Peninsula Health

Melbourne, Australia

Peninsula Health

Melbourne, Australia
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Haines T.P.,Allied Health Research Unit | Kent F.,Monash University | Kent F.,Peninsula Health | Keating J.L.,Monash University
Journal of Interprofessional Care | Year: 2014

Interprofessional student clinics can be used to create clinical education placements for health professional students in addition to traditional hospital-based placements and present an opportunity to provide interprofessional learning experiences in a clinical context. To date, little consideration has been given in research literature as to whether such clinics are economically viable for a university to run. We conducted an economic evaluation based upon data generated during a pilot of an interprofessional student clinic based in Australia. Cost-minimization analyses of the student clinic as opposed to traditional profession-specific clinical education in hospitals were conducted from university, Commonwealth Government, state government and societal perspectives. Cost data gathered during the pilot study and market prices were used where available, while $AUD currency at 2011 values were used. Per student day of clinical education, the student clinic cost an additional $289, whereas the state government saved $49 and the Commonwealth Government saved $66. Overall, society paid an additional $175 per student day of clinical education using the student clinic as opposed to conventional hospital-based placements, indicating that traditional hospital-based placements are a cost-minimizing approach overall for providing clinical education. Although interprofessional student clinics have reported positive patient and student learning outcomes, further research is required to determine if these benefits can justify the additional cost of this model of education. Considerations for clinic sustainability are proposed. © 2014 Informa UK Ltd.

With an upcoming publication in the Worldwide Leaders in Healthcare, Nyree L. Parker, RN/Clinical Nurse Specialist, Dip. Health Science, BN, Graduate Certificate of Health Education, Graduate Certificate Health Promotion, Graduate Diploma Critical Care/Emergency, MN, Master Degree in Disaster Health, joins the prestigious ranks of the International Nurses Association. She is a Registered Nurse with twenty-four years of experience in her field and extensive expertise in all facets of nursing, including emergency care and Disaster Health. Nyree is currently serving patients as Clinical Nurse Specialist in the Emergency Department and Emergency Management and BCP Consultant in the Facilities Management Department at Peninsula Health in Victoria, Australia. This involves policy and procedure/plan writings for i.e. mass casualties incidents, CBR decontamination processes, pandemics, heatwaves, bushfires and severe weather impacting on the public hospital organisation. Furthermore, she works as Assistance in Care Emergency Volunteer Coordinator in the Emergency Departments at Peninsula Health Frankston Hospital in Frankston, Victoria, Australia. Nyree acquired her graduate diploma in applied sciences in 1991 at Monash University, where she also received her bachelor degree of nursing in 1992. She also obtained a diploma of critical care nursing majoring in Emergency care (1997), a master degree of nursing (2001), and a Master Degree in emergency Disaster Health (2013) at Monash University. In 1998, Nyree earned a postgraduate certificate in health promotion from Deakin University. She is a Clinical Nurse Specialist and was a Trauma Nursing Core Course Instructor as well as a member of the Australian College of Emergency Nursing, the Victoria Hospital Management Forum, the Royal College of Nursing Australia, the Australian Nurses Federation, and an active member of the Nursing Section of the World Association of Disaster Emergency Medicine. Furthermore, she was honoured with the Dux of Group Award in 2009 and was a volunteers with St. John’s Ambulance. Nyree credits her success to being a third generation nurse in her family. She also has acted as a Clinical Instructor of Emergency Management and Critical Care at Monash University. Nyree is aiming to commence her PhD in Disaster Health looking at topics of climate change implications on emergency nurses and the role of an Emergency Management Consultant in the hospital environment. In her spare time, Nyree enjoys reading the Great Hospital Emergency Disaster Relief Journal and the Emergency Medicine News Journal. She also dedicates to dog walking and antique shopping and driving her 1948 Morris car! Learn more about Nyree here: and read her upcoming publication in the Worldwide Leaders in Healthcare.

