Health Times March 2016

H

March 2016

Mental Health Feature + Diagnosing autism + Suicide prevention training + Autism spectrum disorder research and developments + 12 hour shifts linked to more nurse errors

HealthTimes - March 2016 | Page 11

603-001 1PG FULL COLOUR CMYK PDF

We do everything as if you are here You work hard caring for others; we work hard to care for you.

Your needs, your goals, your future.

You wouldn’t have it any other way. Neither would we.

Winner.

Best Growth Super Fund.

firststatesuper.com.au | 1300 650 873 Consider our product disclosure statement before making a decision about First State Super. Call us or visit our website for a copy. FSS Trustee Corporation ABN 11 118 202 672 ASFL 293340 is the trustee of the First State Superannuation Scheme ABN 53 226 460 365.

Page 02| www.HealthTimes.com.au

603-021 1PG FULL COLOUR CMYK PDF

A Career in Caring!

Enrol for March/ April intake NOW!

Funding available* CHC30113 Certificate III in

CHC33015 Certificate III in

Early Childhood Education and Care

Individual Support (Ageing, Disability)

CHC43115 Certificate IV in

HLT33115 Certificate III in

Health Services Assistance

Disability

(Assisting in Nursing Work in Acute Care)

• Comprehensive courseware • Experienced educators • One-on-one student support • Flexible formats to suit your convenience • Simulation based training • Practical placements * For eligible students only

Seats are filling up quickly!

Call Now! 1800 22 52 83

Institute of Health & Nursing Australia T h e P re m i e r N u r s i n g I n s t i t u t e

Quality ISO 9001

Melbourne

Perth

Sydney

597-599 Upper Heidelberg Road, Heidelberg Heights, Victoria 3081, Australia Phone: +61 3 9450 5100

Level 2 Carillon City Arcade, 680-692 Hay Street Mall, Perth WA 6000 Phone: +61 8 6212 8200

Level 7, 33 Argyle Street, Parramatta, NSW 2150, Australia Phone: +61 2 8228 6400

RTO ID: 21985

enquiry@ihna.edu.au | www.ihna.edu.au

HealthTimes - March 2016 | Page 03

603-011 1PG FULL COLOUR CMYK PDF

March 2016 We hope you enjoy perusing the range of opportunities included in this Issue.

If you are interested in pursuing any of these opportunities, please contact the advertiser directly via the contact details provided. If you have any queries about our publication or would like to receive our publication, please email us at contact@healthtimes.com.au DISTRIBUTION 46,300

Advertiser list Australian Bridge Federation Barwon Health Best Practice Nursing Agency Bupa CCM Recruitment International Education Cruises at Sea

The HealthTimes magazine is the most widely distributed national nursing and allied health publication in Australia.

For all advertising and production enquiries please contact us by telephone on 1300 306 582, email contact@healthtimes.com.au or visit www.healthtimes.com.au Published by Seabreeze Communications Pty Ltd trading as HealthTimes.

ABN 29 071 328 053. Š 2015 Seabreeze Communications Pty Ltd. All right reserved. No part of this publication may be copied or reproduced by any means without the prior written permission of the publisher. Compliance with the Trade Practices Act 1974 of advertisements contained in this publication is the responsibility of those who submit the advertisement for publication.

Next Publication: Education Publication Date:

Monday 26th of April 2016

Artwork Deadline:

Monday 18th of April 2016

Page Page 04| 04| www.HealthTimes.com.au www.HealthTimes.com.au

First State Super Geneva Health Health Staff Recruitment In Response Institute of Health and Nursing Australia Medacs Healthcare Australia Oceania University of Medicine Queensland Health Quick and Easy Finance Royal Flying Doctor Service Smart Salary Sunshine Psychology Your Nursing Agency

522-016 518-018 524-014 520-015 602-025 1PG FULL FULL COLOUR COLOUR CMYK CMYK PDF PDF 603-0151PG

Need money QUICKLY? TM

Funds on demand, the ‘Quick & Easy’ way

Quick and Easy Finance specialises in secured and unsecured short term personal loans over 3 to 36 months.* A short-term loan means your debt is paid off sooner, and with loans that range from $500 to $20,000* you can afford to pay for the things you’ve always wanted. PLUS, by repaying your loan with Payroll Deduction and by using your unencumbered1 vehicle as security, you can enjoy a discounted installment on your loan.

HOW SOON CAN I RECEIvE THE FUNdS?

Within 2 to 4 days from the moment we receive your completed application form and supporting documents* funds can be deposited directly into your bank account, and then you may spend the funds however you choose.

WHAT CAN I USE THE LOAN FOR?

Anything you want! Guilt-free shopping; gift purchases; a holiday of a lifetime; home renovations; a new car; repairs or new tyres; dental or medical expenses; new furniture and whitegoods; upgrade to a new wide screen TV… in fact, it’s your loan – so use the funds however you choose!

FEES & EARLY SETTLEMENT?

Unlike most other companies, Quick and Easy Finance DOES NOT CHARGE ANY FEES OR PENALTIES if you choose to settle your loan early. So you are free to pay out your loan whenever you want.

There is simply no better way to solve all your cash flow needs than a short-term personal loan from Quick and Easy Finance – it’s your cash on demand, the Quick & easy way™

wrightcreative.com.au 3915-CONNCAH

PERSONAL LOANS FROM $500 TO $20,000

Visit our website www.qef.com.au

*Terms and Conditions Apply. ABN 76 104 030 793. A National Credit Act compliant company. A member of the National Credit Providers Association. A member of Credit & Investment Ombudsman Limited (www.cio.org.au). 1: A motor vehicle which is paid off, registered in your name and not encumbered (i.e. not currently used as security on any loan with another financial institution).

