Marysia Kalcher and Rosemary Jeffery will talk about their experiences in Northern Territory residential aged care facilities using computerised medication administration.Nurses are familiar with the myriad problems that go with a paper-based medication system and prescription systems: among them illegible handwriting, scripts not matching the medication charts, medical records not available or attached to a paper-based system and signatures difficult to identify.
The General Practice Network of the Northern Territory (GPNNT) was funded for a project in Darwin to provide a solution to these problems and demonstrate a digital signing and transfer of electronic prescription.
The system allows a medical officer to connect remotely to a Medchart at any time of day or night whether from home, the surgery, or anywhere they have access to a laptop computer with an internet connection.
Medication orders for an individual client can be added, ceased or changed and at the same time the pharmacist is alerted and a script dispatched electronically. The pharmacist can also view the Medchart remotely.
The system provides a win/win for clients, nursing home staff and organisations and medical officers and pharmacists.
For clients, there are reduced errors of wrong medications due to checking procedures within the system, and there is more time to spend with the client as the time spent administering medication is reduced. Medication reviews can occur any time and off site.
For nursing staff, less time is spent chasing up medication orders and scripts, medication documentation is much clearer and easy to read reducing potential mistakes and errors and the administration of medication history
is at the touch of a button.
ALTERNATIVE FUTURES OF HEALTH
Professor Sohail Inayatullah will explore the alternative futures of health, focusing particularly on the emerging model of Prevention (‘a fence on top of the hill instead of an ambulance below’).
While currently OECD nations only spend 3% of their health budgets on prevention, the reality of an ageing society and more expensive medical technologies will likely force governments to push toward prevention.
Developments in peer to peer networking, genomics, health-bots, green hospitals, healthy cities and the transparent brain make this new future more likely.
However, there are other futures as well: intergenerational and health inequity and the Nanny State.
Professor Inayatullah will address scenarios of alternative health futures, how we think about the long term and the changing metaphors of the life cycle. The audience will be encouraged to explore what this means for the short-, medium- and long-term futures of nursing.
Professor Sohail Inayatullah is a political scientist/futurist at the Graduate Institute of Futures Studies, Tamkang University, Taiwan; the Centre of Policing, Intelligence and Counter Terrorism, Macquarie University, Sydney; and the Faculty of Arts and Social Sciences, the University of the Sunshine Coast, Sippy Downs.
NURSING GRAND ROUNDS VIA VIDEOCONFERENCE
Jenny Preece from the North Coast AHS will describe the Nursing Grand Rounds via videoconference for nurses in small rural and remote facilities.
This trial by the NCAHS began in June 2009. Eight sites were linked monthly by video-conference for case presentation and discussion of interesting or challenging patient journeys, referral patterns to regional referral centres, retrieval team episodes and/or discharge to community support services.
The aim was to further enhance critical thinking and decision-making skills for staff who often have to triage in the absence of a medical officer, and to foster a mentoring network among nurses from smaller and remote sites.
An evaluation was conducted at 18 months, which clearly demonstrated that Nursing Grand Rounds via videoconference has become an accepted form of peer review, and generates reflection on individual and team clinical practice. These rural and remote nurses now feel part of an extended team.
In the establishment phase, Clinical Champions were identified – Nurse Practitioners, Clinical Nurse Consultants and Clinical Nurse Educators – to support nurses at the local sites and to assist in developing the monthly rotational calendar. They also chaired the sessions on a rotational basis and kept sessions structured, focused and running to time.
It is envisaged that site participation in Nursing Grand Rounds via videoconfererence will continue to provide a sense of solidarity for rural or remote generalist nurses from small sites throughout the transition to Local Health Networks during 2011.
HOME TELEHEALTH MONITORING
Kerry Oates, Project Officer from Royal District Nursing Service Victoria, will speak about a Home Telehealth Monitoring project and its impact on the health workforce.
Kerry will present an overview of a demonstration project, funded by Health Workforce Australia, where clients were monitored by RDNS using telehealth technology and how this changed the way of managing clients and delivered improved deployment of staff.
The pilot trialled the use of home telehealth monitoring to supplement home nursing visits.
The technology enabled a shift in focus from scheduled to targeted visits by nurses and GPs, based on changes to the client’s health condition instead of booking routine scheduled visits.
Instead of a nurse having to travel to monitor a client’s vital signs on a regular basis, clients who could, were taught to take their own measurements. They could be monitored remotely by a nurse on a daily basis and received targeted home visits as required.
Anticipated benefits included early identification of exacerbations in a client’s condition, a decrease in unnecessary admissions to hospital, and an increase in the client’s participation in their care.
Benefits for the workforce included establishing the roles & functions required to undertake telehealth monitoring and an expansion of competencies of the current workforce.
Naturally the training of staff and clients and the development of information packages and documentation was important to support staff, GPs and clients.
One surprising result was the willingness of clients to accept the technology and their ability to usethe equipment and technology.
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