Kennedy G.M.,Eastern Health | Brock K.A.,St Vincents Health | Lunt A.W.,Peninsula Health | Black S.J.,St Vincents Health
Archives of Physical Medicine and Rehabilitation | Year: 2012

Objectives: To explore the key factors involved in decision making when selecting patients for rehabilitation after stroke and to examine the level of agreement among physician assessors regarding admission to rehabilitation. Design: Questionnaire. Setting: Health services with rehabilitation units in Victoria, Australia. Participants: Rehabilitation unit physicians. Interventions: Not applicable. Main Outcome Measure: Questionnaire with 2 components: the clinical and nonclinical factors that influence decision making and clinical case scenarios. Results: Responses were received from 17 physicians from 12 of the 18 health services in Victoria. The most influential clinical factors listed by the respondents were prognosis, social supports, anticipated discharge destination, age, and anticipated length of stay. Key nonclinical factors were prioritization of internal health service referrals, patient's residence, and workforce capacity. Analysis of the clinical scenarios of patients with severe stroke showed that there was variability in the responses, with high levels of agreement for some cases and low levels for others. Almost all respondents agreed that prognosis was a key factor, yet, within the case scenarios, the reasons given for accepting or not accepting the patient demonstrated different opinions on the prognosis of the case presented. Conclusions: The decision-making processes in selection for rehabilitation and the factors that influence that decision require further investigation to optimize the use and outcomes from rehabilitation resources. © 2012 American Congress of Rehabilitation Medicine.

Marshall S.D.,Peninsula Health | Marshall S.D.,Monash University | Pandit J.J.,University of Oxford | Pandit J.J.,St Johns College
Anaesthesia | Year: 2016

There is little doubt that these guidelines incorporate advances made in airway management since 2004. They will change day-to-day practice of anaesthesia, as outlined above, from pre-operative airway assessment, to integrating the WHO team briefing, to the use and provision of equipment and drugs, and the recording of information on the anaesthesia chart. They will inform the later analysis of any critical airway incidents, especially as documentation and postoperative management are addressed, and they will encourage training in a range of techniques. Taken together, not quite a revolution but certainly a very radical evolution. Assessment of the utility of the new guidelines should consider if they can be used as tools to enhance knowledge and training, or in addition as a prosthesis to bridge the gap between the requirements of and our abilities during emergencies. Formal testing may reveal which aspects of their design, complex as it is, may distract from, rather than enhance, airway management during crises. All guidelines represent a standard of care or a normative approach to a clinical problem. As such, they not only help guide clinicians, but they also provide the broader community with the opportunity to improve standards, to ensure equipment is available, and that training for the skills and processes required are in place to ensure successful adoption.

Kent F.,Monash University | Kent F.,Peninsula Health | Keating J.,Monash University
Journal of Interprofessional Care | Year: 2013

A student-led clinic was established to investigate the potential for undergraduate students to deliver primary care to older people recently discharged from acute hospital admission. Patients older than 70 years, recently discharged from hospital to home, were invited to attend an interprofessional student-led outpatient clinic for review of physical, functional and social health needs. Teams of final year students from dietetics, medicine, nursing, occupational therapy, physiotherapy and social work reviewed 25 patients over an eight-week period. Using a standardized screening tool, student teams identified factors affecting health or independence and made referrals for relevant support. Patient perceptions of the consultation, measured with the Patient Experience Questionnaire, indicated that this was a very well-received patient-centered intervention and that the student teams provided useful information and education about self-management strategies. © 2013 Informa UK, Ltd.

Webb A.R.,Peninsula Health | Robertson N.,Peninsula Health | Sparrow M.,Peninsula Health
ANZ Journal of Surgery | Year: 2013

Background: Smoking cessation before surgery improves perioperative outcomes and some smokers may quit if undergoing surgery. Quitting smoking in community settings is influenced by physician quit advice and knowledge of smoking hazards, but there are few data on whether this applies in perioperative settings. Method: Survey on day of surgery of elective patients who reported being a smoker at the time of wait-list placement. Duration of smoking abstinence before surgery (if any) and length timing of failed quit attempts was determined. Sources of any quit advice before surgery, including from physicians, and patient knowledge on hazards of smoking and surgery were questioned. Results: While on the waiting list, 44/177 smokers reported quitting (>24h) before surgery and 42/177 others made an attempt. Quitting was usually brief. Fewer than 40% of smokers answered yes (correct answer) to questions on whether smoking increased wound infection rates, worsened wound healing, increased anaesthetic complications or increased post-operative pain. Incorrect answers (no) were less likely in quitters than those smoking until surgery (OR 0.41, 95% CI 0.25-0.68). Patients still smoking by admission recalled quit advice from a surgeon in 22.6% of cases, while wait-list quitters recalled surgical quit advice in 43.2% of cases (OR 2.6 95% CI 1.2-5.4 P = 0.01). Effects of general practitioner quit advice were significant (OR 3.2 95% CI 1.5-6.8 P = 0.004) while anaesthetists, nurse and hospital brochure advice were not. Discussion: Improving patient knowledge of the perioperative risks of smoking and increased physician advice to quit may improve smoking abstinence at surgery. © 2013 Royal Australasian College of Surgeons.

