To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1111/add.12998 or contact your DHB library, or organisational or local library for assistance.

West, R., et al. (2015). Healthcare interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development. Addiction, 29 May [Epub before print].

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.12968/ijpn.2015.21.5.225 or contact your DHB library, or organisational or local library for assistance.

Langemo, D., et al. (2015). Evidence-based guidelines for pressure ulcer management at the end of life. International Journal of Palliative Nursing, 21 (5).

Nationally 33% of people with a mental health problem smoke compared to 18.7% in the population as a whole. A PHE and NHS England survey found that smoking rates among service users in mental health units is even higher at 64%. 

PHE and NHS England have published new guidance to help medium and low secure mental health units best implement the NICE recommendation that all NHS funded sites should provide access to on-site stop smoking services and deliver care in an environment free of smoke.

The guidance highlights case studies which show the benefits of completely smokefree mental health units, where service users are provided support to stop smoking. This has resulted in:

• better patient health
• freeing up staff time
• improved ward atmosphere

Alongside the physical health improvements, an increasing body of research is finding that mental health can be improved by stopping smoking. Contrary to the myth, evidence shows that stopping smoking is associated with reduced depression, anxiety, stress and improved positive mood and quality of life.

Evidence also shows that people who smoke often require higher doses of psychotropic medication as smoking increases the metabolism of these drugs.

To view the guidance and/or the evidence used to create the guidance, go to:  http://www.nice.org.uk/guidance/NG10

These guidelines led by Philip Britton and ASID President, Cheryl Jones, were drafted by the Australasian Society of Infectious Diseases (ASID) Clinical Research Network (CRN) Encephalitis interest group, then endorsed by ASID through the ASID clinical guidelines committee (including ASID NZ), the Australasian College of Emergency Medicine (ACEM), the Australian and New Zealand Association of Neurologists (ANZAN) and the Public Health Association of Australia (PHAA) who are co-authors on the guidelines. 

Click HERE to read the guidelines.

Britton, P. N., et al. (2015), Consensus guidelines for the investigation and management of encephalitis in adults and children in Australia and New Zealand. Internal Medicine Journal, 45: 563–576. 

The authors conclude from the results that "despite experienced critical care practitioners being able to deliver quality end-of-life care without using the Liverpool Care Pathway, junior nursing and medical staff need clear guidelines and support from experienced mentors in practice. Evidence-based guidelines related to family involvement in end-of-life care planning in critical care settings are also needed to avoid future controversies".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1111/jan.12680 or contact your DHB library, or organisational or local library for assistance.

Ramasamy Venkatasalu M., Whiting D. & Carinduff K. (2015) Life after the Liverpool Care Pathway (LCP): a qualitative study of critical care practitioners delivering end-of-life care. Journal of Advanced Nursing, 14 May [Epub before print]

http://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/

• Factors that can affect laboratory investigations
• The New Zealand Laboratory Schedule and Test Guidelines: Anatomic Pathology Tests
• Identifying and managing hereditary haemochromatosis in adults

To view this issue in full text, go to:  http://www.bpac.org.nz/BT/2015/April/contents.aspx

Two RCTs and four CRCTs were included, involving 352 physicians, 48 residents, and 135 allied health practitioners. The authors describe the quality of the evidence as low. They conclude that, " .... when provided with a combination of EHI and training, practitioners used the information more often. Two studies measured doctors' use of electronic treatment guidelines, but showed that the electronic aspect of the guidelines did not mean that doctors followed the guidelines. This review provided no information on whether more frequent use of EHI translated into improved clinical practice or whether patients were better off when doctors or nurses used health information when treating them".

This article can be read in free full text at:  http://dx.doi.org/10.1002/14651858.CD004749.pub3

Fiander M, McGowan J, Grad R, Pluye P, Hannes K, Labrecque M, Roberts NW, Salzwedel DM, Welch V, Tugwell P. (2015). Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes. Cochrane Database of Systematic Reviews, 3, CD004749.

They conclude that, "in 2015, the various international guidelines for GDM continue to show major discrepancies in the prevalence and the women classified dissimilarly. A consensus on a single global guideline would be a giant leap forward".

To read the full abstract, and for information on how to access the full text, go to: http://www.jdcjournal.com/article/S1056-8727%2815%2900102-6/abstract or contact your DHB library, or organisational or local library for assistance.

 Agarwall, M.M., et al. (2015). Gestational diabetes: Differences between the current international diagnostic criteria and implications of switching to IADPSG. Journal of Diabetes and its Complications, 29(4), 544–549

Documents that described or evaluated the processes of planning or undertaking implementation were identified in several publications that had systematically identified such resources, and by searching medical literature databases (MEDLINE, EMBASE). 

Thirty-five documents were eligible. Of these, 16 (45.7%) provided sparse information on implementation planning, 25 (71.4%) mentioned different versions or tools for implementation, and 30 (85.7%) listed options for dissemination or implementation. None provided instructions for operationalizing implementation strategies.

