Volume 10, Issue 7
Royal North Shore Hospital Nursing and Midwifery NEWSLETTER
Sep-Nov 2021
Inside this issue:
Message from the DoNM
2
RNSH N&M Workforce Updates
3
Wound Awareness Week 2021
4-5
EAP
6-7
NSLHD Libraries Update
8
eMR Enhancement Projects
9
CNC Bio — Vicki Evans (Roach) AM — Neuroscience
10
A colourful Thank You at the front of ACC
Staff Profile of the Month — Annaleise Honnef — ICU
11
Team Spotlight — ICU
12-13
Research Study
16
Carer Support Service Update
18
Nursing Research and Practice Development
20
Pages 21-26: Drawings and letters sent in by local school kids
Letters from our local school kids 21-28
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Royal North Shore Hospital Nursing and Midwifery
Message from the DONM
Tracey Gray, Director of Nursing and Midwifery, RNSH
The jacaranda is in bloom again so it must be November. The year has been an unusual one for the world and health has been at the forefront caring for our patients through a pandemic which like the year is now winding down. Just like the year it is not over yet. The vaccination program is now broadening to children so we should begin to see even fewer cases as the vaccination rates rise. I don ’ t know about you but I am now feeling optimistic that we may once again be able to focus on some of the work that has been on hold during the pandemic. As some of the restrictions ease it is important to stay up to date with the latest advice for healthcare workers. For example it is now mandatory for healthcare workers to wear a surgical mask and eye protection when within 1.5 metres of a patient. Nigel Lyons, Deputy Secretary, Health System Strategy and Planning recently announced that he Risk Escalation Panel has determined that the levels of transmission in the community warrant maintenance of Red Level Alert in line with the COVID - 19 Infection Prevention and Control Manual. This advice means all LHDs and Specialty Health Networks across NSW remain under red alert level directions until further notice. All staff working in public health services and multipurpose services across NSW are directed to maintain PPE precautions in accordance with the Red Alert Level set out in the CEC COVID - 19 Infection Prevention and Control Manual this includes: Universal surgical mask use by all staff who work across NSW Health campuses and Eye protection when within 1.5m of a patient Please ensure you follow these instructions until advised we no longer need to do so. Infection control is everybody ’ s business.
Emergency Nurses Australasia (CENA) Australasian Emergency Department of the Year. It has been 7 years since an emergency department in NSW has won this award. The submission was truly impressive , outlining the many quality initiatives they have been leading in recent times.
Well done to you all. Your colleagues are very proud of your achievements.
The work that has been on the back burner as mentioned above is finally being revisited. The Skin Integrity Committee and the RNSH Quality and Safety Committee recently identified a potential issue with the prevention of pressure injuries of the heel. There have been a number of stage 3, 4 and unstageable injuries that are of concern. This is in part driven by the acuity and complexity of our patients which is certainly again on the rise. The Skin Integrity Committee has formed a project group to review practice in this area and trial new approaches to prevention. We will highlight that work in the coming months and provide some practical strategies for adoption in all wards. Finally it is almost tinsel trophy time again. More information will follow soon. Get planning and have some fun.
Recently our Emergency Department Nursing team won a very prestigious award in the College of
Thank you everyone.
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Royal North Shore Hospital Nursing and Midwifery
RNSH Nursing and Midwifery Workforce Updates
New Appointments / Secondments
Alyssa Kim has commenced in the new position TNP Age Care Supportive and Palliative Care Lower North Shore (RNSH & Ryde)
Kate Lyons has commenced in the Temporary CNC Cancer Services position
Thank you to those CNCs who assisted with covering the Helpline and patient education whilst recruitment was underway
Janet Vlasic substantive NUM of 7A AAU has returned from a period of leave.
She is currently job sharing with Chelsea Boland.
Successful CNS Applications
Kaithy Zhang has commenced in the Temporary CNS2 NSCC position
Thank you to Caitlin Springer who temporarily worked in the role for a significant period of time and demonstrated some great initiatives, specialised knowledge and skill whilst in the position. Caitlin has returned to her role in NSCC
Lois Kang has been successful in her application for CNS1 in NSCC. Lois has demonstrated quality improvement initiatives and has specialist knowledge in Cancer Nursing
For the Division of Medicine:
Rumbi Chigwedere
Josfin Charles
Nicholas Grech
Aled Gaynor
Congratulations!
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Royal North Shore Hospital Nursing and Midwifery
Wound Awareness Week 2021 (WAW21)
Wound Awareness Week took place from the 23rd to the 29th August, 2021 — aiming to raise awareness of chronic wounds.
