New nurse-led protocols for stroke patients, based on ACU research, led by the Nursing Research Institute, have resulted in changes to policy, guidelines and clinical practice in Europe and Australia. The protocols were developed through the Quality in Acute Stroke Care (QASC) Trial (published in the Lancet, 2011) to manage fever, hyperglycaemia and swallowing (FeSS) post-stroke.
Professor Sandy Middleton FACN, FAAN is a Professor of Nursing and Director of the Nursing Research Institute at St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne and Australian Catholic University. She focusses on stroke and the way research can improve care, particularly analysing the way nurses can initiate care to improve patient recovery.
Professor Middleton was the lead investigator on the landmark NHMRC-funded QASC cluster trial that demonstrated decreased death and dependency following implementation of nurse-initiated protocols to manage fever, hyperglycaemia and swallowing post-stroke, winning multiple national and international awards including ACU’s Vice-Chancellor’s Staff Excellence Award, Excellence in Research and Research Partnerships in 2019. These protocols have been translated into 64 hospitals in 17 European countries and in adopted in 36 NSW hospitals. She has published in high impact journals including The Lancet and The New England Journal of Medicine.
Australian Health Journal spoke with Professor Sandy Middleton on these significant achievements in nurse-led acute stroke care.
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Continuity of Care under COVID-19
Series 3, Episode 1
Under the COVID-19 pandemic, the Australian Healthcare system has handled the public health crisis by monitoring and responding to challenges in supply chains, testing & tracing of new infections and stock piling of essential equipment.
The public has largely responded by practising social distancing, understanding how hand hygiene can spread contagion and recently installing the COVIDSafe mobile application. Public health messaging has been largely effective and literacy improve, to combat the dangers of misinformation.
To open up access to medical advice during the pandemic, in March the Australian government issued MBS item codes for telehealth consultations, for advanced practice nurses as well as GPs and other specialists.
According to AMA President Dr Tony Bartone, as of mid-May 2020, around 10 million Medicare-funded telehealth services have been provided, either over the phone or via video, a significant majority of which have been provided by GPs and other specialists since the Medicare telehealth items were introduced in March.
However in recent months, the health system has mounting concerns on:
- a reduction in general practice visits for testing, investigation or immunisation
- lower rates of elective procedures resuming since being halted
- reduction in laboratory testing
- reduction in treatments and diagnosis of chronic and acute conditions
- access to, and continuing to take medications
Those with pre-existing conditions have been urged to keep appointments and routine treatments to maintain their health.
Industry has taken action such as the newly formed Continuity of Care Collaboration (CCC). The 15 health organisations forming CCC are an Australian first national communication collaboration of Peak Bodies, Industry and Healthcare Organisations coming together to stress the importance for people to continue monitoring their health and maintaining their regular care.
This Australian Health Journal episode on the continuity of care was produced with commentary from the following health industry associations and organisations: APNA – Australian Primary Health Care Nurses Association, RACGP, Medical Technology Association of Australia (MTAA), West Cessnock Medical Practice, Consumers Health Forum of Australia, Medicines Australia
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Research finds many practitioners feel underprepared to navigate men’s distress
Movember’s Men in Mind expands nationally to equip mental health professionals with the tools to better connect with men before they reach crisis point. Research conducted by the Men’s Health Research team at Movember has found men account for three in every four suicide deaths in Australia, and more than 50% had sought help in the year before they died.