NSLHD News 18 August 2023


Main story A FIRST FOR HORNSBY HOSPITAL Hornsby Hospital has conducted its first-ever major microsurgical soft tissue transplant. Page 3 Short blurb Read more on Page x

Pressing ‘play’ on new healthy kids videos Page 7

Ayah food service receives top gong Page 4


Message from the chief executive A/Professor Anthony M. Schembri AM

shows an increase in positive PCR tests for respiratory viruses, including influenza. I would like to remind all staff members of the importance of receiving the seasonal influenza vaccination to ensure the health and well-being of both ourselves, patients, and the community. If you haven’t yet had your influenza vaccine, we continue to provide free influenza vaccines to staff members through our occupational staff health clinics, which accept walk-in appointments. See NSLHD SharePoint Intranet for clinic locations and operating hours. Alternatively, you can call 9462 9430 or email NSLHD-VaccinationCompliance@ health.nsw.gov.au for any inquiries. My time so far at NSLHD has been wonderful and I’d like to thank everyone for making me feel so welcomed. I also want to thank all staff members across the district for your hard work and for providing wonderful care for our patients, consumers and each other.

I would like to wish a huge congratulations to two of our nurses who have been nominated as finalists in this year’s NSW Health Excellence in Nursing and Midwifery Awards. Royal North Shore Hospital palliative care nurse Caitlin MacDonagh and Gillian Prott who works in the neurogastroenterology unit have both been nominated in the Healing Heart Award – Colleague Nominated category. This award highlights these two nurses as inspiring role models to others for their compassion, commitment to workplace culture, improving the patient’s experience and providing safe, quality care. We will be cheering both Caitlin and Gillian on at the awards ceremony on 16 November. We have many talented and forward- thinking young people working in our organisation who make a huge difference in our district every day. To keep connected to their unique insights and experiences, I am pleased to announce NSLHD is establishing a new Youth Advisory Board (YAB). The board will be a platform for staff aged between 18 to 35 years old to speak directly to the Chief Executive and other senior leaders. Their views will ultimately improve the experience of young staff and consumers, as well as the broader community. Influenza and respiratory viruses are still prevalent in the community. The latest NSW Respiratory Surveillance Report

Adjunct Professor Anthony M. Schembri AM Chief Executive Northern Sydney Local Health District



Nurses honoured in state awards Two Royal North Shore Hospital nurses have

in helping patients who suffer from serious problems related to their bowels, incontinence, and constipation. She has spent over 20 years specialising in the area and has always felt appreciated by patients. “You are really helping them with a problem that can be debilitating,” she said. “Seeing them get better and helping them to have control over their problems is the most rewarding thing because they are so grateful.” Gillian has also long kept up to date with new practice and current research in the field. “It is always interesting,” she said. Northern Sydney Local Health District Chief Executive Anthony Schembri congratulated the pair for being named finalists and said their nomination highlighted their exceptional talent. “This is a wonderful achievement for Caitlin and Gillian, particularly to be up for a Healing Heart Award, which is a peer-nominated category,” he said. “It is an honour to have one’s patient care be recognised by colleagues.” The awards recognise a total of 29 nurses and midwives in nine categories, including Nurse of the Year and Midwife of the Year. Finalists and winners will be celebrated at an awards ceremony, which will be held at Parliament House on 16 November 2023.

been named finalists in this year’s NSW Health Excellence in Nursing and Midwifery Awards. Caitlin MacDonagh and Gillian Prott are in the running for the colleague-nominated Healing Heart Award category, which acknowledges an outstanding nurse who is an inspiration and role model in the workplace and for patients. The pair were both surprised and honoured to be recognised. Caitlin is a palliative care nurse and has been at the hospital since 2012. While she has worked in different departments, including surgical nursing and emergency, she has always been drawn to palliative care. “It’s very satisfying,” she said. The nurse says the bulk of her palliative work is focused on talking to a patient to find out how they want to live. “The nicest part about my job is pulling up a chair next to a patient’s bed,” she said. “How do you live well with this knowing that you’ve got an incurable illness? How does life look?”. Caitlin also paid tribute to her colleagues, including her fellow nurses and the various specialties she works with. “It’s the team approach and having all of us combined actually makes patient care,” she said. Gillian works in RNSH’s Neurogastroenterology Unit, specialising