Australian Credit Licence No. 388145

HealthTimes - March 2016 | Page 05

603-018 1PG FULL COLOUR CMYK PDF

LEARN BRIDGE WWW.ABF.COM.AU

THOUSANDS OF NEW FRIENDS ARE WAITING TO MEET YOU Make new friends Challenge yourself

Beginner classes oered at over 350 clubs around Australia - thousands of clubs around the world 37,500 Australian registered players - millions play world-wide

Have fun!

Exercise your brain AND have fun!

Australian Bridge Federation

Page 06| www.HealthTimes.com.au

602-019 603-012 1PG FULL COLOUR CMYK PDF

3

ways to save on a new car

1

Get a great discount

2

No GST to pay

3

You save Enjoy * great tax $ savings

You save

$

on the car’s purchase price, using our buying power

$

Save

3,795*

20,022*

$

You save

3,095*

as there’s no GST to pay on the car’s purchase price

Over 4 years on a new Mazda CX-5 Maxx Sport valued at $37,945**

13,132 in income tax over 4 years

Save thousands with a novated car lease.

Get an obligation free quote today.

1300 221 971 | www.smartnurses.com.au *Savings example is indicative only and is based on the following assumptions: living in NSW 2123, salary: $70,000 gross p.a., travelling 15,000 kms p.a., lease term: 48 months. The purchase price discount represents a typical saving and is compared to the manufacturer’s on-road price of the new vehicle. All tax savings calculations include budgets for fuel, servicing, tyres, maintenance and re-registration over the period of the lease. These calculations also include comprehensive motor insurance, 2 year extended warranty and gold aftermarket pack, which includes window tint as part of the offer. The total amount saved is a comparison to financing the purchase price of the vehicle over 4 years and paying for all running and maintenance costs out of your post-tax earnings. Your actual savings will depend on your income tax bracket, the GST processing method nominated by your employer, administration fees payable under your employer’s salary packaging plan, the negotiated Smartleasing discount on your chosen vehicle and your personal circumstances. **The vehicle price stated for CX-5 Maxx Sport 2.5i AWD is correct at the time of print and may be subject to change. Vehicle price stated includes all NSW on-road costs and government charges, and excludes gold aftermarket pack.

Smartleasing ad_NCAH_Feb 2016_3 ways.indd 1

22/02/2016 11:42:03 AM

HealthTimes - March 2016 | Page 07

603-026 1/2PG FULL COLOUR CMYK PDF an independent support service for health professionals to win at work puts you in the best position in any workplace matter.

You control the response. You manage the process. provides initial case reviews and support for: Unfair dismissal and termination Conduct and Performance Management Discrimination

Workplace Investigations Bullying and Harassment Responding to complaints and incidents

We can: Act as your support person Review your response strategies Prepare you for meetings or interviews Draft professional correspondence Contact today and link into our website and Facebook page for information, tips and cases

www.inresponse.com.au

email: help@inresponse.com.au 24/7 call 0400 430 496

522-008 423-001 419-001 417-002 416-001 418-001 420-002 421-001 424-002 422-002 503-017 509-009 502-023 514-007 501-027 512-009 FULLCOLOUR COLOURCMYK CMYKPDF PDF 507-0121/2PG 1PG FULL 508-006 505-011 506-008 504-009 524-008 516-007 518-008 520-008 601-017 601-035 603-019 OUM’s innovative teaching style is fantastic and exciting.

Truly foreword thinking, OUM allows the student to benefit from both local and international resources.

Brandy Wehinger, RN OUM Class of 2015

RN to MD

Make the dream of becoming a doctor a reality, earn your MD at Oceania University of Medicine. n Attractive fee structure for our Graduate Entry Program. n Over 150 students currently enrolled and over 50 graduates in Australia, New Zealand, Samoa and USA. n Home-based Pre-Clinical Study under top international medical school scholars, using world leading Pre-Clinical, 24/7 online delivery techniques. n Clinical Rotations can be performed locally, Interstate or Internationally. n Receive personalised attention from an Academic Advisor. n OUM Graduates are eligible to sit the AMC exam or NZREX.

Applications are now open for courses starting in January and July - No age restrictions

OCEANIA UNIVERSITY OF MEDICINE INTERNATIONALLY ACCREDITED For information visit www.RN2MD.org or 1300 665 343

Page 08| www.HealthTimes.com.au

506-031 424-037 1PG FULL COLOUR CMYK PDF 501-005 504-001 502-022 518-026 512-036 508-008 507-028 522-025 520-027 516-037 505-035 603-025

Live your passion.

Be part of a proud Australian tradition.>

Flight Nurses The Royal Flying Doctor Service (RFDS) highly values the contribution and dedication of its people, who enjoy working together to provide high quality health care in a unique environment.

RFDS staff enjoy enriching work which broadens their horizons, builds professional experience and delivers the personal rewards of knowing they are making a difference to rural and remote Australia.

If you’re a Nurse/Midwife ready for a rewarding new challenge, the RFDS has a position for the right person to join our dynamic Flight Nurse Team.

You’ll be working with an amazing and motivated team of professionals dedicated

to providing primary care and emergency evacuations to those living and working in rural and remote areas.

Applicants are required to have: >

Dual Nursing and Midwifery registration

> and/or (ED or ICU)

postgraduate experience in critical care

The successful candidate will receive a comprehensive three-week orientation, generous salar y and salary packaging and assistance with relocation if necessary.

Applications close: Ongoing in 2016

For futher information: Paul Ingram (08) 9417 6300 nursing@rfdswa.com.au

HealthTimes - March 2016 | Page 09

602-024 603-016 1PG FULL FULL COLOUR COLOUR CMYK CMYK PDF PDF 520-016 518-017 524-0151PG 522-015

Own your car?

Borrow up to $20,000 against its value

• It must be a late model vehicle* • It must be registered in your name; if registered in your partner’s name, you can apply jointly • You must repay your loan through Payroll Deduction or Salary Sacrifice (and enjoy potential tax benefits) • You must be government-employed or work in a related industry (education, health care)

Even if you still owe a small amount on your car we can pay it off for you, and use the vehicle as security.