This year ’ s theme: “ The solution is bleeding obvious ”
All healthcare professionals need to be “ wound aware ”. Everyone working in healthcare will come across wounds. These may be surgical incisions, wounds that occur as a result of trauma or wounds that are complications of diseases and conditions and can result in chronic wounds. People with chronic diseases such as diabetes or those over 65 are more at risk of chronic wounds. Every year over 420,000 Australians suffer from a chronic wound. They are a ‘ hidden affliction ’ that is alarmingly common and many people suffer with their wound for much longer than they need to. With the right treatment, a chronic wound can be healed. It is important that health professionals assist patients with slow healing or chronic wounds to get the best treatment for their wounds.
For any further information please see:
http://www.woundaware.com.au/about - wound - awareness - week/
To support the WAW21 campaign, Royal North Shore Hospital had a daily Wound Awareness Week Quiz. There was also an opportunity for staff to undertake virtual wound education during WAW21.
Thank you for supporting the Wound Awareness Week 2021 campaign.
Contributor:
Rachel Hodgkins
Stomal Therapy & Wound Care CNC
Ext: 32824 Pager: 41244
Email: Rachel.Hodgkins@health.nsw.gov.au
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Winners of the WAW21 Daily Quiz:
Top left:
Hannah Don, 8C NUM
Top right :
Alyssa Silcock, 8D CNS
Centre:
Hanna (Boh Yong) Chun, 8B CNE
Bottom left: Mehrdad Heydari, Medical Imaging RN
Bottom right: Nina Atayde, 8D CNE
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Royal North Shore Hospital Nursing and Midwifery
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Royal North Shore Hospital
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Royal North Shore Hospital Nursing and Midwifery
NSLHD Libraries Update
NSLHD Libraries support evidence - based practice and lifelong learning for all NSLHD staff. You have access to a wide range of resources and services to support your learning needs and patient care.This online introduction to NSLHD Libraries demonstrates how to access print, ebooks, full text journals, our services and more.
New Library eBook : COVID ’ s Impact on Health and Healthcare workers
Topics covered in the book are the symptoms, risk factors and typical course of mild to severe COVID - 19 infections, including long COVID, and correlations with hospitalization and death; the physical and emotional toll on healthcare workers; recommendations going forward on how to best address public health issues, health care inequities and health worker well - being.
Read it through our Library Springboard website > ebooks > COVID ’ s Impact on Health and Healthcare Workers.
To set up a Springboard account, go to nslhd.ovidds.com. Login using your Stafflink ID and password, and when prompted, complete the sign - up form. Your Stafflink ID and password will work with all subsequent logins.
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Royal North Shore Hospital Nursing and Midwifery
Clinical Nurse/Midwife Consultant Biography
Name: Vicki Evans (Roach) AM Role Title: Clinical Nurse Consultant, GNC 3 Specialty: Neuroscience Location: Royal North Shore Hospital + LHD Contact Numbers: Ext. No.: 32745 . Pager No.: 41593 Email Address: Vicki.Evans@health.nsw.gov.au
Recently Published - Journal Articles:
Past Experience: NSW :
Evans, V. Steps to Becoming an Advanced Practice Neuroscience Nurse. Australasian Neuroscience Nurses Association (2021) Evans, V. G - Forces and the Impact on the Brain (2020) Australasian Journal of Neuroscience Vol. 30 (1) 5 - 10.
30 years at Royal North Shore Hospital
20yrs as CNC Neuroscience (job - share with Jeanne Barr) 7yrs as NUM Neurosurgery (old hospital 7B)
4yrs as NUM Neurology (old hospital 8B)
List below the CNC/NP ’ s you have connected with both within RNSH and externally on various projects:
USA:
3.5yrs as Senior Nurse Clinician (Neurosurgery & Neuro ICU) - New York University Medical Center, NY NY, USA
RNSH: Neurology, Stroke, Paediatrics, Neuro ICU, Emergency Australia: Hornsby, Nepean, Liverpool, Westmead, NSP, Macquarie Private, MQU International: Barrow Neurological Institute; UC Davis Neurosurgery; NYU Medical Center Neurosurgery; Toronto Western, Canada.