Data were integrated into a multi-item Guideline Implementation Planning Checklist including considerations for implementation planning (12), development of implementation tools (8), types of implementation tools (12), and options for dissemination (11) and implementation (12).

Developers or users can apply the Guideline Implementation Planning Checklist to prepare for and/or undertake guideline implementation. Further development of the checklist is warranted to elaborate on all components. In ongoing research, the authors plan to consult with the international guideline community to do so. 

This is an open access article and is available to read in free full text at:  http://dx.doi.org/10.1186/s13012-015-0205-5

Gagliardi, A.R., et al. (2015). Developing a checklist for guideline implementation planning: Review and synthesis of guideline development and implementation advice. Implementation Science, 10:19.

It has been developed in partnership between the Ministry of Education on behalf of the Children’s Action Plan Directorate and Child Matters, a Hamilton-based NGO with child protection expertise.

The guideline is available at:  http://childrensactionplan.govt.nz/assets/CAP-Uploads/childrens-workforce/Safer-Recruitment-Safer-Children.pdf

The guide is available at:  http://www.hdc.org.nz/complaints/the-complaint-process/complaints-management-guide-for-general-practice

Social Development Minister Anne Tolley today launched two new guidelines for agencies and organisations working with children as part of the Government’s Children’s Action Plan. 

The Guidelines; Safer Recruitment, Safer Children and Safer Organisations, Safer Children advise on how employers of the children’s workforce can consistently recruit safe people to work with children, and how to develop good child protection policies that enable their workers to better identify and respond to the needs vulnerable children.

Mrs Tolley launched the guidelines in Hamilton with local leaders, community groups and those setting up the new Hamilton Children’s Team.

“Every child has the right to be safe from abuse and neglect and these guidelines will help us build a stronger culture of child protection across New Zealand where the safety and security of children is paramount.

“By far the majority of our children’s workforce is safe and conscientious but we know predators target opportunities to be around children – these guidelines provide practical steps to help organisations to manage against that risk,” said Mrs Tolley.

The Vulnerable Children Act 2014 requires state sector agencies who work with children, and the organisations they fund to have child protection policies in place and will phase in a requirement for all paid children’s workers to be safety checked in a consistent way.

Mrs Tolley paid tribute to Child Matters for co-producing the safety checking guidelines Safer Recruitment, Safer Children.

“The Children’s Action Plan is about government and communities working together to better support vulnerable children.  These guidelines are an example of that innovative partnership.”

“The Hamilton Children’s Team will be the country’s first large urban team following the establishment of Children’s Teams in Rotorua, Whangarei, Horowhenua/Ōtaki and Marlborough.

“When it is fully up and running, the Hamilton Children’s Team will be the first big team of frontline practitioners supporting around 1,400 vulnerable children and their families,” Mrs Tolley said.

“Hamilton is renowned for its strong community sector and as a result is well placed to test new initiatives being developed as part of the Children’s Action Plan. 

The region will trial the Vulnerable Kids Information System (Viki) under an Approved Information Sharing Agreement as well as a new Hub triage process to better coordinate services and information for at risk children.

“Today’s launch marks exciting progress in a new children protection system for the country that will prioritise the needs of our most vulnerable children helping ensure they get the right services at the right time to be happy, healthy and safe,” said Mrs Tolley.

For more information on the Children’s Action Plan and guidelines: http://childrensactionplan.govt.nz/

To read more, go to: https://www.nice.org.uk/news/article/first-bladder-cancer-guideline-to-reduce-variations-in-care

To read the full story on the Open for Better Care website, go to:  http://www.open.hqsc.govt.nz/news-and-events-2/news/2001/

The purpose of this review is to synthesise findings of studies that implemented the CCM in primary care, in order to identify facilitators and barriers encountered during implementation.

This review identified barriers and facilitators of implementation across various primary care settings in 22 studies. The major emerging themes were those related to the inner setting of the organisation, the process of implementation and characteristics of the individual healthcare providers. These included: organisational culture, its structural characteristics, networks and communication, implementation climate and readiness, presence of supportive leadership, and provider attitudes and beliefs.

The authors conclude that these findings highlight the importance of assessing organisational capacity and needs prior to and during the implementation of the CCM, as well as gaining a better understanding of health care providers' and organisational perspective.

This is an open access article and is available to read in free full text at:  http://dx.doi.org/10.1186/s12875-014-0219-0

Kadu, M. & Stolee, P. (2015). Facilitators and barriers of implementing the chronic care model in primary care: A systematic review. BMC Family Practice, 16:12.

This evidence-based framework provides comprehensive advice on optimal perioperative care for the patient undergoing gastrectomy and facilitates multi-institutional prospective cohort registries and adequately powered randomized trials for further research.

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1002/bjs.9582 or contact your DHB library, or organisational or local library for assistance.

Mortensen, K., et al. (2014). Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. British Journal of Surgery, 101(10), 1209–1229.

The study was based on data from the NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults aged 50–71 years at recruitment in 1995–1996, and followed for a median of 10.5 years for cancer incidence, 12.6 years for cancer mortality, and 13.6 years for total mortality.

