Practice Connect #41

Welcome to Practice Connect, a fortnightly update for practice managers, nurses and practice administration staff on relevant issues, upcoming events and education.


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Immunisation update 

WA Meningococccal ACWY Paediatric Vaccination Program 

The WA Meningococcal ACWY Paediatric Vaccination Program commenced in January this year and provides state-funded MenACWY vaccine for all children aged 12 months to five years.

Data in the Australian Immunisation Register (AIR) indicates that approximately 20% of children less than five years of age have received a dose of Men ACWY vaccine to date. Although this is a good start, more can be done to ensure WA children are protected against serious illness caused by MenACWY.

Further analysis of the AIR data also suggests many children who receive routinely scheduled vaccinations at 12 months, 18 months and four years of age are not being given the MenACWY vaccine.

The WA Department of Health states that the MenACWY vaccines are safe to administer at the same time as other scheduled childhood vaccines. Specifically, for the WA program:

  • Nimenrix® should be given a single dose to children aged 12 months to two years, including when they present for their scheduled vaccinations at 12 and/or 18 months
  • Menveo® should be given as a single dose to protect children aged two years to five years, including when they present for scheduled vaccinations on or after 3.5 years of age

Note: There is currently no government program to provide MenACWY vaccination to children aged less than 12 months. However, as a temporary measure to respond to vaccine shortage in the private market, in cases where Menveo® vaccine cannot be obtained privately, the WA Department of Health can supply Menveo® for children aged less than 12 months to finish a vaccination course that has already been started.

Please ensure that you consider offering MenACWY vaccination to all children aged 12 months to five years who attend your practice, even those who attend for another reason.

For more information on safety and administration, please visit here.

 

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My Health Record update 

Support for general practice 

Does your general practice require training or support implementing My Health Record? The WA Primary Health Alliance (WAPHA) is working with the Australian Digital Health Agency (ADHA) to ensure providers and consumers are ready for the expansion of My Health Record. General practices can request training by contacting Practice Assist on 1800 2 ASSIST (1800 2 277 478) or email myhealthrecord@wapha.org.au.

The WA Department of Health is planning to commence uploading public diagnostic imaging reports into a patient’s My Health Record from September 2018. PathWest pathology reports will also be available by December 2018. In addition, the ADHA is working with a number of private sector imaging and pathology providers to make their reports available.

The ADHA is holding a national ‘Diagnostic Reports and My Health Record’ webinar for healthcare providers on Tuesday, 27 March 2018 at 4.30 – 5.30pm. This webinar will provide an update on progress towards sharing of diagnostic reports with the My Health Record. To register, visit here

 

Further information on My Health Record 

If you require support implementing My Health Record at your practice or have general queries, you can contact the My Health Record team in WA via myhealthrecord@wapha.org.au. Another way to keep up to date around My Health Record is to follow WAPHA on LinkedIn via www.linkedin.com/company/wapha or on Twitter by following the Primary Health Networks – Country WA, Perth North Metro or Perth South Metro.

My Health Record events and webinars can be found on the WAPHA events calendar at www.wapha.org.au and all other information such as answers to frequently asked questions for providers can be found at www.myhealthrecord.gov.au.

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HealthPathways update 

Connecting local general practitioners with local specialists 

This year, HealthPathways is partnering with metropolitan health services to host several continuing professional development (CPD) events. These events are free and will bring attendees face to face with local specialists to share knowledge and increase awareness of local services.

The first education day was held at Fiona Stanley Hospital on Saturday, 10 March and was a great success. General practitioners and nurses heard from multiple Fiona Stanley Hospital specialists and executives who were honest in conveying the challenges they faced, whilst demonstrating willingness and commitment to work in collaboration with primary care. They generously shared their knowledge on a range of different topics and feedback received from the day was outstanding.

The following CPD events have been confirmed for 2018. Please save the date:

  • 26 May 2018 - Rockingham Hospital 
  • 9 June 2018 - Fremantle Hospital 
  • 23 June 2018 - Armadale Health Service 
Additional CPD events are planned at other metropolitan health services, however dates are yet to be confirmed. When confirmed, dates and detials will be available on the HealthPathways home page.

