Friday Abstracts

Find out a little more about each of the presenters and Abstracts primed to shine on Friday 5 April

Friday Abstracts

Results of a qualitative study aimed at understanding the attitudes and experiences of student nurses towards primary healthcare following the completion of a clinical placement in this setting. The study is associated with the first authors Higher Research Degree.

Zach is an RN and Lecturer in nursing at the University of New England. Zach has worked across both the primary healthcare and acute settings and is currently engaged in a number of research projects including his research Masters focusing on the student nurses attitudes and experience towards primary healthcare.

General Practice plays a key role in Cancer Screening, with endorsement by clinicians increasing participation in screening programs. Research was undertaken to explore clinicians’ attitudes and behaviours to inform the development of targeted strategies to improve cancer screening participation. 

Outcomes of the clinician survey validated perceived barriers and enablers to cancer screening  by primary care clinicians, identifying a need to improve general practice recall and reminder systems and provide ongoing clinician, patient and community education.

Working as a Cancer Screening Project Officer, I am responsible for the improvement of cancer screening participation across HNECCPHN region, with a particular focus on General Practice.
I am a Registered Nurse with a Masters of Health Science and have worked in the area of Public Health focusing on Chronic disease prevention for 15 years. I have worked for Cancer Council NSW and have a special interest in reducing the impact of cancer through promoting risk reduction, focusing on healthy lifestyles and secondary prevention through population screening.

Primary Health Care Nurses (PHCN) are at the heart of the primary care workforce.  The National Men’s Health Strategy 2020-2030 was launched early 2019.  Andrology Australia recognises the vital role that PHCNs play in delivering better outcomes, across all determinants of health for Australian males, and society more broadly.  Nursing accounts for over 50 per cent of all health practitioner registrations in Australia (AHPRA, 2018).  Andrology Australia recognises the growth in the nursing sector of PHCNs, as evidenced by the excellent growth in membership of the Australian Primary Health Care Nurses Association (APNA, 2017).

Andrology Australia is committed to collaborating with PHCNs and APNA to inform the implementation of the strategy moving forward. The diversity in practice settings and variety of roles in which PHCNs operate, provide a unique opportunity to deliver sustainable and meaningful change to improve the health and wellbeing of Australian males. 

The goal of the National Men’s Health Strategy 2020-2030 is that every man and boy in Australia is supported to live a long, fulfilling and healthy life.  Primary care must play a leading role to achieve this goal.


While nursing in primary health care continues to grow, the evidence underpinning this area of practice needs to continue to be developed. Such evidence is important to drive clinical activity, inform models of care, plan education and training needs and shape health policy. This workshop seeks to provide an overview of the importance of nursing engagement in PHC research, differentiate the various roles that clinical nurses can play in research, highlight key considerations when planning to evaluate practice or PHC issues and present resources to support clinicians to engage in robust knowledge generation, translation, utilisation and dissemination. Nurses need to take an active role in this space to ensure that they are driving the generation of evidence that underpins their professional practice. This workshop will encourage participants to explore these issues and plan for how they can better engage in this aspect of nursing.

Professor Elizabeth Halcomb is Professor of Primary Health Care Nursing at the University of Wollongong, Australia. She is an experienced academic nurse leader who is committed to developing researchers in both academia and the clinical setting. Professor Halcomb leads a strong research program in primary care nursing, with particular emphasis on nursing in general practice, chronic disease and nursing workforce issues.

Dr Leah East is an Associate Professor in Primary Health Care at the University of New England and a Registered Nurse. She is an active researcher and holds a joint appointment with UNE and Hunter New England Health. Leah’s research focus on primary health care, vulnerable populations and quality healthcare within the context of nursing.

Hypertension is a frequently seen condition in Australian General Practice which, when sub optimally managed, leads to kidney disease, stroke, cardiovascular disease and premature death. Opportunity exists for nurse delivered interventions to improve blood pressure and reduce lifestyle risk factors. However, evidence to support the effect of nurse intervention on patients is unclear. This trial seeks to generate robust evidence of nurse impact on patient outcomes. 
ImPress (Improving Blood Pressure) is a cluster randomised control trial being conducted in 8 General Practices across South West Sydney and Southern Illawarra. Registered Nurses employed in general practice and General practitioners worked in partnership with Primary Health Care Nursing researchers at the University of Wollongong, NSW, to improve health outcomes for individuals with hypertension and build globally relevant, robust evidence of nurse impact. The ImPress model is translational and highlights the importance of generating evidence of the impact of nursing care. This robust evidence is essential to advance the nursing role, transform individual practice, improve patient outcomes and inform health policy.