Let’s talk. We’ll show you how we make it quick and easy to get yourself up to $20,000 using your vehicle as an asset.* It’s a great way to use the value of your car to get the finance you need with terms from 3 to 36 months.

Call us today or visit our website www.qef.com.au to see how we live up to our name: Quick and Easy Finance.

Visit our website www.qef.com.au

*Age of vehicle determines the amount client is eligible to borrow; Terms and Conditions Apply. ABN 76 104 030 793 A National Credit Act compliant company. A member of the National Credit Providers Association. A member of Credit & Investment Ombudsman Limited (www.cio.org.au). Australian Credit Licence No. 388145

Page 10| www.HealthTimes.com.au

wrightcreative.com.au 3915-NCAH-CAR-FC

If you own a car that is registered in your name (or your partner’s) you can borrow* up to $20,000 against its value.

603-0241PG FULL COLOUR CMYK PDF

See your career go places with Geneva Healthcare Opportunities in Australia, New Zealand and the Middle East Step up your career and move to your next job in some of the greatest cities in the world!

Geneva Healthcare are the experts in placing Nurses, Midwives and Allied Health professionals like you into great jobs to suit your goals.

Want a fixed term contract or permanent work? Or to move elsewhere to be closer to your family? Need to save for a deposit on a house? Or just want a change?

We can help you make that move. Call Geneva Healthcare today!

Contact: Shane King shanek@genevahealth.com Freephone from Australia: 1800 123 900 Freephone from New Zealand: 0800 900 801 www.genevahealth.com

Be in to win $100 on us!

Here’s your chance to win $100!

Simply visit www.genevahealth.com/100 and enter the code “Health Times” online to go into this draw. Ts & Cs apply.

HealthTimes - March 2016 | Page 11

Suicide safety planning app aims to save lives

By Karen Keast

A

world-first safety planning smartphone app and website are the latest high-tech tools in the fight to prevent suicide.

Thousands of people have already downloaded the free BeyondNow app, a collaboration between Monash University and beyondblue with funding from the Movember Foundation, since it was launched in mid-March.

Dr Glenn Melvin, a clinical psychologist and senior lecturer at Monash University who was central to developing the app’s safety planning component, said while health practitioners working with people at risk of suicide have long used safety plans in written paper format, the app provides a user-friendly and easily accessible tool for people in crisis.

“I guess one of the advantages of having the app is that people tend to have their phones with them at all times,” he said.

“We know that suicidal thinking comes and goes so the role of the app is to be there when the person is in that state, and it’s all prepared beforehand to help them survive that crisis or really tough time that they find themselves in.”

Dr Melvin said clinicians can incorporate the app into their practice to use with clients or patients.

“We’re encouraging health professionals to download the app, have a look at it, become familiar with it, then consider how they might go about introducing the idea of an app with one of their patients,” he said.

“We received a lot of very positive feedback on the app from people who are using the app and clinicians who will be using it in their practice.”

The app features a safety planning technique developed by American psychologists and researchers Professor Barbara Stanley and Professor Gregory Brown.

Page 12| www.HealthTimes.com.au

“We’ve tried to bottle that technique into an app so that it’s accessible and includes relevant Australian health services such as Lifeline and 000,” Dr Melvin said.

“It’s been about two years of development and we started out by doing a round of consultation with people with lived experience of suicide and talked to them about what they would like to see in an app, what it should look like, what features it should have.

“We also talked to clinicians from a variety of professional backgrounds - psychiatrists, psychologists, social workers, nurses about the features that they would like to see in the app and what would make it a useful thing for them to easily incorporate into their practice with their patients and clients.”

The app focuses on enabling people to create a structured plan, either on their own or with a health professional, that lists a series of steps the person can use to help themselves stay safe.

Through the app, they can outline their warning signs, ways to keep their environment safe and their reasons for living.

“Then we move to internal coping strategies so these are things that a person can do to perhaps distract themselves from suicidal thoughts,” Dr Melvin said.

“We know in general that distraction isn’t necessarily a good coping strategy in the longer term but in terms of say riding the waves of suicidal thoughts, distraction can be helpful.

“It might be taking a cold shower, going for a walk, doing some exercise, watching a favourite movie, those type of things.”

For the full article visit HealthTimes.com.au

603-027 1PG FULL COLOUR CMYK PDF

HealthTimes - March 2016 | Page 13

602-005 1/2PG FULL COLOUR CMYK PDF 603-004 Nurses, Midwives & Carers, we need you!

Tier 1 provider to public and private hospitals across Australia.

Theatre, ICU, Midwives, Emergency and Paediatric staff in high demand.

Specialist rates and joining bonuses apply.

For more information call 13 10 99 or visit www.yna.com.au

603-023 1/2PG FULL COLOUR CMYK PDF Expand your skills and knowledge with the exciting concept of Education at Sea Take your professional skills on a new experience by attending an Education at Sea Seminar or Conference. Our programs are designed to meet the education needs of professionals. Specialising in face to face contact hours to build on your continued professional development. Our unique programs allow you to combine education, relaxation and all the fun cruising is renowned for.

Upcoming 2017 Education at Sea Events

Contentment or Mediocrity

The impact of nursing knowledge on the quality of life experience by the older person

First Global Multidisciplinary Emergency Care Conference Striving for excellence in Emergency Care

Page 14| www.HealthTimes.com.au

603-028 1PG FULL COLOUR CMYK PDF

healthstaffrecruitment.com.au

HealthTimes - March 2016 | Page 15

Suicide prevention training

S

uicide is preventable yet the latest Australian Bureau of Statistics (ABS) data shows 2864 lives were lost to suicide in 2014, which equates to almost eight a day - an increase of almost 13.5 per cent in a year.

Australia’s health practitioners have a vital role to play in preventing suicide.

