NSLHD News April 23 COVID-19 edition

Get the latest news from across Northern Sydney Local Health District.


Special Covid-19 edition

reminder: get your flu jab Members of the general public and staff across the district are being reminded to get their flu vaccination as soon as possible.

Read more on Page 3

school children create art works to thank hospital staff Page 5

Pandemic rapid training program at royal north shore Page 5

Leaders in healthcare, partners in wellbeing


Message FROM the acting Chief executive Dr Tamsin Waterhouse

message FROM the Chief executive Deb Willcox

In a matter of weeks, our hospitals have been able to transform themselves in readiness for COVID. Building new wards, relocating Intensive care units, splitting EDs into two and increasing staff numbers. The speed in which this has been done has never been seen before. The way our staff have come together and had to think in such new ways is so impressive. There is a real sense of achievement among staff who are in high spirits, buoyed by the support of the community. Of course, none of this could have been achieved without the support of the Australian people which has played such an important role in buying the health system valuable time to prepare. By everyone following the advice to stay at home, keep social distancing and practice hand hygiene it appears to have slowed the transmission of COVID-19, and allowed our hospitals to prepare and not be overwhelmed with patients needing critical care. It has also provided some wonderful opportunities for our hospitals to trial new models of care to treat patients, work in ways staff have never had to before and give our nurses an opportunity to upskill in

critical care they may not have considered. In times such as these, when our daily lives have been curtailed and we face the unknown, it can be easy to dwell on the negatives. Yet, through this adversity I have seen some wonderful acts of kindness and been impressed by the resilience of all our healthcare workers, whether they be in patient care, support staff cleaning hospitals, engineering or administration. Our hospitals have been overwhelmed by the generosity of not just businesses, but local restaurants and members of the public wanting to drop off cookies, meals, quilt scrub hats, mask covers and school children sending thank you cards and art works. I hope we don’t see an increase in coronavirus cases, but I do know our hospitals from Hornsby to Ryde, Mona Vale and Royal North Shore, along with our community health services are ready. Importantly, at the end of this, whenever that may be, we will be a stronger and better local health district.

Deb Willcox Chief Executive Northern Sydney Local Health District


Reminder to get your flu jab While COVID-19 occupies the mind of many of us, everyone is being reminded to get their flu vaccination as soon as possible. Members of the general public can get their flu jab at their GP and participating pharmacies. People in a number of categories are eligible for free vaccination, including: • All Aboriginal and Torres Strait Islander people aged 6 months and over • All children aged 6 months to less than 5 years of age (including Aboriginal and Torres Strait islander people and medically at risk people) • All individuals aged 5 years and over with medical risk conditions, namely: • Cardiac disease, including cyanotic congenital heart disease, coronary artery disease and congestive heart failure • Chronic respiratory conditions, including suppurative lung disease, chronic obstructive pulmonary disease and severe asthma • Other chronic illnesses requiring regular medical follow up or hospitalisation in the previous year, including diabetes mellitus, chronic metabolic diseases, chronic renal failure, and haemoglobinopathies • Chronic neurological conditions that impact on respiratory function, including multiple sclerosis, spinal cord injuries, and seizure disorders • Impaired immunity, including HIV, malignancy and chronic steroid use • Children aged six months to 10 years on long term aspirin therapy • Pregnant women (influenza vaccine can be given at any stage of pregnancy) • People aged 65 years and over (a vaccine that is specifically designed to

NUM Laura Brain and her team

produce a higher immune response is available for this group) Each year the strains of the influenza virus which are predicted to affect Australians are reviewed and the available vaccines may be changed according to the strains. While the general public campaign is ramping up, Staff health has already vaccinated more than 6000 NSLHD staff. Nursing Unit Manager Laura Brain said it was important to flatten the curve for Influenza as well as COVID-19. “Every flu season, there are different flu viruses circulating, so it’s important to be vaccinated and have protection against as many strains as possible,” she said. “We are really pleased to see so many staff protect themselves by getting vaccinated, especially those working in areas with patients who are more at risk.” Flu vaccination is mandatory for staff working in cancer services, neonatal and maternity services, transplant services and ICU, but all other staff are also encouraged to get vaccinated. For staff, getting a flu vaccine is easy with the online FluPortal on the intranet.