If there are topics you would like to see included in CPD events, please email healthpathways@wapha.org.au.

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New clinical guidelines for care during pregnancy  

THe Australian Government Department of Health has released a revised version of the Clinical Practice Guidelines - Pregnancy Care 

The 2018 edition of the guidelines combines Module One and Two of the Antenatal Care Guidelines, published in 2012 and 2014 respectively. Several chapters were reviewed and updated for this edition, in accordance with National Health and Medical Research Council (NHRMC) requirements for guideline development.

The Clinical Practice Guidelines - Pregnancy Care provides evidence based recommendations to support health professionals to provide high quality and safe antenatal care in all settings. They highlight specific approaches to pregnancy care for Aboriginal and Torres Strait Islander women, migrant and refugee women, and women with severe mental illness.

Among the changes is a new recommendation to encourage routine Hepatitis C testing at the first antenatal visit, and routine testing for Vitamin D status is now discouraged, unless there is a specific indication.

The Guidelines also recognise body mass index prior to pregnancy and weight gain during pregnancy as important determinants of health for both mothers and babies. The Guidelines are designed for all health professionals caring for pregnant women, including midwives, obstetricians, general practitioners, Aboriginal and Torres Strait Islander health workers and allied health professionals.

The Clinical Practice Guidelines - Pregnancy Care can be downloaded here.

 

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Alert for severe euglycaemic ketoacidosis with SGLT2 inhibitor use in the perioperative period

There have been a number of reports of severe euglycaemic ketoacidosis in patients with Type 2 diabetes who are taking sodium-glucose co-transporter-2 inhibitors (SGLT2i) during the perioperative period. SGLT2i’s are oral medications that promote glucose excretion in the urine for the treatment of Type 2 diabetes.

Diabetic ketoacidosis (DKA) should be considered in patients taking SGLT2i who:

  • develop abdominal pain, nausea, vomiting, fatigue or unexplained acidosis (a normal plasma glucose level does not exclude the diagnosis);
  • have fingerprick ketone (or blood beta-hydroxybutyrate) levels >0.6 mmol/L in the perioperative period or >1.5 mmol/L at any other time; or
  • have low pH on VBG or ABG, and low bicarbonate with a high anion gap, indicating metabolic acidosis.

SGLT2i agents include dapagliflozin (Forxiga), empagliflozin (Jardiance), or a combination with metformin (Xigduo, Jardiamet).

Recommendations for practice are:

  • SGLT2i be ceased at least three days pre-operatively (two days prior to surgery and the day of surgery) or in other physically stressful situations. This may require an increase in other glucose-lowering drugs during this time.
  • Strongly consider postponing non-urgent surgery if SLGT2 inhibitors have not been ceased prior to surgery and either blood ketones are >0.6 mmol/L, or HbA1c is >0.9%, as these are indicators of insulin insufficiency and a higher risk of DKA.
  • Routinely check both blood glucose and blood ketone levels in the perioperative period if the patient is unwell or is fasting or has limited oral intake, and has been on an SGLT2i prior to surgery.
  • It is strongly recommended that all patients with DKA are reviewed by an endocrinologist or physician on-call. If required contact your referral tertiary hospital for advice.
Please read the alert here for further information about the symptoms and recommendations for practice.

 

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Do you or your practice provide care for patients in their last 12 months of life? 

The University of Western Australia (UWA) are seeking expressions of interest from general practitioners in Perth to be interviewed about any kind of care that they provide in the last 12 months of a patient’s life. These interviews are part of the Evaluation of community-based end of life care in Australia study which is run within the Faculties of Medicine at the UWA, Monash University and the University of Queensland.

The interviews will be conducted within your practice at a convenient time (such as before work, lunch-time or after work) or any other specified location that you prefer. The duration of the session is usually around 25-35 minutes. All responses will be considered completely anonymous.

The project team will provide reimbursement of $85 to each general practitioner to acknowledge the time taken in being part of the project.

If you are interested in finding out more about the study, please contact angus.cook@uwa.edu.au at UWA or phone (08) 6488 7805.