Gillian Prott works in RNSH’s Neurogastroenterology Unit

Caitlin MacDonagh is a palliative care nurse at RNSH



AYAH chef Phil is always cooking up a storm for patients, their families and carers

AYAH food service receives top gong The food service at the Manly Adolescent and Young Adult Hospice has been awarded the Institute of Hospitality in HealthCare Values in Action/Customer Service Award.

who worked on making this project happen.” AYAH Service Manager Tayia Yeates said the service has been a way for patients to spend quality time with their families and carers without needing to leave the facility. “Patients and their families have reported high level of satisfaction with the food services at AYAH,” she said. “The fresh cook menu provides flexibility for providing meals that meet the nutritional and texture requirements for patients, families and their carers, whilst still incorporating patient and family preferences into the menu. “At the AYAH they can all sit down and enjoy a home cooked meal together and spend that quality time together.” As this was a Queensland/New South Wales state award, the project has been now been nominated to the national category.

NSLHD and HealthShare collaboratively implemented the model of care in a short- term frame, which has been received well by patients and their families. HealthShare General Manager of Patient Services for NSLHD Merina Hadziahmetovic accepted the award and said the project has proved to be a great outcome for patients of the AYAH and their families. “The team working on the project are and have always been driven by a genuine desire to make a positive impact on the lives of young adults and their families,” Merina said. “It was a privilege to be able to accept the award on behalf of the AYAH and everyone International Youth Day NSLHD recently celebrated International Youth Day. Designed by the United Nations, the day is commemorated every year on 12 August bringing youth issues to the attention of the international community and celebrating the potential of youth as partners in today’s global society NSLHD has a proud history of empowering young people across the district and has ran the Youth Health Consultant Program since 1999. As part of the ongoing program, NSLHD Population Health Promotion currently has a team of 12 youth consultants aged between 17 and 23, who are trained and empowered to share their unique perspective and expertise

Youth Consultant team

as local young people. The consultants do a range of work to consult with health services available to young people across the district. For more information about the team and what they are up to, please visit: https://bit. ly/47AJCwK



(Left to right) Plastic surgeon Dr Tim Wang and anaesthetist Dr Chris Kay

A FIRST FOR HORNSBY HOSPITAL Hornsby Hospital has conducted its first-ever major microsurgical soft tissue transplant. The procedure—known as a free flap— involved tissue from a patient’s back transplanted into their thigh. Plastic surgeon Dr Tim Wang, who performed the operation, said it was an exciting event at the hospital. “This is a major milestone as it not only means Hornsby can provide state-of-the-art reconstruction care to the local community, but staff are also learning important new skills,” he said. Free flap surgery is vastly different from a skin graft. With a free flap, a very thick piece of a patient’s own tissue is transplanted into another part of their body. The tissue can be made up of skin, fat, muscle, and bone, and its veins and arteries are reconnected under a microscope in their new location. A skin graft, however, involves shaving off a very thin piece of tissue from a patient or donor. The surgeon moves the skin to a different part of the body where it picks up a new blood supply and grows. A free flap is a reconstruction technique that has been around for decades but in the last fifteen has become the “gold standard”. It is common with breast reconstruction and traumas of the lower limb.

Tim said Hornsby Hospital has been planning to do a free flap procedure ever since it reopened its plastic surgery department in 2022. The patient, a local, was considered a good first case to take on. He said the operation was a successful collaboration between management, nurses, and ICU. “It took a lot of work to physically get there in terms of people skills such as training nurses from the ward and ICU in how to look after and how to monitor a flap of this nature,” Tim said. Special equipment was needed for the procedure as well as coordinating theatre time. He said the operation is a sign of changing times at Hornsby, an area which has a growing population and a redeveloped hospital with surgeons and surgical services that need plastic surgery support. “Ultimately it is about being able to provide a full plastic surgery service at Hornsby Hospital — from lacerations in children, skin tears in the elderly to complex state of the art reconstruction,” he said. “This will complement the busy orthopaedic and general surgery services.”