covid-19 recovery ward under construction at RNS A COVID-19 recovery ward is one of a number of changes being made at Royal North Shore Hospital to prepare for the anticipated increase in COVID-19 positive patients requiring respiratory

support over the coming weeks and months. The Royal North Shore Hospital COVID-19 recovery ward will have more than 40 beds to cater to patients recovering from COVID-19 and require ongoing care before they are able to return home. NSLHD Chief Executive Deb Willcox said the new ward, which will sit across two levels of the Douglas Building, will greatly support the hospital’s response to COVID-19. “The COVID-19 recovery ward will be for those patients who don’t need to be in the ICU, freeing

The COVID-19 recovery ward is under construction

up those beds for critically ill patients,” she said. “It means as soon as COVID-19 positive patients are stable they can be safely discharged to the recovery ward to fully recuperate before going home.”



Hornsby hospital covid-19 ready Within a matter of weeks,

Hornsby Ku-ring-gai Hospital has become COVID-19 ready. Rising to the challenge, staff from across the hospital have worked together to rebuild wards, relocate parts of the Emergency Department, move the Intensive Care Unit and triple its capacity to treat patients and train more nursing staff. General Manager Lee Gregory said the hospital was ready for a surge in patients if COVID-19 cases increased, but it was still open to treat patients who needed care. “The hospital is basically split into two: one for COVID-19 and the other for patients who have non- COVID-19 illnesses,” Mr Gregory said. “This means better protection for all patients and staff, but it also means we can continue to treat patients who need urgent care but don’t have COVID-19. “I want the community to understand that our hospital is still here to treat them if they are acutely unwell and need urgent attention. We are still performing emergency and urgent (within 30 days) surgery.” Visitors to the Emergency Department will notice the area has been split into two zones, which staff are calling “hot” and “cold”. Anyone presenting with respiratory symptoms are taken to the hot zone which

NSLHD Chairman Trevor Danos, Chief Executive Deb Willcox and Hornsby General Manager Lee Gregory

is one section of the ED, while other injuries and illnesses are located in another section.

Co-locating physiotherapists from the Fracture Clinic with the Emergency Department’s fast-track has also meant patients are benefiting immediately from specialised treatment, rather than having to wait or return for another appointment. Nurses are being offered further training in critical care and intensive care skills in the event there is a surge in COVID-19 patients needing ICU. Director of Nursing and Midwifery Linda Davidson said the community should not fear coming to hospital. “Hospitals are safe and you will receive the highest standard of care,” she said. “The hospitals are here for those people who are acutely unwell and they are the right place for those who have an acute condition. “It is poignant that this is the International Year of Nurses and Midwives celebrating 200 years of nursing. It was actually Florence Nightingale who really brought in infection control, the importance of washing hands and reducing infections.”

Physical changes have also been made to the ED with new negative pressure rooms built in the Psychiatric Emergency Care Unit. This means if a patient is suspected with COVID-19 in ED, they can be immediately placed in isolation with no risk to other patients in the department. In preparing for a worst- case scenario if COVID-19 cases surge, the hospital has also made plans to turn the outpatients building into a second ED to treat people with minor illnesses. Despite the challenges of COVID-19, the hospital is using the opportunity to explore new models of care and practices which may lead to more permanent changes. Children are now spending less time waiting in ED under new arrangements, with patients being taken directly to paediatrics. This means less exposure in ED, a more child-friendly environment and dedicated paediatric staff.