Studies Currently Being Undertaken: Research studies - Concussion
Main Interests:
World Federation of Neuroscience Nurses – Executive Committee
Australasian Neuroscience Nurses Association
Additional Information:
Concussion research & education
Member of the Order of Australia 2021, for ‘ significant contribution to neuroscience nursing and professional federations ’. Editor of professional journal for 7yrs ( Australasian Journal of Neuroscience ) Reviewer for World Neurosurgery (online journal medical/nursing); Polish Neuroscience Nursing Journal.
Neuro trauma
Recently Published - Book Chapter:
Evans, V. Caring for Traumatic brain Injury Patients; Australian Nursing Perspectives, Critical Care Nursing Clinics of North America , Vol. 33 issue 1, 2021 p21 - 36. ISSN 089 - 5885, ISBN 9780323776349
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Staff Profile of the Month
Annaleise Honnef - Registered Nurse, ICU
How long have you been in the nursing profession? Seven years What are three things that you are most proud of about your profession? Nursing is an evolving profession where you are always learning and adapting What is your best nursing story? Seeing a very unwell patient survive and then come in to visit and thank us. Best travel destination you have visited and why?
South America and Argentina for the food scenery and culture What study have you completed during your nursing career? I have done a Masters in Advanced Nursing, a Graduate Certificate in Critical Care Nursing and a Graduate Certificate in Cardiovascular Nursing. What are the aspects of nursing you find most rewarding? I find that the little things you do can do for patients that promotes dignity is often the most meaningful to patients and thus the most rewarding. What is your favourite part of your job at the hospital? I enjoy the ongoing challenge of ICU and the variety of opportunities available within the specialty. What is the most challenging aspect of being a nurse? Definitely the shift work is the most challenging aspect of nursing for me. It is also obviously
challenging emotionally at times. How would you describe your team?
I believe I am very lucky to work within an extremely supportive team that focuses on team work and the learning and development of others. I believe that this culture is vital for excellent nursing and makes the job so much more enjoyable. Do you have any plans for further development? I would be interested in further developing my skills in management or education, but am undecided which pathway to pursue. When did you know you wanted to be a nurse? In high school I decided to do nursing because I liked the idea of a job that is hands on, helping people and science based.
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Team Spotlight of the Month
ICU
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What are some things that your ward does differently to other wards/units? We have a very strong multidisciplinary approach with great collaboration between teams (Medical, Nursing, Allied Health). We have some unique positions that are uncommon in large tertiary centres: 1) Bereavement Coordinator (liaises with families who have had a relative pass away as a patient and also provides support to staff in the workplace 2) ICU Nurse Practitioner service (who provide consistency of care for longer - term patients in the ICU as well as running a vascular access service for the hospital). Do you celebrate any health promotion days? Loud shirt day, RUOK day Has your ward completed and fundraising or have you received donations that have been used towards helping improve the ward? We have used donations recently to fund an extension to the ICU Nurse Practitioner Service How many staff do you have that are completing post - grad studies? Approximately 65% of nursing staff have completed or are completing post - grad studies Has your ward or any staff members received any recent awards? 6H were recently awarded as the April Falls Champions. What projects are your team currently working on? We have been up - skilling ICU and ward staff to assist with the COVID surge response Does your ward/unit have any specialty area educational courses? ALS, CALS, CRRT, Foundations of Clinical Practice, NIHSS scores, Neuroscience Study Day, various workshops What does your team do for team building? Intensive plant day where staff donate a gold coin or a plant. We also have the Spartan Games once a year and each ICU teams compete against each other (see attached photos). We celebrate Melbourne Cup day as a department and have quiz nights etc.
Team Mission Statement:
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Team Spotlight of the Month
ICU
Getting to know the team: Who in your team would be most likely to …
Win an Olympic gold medal? In what event? Deidre Moran when the Olympics has yoga Louise Sayers for mindfulness and listening
Become famous? What for? Matt Tinker Bonsai and Photography
Save the planet? Maddie Ohlback save the planet warrior
Who is the team ’ s ….