Based on the results of their analysis, the authors conclude that, "in both men and women, adherence to the ACS guidelines was associated with reductions in all-cancer incidence and the incidence of cancer at specific sites, as well as with reductions in cancer mortality and total mortality".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.3945/ajcn.114.094854 or contact your DHB library, or organisational or local library for assistance.

Kabat, G.C., et al. (2015). Adherence to American Cancer Society cancer prevention guidelines and cancer incidence, cancer mortality, and total mortality. American Journal of Clinical Nutrition, 101(3), 558-569.

In the latest issue (attached below):

The clinical guideline was developed by Auckland Uniservices using an expert working group after an extensive literature review, and was funded by the Ministry of Health as part of the Maternity Quality Initiative.

The guideline is available to download and read in free full text at:  http://www.health.govt.nz/publication/screening-diagnosis-and-management-gestational-diabetes-new-zealand-clinical-practice-guideline

Ministry of Health (2014). Screening, diagnosis and management of gestational diabetes in New Zealand: A clinical practice guideline . Wellington: Ministry of Health.

Health Minister Jonathan Coleman says all pregnant women will be routinely screened for diabetes as part of new national guidelines.

“Diabetes is one of our biggest health challenges in New Zealand. We need to ensure best practice for screening and managing diabetes in pregnancy to reduce the health risks for both mothers and babies,” says Dr Coleman.

“The new national guidelines on gestational diabetes will ensure more consistency across DHBs, and all pregnant women will have access to early diagnosis and management of diabetes in pregnancy.”

Following an extensive clinician-led process over the last two years, the Ministry of Health has compiled national guidelines which DHBs are expected to implement over the next 18 months.

Many of the 37 evidence-based recommendations are already in place across the country. The Ministry of Health will work with DHBs on implementation, and ensure they are integrated into DHB Maternity Quality and Safety Plans.

“DHBs currently do limited screening for diabetes in pregnant women. Under the new guidelines, DHBs will progressively introduce screening over the next 18 months,” says Dr Coleman. 

“We expect the new guidelines will result in more women being diagnosed earlier with gestational diabetes and type 2 diabetes. Early diagnosis means pregnant mothers will be able to get the advice and support they need.”

Gestational diabetes occurs when a pregnant woman cannot produce enough insulin which can lead to high blood sugar levels. Although the condition is temporary, it increases the risk of complications for mother and baby, and it significantly increases the woman’s risk of getting type 2 diabetes in the future.

The new guidelines can be found at www.health.govt.nz.

The guide summarises the recommendations in the clinical practice guideline Screening, Diagnosis and Management of Gestational Diabetes in New Zealand.  The clinical guideline was developed by Auckland Uniservices using an expert working group after an extensive literature review, and was funded by the Ministry of Health as part of the Maternity Quality Initiative.

The quick reference guide is available to download in free full text at:  http://www.health.govt.nz/publication/diabetes-pregnancy-quick-reference-guide-health-professionals-screening-diagnosis-and-treatment

Ministry of Health (2014). Diabetes in Pregnancy: Quick reference guide for health professionals on the screening, diagnosis and treatment of gestational diabetes in New Zealand. Wellington: Ministry of Health

All guidelines in the issue are available to read in free full text:  http://onlinelibrary.wiley.com/doi/10.1111/imj.2014.44.issue-12b/issuetoc

Specific objectives include identifying and prioritising at-risk population groups for targeted intervention of LTBI testing and treatment, including defining an algorithm, and recommending specific treatment options. The guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management based on available resources, epidemiology of TB including intensity of transmission, the health-care delivery system of the country, and other national and local determinants.

The guidelines are primarily targeted at high-income or upper middle-income countries with an estimated TB incidence rate of less than 100 per 100 000 population.

The guidelines are available to download and read in free full text at:   http://www.who.int/tb/publications/ltbi_document_page/en/

World Health Organization (2015). Guidelines on the management of latent tuberculosis infection. Geneva: World Health Organization.

The authors describe the establishment of a multidisciplinary European Association of Palliative Care Taskforce and its work to scope the extent of and learn what facilitates and hinders the development of palliative care in the community across Europe.

The publication is available to download and read in full text at: http://www.health.govt.nz/publication/self-management-support-people-long-term-conditions

Ministry of Health (2014). Self-management support for people with long-term conditions. Wellington: Ministry of Health.

The nurses work in their own ways with people from a wide range of backgrounds. They deliver personalised interventions which respond to the voices of the patients and are within the evidence-based Stop Smoking Guidelines.

Smokefree Nurses invites anyone who is interested to use the videos to

• support nurses with delivering brief stop smoking intervention,
• show real nurses at work and
• address health inequalities.

The videos are available at: http://whatsmokersreallywant.co.nz/

There was a general agreement between the 12 moderate-to-high quality guidelines included for many practice recommendations. However, direct comparisons between guidelines were challenging.

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1093/ageing/afu143 or contact your DHB library, or organisational or local library for assistance.