Dr Fiona Shand, a clinical psychologist and Senior Research Fellow at the Black Dog Institute, says it’s imperative nurses, midwives and allied health practitioners tap into suicide prevention training.

“We’re seeing an increase in death by suicide unfortunately and also potentially an increase in the number of people who are presenting for self-harm,” she says.

“Suicide is the leading cause of death amongst young people in Australia and also certainly one of the leading causes of death for middle-aged men, so I just think that it’s one of those issues that we can’t afford to ignore.”

Dr Shand, who has worked in suicide prevention for the past four years, says upskilling in the areas of screening for depression and suicide, responding to suicide attempts, and being able to discuss suicide with patients is a key part of prevention.

Evidence shows screening for depression and suicide, and treating depression and distress, are some of the best ways to circumvent a suicide attempt.

Dr Shand says while particular groups of people are considered to be at risk of suicide, such as those presenting with a psychiatric

Page 16| www.HealthTimes.com.au

diagnosis including depression, anxiety or bipolar disorder, it’s also important to identify other patients or clients who may be at risk.

“There isn’t any one particular profile of a person who might experience suicidal thoughts, it depends on what’s happening in the person’s life, and suicide risk changes over the course of a person’s lifetime so it’s always important to screen,” she says.

Most importantly, it’s crucial health practitioners are able to have the conversation about suicide with patients. Dr Shand says it doesn’t have to be a complicated process.

“Even just asking a couple of questions and finding out whether the patient has ever had a suicide attempt or if the person is having those kind of thoughts can be the start of putting some positive things in place,” she says.

“Saying it in a way that says - ‘when someone is going through a tough time like you are, it’s not unusual to have these kinds of thoughts and I’m wondering if you’re having them’.

“It’s really just giving the person permission to talk about it. Certainly in our interviews with people who have had a suicide attempt, they said they want to be asked and they want to be asked on the suicide attempt on a regular basis, so they don’t have to be the ones to raise the subject.

For the full article visit HealthTimes.com.au

603-009 1PG FULL COLOUR CMYK PDF

HealthTimes - March 2016 | Page 17

Autism spectrum disorder research and developments

T

here’s a saying that ‘if you’ve met one person with ASD, you’ve met one person with ASD’.

Autism spectrum disorder (ASD) is an extremely heterogeneous disorder that presents differently in the difficulties and abilities of every person, making it harder to detect and diagnose early in children.

Autism spectrum disorder is a life-long neuro-developmental disorder that affects both a person’s social and communication abilities and features behaviours that are repetitive and restrictive. It also often includes sensory sensitivities.

While it’s estimated one in 100 people have autism spectrum disorder, researchers at La Trobe University’s Olga Tennison Autism Research Centre (OTARC) have found most children are not diagnosed until they are four years old - more than two years after they can be accurately diagnosed and receive life-changing intervention.

Autism symptoms The signs and symptoms of autism spectrum disorder fall into two main areas - social and communication as well as fixated interests and repetitive behaviours.

Dr Josephine Barbaro is a lead clinician at Australia’s first Early Assessment Clinic for autism spectrum disorder and a post-doctoral research fellow at OTARC.

Page 18| www.HealthTimes.com.au

Dr Barbaro’s research has made headway in the early diagnosis of autism spectrum disorder and has led to the development of ‘red flag’ markers or autism symptoms, used to identify at-risk babies.

“We really need to get the message out there that autism can and should be diagnosed in children under three, in those children who are presenting with symptoms of autism spectrum disorder,” she says.

Social and communication deficits Dr Barbaro says concerned parents and health professionals can look for key signs in the social and communication area for babies or children.

Signs of autism include difficulties or deficits in the child’s use of eye contact, shared smiles, gestures, responses and when it comes to imitating others.

“The behaviours we look for are whether or not children have difficulties or deficits in their use of eye contact, in responding to his or her name when someone calls them, and in engaging in pretend play, so pretending to feed a teddy or give a teddy a drink,” she says.

“We also look to see whether they have difficulty in copying other people, so for infants that would be copying facial expressions or blowing raspberries or clapping their hands and in older children that would be in domestic activities like sweeping the floor or pretending to comb their hair or things like that.”

Fixated interests and repetitive behaviours Professor Sylvia Rodgers, director of research and education for the Cooperative Research Centre for Living with Autism (Autism CRC) which works in partnership with OTARC, says autism signs and symptoms are also found in repetitive and restrictive behaviours, such as an intense interest in particular toys or objects, or where a child has a narrow focus on an object, such as playing with the wheels on toy cars or lining cars up.

Professor Rodgers says many children with autism prefer the same routines and find it difficult when it comes to changes in their day to day activities, such as parents taking an alternative car route to childcare or kindergarten due to roadworks.

“That’s all about the predictability being gone and then there’s severe anxiety around things not being the same,” she says.

Most people on the autism spectrum disorder also have sensory sensitivities.

Sensory sensitivities Children with autism spectrum disorder can under-react or overreact to sensory stimuli, from enjoying watching a spinning fan or wheels to wanting to only eat foods with a certain texture, such as smooth foods, or trying to block out the noise of a ticking clock.

“Certain noises just become disproportionately problematic for them and one of them is the noise of hand-dryers in public toilets,” Professor Rodgers says.

“Those can be so distressing that they will avoid them or if a child hears that and is not expecting it, it can cause a meltdown in the shopping centre.

“We hear those noises as noisy maybe and unpleasant but they’re tolerable to us, the sounds that they hear are potentially earpiercing, uncomfortable to the point of pain they will sometimes describe.”

Causes of autism spectrum disorder There is no single known cause of autism.

Researchers are examining whether there are multiple causes of this complex disorder, and are looking at genetics and whether there are links to environmental factors which could cause the brain to develop differently.

Professor Rodgers says while researchers know more today than they did 10 or 20 years ago, there is still a long way to go before researchers uncover the cause of autism spectrum disorder.