O'Dowd C.,Peninsula Health
Australian Family Physician | Year: 2013

Background: Strabismus ('squint') is a common childhood disorder that can cause psychosocial distress and permanent functional disability. Early diagnosis is important to maximise visual rehabilitation and reduce the risk of amblyopia. There is currently no national Australian screening program for strabismus, which makes it important for all general practitioners (GPs) to master practical skills for evaluating this condition. GPs should also be aware of red flags in a history and examination that necessitate prompt investigation and management. Objective: This article reviews practical screening tests to identify childhood strabismus, and discusses a framework for timely intervention. Discussion: A comprehensive history is used to distinguish between primary and acquired strabismus. The four tests used to screen for strabismus are the light reflex test, the red reflex test, the cover test and the uncover test. Any child diagnosed with strabismus should be referred to an ophthalmologist for further assessment.

Hersh D.,Edith Cowan University | Armstrong E.,Edith Cowan University | Bourke N.,Peninsula Health
Disability and Rehabilitation | Year: 2015

Purpose: To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation.Methods: This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions.Results: The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation.Conclusions: Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. © 2015 Informa UK Ltd.

Singh R.,Royal Melbourne Hospital | Nath Trivedi A.,Peninsula Health
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2011

The indications of caesarean section are increasing. The need to respect maternal desire in the decision making has been supported by law and ethics. Some of the other contributors to the increasing caesarean section rate are breech with failed external cephalic version, decreasing rate of trial of scar, increasing induction rate and electronic fetal heart rate monitoring and changing demography. Despite the adverse effects of caesarean section, the incidence of severe morbidity and mortality is low. The strategies put forward to reduce the caesarean section rate (CSR) have not been effective and in no country or province, the CSR has come down. CSR should not be looked at in isolation or as high or low. It is the product of changing obstetric practice and societal norms and demographics. CSR not reflect the performance of a maternity unit. © 2011 Informa UK, Ltd.

Bright S.J.,Curtin University Australia | Bright S.J.,Peninsula Health | Bishop B.,Curtin University Australia | Kane R.,Curtin University Australia | And 2 more authors.
International Journal of Drug Policy | Year: 2013

Background: Having first appeared in Europe, synthetic cannabis emerged as a drug of concern in Australia during 2011. Kronic is the most well-known brand of synthetic cannabis in Australia and received significant media attention. Policy responses were reactive and piecemeal between state and federal governments. In this paper we explore the relationship between media reports, policy responses, and drug-related harm. Methods: Google search engine applications were used to produce time-trend graphs detailing the volume of media stories being published online about synthetic cannabis and Kronic, and also the amount of traffic searching for these terms. A discursive analysis was then conducted on those media reports that were identified by Google as 'key stories'. The timing of related media stories was also compared with self-reported awareness and month of first use, using previously unpublished data from a purposive sample of Australian synthetic cannabis users. Results: Between April and June 2011, mentions of Kronic in the media increased. The number of media stories published online connected strongly with Google searches for the term Kronic. These stories were necessarily framed within dominant discourses that served to construct synthetic cannabis as pathogenic and created a 'moral panic'. Australian state and federal governments reacted to this moral panic by banning individual synthetic cannabinoid agonists. Manufacturers subsequently released new synthetic blends that they claimed contained new unscheduled chemicals. Conclusion: Policies implemented within in the context of 'moral panic', while well-intended, can result in increased awareness of the banned product and the use of new yet-to-be-scheduled drugs with unknown potential for harm. Consideration of regulatory models should be based on careful examination of the likely intended and unintended consequences. Such deliberation might be limited by the discursive landscape. © 2012 Elsevier B.V.

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