Ngo, J. & Holroyd-Leduc, J.M. (2015). Systematic review of recent dementia practice guidelines. Age and Ageing, 44 (1), 25-33.

Fit for Frailty is produced in association with the Royal College of General Practitioners (RCGP) and Age UK, and aims to be an invaluable tool for social workers, ambulance crews, carers, GPs, nurses and others working with older people in the community. The guidance will help them to recognise the condition of frailty and to increase understanding of the strategies available for managing it.

This article discusses the guideline.

The article is available to read in free full text at: http://ageing.oxfordjournals.org/content/43/6/744.full

The guideline is available at: http://www.bgs.org.uk/index.php/resources-6/bgscampaigns/fit-for-frailty

Turner, G. & Clegg, A. (2014). Best practice guidelines for the management of frailty: A British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age and Ageing, 43(6), 744-747.

• Evidence-based medicine
• Clinical practice guidelines
• Clinical decision making
• Clinical services organisation
• Implementation and delivery
• Health economic evaluation
• Health process
• Outcome measurement and
• New or improved methods (conceptual and statistical) for systematic inquiry into clinical practice.

Although the information in this document may be of benefit to the community as a whole, it is intended to apply to clinicians with a view to advocating cessation of smoking and ensuring optimal timing for cessation".

The guidelines are available to read at: http://www.anzca.edu.au/resources/professional-documents/pdfs/ps12-2013-guidelines-on-smoking-as-related-to-the-perioperative-period.pdf

A background paper is available at: http://www.anzca.edu.au/resources/professional-documents/pdfs/ps12-bp-2013-guidelines-on-smoking-as-related-to-the-perioperative-period-background-paper.pdf

In this issue:

• Patient Safety Week workshops with Jim Bagian
• Focus on reducing perioperative harm
• Winners of the surgical safety checklist video competition
• Update from the Medication Safety programme
• Call for nominations for the Commission's mortality review committees
• Quality and safety markers show improved falls assessment and care planning
• Australian and New Zealand guidelines for hip fracture released.

To read the e-update, go to: http://www.hqsc.govt.nz/news-and-events/news/1791/

The book is divided into 15 sections, which include: decision support systems and clinical practice guidelines; improved healthcare through informatics; data analysis; mobile health; technology and system evaluation; and text mining. The final two sections present posters from the conference.

This e-book is open access and the content can be downloaded and read in full text at: http://ebooks.iospress.nl/volume/e-health-for-continuity-of-care-proceedings-of-mie2014

Information for patients and caregivers just got better with the launch of patient pathways on the Central Primary Health Organisation website.  The pathways outline the steps used by local health professionals in the diagnosis and management of health conditions.  Access to this information will enable patients and their families/whānau to be better informed about what to expect and to have greater confidence in the care provided to them.   

The patient pathways have been developed as part of the Collaborative Clinical Pathways programme initiated in 2011.  These clinical pathways provide health professionals throughout the MidCentral district with patient-centred, evidence-based best practice care.  The pathways have been developed locally by clinicians working both in the community and within the hospital.  John Hannifin, a consumer representative, has worked alongside clinicians to adapt the pathways for patients.  John comments “Patients are always sharing their information with clinicians; in this case the clinicians are sharing the information about how they work with their patients”. 

Patients and caregivers can expect to find information in the pathways that has not been widely available to date.  For example, the Gastroenteritis in Children (Stomach Bug) patient pathway alerts caregivers to the free hydration fluids (pedialyte) service and advice available from most pharmacies.  The Eczema in Children patient pathway refers to the MidCentral DHB’s Children’s Eczema Service.   Patients can also see some of the time periods for trying different treatments and when they can expect to be referred for specialist treatment.     

“The patient pathways enable patients and their families/whānau to understand the steps used in the diagnosis and management of their health conditions”, says Dr Delamy Keall, Clinical Lead of the Collaborative Clinical Pathways programme.  “The patient pathways align exactly with the collaborative clinical pathways available to all doctors, nurses, pharmacists, primary health providers, and other health professionals in the MidCentral district.”

The patient pathways are publicly available on the Central PHO website at http://www.centralpho.org.nz/CollaborativeClinicalPathways/PatientInformation.aspx.   The pathways can be printed.  Links to other useful resources are also provided.  The website will be regularly updated as other patient pathways are finalised. 

Attachments:

• Example:  Eczema in Children – Patient Pathway
• Example:  Gastroenteritis (Stomach Bug) – Patient Pathway

This clinical practice guideline was developed using a rigorous scientific methodology to appraise available research and make 575 evidence-based recommendations.

The Guideline also includes the NPUAP/EPUAP International Pressure Ulcer Classification system, complete with full Category/Stage descriptions and illustrative photography.

The Practice Guideline is the result of a collaborative effort between three international organisations:

• National Pressure Ulcer Advisory Panel 
• European Pressure Ulcer Advisory Panel 
• Pan Pacific Pressure Injury Alliance (consisting of the Australian Wound Management Association, Hong Kong Enterostomal Therapists Association Society, New Zealand Wound Care Society, and the Wound Healing Society Singapore).