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Training ramps up in response to COVID-19

RNS staff undertaking the Pandemic Rapid Training Program

Nursing staff from Royal North Shore Hospital have been adding ICU skills to their life-saving repertoire as part of the Pandemic Rapid Training Program. The program has been developed by senior ICU nurses to prepare nurses from all parts of the hospital to work in Intensive Care when the pandemic peaks. So far around 200 nurses from theatres, recovery and various medical and surgery wards have attended the training and spent time shadowing nurses in ICU. ICU Nurse Practitioner Sarah Webb said the incredible uptake from staff would hold the hospital in good stead in the face of COVID-19. “Increasing the ICU nursing workers during COVID-19 by creating pictures and decorative cards. Hospital staff have been buoyed by the art works which have been created by students across the district. Year one students at Dural Public School spent the last day of Term One writing a letter of gratitude to doctors and nurses at Hornsby Ku- ring-gai Hospital. Their art work is on display, joined by students from Northholm Grammar School. At Ryde Hospital, artworks are on display from the children at Goulding Hill Preschool. The children were asked

workforce is critical to our ability to safely care for the large number of critically unwell patients that we are expecting,” she said. “Right now it feels like the calm before the storm, we need to use this time wisely for training and preparation. “One truly heart-warming aspect has been the large number of nurses who have volunteered for the training and their attitudes of comradery and solidarity. “When they come to work in ICU they will be very welcome and very well supported.” The training program consists of a two-to- thee hour tutorial, online resources and supernumerary time in ICU.

However, it isn’t just nurses paving the way to this response, with Sarah saying the whole district had played its part. “We are very grateful for the high level of engagement from our nursing, medical, management and executive colleagues in establishing and running this training program,” she said.

Local school children’s gratitude on display School children are showing their gratitude to healthcare

Artwork at Ryde

Artwork at Hornsby

to paint something they thought would make staff feel happy during this challenging time. Ryde Hospital General Manager Heather Gough said: “We’ve hung the artworks up around the hospital as a reminder to staff of how grateful the community is for the care they are providing today and every day.”

Artwork at RNS



Ryde hospital’s Covid-19 response Ryde staff have been working hard managing the unprecedented COVID-19 workload and preparing the hospital for the anticipated increase. A few of the key changes include the creation of a COVID-19 clinic, a dedicated COVID-19 ward and the upskilling of intensive care and anaesthetic nurses so they can deliver the highest-quality care to those who need it. There has also been the creation of a central

storage system for Personal Protective Equipment (PPE) to manage the stock availability. Ryde’s emergency department has been reconfigured so there are separate areas for those presenting with respiratory symptoms and those presenting with other injuries and illnesses. This ensures appropriate management can be followed and reduces the risk of cross infection amongst patients. A clinical advisory group has been established so senior clinicians can advise and talk with members in Ryde’s executive team about clinical care amid the evolving COVID-19 situation. A Director of ICU has been appointed and together with eight intensivists who have come onboard are preparing the hospital’s HDU/ICU for critical COVID-19 patients. Ryde Hospital General Manager Heather Gough said staff have worked tirelessly to ensure the hospital is effectively responding to the virus. “We’ve established and strengthened our infection prevention and control team, and our staff have undergone extensive PPE training and continue to do so,” she said.

Staff from Ryde’s Pathology team

“The hospital is also developing and enhancing the use of telehealth particularly in its emergency department and rehabilitation services. “Some patients recovering from COVID-19 require extensive rehabilitation but may be too weak to travel, so we are working on how we can adequately provide treatment via telehealth.” Director of Nursing Drew Hilditch-Roberts encourages the community to still come to hospital for treatment if they are unwell. “While we are responding to COVID-19, it is so important that the community is aware the hospital is open and safe for those who are sick and require critical care for all illnesses and injuries,” he said. The hospital has also started an Exceptional People Program to recognise and acknowledge hard working staff who have worked above and beyond the call of duty during these challenging times.

rns patient celebrates 100 years There were 100 reasons to smile at Royal North Shore Hospital recently when patient, Marjory, celebrated her milestone birthday. Nursing staff were eager to decorate

Marjory’s room and put on a celebration, giving everyone a reason to be cheerful especially during these difficult times. The patient of ward 5 East was surprised when a cake, baked by a staff member Nompumelelo Mpande, who came in on her day off to deliver the three-tiered vanilla and raspberry creation. “She gave a little smile,” Nurse Unit Manager Rose Hills said.

