of our clients.” Our teams consist of staff who have trained both here in Australia and overseas. Together we have rich experience, memories and stories that have shaped our practice today. Highlights this year have included members of the profession the Allied health award roll of honour, contributing to community -based education sessions to older persons in the local Chinese community, contributing to a successful research application for our rehab service and setting up an outpatient clinic to support community-based clients to apply for personal alarms. If you would like to know more about Occupational Therapy, please chat to a member of our team or contact Pip Wilford Head of Department on 98587341 or our general email on NSLHD-Ryde- OT@health.nsw.gov.au
Members of the CAReS OT Team
Members of the Graythwaite OT Team
Members of the Acute OT Team
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Unsigned Documentation As we approach our upcoming hospital accreditation, it is crucial that all allied health, nursing, and medical teams ensure that all documentation is completed and signed off. Ensuring our documentation is up to date not only improves patient outcomes but also demonstrates our commitment to maintaining the highest standards of care.Specifically, we need to address the following areas: 1. Unsigned PowerNotes and PowerCharts: • Our latest reports indicate there are still several unsigned documents across departments. For example, in 2024 up to end of August, there were 632 unsigned Nursing PowerNotes, 2451 unsigned Medical PowerNotes, and 11 unsigned Allied Health PowerNote. • It is vital that these documents are reviewed and signed to ensure compliance with the communicating for patient’s safety standards. 2. Outstanding Discharge Referrals: • We have noted a steady increase of number of outstanding discharge referrals, up to end of Aug, with 213 referrals remaining unsigned in 2024. • Please make it a priority to complete these as they directly impact patient continuity of care. Hospital Information Service (HIS) thank you for your attention to this matter. Let’s work together to ensure we are fully prepared.
Multilingual Medication List Patients receive information about their medications in the eMR Discharge referral paperwork. However, the Pharmacy dept is able to produce a patient friendly medication list printed from the pharmacy dispensing program. This contains detailed information about when and how to take medications as well as indications for use and any cautionary advisory warnings. As part of a quality improvement initiative to support our culturally and linguistically diverse (CALD) patients, the medication list is now multilingual and available in 4 languages other than English; Chinese (simplified and traditional), Korean, Japanese, and Italian. This was a local initiative from the pharmacists working within the NSLHD Digital Health Service to improve the level of support we provide our CALD patients.
The patient friendly medication list is often recommended for patients taking multiple medications, medications with complex instructions, patients with multiple changes to their pre-admission medication regimen or to aid medication adherence. The provision of a medication list (also known as a Medilist) is recorded in the Pharmacy Discharge Review eMR document in the section “Medication supply and education.” Any clinician can recommend the provision of this tailored medication list by contacting the ward pharmacists. The pharmacists make an assessment regarding the information needs of the patient as part of their Medication Reconciliation on Admission eMR document and document this in the section “Pharmacy Discharge Plan.”
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Allied Health News GRC staff received recognition afternoon tea for the care they provided to a long stay patient over the last years. Staff were acknowledged for their dedication, administrative efforts, and professionalism, which have collectively contributed to this dignified outcome for this patient. Thank you GRC staff.
Umbrellas donated to CAReS from Bendigo Bank
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Drug Burden Index Medication Review The Drug Burden Index (DBI) measures total exposure to medicines with anticholinergic and sedative effects which may impair physical and cognitive function. The DBI is validated as a clinical risk assessment tool in practice. It is built into the eMR and calculates the DBI for each patient admitted. Ryde Hospital participated in a Multi-Centre Cluster Randomised Controlled Trial in 2022/23 which involved an intensive DBI stewardship intervention to look at the impact on prescribing, readmission, mortality; as well as clinician and patient feedback. A stewardship pharmacist worked with the medical, pharmacy and nursing teams on 4 study wards to facilitate use of the DBI in eMR to prompt and inform medication review. Ryde has followed on from the trial to embed the DBI risk assessment into the clinical review of patient’s medications. The Ryde Hospital Medication Safety and Quality Committee recently endorsed the Work Instruction for the Multidisciplinary Drug Burden Index Medication Review. The purpose of this work instruction is to outline the process undertaken by the ward multidisciplinary team in conducting medication review with a focus on reducing falls risk and drug burden. Any inpatients with a drug burden index (DBI) score of greater than zero or identified as having challenging behaviours or high falls risk should be reviewed. The DBI score indicates total exposure to anticholinergic and sedating medications. This review is to be undertaken by the multidisciplinary team comprising of the treating medical team, ward pharmacist and ward-based leadership team (Nurse Unit Manager, Clinical Nurse Educator and/or Clinical Nurse Specialists). Medications contributing to DBI are rationalised if possible and opportunities to titrate or deprescribe are discussed and documented. Deprescribing guidelines such as those published by the NSW Therapeutic Advisory Group are used as appropriate. The consumer should be actively involved where possible in making decisions concerning their medications. The Multidisciplinary Drug Burden Index Medication Review currently takes place fortnightly on Graythwaite and weekly on Ward 7. Our other wards will be implementing this review process soon. This activity aligns with the National Safety and Quality Health Service Standards 4, Medication Safety as well as 2, Partnering with Consumers, 8 Recognising Responding to Acute Deterioration Standard and 5 Comprehensive Care.