To download the quick reference guide or order a print copy of the full guidelines, go to: http://www.nzwcs.org.nz/publications/70-2014-prevention-and-treatment-of-pressure-ulcers-clinical-practice-guideline

In August 2013, the authors searched Facebook and three top Internet search engines using smoking cessation keywords to identify relevant Facebook apps. Resultant apps were screened for eligibility (smoking cessation-related, English language, and functioning). Eligible apps were reviewed by 2 independent coders using a standardized coding scheme. Coding included content features (interactive, informational, and social) and adherence to an established 20-item index (possible score 0-40) derived from the US Public Health Service’s Clinical Practice Guidelines for Treating Tobacco Use and Dependence.

Twenty-two apps were screened for eligibility. Of these, 12 underwent full coding. Only 9 apps were available on Facebook. Facebook apps fell into three broad categories: public pledge to quit (n=3), quit-date–based calculator/tracker (n=4), or a multicomponent quit smoking program (n=2). All apps incorporated interactive, informational, and social features except for two quit-date–based calculator/trackers apps (lacked informational component). All apps allowed app-related posting within Facebook (ie, on self/other Facebook profile), and four had a within-app “community” feature to enable app users to communicate with each other. Adherence index summary scores among Facebook apps were low overall (mean 15.1, SD 7.8, range 7-30), with multicomponent apps scoring the highest.

The authors conclude that there are few smoking cessation apps available within Facebook. Among those available, adherence to cessation treatment guidelines was low. Smoking cessation interventions provided via the Facebook platform are a unique and as yet untapped treatment strategy that can harness existing social support and social networks for quitting. Research is needed to examine whether apps that adhere to clinical practice guidelines for tobacco dependence treatment are more effective in promoting cessation than those that do not.

This is an open access article and is available to read in full text at: http://dx.doi.org/10.2196/jmir.3491

Jacobs, M.A., et al. (2014). Facebook apps for smoking cessation: A review of content and adherence to evidence-based guidelines. Journal of Medical Internet Research, 16(9), e205.

The authors included 101 full-text articles in the analysis. The most frequent study design was pre-post, followed by prospective, population based case series or consecutive case series, and randomized trials. Paper-based reminders were the most frequent with fully computerized, then computer generated, and other modalities. No study reported a decrease in health care practitioner performance or declining patient outcomes. The most common primary outcome measure was compliance with provided or prescribing guidelines, key clinical indicators such as patient outcomes or quality of life, and length of stay.

The authors conclude that the number of publications on asthma protocol reminder systems is increasing. The number of computerized and computer-generated studies is also increasing. Asthma guidelines generally improved patient care and practitioner performance regardless of the implementation method.

This is an open access article and is available to download and read in full text at: http://dx.doi.org/10.1186/1472-6947-14-82

Dexheimer, J.W., et al. (2014). A systematic review of the implementation and impact of asthma protocols. BMC Medical Informatics and Decision Making, 14:82.

Based on 163 responses (25% response rate) from 39 countries, they identified "... variability in the use of evidence-based guidelines, a continued reliance on giving patients information rather than investing in self-management training, suboptimal involvement of patients in the development of, and training on, care pathways, and reported challenges of evaluating the effectiveness of care pathways against a range of indicators". The authors discuss the implications of these findings.

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1179/1750168714Y.0000000028 or contact your DHB library, or organisational or local library for assistance.

Knai, C., et al. (2013). International experiences in the use of care pathways. Journal of Care Services Management, 7(4), 128-135

From 1 October 2014 UK schools will be allowed to keep a salbutamol inhaler for use in emergencies when a child with asthma cannot access their own inhaler.

A guidance document, publushed by the Department of Health will give schools that choose to keep an emergency inhaler the basis to create a policy or protocol for using it.

To read the guidance document, go to: https://www.gov.uk/government/publications/emergency-asthma-inhalers-for-use-in-schools

The paper provides an overview of obesity and type 2 diabetes among adults, describing the epidemiology of each disorder, how the two conditions are linked and why they present a major public health challenge. Latest available data and evidence from England illustrates prevalence trends in both obesity and diabetes at a national and local level as well as the potential implications in terms of health consequences, inequalities and cost. The paper also signposts latest relevant policy and guidance documents.

Access to the full text of the paper is free online at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/338934/Adult_obesity_and_type_2_diabetes_.pdf

This 2013 background guide, produced specifically for the use of health professionals, gives some background information on the main messages in the 'Healthy Heart' initiative.

Access to the full text of this guide is free online at: http://www.heartfoundation.org.nz/uploads/HF_HealthyHeart_Guide_Final.pdf

This 'Healthy Heart' guide is accessible from the Heart Foundation website.

The visual food guide shows the balance of foods to eat, foods that can be substituted for each other within food groups, and the types of food to eat for good health.

This 'Healthy Heart' guide is accessible from the Heart Foundation website.

While there may be differences between parliamentary and central and local government consultation processes, this guide provides general advice that applies to many submission opportunities. In particular, the guide is designed to help you work with communities to identify their concerns and responses on a particular issue and prepare and deliver their own written and oral submissions.