Happy Birthday Marjory

The ward has two patients aged 100 currently which is quite rare. Marjory’s family sent flowers and were “incredibly grateful” of the gesture by staff.


Share your news and achievements. Contact our team on 9463 1722 or email NSLHD-media@health.nsw.gov.au to submit your news.


Changes at Mona Vale Hospital due to COVID-19 In response to COVID-19, Mona Vale Hospital has made a number of changes to everyday business, while a testing clinic continues to operate on site.

The clinic is currently seeing around 70 patients per day at the Community Health Centre. Patients using the testing clinic are reminded to present if they are suffering minor respiratory symptoms. Those suffering severe symptoms should attend their nearest emergency department. Staff and patients are also being screened upon arriving on site at the entry to the Beachside Rehab Unit, the Mona Vale Community Health Centre and outside the Urgent Care Centre. Here, people are asked a series of questions and have their temperatures taken before starting their shift, visiting or attending an appointment. On site infection prevention and control training sessions are continuing for all clinical staff, while the onsite hydrotherapy pool remains closed until further notice. Currently, only urgent and essential outpatient appointments are being held, with many service now being conducted via telehealth.

Mona Vale Hospital

Acting General Manager Jennifer Parkin said she was delighted to see the staff and community adapting to the changes and following public health advice. “It’s really important we continue to do the right thing as we respond to COVID-19,” she said. “Our community has done a tremendous job so far in looking after our staff and each other – so for that we’d like to say thank you. “The staff have also been phenomenal in adapting our practice while continuing to provide excellent patient care during this time, and I know they will continue to do so for as long as necessary.” If you have any questions regarding services at Mona Vale Hospital, please call 02 9998 6300.

New funding to help reduce bowel cancer rates Professor Mark Molloy’s ground-breaking bowel cancer research has received a boost, with the Cancer Council NSW awarding the Kolling Institute researcher a three-year $450,000 grant.

Professor Molloy has welcomed the funding, saying bowel cancer claims more lives each year than breast, prostate or skin cancer. “It is now Australia’s second biggest cancer killer, with more than 300 Australians diagnosed with the disease each week,” he said. “We hope our research will help improve treatments and outcomes for patients, and ultimately save lives. “We know that bowel and rectal cancers develop from polyps, and our team is seeking to understand why and how polyps become cancerous. “Our research will involve colonoscopy patients at RNSH, and we’ll be using an innovative approach to examine polyps at a molecular level. “This will give us a better understanding of how gene mutations, protein expression, immune cells and gut microbes govern the growth of bowel polyps. “It will help us develop strategies to slow the growth of polyps or even prevent the growth

Professor Mark Molloy

all together.” Colorectal surgeon and co-investigator Professor Alexander Engel said this research has the potential to inform recommendations around the frequency of colonoscopies for low and high-risk patients. “We hope it will improve early detection and help prevent bowel polyps growing into cancers, significantly reducing the number of bowel cancer cases in Australia,” he said.



Keeping everyone safe: Social distancing helps stop the spread of COVID-19 between people

Stay at home. You can go out to shop, see a doctor or care for someone.

Stay 1.5 metres or 2 big steps away from other people.

Don’t visit family or friends. Talk to them on the phone or online instead.

Outdoor exercise is OK but stay 1.5 metres away from others.

No shaking hands, hugging or kissing other people.

If you are sick, stay at home.

Stay Safe

Cough or sneeze into your elbow or a tissue. Throw the tissue away immediately.

Wash your hands with soap for at least 20 seconds or use a hand sanitiser.

Do not touch your mouth, nose or eyes.

For more information Call the National Coronavirus Health Information Line on 1800 020 080. For a free telephone interpreter ring 131 450, say the language you need. Ask the interpreter to connect you to the Coronavirus Health Information line.

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