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Basic skills in perinatal mental health 

The Centre of Perinatal Excellence (COPE) have released the new Basic Skills in Perinatal Mental Health online training program for health professionals.

This free, accredited training program supports health professionals to implement best practice systems as informed by the 2017 National Perinatal Mental Health Guidelines. The program includes engaging content on screening, assessment and referrals, as well as the ability to progress at your own pace, complete built in evaluations and receive a certificate for accreditation purposes upon completion of the course.

Review an outline of the course, watch a video preview and enrol here for free.


Education and training 

Visit our Webinars & Workshops page at www.practiceassist.com.au for more events in your area.

The 2018 update on Meningococcal Disease vaccination webinar

The recent 2018 Meningococcal Disease update (presented via webinar) was extremely well received, and is now available as a recording on the Immunisation Coalition website.

Learn about:
  • Meningococcal Disease and possible progression pathway of disease
  • Meningooccal Disease in Australia 
  • Risk Factors
  • Vaccination recommendations and the different vaccines 
  • Vaccine effectiveness and safety 
  • Management of Meningococcal Disease 
If you missed the webinar or would like to replay it, please visit here.
 

Take your practice management skills to the next level 

Australian Medical Association (AMA) Training Services has announce the introduction of the popular HLT57715 Diploma of Practice Management. The Assisted Study Program (ASP) delivery combines in-person workshops, networking events and professional development seminars with live, weekly online classes. Two ASP units will be completed per school term and four units are completed as self-paced study which means you can commence your studies at any time without having to wait for the next ASP study term to begin.

Discount of $500 for AMA members or nominated staff members. For more course details, please visit here
 

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Australian Diabetes Educators Association WA Branch Conference - 6 April ​

This year’s conference welcomes an array of leaders in diabetes, diabetes management and diabetes care, addressing topics such as technology and diabetes, the impact and importance of vascular calcification in patients with diabetes mellitus and diabetes in pregnancy with National Diabetes Support Services (NDSS) initiatives to support women before, during and after pregnancy. 

Date:                  Friday, 6 April 2018
Time:                  8.00am – 4.00pm  
Venue:               Pan Pacific Perth, 207 Adelaide Terrace, Perth 6000
Cost:                   $185 for Australian Diabetes Educators Association members, $205 for non-members  
Register:          To register, please visit the following website

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Western Australian Practice Nurses Association Annual Seminar - 7 April ​

The Western Australian Practice Nurses Association (WAPNA) annual seminar will include topics such as immunisation updates, gut microbiome and health, self-care inspiration, and wound care in the primary care setting. For more information, see the flyer here.   

Date:                     Saturday, 7 April 2018
Time:                     8.45am – 4.50pm   
Venue:                  International on the Water Hotel, 1 Epson Ave, Ascot 6104
Cost:                      $70 for WAPNA members, $15 for rural members, $15 for WAPNA committee
Register:             To register, please visit the following website.

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Rheumatoid arthritis and methotrexate webinar - 12 April ​

This free webinar will discuss why early diagnosis and treatment are crucial for improved health outcomes for people with rheumatoid arthritis, and how good communication and collaborative care can help patients get the most out of their methotrexate treatment. This activity has 2 Category Two QI&CPD points attached.

Date:                     Thursday, 12 April 2018
Time:                     4.00pm – 5.00pm  
Venue:                  Live via webcast
Cost:                      Free
Register:             To register, please visit the following website

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Codeine rescheduling webinar - 12 April ​

Presented by the Australian College of Rural and Remote Medicine (ACCRM), this webinar is an interactive question and answer session with a panel of rural health professionals including general practitioners, a pharmacist and specialists in pain management and palliative care. It will have a particular focus on options for the management of pain and opiate replacement in chronic disease and palliative care patients.

Date:                     Thursday, 12 April 2018
Time:                     5.30pm – 7.00pm  
Venue:                  Live via webcast
Cost:                      Free
Register:             To register, please visit the following website.
 