She says the Autism CRC is creating the nation’s first and largest autism Biobank, which will collect detailed phenotypic and genotypic information from hundreds of families affected by autism.

“We are collecting blood and other biological materials from children on the spectrum and their mothers and fathers and we are trying to look at the genetic basis of the children’s situation,” she says.

“We need lots of children and families to be involved. We are hoping to be able to bring a whole new understanding together of what’s underpinning the condition.”

Assessment and diagnosis In 2013, changes were introduced to the criteria that health professionals use for diagnosing autism spectrum disorder.

The previous fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) listed children with autism spectrum disorder as having either Autistic Disorder, Asperger’s Disorder and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS).

Under the fifth edition of the manual, the DSM-5, there is now a single diagnosis of autism spectrum disorder with a severity ranking of levels one, two or three along the spectrum.

There is no single test to diagnose autism spectrum disorder.

For the full article visit HealthTimes.com.au HealthTimes - March 2016 | Page 19

Diagnosing asthma in children While a diagnosis of asthma is important for children, there’s also increasing concerns surrounding overdiagnosis and overtreatment.

By Karen Keast

A

sthma is a common and chronic longterm lung disease which affects about one in 10 Australian children.

Children with a diagnosis of asthma have sensitive airways in their lungs that react to triggers, such as respiratory infections, cigarette or bushfire smoke, allergies, a change in temperature, high emotions and particular medicines.

These triggers can cause flare-ups where the muscles around the airways compress, the airways swell and become narrow while getting thick with mucus, making it more difficult for the child to breathe.

People can develop asthma at any stage throughout their life. The signs or symptoms of asthma may come on gradually or suddenly.

Researchers are working to understand the causes of asthma, and are examining links between genetics and environmental factors.

There is no cure for the condition but in children with an asthma diagnosis, their asthma can be well controlled. Children can lead a healthy, normal life through managing their asthma.

Diagnosing asthma in children There is no single reliable test and no standardised diagnostic criteria for asthma.

Page 20| www.HealthTimes.com.au

A diagnosis of asthma involves demonstrating excessive variation in lung function combined with respiratory symptoms.

When making a diagnosis of asthma, a GP or a paediatrician will examine a child presenting with symptoms of the condition, such as breathlessness, wheezing, a continuing cough and a tight feeling in the chest.

The doctor will consider the child’s medical history, including whether the child has allergies such as eczema or hay fever and a recurrent or persistent wheeze, conduct a physical examination, and consider other possible causes of the symptoms.

The doctor will also consider tests that support the diagnosis, such as a spirometry test to assess the child’s lung function, and may consider a treatment trial.

A spirometry test involves the child blowing forcefully into a mouthpiece or tube for several seconds, which is connected to a recording device. The spirometer measures the amount of air pushed through the tube, as well as lung capacity and other measurements.

Adam Jaffé is a Professor of Paediatrics at the University of New South Wales, a respiratory paediatrician at the Sydney Children’s Hospital, a member of Asthma Australia’s Medical and Scientific Advisory Committee and he helped write the National Asthma Council Australia’s Australian Asthma

306-037 602-037 1/2PG FULL COLOUR CMYK PDF

MINDFULNESS AND SELF-CARE: A Retreat for Health Professionals 16+ hours CPD points, June 15-19 Nusa Lembongan Island, Indonesia

5 nights of 5 star bliss!

Feeling a little burned out? Escape this winter and join us to rejuvenate on the stunning island of Nusa Lembongan. Practice new skills in Mindfulness and other modalities while enjoying a range of experiential activities including yoga, stand-up paddle boarding, and snorkeling. Dr Alanda Thompson is clinical psychologist of 20+ years standing. She has long experience with helping health professionals to help themselves, in both corporate and individual settings, and is dedicated to facilitating vitality and engagement with the clinical role. Prices start at $2250 including 5 nights idyllic accommodation, expert clinical tuition, beautiful breakfasts, spa time, yoga, snorkeling trip, stand-up paddle lesson, transfers from Denpasar and more. Some accommodations options have already sold out and numbers are strictly capped to ensure a small-group experience. For more information, or to discuss your needs please.

Contact : Dr Alanda Thompson, Clinical Psychologist on mindfulprofessionals@gmail.com www.mindfulprofessionals.squarespace.com

Handbook, which outlines national guidelines for asthma management.

“With every child that presents to the doctor, one would take a proper history, and you ask about the triggers, what the symptoms look like and there are a few clues on examining a child - the shape of their chest, and whether they’re sick at the time or they’re wheezing,” he says.

“In those aged over five, you should do lung function testing and look at the response to something like a reliever, to measure the response before and after.

“In older children, we can actually do a challenge test where they inhale a substance to try and make them wheeze, which helps with the diagnosis.

“Once you think you’ve got the diagnosis of asthma, then it will be about trying this medicine to see if it actually improves and relieves your symptoms or improves your lung function if it’s abnormal.”

Diagnostic challenges It can be incredibly difficult to diagnose asthma with certainty in children under five.

Young children are unable to perform the lung test to acceptable standards while wheezing and coughing are common in this age group.

There are many causes for coughing and wheezing, and a wheeze does not automatically mean a child has asthma.

Professor Jaffé says the most satisfying part of his work, and much of his job, involves undiagnosing asthma.

“Nothing gives me greater pleasure than seeing children in my clinic when I say - ‘you haven’t got asthma, take them off their medicines’,” he says.

For the full article visit HealthTimes.com.au HealthTimes - March 2016 | Page 21

12 hour shifts linked to more nurse errors

By Karen Keast

N

urses who work at least 12 hours on a single shift face a greater risk of making errors that can injure themselves or their patients, research shows.

New Zealand nursing researchers Dr Jill Clendon and Dr Veronique Gibbons, who published their systematic review of research evidence in the International Journal of Nursing Studies last year, found six studies, comprising 60,780 nurses or 89 per cent of the review’s total sample size, revealed a significant rise in error rates among nurses working more than 12 hours on a single shift in acute care hospital settings.