SPREAD THE GOOD NEWS Share your news and achievements. Contact the Media and Communications team on 9463 1722 or email NSLHD-media@health.nsw.gov.au to submit your news.



A Revolution at Hornsby ICU Pressure injuries can be gruelling for patients and the bane of the medical system but in a first for an Australian hospital, clinicians at Hornsby’s ICU are trialling a scanning device that is transforming how they are treated. Each day, nurses hold a small, wireless sub-epidermal moisture (SEM) scanner against various spots on a patient’s heel and sacrum area for one second. Pressure injuries create SEM in the tissue and the Provizio scanner can detect it 4 mm below the skin’s surface, and usually five days before it can be seen. “It’s an extraordinary piece of technology and there is only one of its kind in the world,” said Nurse Unit Manager of the Intensive Care Jay Halkhoree, who came across the device while reading articles about pressure injuries management. He spoke to friends and colleagues in Europe who were using the device and recommended it. Pressure injuries have a negative impact on a patient’s psychological well-being and quality of life. As they may not initially form on the skin, there is no feasible way to detect them. As a result, nurses make a subjective assessment about whether they are likely to form. In a trial run of the device in 2022, 90 percent of scans showed a high-risk score in patients who had been identified as having low or no risk of getting a pressure injury using this subjective method. Jay said pressure sores are a leading hospital-acquired complication. They are also an enormous financial drain on the global medical system.

Nurse Unit Manager of the Intensive Care Jay Halkhoree holding the sub- epidermal moisture (SEM) scanner

It is believed Hornsby is the first hospital in Australia to pick up the technology Jay said. “We are really excited for Hornsby Hospital ICU to be the first ICU to introduce this technology,” he said.

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(Left to right) Dr Elisabeth Murphy, Amy Robertson, Nicole Tate and Paul Klarenaar

Pressing ‘play’ on new healthy kids videos NSLHD’s Population Health Promotion team officially recently launched a new video series.

“In fact, we now include a video in each of our newsletters to help parents and carers also support their kids development.” Early Years Program Manager, Nicole Tate, was excited to see the resources now being used with such a positive response to them. “Although just officially launched, the videos have actually been available for about two months, attracting around 2500 website visitors and 300 educators completing the accompanying professional development,” Nicole said. “We’ve also had a great response to the accompanying professional development package with 300 educators completing a course.” The free videos cover a wide range of topics to support Early Childhood Educators, and families, including breastfeeding, healthy eating and physical activity. Watch all the Small Bites for Big Steps videos at: https:// nshp.com.au/SmallBitesForBigSteps Researchers say there’s also a misconception that low back pain mostly affects adults of working age. This study shows that most low back pain cases affect older people, and more women than men. Kolling Institute researcher and lead author Professor Manuela Ferreira said the analysis paints a picture of growing low back pain cases globally, putting enormous pressure on our healthcare system. “We need to establish a national, consistent approach to managing low back pain that is informed by research,” she said. “Currently, how we have been responding to back pain has been reactive. Australia is a global leader in back pain research, so we can be proactive and lead by example on back pain prevention.”

The Small Bites for Big Steps videos were launched at Artarmon Kids Cottage with help from Dr Elisabeth Murphy, Senior Clinical Advisor for Child and Family Health, NSW Ministry of Health. Elisabeth set the scene by giving a fascinating overview of the importance of the First 2000 days of a child’s life and praised the videos for promoting early childhood development and the way they are delivered. Joining in the celebrations was Amy Robertson from Little Zaks Academy Hornsby, whose centre and educators star in the videos and helped make them such a success. “Our team finds the videos to be a fantastic resource for our own education, as well as for inclusion in our newsletters for families,” Amy said. Back pain cases to rise sharply A new study by researchers at the Kolling Institute estimates more than 800 million people will be living with low back pain by 2050, a 36 percent increase from 2020. The prediction follows an analysis of 30 years of global health data from over 200 countries. Modelling shows the number of back pain cases globally will rise to 843 million people by 2050, while in Australia, it’s expected there will be a 50 percent increase. The biggest jump is likely to be seen in Asia and Africa. Researchers are concerned the trend will only get worse with an inconsistent approach to back pain treatment. They say many commonly recommended treatments have been found to be ineffective, including some surgeries and opioids.



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