Catherine is an RN and Primary Health Care researcher at the University of Wollongong, NSW. 
Motivated to increase the visibility and representation of the nursing role in primary health care, she commenced her PhD in 2017. Several journal articles and a co-authored chapter later, Catherine continues to research and publish on nurse-led management of hypertension. 
A strong advocate for universal health care, collaborative research, undergraduate engagement and hidden coffee spots, she’s thrilled to share her latest research at APNA’s 2019 Building on the Best Conference in Adelaide.

Gold Coast general practices have been involved with Quality Improvement (QI) initiatives since 2005 however most practices rely on GCPHN Practice Support staff to support this activity. This support includes preparing data reports, leading QI meetings to analyse data, identifying areas for improvement, setting actions, outcomes and monitoring results. With a recent shift to a focus on quality & safety of healthcare provision, evidenced through the 5th Edition Standards for General Practice Accreditation and the imminent introduction of the Quality Improvement Practice Incentive Program (QI PIP) general practice involvement with QI is increasing. This increase along with an ever-increasing number of general practices on the Gold Coast has led to a review of our current model of QI support to identify a sustainable, efficient model to meet future requirements. 
The vision for change is for Gold Coast General Practice staff to have the skills required to independently implement innovative, evidenced based, QI strategies to improve the health & wellbeing of their practice population.

A Registered Nurse by background Bev has, for the past 12 years, worked in various roles supporting general practice through project implementation for various organisations including Gold Coast Division of General Practice, General Practice Gold Coast, Gold Coast Medicare Local and currently Gold Coast Primary Health Network. Bev’s current role is Primary Health Care Program Manager with primary responsibility of managing programs and projects related to developing and supporting high performing primary care on the Gold Coast.

Beth Ward Smith is a Project Officer in Practice Support at Gold Coast PHN.
After completing her Masters of International Public Health in 2013, Beth has worked in a variety of roles both domestically and internationally including the Provincial AIDS Committee Secretariat in Papua New Guinea and the Royal Free Hospital in London. Since returning to Australia in 2016, Beth has worked in general practice support with a particular focus on chronic disease and quality improvement. She recently relocated from Central and Eastern Sydney PHN to Gold Coast PHN where she continues her work in the role of Project Officer – Practice Support, to provide innovative quality improvement support for practices.

This paper describes the outcomes of two small research projects that demonstrate how Shared Medical Appointments have been used with Aboriginal patients.  Named Medical Yarn Ups, this tool allows for one on one consultation but with others looking on and adding supporting when required.  The process is managed by a Yarn up Facilitator which was either trained practice nurse and or Aboriginal health worker.  The paper suggests that this method of consultation may provide a culturally safe and accessible process for Aboriginal patients.

John is a Registered Nurse and Director of the Australasian Society of Lifestyle Medicine (ALSM).  He remains an Associate Professor (Adjunct) with Southern Cross University’s School of Health and Human Sciences. In the past John has been Head of the School of Nursing and Health Practices (SCU), the Director of Post Graduate studies.  His current focus in in translating the science in illness prevention and chronic disease management for use in clinical practice    Currently John and his colleagues are pioneering the introduction of Shared Medical Appointments in Australia and the role that practice nurses can have in the facilitation of SMAs. 

Patients with life-limiting conditions such as cancer, or chronic diseases like COPD and heart failure, normally have a regular primary care practice that they attend. Primary care providers have a good knowledge of their patient’s medical history and their preferences for care, as well as their physical, psychological and social capacity to deal with their illness and symptoms.

While most primary care providers feel they have a role to play in caring for patients at the end of life, many do not feel confident in doing so. Primary care providers and teams need appropriate skills, linkages and confidence to provide high-quality palliative care and advance care planning for patients and their families.