One study reported higher rates of care left undone than nurses working up to eight hours, another study found the likelihood of making an error was three times higher while a third study found the risk was almost double.

Another study found nurses were more likely to suffer a needlestick injury, a separate study found nurses working more than 13 hours are far more likely to report frequent central line-associated bloodstream infections, while the sixth study found patients’ pain was less likely to be controlled.

Out of the 13 studies examined, four found higher rates of error in shifts of up to eight hours while three found no difference between the number of shift hours worked.

Page 22| www.HealthTimes.com.au

While 12 hour shifts are common and offer flexible working hours for nurses, the researchers said their review shows 12 hour shifts result in an adverse impact on patient and nurse outcomes.

“The (12 hour shift) approach has proven popular, with many proponents citing good quality time off work, ease of travel to work, improved relationships with patients, and better family time as benefits,” they state.

“However, there is significant debate in the literature regarding the disadvantages of 12 hour or longer shifts with some authors claiming extended shifts cause increased fatigue, greater risk of errors, greater risk of injury to self, and negative physiological outcomes, others claiming no difference in patient outcomes, and yet others attributing greater risk of error to poor scheduling practices rather than length of shift.”

Dr Clendon, a New Zealand Nurses Organisation (NZNO) nursing policy advisor, and Dr Gibbons said hospitals and units now using 12 hour shift systems should review the scheduling practice because of the potential negative impact on nurse and patient outcomes.

For the full article visit HealthTimes.com.au

601-032 1PG 1PG FULL FULL COLOUR COLOUR CMYK CMYK PDF PDF 602-020 603-034

Best Practice Nursing Agency You’ve tried the rest... now try the BEST!

Work with an agency that cares about YOU, and works hard to find YOU work.

We are currently recruiting Registered Nurses with experience in various specialties- Critical care (ICU), surgical, medical oncology and midwives.

BPNA will give YOU: •

Great pay rates

•

Comfortable & groovy scrub uniform

•

Personalised service from a recruitment consultant who is an experienced nurse just like you

•

Access to the best shifts in the best private hospitals

•

Great rewards and incentives

•

Weekly pays by EFT

•

Superannuation

•

Ongoing education and course sponsorship

Call us today on 0499 255 688 Sydney office ph. 1300 276528 Email: info@bpna.com.au www.bpna.com.au

Best Practice Nursing HealthTimes - March 2016 | Page 23

Diagnosing autism

By Karen Keast

T

here is no one simple test to assess and diagnose autism spectrum disorder (ASD).

Best practice for a diagnosis of autism spectrum disorder involves a multidisciplinary team of health professionals, including a paediatrician or a child psychiatrist along with a psychologist, speech pathologist or an occupational therapist.

Diagnosis of autism spectrum disorder Dr Josephine Barbaro, a research fellow at the Olga Tennison Autism Research Centre (OTARC) at La Trobe University, says a diagnosis can only occur through behavioural observation and through developmental history.

“That involves interviewing parents and observing the child; we don’t have any concrete biological markers that we can pare up with our observations at this stage,” she says.

When making a diagnosis of autism spectrum disorder, health professionals will use the latest version of the standard criteria for the classification of mental disorders, the Diagnostic and Statistical Manual of Mental Disorders - the DSM-5, produced by the American Psychiatric Association in 2013.

The new edition, which replaces the fourth edition of the DSM, introduced major changes to the diagnostic definitions of autism and its related conditions.

The fifth edition features a single diagnosis of autism spectrum disorder with a severity

Page 24| www.HealthTimes.com.au

ranking of levels one, two or three, depending on the amount of support the child requires.

Under the DSM-5, a diagnosis of autism spectrum disorder replaces the previous range of conditions such as Autistic Disorder, Asperger’s Disorder and Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS).

Health professionals now diagnose autism spectrum disorder on the basis of difficulties in two areas.

The first area is social communication deficits, where the child rarely or never uses language, doesn’t respond to people or doesn’t copy people’s actions.

The other area is fixated interests and repetitive behaviours, where the child has an intense interest in certain objects and plays with them in a particular way, such as lining objects up.

This area includes sensory sensitivities, where a child will overreact or under-react to stimuli such as the sound of a ticking clock or the noise of a hand-dryer in public toilets.

The DSM-5 includes a new diagnostic label of Social Communication Disorder (SCD).

SCD is similar to ASD but is diagnosed based on difficulties with both verbal and non-verbal social communication skills and does not include the ASD definition of fixated interests and repetitive behaviours.

Under the change, some children who would previously have received a diagnosis of ASD may now receive this new diagnosis of SCD.

Importantly, those diagnosed under the previous DSM retain their diagnosis and are not required to be re-assessed.

When it comes to diagnosing autism, there are a range of diagnostic assessment tools clinicians use, including two considered to be gold standard - the Autism Diagnostic Observation Schedule (ADOS-2) and the Autism Diagnostic Interview (ADI-R).

Dr Anne Chalfant, a clinical psychologist who specialises in autism and is director of Annie’s Centre, says the ADI-R is a structured interview conducted with parents or the primary caregiver of the child.

“For a hypothetical example, John is three and when he and his parents come in for assessment about John, the clinic should sit down with the parents and go through this standardised interview process asking the parents questions all about John’s developmental history to date and his milestones,” she explains.

“They’re very detailed questions looking for what we call behavioural evidence - so concrete behaviours that we can code using the assessment tool to do with his social and communication skills and repetitive behaviours.

“All of the questions are basically designed to bring to life, if you like, the diagnostic criteria for autism spectrum disorder in a way that clinicians can then analyse and in a standardised way, in a way that’s reliable between one clinician and the next, and makes sense of the information that the parent gives them.”

The ADOS-2 is a standardised diagnostic measure used to observe the child which targets the symptoms of autism spectrum disorder.