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Carers Week Millions of Reasons to Care The week of 13 to 19 October was dedicated to recognising and celebrating the incredible contribution carers make every day. It was a wonderful reminder of the invaluable role carers play as our partners in care. Engaging with carers and recognising their contributions is essential to providing holistic patient-centred care. By identifying and supporting carers, we can better meet the needs of those we treat and care for in our hospitals and community. Let’s continue to work together to ensure carers are identified Carers Week 2024 was a great success, and we’d like to extend a big thank you to everyone who visited our foyer stall at Ryde Hospital! We were able to support and connect carers and staff alike with resources, information and to useful services. With over 2.65 million carers in Australia - and more than 130,000 in our local health district alone – carer’s week was a great time to engage with, listen to and acknowledge all that carers do. (with their details entered into eMR), feel acknowledged and supported every day. Remember, you can refer a carer to us anytime via phone (02 9462 9488) or eMR or email NSLHD- Carers@health.nsw.gov.au, or visit the Carer Support Service intranet or the Carer Support website for information and resources.
Spiritual Care The Ryde Chaplaincy Working Group held a spiritual care stall for staff and visitors in the hospital main foyer on Monday 28 October from 8.30am till 2.30pm. All faiths were represented and literature spiritual care and the chaplaincy services were also available. All staff were invited to drop by the stall. Meet the Chaplaincy Coordinator, Chris Isika and the Chaplaincy Working Group members; pick up some resources; ask questions; complete a quiz; and find out about the plans for a Multi Faith Room in the redeveloped hospital.
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Graduate Certificate Clinical Redesign Program Applications Open The ACI partners with the University of Tasmania to deliver the Graduate Certificate Healthcare Redesign for
healthcare teams to conduct priority projects and learn in- depth skills in project, change management and service redesign. Investing in staff capability and capacity, the ‘school’ continues to be in high demand and this year has been shortlisted as finalist for the Australian Collaborative Education Network 2025 Work Integrated Learning awards. Redesign can help you address strategic challenges and deliver essential service innovation and new or alternate models of care, building capacity to achieve the Future
Health Strategic objectives. It is designed to be scalable and adaptable, accommodating all areas of healthcare delivery. They are pleased to announce that in 2025, the Centre for Healthcare Redesign will offer three courses. The dates for 2025 are listed below:
Program Intake
Applications Open
Applications Close
Notification Program Starts
Program Ends
End of Program Event
2025.01 2025.02 2025.03
1-Oct-24 2-Dec-24 21-Feb-25
2-Dec-24 21-Feb-25 15-Apr-25
16-Dec-24 7-Mar-25 29-Apr-25
11-Feb-25 3-Jul-25
Dec-25 May-26 Aug-26
7-May-25
4-Nov-25
17-Jun-25 12-Dec-25
The 2025 theme is designed to attract a diverse range of projects focusing on three critical and interconnected challenges. • Efficiency: Encouraging projects that optimise resource and financial management, reduce waste, and streamline processes to ensure sustainable service delivery. • Equity: Focusing on projects that address health disparities and ensure equitable access to care, particularly in underserved populations, including rural, remote, and Indigenous communities. • Innovation: Promoting the adoption of digital technologies and alternate models of care that integrate services across different levels of the healthcare system, driving improvements in patient outcomes and system efficiency and pushing toward net zero. Applications are welcomed from teams with 2-4 people who have a strong focus on strategic impact and improving value-based care that delivers excellent health outcomes, experience, and efficient, sustainable care. If you have redesign idea and would like to some more information about the course please contact the Ryde Hospital Redesign & Innovation Manager at catherine.jones3@health.nsw.gov.au Applications close on 2 December 2024. Further information and reminders for the second and third intakes will be sent out in late 2024 and early 2025. Further Information available on the Ryde Intranet – Clinical Redesign & Innovation
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Healthy Food & Drink Audit
Excellence at Ryde Results from the 2024 Healthy Food and Drink Framework audit demonstrated that Ryde Hospital has maintained an excellent level of compliance with the audited Framework practices since 2020 The fifth annual state-wide audit of the Healthy Food and Drink in NSW Health Facilities for Staff and Visitors Framework, was conducted in February/March 2024 and measured progress by food and drink outlets to meet a set of 13 healthy food and drink practices required by the Framework. All eligible outlets at Ryde Hospital were assessed against the 13 practices. One café and four vending outlets were audited. 100% of outlets achieved 100% compliance with all Framework practices, this has increased from 60% in 2020 and 80% in 2023, and reflects considerable effort by all involved. Thank you for your on-going support with this initiative to provide healthy options for our staff and visitors.