To access the full text of this resource, go to: http://www.rph.org.nz/content/998812a2-37c9-4a30-a3f5-997f971eaece.cmr

When it comes to prostate cancer diagnosis and treatment, Maori men emerge worse in most or all statistics and there is significant variation in screening between GP practices, with Maori and rural men less likely to be screened.

These are the key findings to emerge from a three-year study exploring the pathways of care associated with prostate cancer which was conducted by the Midland Cancer Network in conjunction with researchers from the University of Auckland.

The study was launched today at Waikato Hospital’s Bryant Education Centre, where Health Minister Tony Ryall featured as keynote speaker (read the Ministry of Health release).

Funded by the Health Research Council and Ministry of Health, the Midland Prostate Cancer Project researched access to quality of care, with a particular focus on urban vs. rural men and Māori vs. non-Māori men.

"We wanted to understand more about the care pathway for men following an abnormal prostate-specific antigen (PSA) test, and to demonstrate the equity issues, costs and complications arising from diagnosis,” says Professor Ross Lawrenson who led the study. 

“Among our findings, we have found significant variation in screening between GP practices, with Māori and rural men less likely to be screened.

“There is also considerable unnecessary screening of men aged 70 years and over, even in men over 70 years who were asymptomatic with a history of negative PSA results. Very few of these men went further along the pathway to the referral and biopsy stage.”

Speaking at the launch today, Mr Ryall said, “the study showed good results for men with prostate cancer. There is a high survival rate – with a majority of men surviving over ten years.

“It has also identified areas where we can make future improvements to the work already being done to improve patient care. 

“The report made 18 recommendations which support the work already underway by the Ministry of Health to improve health outcomes for men with prostate cancer.”

The study found that most PSA testing is conducted for screening purposes, most commonly when the individual is being examined for another reason. 

It also found that Māori men are significantly less likely to be screened and tested than non-Māori; that Māori men have an overall lower rate of prostate cancer than non-Māori men, but their mortality is much higher with Māori men being more likely to die with and of prostate cancer compared to non-Māori men. 

The researchers believe the disparity in survival rates is also a factor of location and socio-economic situations.

The study population was 37,529 New Zealand men who had been diagnosed with prostate cancer in the period 1 January 1996 - 31 December 2010, with 5748 (or 15 per cent) residing in the Midland Cancer Network region at the time of diagnosis. 

More than 30 GP practices in the region were involved with the study and helped researchers to identify the pathways for patients following diagnosis. 

Professor Lawrenson said the study also looked at the costs associated with prostate cancer which extend beyond the health professional to social, economic, psychological and physical effects, affecting both the man and his family.

This is particularly notable with Māori men.

“We interviewed more than 100 men who had been diagnosed with prostate cancer and found that many men and their families want more information at the primary health care level, and that Māori men and their families need long-term post-treatment support ranging from counselling to navigating the healthcare system,” he said.

“Our goal was to understand the prostate cancer pathway, across New Zealand and in the Midland Region in particular. 

“We believe our research shows that clear recommendations for GPs regarding PSA testing, referrals to specialists, monitoring after an abnormal PSA test, the recording of data, and post-treatment care and support will improve that pathway.”

Professor Lawrenson and his team have developed recommendations, including:

• Regional cancer networks to record basic information on all men newly diagnosed with prostate cancer.
• Primary healthcare professionals need to give patients more information and information that is culturally appropriate.
• Men newly diagnosed should have a digital rectal examination (DRE) as part of their initial assessment.
• Men over 70 who have had a previously negative PSA test should not be screened again.
• Standardisation in recording biopsies and histology.
• Clear guidelines for managing men with localised prostate cancer.
• Further research to identify the reasons for higher mortality for Māori men
• More support for Māori men and their partners who identified a higher long-term need for assistance with the healthcare system and further information
• Post-treatment counselling to manage social, economic, psychological and physics outcomes, particularly for Māori men and their partners
• Funding for dedicated sexual function support as part of post-treatment rehabilitation.

Read the prostate cancer study presentation [PDF, 1.1 MB]

High levels of data heterogeneity negated statistical synthesis. Instead, evidence for effectiveness was summarised narratively, according to each study's aim for assessing the impact of handheld computer use.

The authors included seven randomised trials investigating medical or nursing staffs' use of Personal Digital Assistants. Effectiveness was demonstrated across three distinct functions that emerged from the data: accessing information for clinical knowledge, adherence to guidelines, and diagnostic decision making.

When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources. When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources. Finally, healthcare professionals made significantly more appropriate diagnostic decisions using clinical decision making tools on handheld computers compared to colleagues who did not have access to these tools.

The authors conclude that future research is needed to replicate these early results and to identify beneficial clinical outcomes.

This is an open access article and is available to download and read in free full text at: http://dx.doi.org/10.1186/1472-6947-14-56

Mickan, S., et al. (2014). Use of handheld computers in clinical practice: a systematic review. BMC Medical Informatics and Decision Making, 14:56.