Dr Chalfant says the tool focuses on mostly play-based activities.

“Those activities are designed to draw out the features of an autism spectrum disorder if they’re present for that child,” she says.

“Another hypothetical example is if you have a two-year-old coming for an assessment at the clinic and they had very little language and there

was high suspicion of autism, the tool might involve things like the way they play with certain toys, certain play routines, things like peekaboo, pretend birthday parties, games to do with bubble or balloon play, etc.

“What you’re looking for, in a standardised way, is a certain type of response from the child - so you’re looking for things like repetitive behaviours, lack of eye contact, all of the things that are part of the diagnostic criteria for autism.

“We have these activities in order to draw them out and again code them in a way that is standardised and normed against other children their age, against other children with other types of difficulties, so that we can make solid conclusions as to whether it seems like there is quite a high likelihood that the child has a diagnosis or not.”

Clinicians require training to use the gold standard diagnostic assessment tools.

Training is available through Annie’s Centre in Sydney, La Trobe University and Monash University in Melbourne, and through a Graduate Certificate in Autism Diagnosis at the University of Western Australia.

Push for a standardised approach The Cooperative Research Centre for Living with Autism (Autism CRC), which works in partnership with OTARC, is examining diagnostic practices for autism spectrum disorder across Australia and aims to establish a baseline of current assessment processes.

The study is an essential first step towards developing national standards for autism spectrum disorder diagnosis in Australia.

Dr Chalfant says for too long, assessment of autism spectrum disorder has varied from clinician to clinician depending on their interpretation of social and communication deficits as well as fixated and repetitive behaviours.

For the full article visit HealthTimes.com.au HealthTimes - March 2016 | Page 25

Unnecessary health tests, treatments and procedures to avoid Physiotherapists say routine imaging for non-specific low back pain and for the cervical spine in trauma patients should be avoided.

The Australian Physiotherapy Association (APA) advice is part of 61 new recommendations for tests, treatments and procedures that are often unnecessary and can also harm Australian patients.

Physiotherapy’s peak professional body has joined 13 colleges and societies representing health practitioners including nurses, hospital pharmacists, pathologists, radiologists, GPs, surgeons and palliative care specialists, as part of the NPS MedicineWise Choosing Wisely Australia campaign.

The APA’s six recommendations include urging physiotherapists against routinely using spirometry after upper abdominal and cardiac surgery, to avoid using electrotherapy modalities for patients with low back pain, and to avoid ongoing manual therapy for patients with adhesive capsulitis of the shoulder.

It also urged physiotherapists against requesting imaging for acute ankle trauma unless indicated by the Ottawa Ankle Rules (OAR).

APA vice president Phil Calvert said the association’s recommendations are the result of almost 3000 responses to a member survey, which were then put to a panel of physiotherapy experts.

“We really recognise that the recommendations are just that - they’re recommendations,

Page 26| www.HealthTimes.com.au

they’re to be used as a guide. We understand every clinical situation is different,” he said.

“I think physiotherapy as a profession is very, very good at looking at what it does critically evaluating what it does.

“This forms part of that but I think the real thing that we’re focused on here is the opportunity to actively engage and have good conversations with our patients.”

One of the APA recommendations urges physiotherapists against requesting imaging for patients with non-specific low back pain, with trials consistently showing routine imaging has no advantages while there are potential harms, such as exposure to radiation.

“Imaging is instead recommended for cases of low back pain where there is a suspicion of an underlying medically serious disease, like cancer or infection. Patients with a higher likelihood of medically serious disease as the cause of their low back pain can be identified by red flags, like a history of cancer,” the recommendation states.

Mr Calvert said people presenting with the common problem of acute low back pain often mistakenly believe that imaging will identify the cause of their pain.

“We know that people who come to see a health professional will come with often very specific expectations about what their care might be,” he said.

For the full article visit HealthTimes.com.au

603-0061PG FULL COLOUR CMYK PDF

Great jobs for health professionals (you won’t find anywhere else)

Registered Nurses Central Coast - Very attractive opportunities for continued career progression.

Assistant Director of Clinical Services Cairns - Career opportunity Assistant Director of Clinical Services for a busy Day Surgery Unit.

Clinical Supervisor - Mental Health Sydney - Be recognised as an industry leader, work with a recognised, respected provider.

Registered Nurse Wagga Wagga - Competitive remuneration and excellent, flexible, working conditions.

These and hundreds more great job opportunities at

HealthTimes.com.au HealthTimes - March 2016 | Page 27

ANMF calls for around-the-clock registered nurses in aged care The Australian Nursing and Midwifery Federation (ANMF) wants a registered nurse on duty around-the-clock in all of the nation’s aged care facilities to improve care for vulnerable older patients with complex and chronic conditions.

The ANMF has called for mandated 24/7 RNs in residential aged care facilities as one of six recommendations outlined in its submission to a Senate inquiry set to shine the spotlight on the future of Australia’s aged care sector workforce.

The ANMF has also recommended mandated minimum staffing levels and skill mix for RNs, enrolled nurses (ENs) and assistants-in-nursing (AINs) or personal care workers (PCWs) in aged care, and for minimum education and licensing for AINs. It’s also pushing to close the wages gap between nurses and AINs working in aged care and their public hospital colleagues.

ANMF federal secretary Lee Thomas said the recommendations aim to strengthen the underresourced workforce in the midst of a shortage of 20,000 nurses, in a sector where nurses are undervalued and underpaid.

Ms Thomas said the size and composition of the direct care workforce is the key ingredient to providing quality, safe care to the nation’s rapidly ageing population.

“Staffing levels must be urgently addressed,” she said.

“Without legislated requirements in all Australian jurisdictions to mandate a minimum number and type of nursing and care staff, safe and quality care for the elderly cannot be assured. That is a huge concern for all of us.”