The End of Life Directions for Aged Care (ELDAC) Primary Care Toolkit addresses this need by supporting those providing and coordinating palliative care. The toolkit includes resources for managing disease symptoms, psychosocial and spiritual aspects of care, as well as providing effective coordination of services across the health system.

Katharine is the Integration and Innovation Manager at the Australian Healthcare and Hospitals Association and is a practising physiotherapist. She has a background in medical science, critical care, health policy and economics, providing her with the necessary knowledge and skills for operational roles in organisational collaboration, clinical governance, national training and education and professional leadership.

Katharine has worked clinically in rural and metropolitan regions fostering her interest in the provision of safe, evidence-based, equitable and outcomes-focused contemporary healthcare. She has experience working with government and non-government health organisations including departments of health, PHNs, health services, peak bodies, professional groups, healthcare providers, consumer organisations and Aboriginal and Torres Strait Islander organisations.

Katharine is the author of the End of Life Directions in Aged Care (ELDAC) Primary Care Toolkit focusing on improving palliative care for older Australians.

Australia is a trialling a transformative model of primary health care (Health Care Homes) to provide better coordinated and more flexible care for people with chronic and complex health conditions. Nurse driven care planning and nurse-care team collaboration are central to managing the continuum of patient care and digital technologies (cdmNet) assist practices, patients and their care team to efficiently manage chronic illness and preventive care.
Since 2011 nurse creation of structured care plans has increased since 2011 from 30% to 62% with GPs now creating only 26% of plans.
Support and leadership by nurses in using the cdmNet platform and encouraging patient engagement has demonstrated a new model of coordinated care, enabling patients with chronic conditions to optimise their health and improve adherence to their health plans. Nurse led chronic disease management is central to driving practice implementation of Health Care Homes and integrated care.

Dr Marienne Hibbert is the Chief Clinical Information Officer at Precedence Health Care with implementation oversight of key national strategic projects, clinical data and privacy.  Marienne has extensive experience in eHealth and research, with expertise in Hospital and primary health IT integration and system implementation, strategic planning, and project management.

The nurse practitioner role and the unique opportunity of co-owning a general practice has enabled Kerrie the opportunity to iinitiate and establish a team-based, patient-centred, holistic health service. The service has a nursing focus with extensive collaboration and support from the local community.
The practice started in May 2014 with 90 patients and 5 team members. There are now over 2,100 patients and 14 team members. The practice's mission is "kind,holistic health care with a community spirit".
Collaboration with the patients, team members and the local community has been the key for the growth of the service and satisfaction of all involved.
A patient Advisory Group provides feedback to improve our services.
The nurse practitioner "Health Check for new patients ensures a systematic and comprehensive approach to identify gaps in care, and identify and manage early, risk factors for chronic disease development.
Kerrie has plans for a practice supported community garden, shared medical/nursing appointments to support quit smoking, and a menopause clinic.
Kerrie is most proud of the number of people who are now able to access a unique, quality health care service within their local community and feel kindness when most vulnerable.

Kerrie Duggan is a Primary Health Care Nurse Practitioner and co-owner of Cygnet Family Practice, a general practice 1 hour south of Hobart in the beautiful Huon Valley.
Kerrie started the practice 4 years ago with 90 patients which has grown to over 2,100 patient in November 2018. She leads a practice team of 14.
She uses a holistic, evidence based, team approach in her practice to ensure the nursing and medical models of care work together for the best patient care.
Kerrie specialises in disease prevention, health promotion, chronic disease management and immunisation. 
She  assesses, diagnoses and treats patients whose health care needs are within her scope of practice and collaborates with other members of the health care team when needed.
Kerrie was runner up for Rural Health Worker Award 2009 in recognition for her work as a practice nurse setting up a nurse led diabetes clinic.

Australia settles refugees each year and the numbers are expected to increase to just under 20,000. The complex needs of this vulnerable group requires specialised skills and knowledge. In 2015 an national interest group was formed for nurses working with refugees. It is called the Refugee Nurses of Australia. Following the inaugural national forum in 2017 and with input from every member, the Standards of Practice for refugee nurses was developed.
All though still in its infancy the Refugee Nurses Standards of Practice will help guide nurses in Australia to a model of best practice.

Bronwen Blake is a Clinical Nurse Consultant in Refugee Health. She has studied a master of nursing (NP), master of public health and undertaken a post graduate diploma in immigration health.