This guide will help you to navigate the strategy and provides a description of its various elements – including its overarching aim: Pae Ora – Healthy futures for Māori.

The guide is available to read at:  http://www.health.govt.nz/publication/guide-he-korowai-oranga-maori-health-strategy

The resources include a short case study video, workbook, Facilitator guide, certificate and evaluation sheet.

For further information and to download the resources, go to: http://www.fmhs.auckland.ac.nz/en/son/about/our-research/research-news-and-events/news/12082013_focus_on_quality.html

The video is available at: https://www.youtube.com/watch?v=ZDAF4IrlDuE

The "Silver rainbow NZ" facebook page contains links to resources and reports of interest about older rainbow populations.
https://www.facebook.com/pages/Silver-Rainbow-NZ/245961402250263

Studies reported in this issue (attached below):

These guidelines target both Pacific and non-Pacific researchers who are engaged in HRC-funded health research with Pacific populations residing in New Zealand and the realm countries of New Zealand (Cook Islands, Niue, and Tokelau). Researchers conducting non-HRC funded studies in Pacific communities may also find this document useful.

The guidelines aim to ensure that the research undertaken informs and empowers Pacific peoples about health research within their own communities, and their rights as research participants; provides an ethical and operational guide for health research that contributes to the attainment of the highest level of health and wellbeing for Pacific peoples in New Zealand; and provides a common template and shared vision on Pacific health research.

The guidelines are available to dowload at:  http://www.hrc.govt.nz/news-and-publications/publications/pacific

A number of other resources have also been developed that offer guidance on specific - topics (see Appendix 2). These resources can be found on the New Zealand guidelines for helping people to stop smoking page of the Ministry of Health website.

The document is available to download in free full text at:  http://www.health.govt.nz/system/files/documents/publications/abc-pathway-for-frontline-health-care-workers-jun14.pdf

Ministry of Health (2014). The ABC Pathway: Key messages for frontline health care workers. Wellington: Ministry of Health.

A number of other resources have also been developed that offer guidance on specific - topics (see Appendix 2). These resources can be found on the New Zealand guidelines for helping people to stop smoking page of the Ministry of Health website.

A number of other resources have also been developed that offer guidance on specific - topics (see Appendix 2). These resources can be found on the New Zealand guidelines for helping people to stop smoking page of the Ministry of Health website.

This background document is available at:  http://www.health.govt.nz/system/files/documents/publications/background-and-recommendations-of-the_new-zealand-guidelines-for-helping-people-to-stop-smoking.pdf

Ministry of Health (2014). Background and recommendations of The New Zealand guidelines for helping people to stop smoking. Wellington: Ministry of Health.

These Guidelines remain structured around the ABC pathway, which was introduced in the 2007 Guidelines. However, the definitions of A, B and C (see below) have been improved to emphasise the importance of making an offer of cessation support and referring people who smoke to a stop-smoking service.

To download the guidelines, go to:  http://www.health.govt.nz/publication/new-zealand-guidelines-helping-people-stop-smoking

A number of other resources have also been developed that offer guidance on specific - topics (see Appendix 2). These resources can be found on the New Zealand guidelines for helping people to stop smoking page of the Ministry of Health website.

Ministry of Health (2014). The New Zealand guidelines for helping people to stop smoking. Wellington: Ministry of Health.

This study used interviews with 25 GPs in New South Wales to explore GPs' descriptions of their CVD risk communication strategies, including the role of absolute risk.

The study demonstrated how GPs use three different communication strategies to address the issue of CVD risk, depending on their perception of patient risk, motivation and anxiety. Absolute risk played a different role within each strategy. The authors suggest that providing GPs with alternative ways of explaining absolute risk, in order to achieve different communication aims, may improve their use of absolute CVD risk assessment in practice.

This is an open access article and is available to read in free full text at: http://dx.doi.org/10.1186/1471-2296-15-106

Bonner, C., et al. (2014). Communicating cardiovascular disease risk: An interview study of General Practitioners' use of absolute risk within tailored communication strategies. BMC Family Practice, 15 :106.

To access the Handbook in PDF or Word format, go to:  http://www.health.govt.nz/publication/immunisation-handbook-2014

For other imunisation resources, go to the Ministry of Health website.

Ministry of Health. (2014). Immunisation Handbook 2014. Wellington: Ministry of Health.

To view the video, go to: http://www.hqsc.govt.nz/our-programmes/reducing-perioperative-harm/publications-and-resources/publication/1382/

The video, filmed at MidCentral District Health Board, shows all three parts of the checklist being used. It can be downloaded from the Commission’s website, or copies on a DVD or USB can be ordered free from the Commission by emailing .

Mr Ian Civil, the Commission’s reducing perioperative harm clinical lead, says the video demonstrates a theatre team going through the core set of safety checks to be performed as part of the checklist, including checking the team has the right patient in the operating theatre, they are intending to perform the correct operation, and making sure the patient has received antibiotics to prevent infection.