Multicultural Lunch The Ryde pharmacy department enjoyed a very multicultural lunch with; Lebanese Flatbreads (Manoushe Zaatar), Indian Naan bread stuffed with shredded Cheese and chopped Onions with Egg plant curry, as well as Vegetarian Vietnamese rice paper roll with Peanut sauce , Vietnamese Banh mi (pork roll and Nem Nuong), Chips and shortbread biscuits. Their participlation in the NSLHD Multicultural week celebrations was acknowledged with the department receiving their framed MWH Champion Certificate.
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Library Update
Management Opportunity
Opportunity NSLHD, in partnership with UNSW, is offering a Master of Health Leadership & Management Scholarship Program, starting February 2025. Further information about the program can be found here. A virtual information session will also be held on Thursday, 31 October, 14:30-15:30 via Teams. The session can be accessed here.
To Apply for this fantastic opportunity, all interested NSLHD employees must complete an application form by 11:45pm Sunday, 10 November 2024.
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Beautiful Ward Competition In preparation for accrediatation Ryde held the ‘Beautiful ward or Department” competition All areas were asked to tidy cupboards, update noticeboards, clear corridors, and organise storerooms for a chance to win yummy pizza prizes! The winners were: FIRST – Ward 8 - Pizza Voucher $100 SECOND – Physiotherapy - Pizza Voucher $75 THIRD – Ward 3 – Pizza Voucher $50 Highly Commended
Critical Care
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Theatres
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PeriOp
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Speech Pathology
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Library
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Welcome to Ryde New Staff Ryde Hospital welcomed the following new staff in July and August to join our wonderful teams. Welcome to you all.
Name
Position
Anne Nguyen
Assistant in Nursing
Just For Fun
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Photo Gallery On Friday, 18 October Ryde celebrated Loud Shirt, rasining awreness of the needs of tose who are deaf or have a hearing loss by wearing their brightest, loudest shirt or scrubs. The day was full of fun and help raise awareness for those with hearing loss.
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Noticeboard
Respecting the Difference: Be the Difference face-to-face training 2024 Hornsby
Program Overview Respecting the Difference – Aboriginal and Torres Strait Islander Cultural awareness training enhances our organisation’s capacity to provide respectful, responsive, and culturally safe services. It is designed to build upon staff knowledge and skills. The face-to-face session is presented in a relaxed interactive workshop style, where conversations and questions about Aboriginality, culture, urban myths, and beliefs can be openly discussed. The session follows on from the Respecting the Difference e-learning module.
Royal North Shore Hospital Auditorium and Wallace Freeborn - level 5 Kolling Building • Thurs 10 Oct: Auditorium – 9am to 1pm
• Thurs 17 Oct: Auditorium – 9am to 1pm
• Thurs 31 Oct: Auditorium – 9am to 1pm
• Thurs 28 Nov: Auditorium – 9am to 1pm
• Thurs 5 Dec: Wallace Freeborn – 9am to 1pm
• Thurs 12 Dec: Wallace Freeborn – 9am to 1pm
Target Audience: Mandatory for all NSLHD Employees Duration of Program: 4 hours
• Thurs 19 Dec: Wallace Freeborn – 9am to 1pm
Ryde Hospital Dates – ELCA Training Room • Tue 29 Oct: 9 to 1pm
Enrol via My Health Learning
• Tue 19 Nov: 12 to 4pm
ENQUIRIES: NSLHD-DACinfo@health.nsw.gov.au
• Wed 11 Dec: 9am to 1pm
Hornsby-Ku-ring-gai Hospital - Level 5 - Meeting room 1 • Wed 25 Sep: 9am to 1pm
Macquarie Hospital – Emily’s Cottage on Manning R • Thurs 7 Nov: 9am to 1pm
• Wed 30 Oct : 12 pm to 4pm
Enrolments via My Health Learning
For information on other available courses, visit the Intranet and the NSLHD Course Calendar Cost: NSLHD employees Nil
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