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Australian Association of Practice Management - Peel region networking - 17 April ​

The Australian Association of Practice Management (AAPM) will be running a casual open discussion forum that offers a great opportunity to network with like-minded practice managers and discuss any management issues/concerns you may be experiencing. People involved in practice management and non-members of AAPM are welcome to join. Hosted by Raelene Tully.

Date:                    Tuesday, 17 April 2018
Time:                    6.30pm – 8.00pm
Venue:                 Ravenswood Hotel, 65 Lloyd Ave, Ravenswood 6208
Cost:                      Free (food and beverage at own cost)
Register:             To register, please visit the following website.

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Discussing preconception and pregnancy options - 18 April ​

Healthdirect Australia’s Pregnancy, Birth and Baby Service invites you to a webinar on the topic of discussing preconception and pregnancy options with patients. The webinar will be presented by Dianne Zalitis, practicing midwife and Clinical Lead at the Pregnancy, Birth and Baby Service with an introduction by Dr Michael Araco, Medical Advisor at Healthdirect Australia.

Date:                    Wednesday, 18 April 2018
Time:                    9.00am – 9.30am
Venue:                 Live via webcast
Cost:                      Free
Register:             To register, please visit the following website.

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Dementia in general practice - 21 April ​

This active training module (ALM) by Dementia Training Australia provides you with the opportunity to gain insight into how you can be assisted with best practice identification and management of dementia in general practice. Presented by Dr Allan Shell and Professor Leon Flicker.

Date:                     Saturday, 21 April 2018
Time:                     9.00am – 5.00pm (8.30am – Registration)
Venue:                  Pan Pacific Perth, 207 Adelaide Terrace, Perth 6000
Cost:                      Free
Register:             To register, please visit the following website.

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Beyond the Stethoscope - 27 April ​

Health Consumers’ Council (HCC) is partnering with Child and Adolescent Health Service and the WA Primary Health Alliance (WAPHA) to host a Patient Experience Week Breakfast. This is a free event to bring together clinician, health professionals, consumers, carers and community to hear from Lucy Maye, the author of Beyond the Stethoscope. Beyond the Stethoscope is for doctors, patients and for those who work in or have an interest in healthcare.

Date:                     Friday, 27 April 2018.
Time:                    7.00am – 9.00am
Venue:                 The Platform, Level 3, 256 Adelaide Terrace, Perth 6000
Cost:                      Free
Register:             To register, please visit the following website.           

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Health promotion events in March 

Is your practice looking for a health promotion activity for your practice?  Each edition we provide a list of upcoming health promotion activities for the coming months along with resources and contact details. You can also view all health promotion activities for the year by visiting Practice Assist’s health calendar.

The March Charge​

The March Charge is a fun personal fitness challenge that has an enormous impact on how cancer is researched and treated. Just by walking or running for the Cancer Council this March, and raising funds, you can help us Charge ahead with cancer research, prevention, advocacy and support services. You can choose to go solo or get your friends/family/colleagues together and do it as a team – it’s up to you!

For more information and to register, please visit: https://www.themarchcharge.com.au/  

World Autism Month 

The eleventh annual World Autism Awareness Day is April 2, 2018. Joined by the international community, hundreds of thousands of landmarks, buildings, homes and communities around the world, light blue in recognition of people living with autism. Autism-friendly events and educational activities take place all month to increase understanding and acceptance and foster worldwide support.

For more information, please visit: https://www.autismspeaks.org/what-autism/world-autism-awareness-day
 

Patient group education programs for Type 2 Diabetes  

Diabetes WA provide a range of group education sessions for patients living with Type Two diabetes, throughout regional Western Australia and metropolitan Perth.

The SMART programs are a range of short group education sessions designed to help better manage patient’s Type 2 diabetes.  Bookings are essential, and attendance at all of the SMART programs is free for NDSS Registrants and Diabetes WA members.

The group education calendar can be found at https://diabeteswa.com.au/get-involved/news-and-events/whats-on/

Bookings can be made on line into programs using the interactive calendar, or by contacting Diabetes WA on telephone 1300 001 880.                                                          

 

Practice Assist acknowledges the Traditional Owners of the country on which we work and live and recognises their continuing connection to land, waters and community.

We pay our respects to them and their cultures and to Elders both past and present.