“The most important aspect of using the surgical safety checklist is ensuring the surgical team is engaged in its use.

“To date we have focused on getting people to use the checklist – now we want to shift that focus to a new way of using the checklist. For teams to use the checklist well they should all be engaged. This means all members stop other activities, concentrate on the checklist and are supportive of the process.

“Ensuring that everyone in the room has spoken at least once before the operation begins is important as research has shown they are more likely to speak up if they have concerns about patient safety.

While the video released today shows the checklist being run by a member of the nursing team, different methods, such as having the surgeon and anaesthetist run the checklist using large wall posters, are also now being trialed to help improve team engagement.

“We would also like to see more teams undertaking a briefing before the operations start for the day. This ensures all members know each other and understand each other’s roles. The team should also discuss anticipated problems with staffing or equipment, talk about expectations for the day and deal with any questions or concerns. This means everyone knows exactly what is, or should be happening.”

Mr Civil said some people were resistant to using briefings because they believed it would slow them down and they wouldn’t start on time.

“In reality, what we have seen is that the team will often identify issues before the day starts, meaning they can be more efficient and actually save time.

“But most importantly, people work better and take more ownership when they feel part of a team. If people feel they can speak up when they have concerns and make suggestions that can improve the way we work they are more engaged and enjoy their jobs, and this ultimately means we provide better and safer care for our patients.”

Those viewing the video might notice some familiar faces! Those featured include Commission Chair Professor Alan Merry, reducing perioperative harm clinical lead Mr Ian Civil and Dr Leona Wilson, Chair, Perioperative Mortality Review Committee, along with Dr Will Perry (surgical registrar), Kim Draper (anaesthetic technician), Mr Pravin Kumar (consultant surgeon), Ellie Aitkenhead (circulating nurse), Rachel Sturgess (circulating nurse), Hannah Witham (scrub nurse) and Dr Vik Singh (anaesthetist).

The Open for better care campaign is being led by the Health Quality & Safety Commission and is implemented regionally by DHBs and other health providers, and with the First, Do No Harm patient safety campaign in the Northern region.

You can find more information about the Commission’s reducing perioperative harm programme here.

To download a full text copy of the report, go to: http://apps.who.int/iris/bitstream/10665/111548/1/9789241506892_eng.pdf?ua=1

World Health Organization. (2014). Principles and considerations for adding a vaccine to a national immunization programme: From decision to implementation and monitoring. Geneva: World Health Organization.

To read the full abstract, and for information on how to access the full text, go to: http://www.heartlungcirc.org/article/S1443-9506%2813%2901368-1/abstract or contact your DHB library, or organisational or local library for assistance.

Iyngkaran, P., et al. (2014). Implementing guideline based heart failure care in the Northern Territory: Challenges and solutions. Heart, Lung and Circulation, 23 (5) , 391-406.

This statement from the American Heart Association/American Stroke Association summarises data on stroke risk factors that are unique to and more common in women than men, and expands on the data provided in prior stroke guidelines and cardiovascular prevention guidelines for women. It is also recommended that, to more accurately reflect the risk of stroke in women across the lifespan, a female-specific stroke risk score is investigated.

To read the full abstract, and for access to a free full text version of the article, go to: http://stroke.ahajournals.org/content/45/5/1545.abstract

Bushnell, C., et al. (2014). Guidelines for the prevention of stroke in women. A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45, 1545-1588.

To download the full guideline, go to: http://guidance.nice.org.uk/CG179

Nine papers were included. The authors find that "evidence that supports the use of surgical checklists in countries with a large number of protocols already in place is limited. Adequate checklist implementation plays a central role in checklist effectiveness, which in turn is dependent on multiple factors".

The authors conclude that, while the evidence from OECD member countries is non-conclusive, "... it does suggest that surgical checklists, when effectively implemented, have the potential to be effective at reducing complication and mortality rates following surgery".

Available to read in full text at:  http://onlinelibrary.wiley.com/doi/10.1111/ans.12168/full

Tang, R., Ranmuthugala, G. and Cunningham, F. (2014), Surgical safety checklists: A review. ANZ Journal of Surgery, 84: 148–154.

Among other features, the ‘iTreat’ contained disease management and antibiotic dosing guidelines and a contact number phonebook. and a favourites section. "Sixty eight per cent of participants felt the application saved them time during clinical activities .... The findings from this pilot study point towards the internal hospital environment as having a major impact upon smartphone usage. Participants viewed smartphone use as unprofessional in the ward-based setting, with a perceived negative attitude from other healthcare staff. An understanding of how healthcare staff choose to utilise smartphones in the clinical environment is crucial to enable the successful assimilation of smartphone technology into the hospital setting".

To read the full abstract, and for information on how to access the full text, go to: http://dx.doi.org/10.1177/1460458213478812 or contact your DHB library, or organisational or local library for assistance.

Payne, K.F.B., et al. (2014). A mixed methods pilot study to investigate the impact of a hospital-specific iPhone application (iTreat) within a British junior doctor cohort. Health Informatics Journal, 20(1), 59-73.