To improve medication abortion access in service poor areas of Victoria, nurse-led medication abortion provision is feasible. Yet, a range of barriers can hinder model implementation. These include limited medication abortion training for primary health care nurses, a lack of professional support, restricted access to diagnostic facilities, abortion stigma, and insufficient funding for nurse-led medication abortion provision in general practice. Regulatory and structural interventions are therefore needed, and underlying unfounded medication abortion concerns and prejudices must be addressed.

Caroline recently submitted her PhD at Deakin University, Melbourne. Her mixed-method research focused on nurse-led medication abortion provision in regional and rural Victoria to improve abortion access. Caroline is currently a research assistant in the field of gambling harm prevention, and a sessional academic tutor in epidemiology and biostatistics. Previously, Caroline worked for 12 years as a General Practitioner with a great interest in women’s sexual and reproductive health in the Netherlands. She managed, in co-ownership, a large practice with three practice nurses for nearly 10 years.

There is high prevalence and incidence of Hepatitis C amongst prisoners. Prison treatment programs therefore provide an excellent opportunity to treat a marginalised population.  Prisoners being free of hepatitis C on release improve public health risks. 
A health record review revealed many prisoners who had not taken up Hepatitis C screening opportunities. These prisoners were targeted as part of a campaign to recognise and treat all Hepatitis C positive prisoners at Hopkins Correctional Centre.

David is an experienced correctional nurse who is passionate about making Hopkins Correctional Centre Hepatitis C free.  Working under a nurse led model of care allows David to lead a proactive project in which his team are dedicated to achieving this common goal. 

A nurse led model of delivering iron infusions in general practice. We are a small private bulk billing general practice co located within a GP Plus Super Clinic. We were approached to be a part of an out of hospital initiative to improve post operative recovery by ensuring patients go to theatre with optimal iron levels. Over the last 3 years we have developed the procedure to be far more than that. This presentation will showcase our practice's experience of providing iron infusions for our patients, pre operative patients and patient's referred from other practices.

Karen is a RN/RM working in a GP Plus Super Clinic within metropolitan Adelaide

In 2018, Kidney Health Australia developed a new program called ‘CKD Ambassador’ that aims to drive behavioural change in primary care.  The program involves exclusive access to a continuing professional development (CPD) quality improvement activity, education, resources and support and ultimately leads to endorsement as a CKD Ambassador.
A key element of the program is to foster a team approach to CKD detection and management.  Primary Health Care Nurses involved in the program are provided with tools to facilitate discussion with their colleagues and implement systems within their practices.
Currently, fifteen primary care practices are enrolled nationally in a pilot program due for completion in March 2019.
This presentation will discuss the results from the first round of the CKD Ambassador program and will encourage Primary Health Care Nurses to reflect on their current practice.  Practical tools and a simple framework that Primary Health Care Nurses can use to drive meaningful change in their practice will be provided.  Key CKD management strategies that Primary Health care Nurses can implement will also be discussed.

Breonny is the National Education Manager for Kidney Health Australia – a not-for profit organisation dedicated to improving health outcomes and quality of life for people living with kidney disease, their families and carers.  In this role she is responsible for the delivery of national programs providing education and resources for health professionals working in primary care, people living with kidney disease, and the general community.
Breonny completed her Bachelor of Medical Science at Flinders University and has worked in the health industry for the last 15 years in roles spanning from health coaching, pharmaceutical sales to education and project management.

A high correlation has been identified between professional success and a positive mentoring experience.  
Participation in the APNA Transition to Practice Pilot Program as a mentor provided the opportunity to utilise various modes of communication to provide support from a distance.  Mentoring a nurse from a different site had no negative impact on the supportive relationship. 
Supporting a nurse transitioning into a primary care role in correctional nursing with Correct Care was a very positive experience that saw the nurse gain confidence in the new role throughout the program.  The nurse continues in the role and is considered a valuable member of the correctional nursing team.  
The mentor program is considered a useful model for other primary care practice settings, including those where the nurse may be part of a small team or a sole practitioner.   It could be considered to be a valuable addition to the retention strategies used to keep nurses practising in primary care.  
Correct Care will continue to use this model in supporting first year graduate nurses in 2019.  It is hoped that providing the support of an experienced mentor will encourage graduates to continue their career in correctional nursing.

