Australian journal of primary health
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Nurses are well positioned to initiate and conduct advance-care planning (ACP) conversations; however, there has been limited research on practice nurses performing this role in Australia. The aim of the present study was to understand the beliefs, attitudes, perceptions, confidence, training and educational needs of New South Wales practice nurses with regards to involvement in ACP. A cross-sectional online survey was conducted in August to October 2014. ⋯ Nurses were also concerned over legalities of ACP, ethical considerations and their understanding of end-of-life care options. Nevertheless, they were highly receptive of integrating ACP discussions and were willing to enhance their skills. These findings uncover a need for further training and development of practice nurses for ACP discussions.
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Prescribing guidelines are an essential component of antimicrobial stewardship programs in Australian hospitals. Nonetheless, the majority of antibiotic prescribing occurs in the community and the effectiveness of guidelines developed specifically to meet the needs of Australian general practice is unknown. This study aims to assess the uptake and effectiveness of a quick reference guide to antibiotic prescribing among primary care prescribers. ⋯ Thirty-three surveys were returned and, of those answering specific sections, 75% were aware of the guide and 71% had used it within the last month. The guide affected the antibiotic prescribing practice of 74% of responding prescribers; most often on choice of antibiotic; but also on duration of treatment, dose and dosing frequency. A quick reference guide to antibiotic prescribing was well received by prescribers and may usefully support efforts to improve antimicrobial stewardship in the community.
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Monitoring patient experience is essential for stimulating innovation in health care and improving quality and accountability. Internationally, standardised approaches are used to collect patient experience information, but in Australian primary health care (PHC), little is known about which patient experience surveys are used and which aspects of experience they measure. This prevents routine inclusion of patient experience data in quality improvement or system performance measurement. ⋯ Collection of patient experience data in Australian PHC is not well developed or standardised and there are few publicly available instruments. There is a need to clearly identify the purposes for which data are to be used and to develop an integrated approach that articulates these collections with other quality and performance data. Some options are discussed.
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The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women's experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. ⋯ The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.
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Pharmacists are well positioned to provide quality care to people with low back pain (LBP). Education and training can equip pharmacists with the knowledge to optimally manage LBP in primary care. The aim of this study was to investigate the knowledge and satisfaction of pharmacists who attended a 2-h educational workshop on the evidence-based management of LBP. ⋯ Ninety-nine per cent of pharmacists identified the symptoms presented in the vignette as a syndrome representing a significant clinical red flag requiring urgent referral. This educational intervention has delivered key messages on LBP management to pharmacists. There is a continued need for educational interventions addressing common conditions.