The inquiry, due to report on June 30, will consider areas including future aged care workforce requirements, challenges in attracting and retaining aged care workers, and aged care

Page 28| www.HealthTimes.com.au

workforce difficulties in regional towns and remote communities.

It will also examine remuneration, working environment, staffing ratios, education and training, skills development and career paths for aged care workers.

The ANMF submission shows the changing composition of the aged care workforce at a time when a growing number of residents are being assessed as high care.

It states the number of full-time equivalent (FTE) RNs in residential aged care dropped 14 per cent between 2003 and 2012, the number of ENs rose slightly at 0.5 per cent while the number of AINs/PCWs grew 50 per cent.

The shift away from employing RNs coincided with a 25 per cent increase in the number of operational residential aged care places, rising from more than 151,000 in 2003 to more than 189,000 in 2014.

There’s also been a rise in the number of residents assessed as high care, from 64 per cent in 2003 to 83 per cent in 2014, while more than half of residents had a diagnosis of dementia in 2014.

The ANMF says it strongly supports AINs/ PCWs in aged care as an integral part of the nursing team alongside RNs and ENs. “However, the workforce data clearly indicates a substantial shift towards the employment of AINs/PCWs at the expense of registered and enrolled nurses in a care environment where the work in many instances requires the skills and knowledge of either a registered or enrolled nurse,” the submission states.

“The consequence of this shift is that the quality of care provided to the elderly has been directly affected.”

For the full article visit HealthTimes.com.au

603-038 1PG FULL COLOUR CMYK PDF 602-022

Aged Care

Career Opportunities in beautiful Ballarat!

Bupa Aged Care is excited to be opening a brand new 144 bed care home in Ballarat, due to open in May. We are Australia’s largest private residential aged care provider, caring for over 6,000 residents across 65+ homes and delivering an innovative model of care.

We are looking for the following passionate people with a person-first approach to join our team: • • • • •

Care Manager Clinical Manager Registered Nurse Enrolled Nurse Personal Care Assistant

To learn more about the opportunities available, visit BupaAgedCare.com.au/careers/

HealthTimes - March 2016 | Page 29

602-007 601-013 603-007 1PG FULL COLOUR CMYK PDF

Time to give your career a lift?

BSc (Hons) Nursing Studies (top up) Online course

Graduate Diploma of Cosmetic Nursing Online and classroom

Catheterise with Confidence Classroom - Melbourne

Sharing Innovation in Healthcare Delivery Classroom - Cruise, sailing out of Vancouver

Master of Healthcare Leadership Online

Master of Emergency Health Classroom - Melbourne

Search Postgraduate and CPD course opportunities at HealthTimes.com.au

Page 30| www.HealthTimes.com.au

603-002 1PG FULL FULL COLOUR COLOUR CMYK CMYK PDF PDF 602-003 1PG

Cleveland Clinic Abu Dhabi is now hiring Information days & Interviews as follows: MEL 5th & 6th April - BRIS 8th April - SYDNEY 10th & 11th April PLUS SKYPE Interviews available for NZ applicants – BOOK TODAY! Cleveland Clinic Abu Dhabi, part of Mubadala’s network of world-class healthcare facilities, is a multispecialty hospital on Al Maryah Island in Abu Dhabi, UAE. Cleveland Clinic Abu Dhabi is a unique and unparalleled extension of US-based Cleveland Clinic’s model of care, specifically designed to address a range of complex and critical care requirements unique to the Abu Dhabi population.

Benefits: In addition to being part of an international clinical team, successful applicants will receive accommodation, a transportation allowance, health insurance, annual travel allowance to home country and generous annual leave package.

VACANCIES

Nurse Practitioners

Staff Nurses: Medical/Surgical (for VIP and Royal Critical Care), Emergency, ICU, ICU Step Down, Critical Care Transport, Radiology, Cath Lab, Theatre, PACU, Heart and Vascular Institute/Medical and Endoscopy/Procedures areas. Ambulatory Care Nurses (large out-patient department) with experience in: Urology, Ophthalmology, Multiple Sclerosis, Coagulation Management, Imaging & Dermatology/Neurology/DDI procedures.

Infection Control Practitioners Allied Health Professionals: Dieticians, Physiotherapists, Occupational Therapists, Speech Therapists, Laboratory Technologists (Blood Bank, Chemistry, Haematology), Cardiovascular Technologists (with EP experience), Electroneurodiagnostic Technologists, Sonographers, Echo Technologists, General X-Ray Technologists, Nuclear Medicine Technologists, MRI Technologists and Exercise Physiologists.

To apply, please email: Dawn at dawn@ccmrecruitment.com.au or Raquel at raquel@ccmrecruitment.com.au or by phone at Free Phone AUS: 1800 818 844, Free Phone NZ: 0800 700 839

www.ccmrecruitment.com HealthTimes - March 2016 | Page 31

PRINT POST

POSTAGE PAID AUSTRALIA

Seabreeze Communications Pty Ltd (ABN 29 071 328 053) PO Box 6744, Melbourne, VIC 3004

603-008 1/2PG FULL COLOUR CMYK PDF

CHANGE OF ADDRESS: If the information on this mail label is incorrect, please email contact@healthtimes.com.au with the address that is currently shown & your correct address.

Mental Health Nurses.

You are in demand!

Medacs Healthcare are currently seeking experienced Mental Health Nurses for the following opportunities: Perth, fulltime - RN with post grad qualification in mental health. Day shifts only. $92k + Super NSW - Short term rural contracts available in hospital and community mental health, 2 - 13 wks Casual and flexible mental health nursing shifts avail in Sydney metro region. Great Pay Rates!

Contact us for more temp or perm opportunities.

Page 30| www.HealthTimes.com.au

For more information call or email the Medacs Healthcare Nursing Team today.

We care about our Nurses!

Contact Us Email: nurses@medacs.com.au Telephone: 1800 059 790 www.medacs.com.au

Printed by BMP - Freecall 1800 623 902

100015906