Head chef? Kay Fong for cake baking
Animal whisperer? Gisela Steiner
Is there anyone else with other special talents? Dawn Tiller (RN) - runner Khairil Musa (Dr) Ballet Dancer Kate Barnes (RN) Artist
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Royal North Shore Hospital Nursing and Midwifery
Research Study in the spotlight
Exploration of a rapid response team model of care: Aim: To explore a rapid response team model of care, patient outcomes and the collaborative characteristics between the team members and ward clinicians. Rapid
response systems and teams are designed to enhance the recognition and treatment of patient deterioration. Rapid response systems and models of care vary with regard to collaborative and consultative attributes. The effectiveness of rapid response systems and teams is not fully understood. Results: The audit identified that the rapid response team provided timely consultation and a range of critical care interventions for 2,195 adult patients. Activations (n = 4,092) occurred most often in general medicine (n = 1,124, 70.8%) and cardiology (n = 815, 19.1%) wards. The themes that were synthesised from interviews included: i) managing patient deterioration as a ward nurse; ii) meeting at the bedside; iii) rapid response team at the bedside; and iv) ‘ staff concern ’ rapid response activation. How this research adds to our knowledge This exploratory study revealed that the rapid response team provided an extensive dedicated 24 - hour collaborative service. Rapid response team member and ward clinician interviews highlighted a focus on patient safety, support and clinician wellbeing, to optimise early assessment, detection, monitoring and management of ward inpatient deterioration.
The rapid response team created a culture of support and collaboration with inpatient staff, and achieved timely assessment, and early management of patients experiencing deterioration.
The rapid response team created a culture of support and collaboration with inpatient staff, and achieved timely assessment, and early management of patients experiencing deterioration.
Contributed by:
Professor Margaret Fry
Director Research and Practice Development | Nursing and Midwifery Directorate NSLHD
Level 7 Kolling Building, Royal North Shore Hospital, St Leonards NSW 2065 Professor of Nursing Faculty of Health, University of Technology Sydney Tel (02) 9926 4693 | Mob 0417 985 214 | Margaret.Fry@health.nsw.gov.au Margaret.Fry@uts.edu.au
Faculty of Health University of Technology Sydney
T. +61 (02) 9926 4693 M. +61 0425 313 391 PO Box 123 Broadway NSW 2007 Australia uts.edu.au ORCID: 0000 - 0003 - 1265 - 7096
Adjunct Professor Susan Wakil School of Nursing and Midwifery University of Sydney Senior Editor: Australasian Emergency Care Journal
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Royal North Shore Hospital
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NSLHD Carer Support Service Update
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Royal North Shore Hospital Nursing and Midwifery
Nursing Research and Practice Development
The Principles of Effective Oral and Denture Care in Adults
Oral health is essential to good health and quality of life, and is defined by the World Health Organisation (2018) as “a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychological wellbeing.” That is certainly a mouthful…so to speak. In addition to the WHO’s definition it is also essential for the prevention of Non-ventilator Hospital Acquired Pneumonia, or NV- HAP. Despite being so important it is one of the most fundamental aspects of nursing care and often one of the most frequently overlooked . Evidence suggests that oral health deteriorates while people are in hospital. Many of your patients will be able to perform their own mouth care, however, may need to be reminded whilst in hospital and out of their usual routine. The most effective form of mouth care is to use a soft bristled tooth brush and toothpaste whenever this is possible twice per day. Only in the presence of immunocompromise, significant gum disease or mucosal compromise should alternatives be considered.
Oral assessment is as essential as skin assessment and should occur on admission and routinely at intervals depending upon your patient’s risk profile and then a plan of care developed in consultation with the patient.
Barriers to providing effective oral care are:
Lack of adequate training.
Lack of mouth care assessment tools, policies and equipment.
Mouth care will therefore be one of our focus areas for practice development in 2022 .
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2021 NSLHD Annual Report – Nursing and Midwifery If you have published, presented at a national or international conference, received a grant or award, or have undertaken a higher degree in research in 2021, we encourage you to submit details for inclusion in our 2021 annual report.
Please refer to our submission guidelines for further information. Click here to view our 2020 annual report.
RNSH Nursing and Midwifery Executive Team
Tracey Gray Director of Nursing and Midwifery Ph: 9463 1901 (EA: Hayley Johnson)
Fiona Carmichael Deputy Director of Nursing and Midwifery Ph: 9463 1901 (EA: Hayley Johnson)
Michelle de Vroome A/ Divisional Nurse Manager Division of Women ’ s, Children ’ s and Family Health
Margie Webster Divisional Nurse Manager Division of Medicine Ph: 9463 1906 (EA: Surekha De Silva)
Sophie Lange Divisional Nurse Manager Division of Surgery and Anaesthetics Ph: 9463 1905 (EA: Michelle Harding)
Ph: 9463 9692 (EA: Insu Lobo)
Rowena Broadbent Nurse Manager Cancer and Palliative Care Ph: 9463 1200 (EA: Sarah Hockey)
Deb Mayall Nurse Manager Patient Flow Ph: 9463 2260 (CSO: Jennifer Waters)
Larissa Monney Nurse Manager Workforce Ph: 9463 1583
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