Dianne is an experienced nurse, having commenced her nursing training 40 years ago.  A diverse career has seen Dianne practise in acute wards, accident & emergency, operating theatres before making a change nine years ago to take on the challenge of correctional nursing.   Dianne’s diverse clinical background made her well-suited to practising in the correctional environment. As an experienced correctional nurse, Dianne now shares her knowledge with those new to this nursing field. Dianne is currently Correct Care Australasia’s Health Services Manager at Dhurringile Prison, a low security prison housing 320 male prisoners.

Utilising North Western Melbourne Primary Health Network (NWMPHN) population health data and the Health Needs assessment 2017, NWMPHN developed a model to administer influenza vaccines to vulnerable populations in a variety of settings.
Through existing relationships, NWMPHN were able to seek commitment from partner organisations and stakeholders to implement nurse-led pop-up influenza clinics in places that are accessed frequently by the target populations. 
The nurse led pop-up clinics were established in locations where the target population felt comfortable and were familiar. 
20 Pop-up influenza clinics were held: 
o    Bunnings Stores (4 clinics)
o    Homeless Residential Services (5 clinics)
o    Youth focused after-hours outreach services (7 clinics)
o    Women’s Health Clinic (2 clinics) 

480 influenza vaccinations were administered. 40% of vaccinated people had never received a flu vaccine before and 29% reported having a chronic condition. 100% of participants from both the Bunnings and other clinics stated that they would have the influenza vaccine next year.

Wendy Reid is currently a Regional Team Leader of the Primary Care Practice (PCP) team at North Western Melbourne Primary Health Network.
My key responsibilities include working on the Immunisation Program portfolio which is a national priority area of Children and Families as outlined by the Commonwealth Government.
The PCP team provide education, support and assistance to primary care providers in our region to help improve the health outcomes of our community.

Eastern Melbourne PHN (EMPHN) has a clear direction towards developing Quality Improvement (QI) activities and infrastructure to support the framework for Continuous QI within general practices in the EMPHN catchment.

The delivery of the QI Program: Cancer Screening Collaborative encouraged and supported general practices to apply quality improvement methods and skills to deliver rapid, measurable, systematic and sustainable improvements in the rate of Cervical Cancer Screening. This program provided a platform for general practice to:
•    Give their patients the best chance possible of avoiding a preventable cancer diagnosis
•    transition their practice into the renewed National Cervical Screening Program (NCSP) introduced in December 2017
•    Support woman at heightened risk of not screening, including Aboriginal and Torres Strait Islanders woman, rural and remote women and women with disabilities
•    Build their practice’s capacity to use simple, practical and effective quality improvement methods that can transferable to other priority areas

Angela Heathcote is a Redesign Facilitator at Eastern Melbourne PHN. She is responsible for the development of Quality Improvement support and training for general practices. Angela graduated from Bachelor of Orthoptics in 2001 and transitioned into primary care with her initial role at Eastern Melbourne Medicare Local where her interest in Quality Improvement began through supporting general practices with the APCC programs. Angela furthered her skills and knowledge through undertaking a role as program lead with the Improvement Foundation developing and implementing Quality Improvement programs before starting her current position in 2016.

The risk of heart attack and stroke is vastly underestimated in primary care where the recording of risk factors to identify high risk patients, including those at risk of readmission after a nova event, is below that recommended in the guidelines.
Over the last 12 months, a number of Heart Foundation supported Nurse Ambassador and primary care based quality improvement projects across Australia have taken a common approach to establish Nurse led quality improvement initiatives to introduce systems change within primary health care settings.
This presentation will present a review of these projects and their results by providing a summary snap shot of what worked well and what didn’t across, the individualized activity plans the Nurses developed and implemented relevant to their practice and patient demographics.

Kerry Hollier is the Senior Coordinator Primary Health Engagement at the Heart Foundation Victoria.

Social isolation and loneliness are known to have significant effects on an individual's physical and mental health. This is particularly problematic in older Australians aged over 75 (and Aboriginal people aged 65+), and becomes more prevalent with chronic disease and as age advances. This presentation will provide primary care nurses with information around who is particularly at risk, in order to support identification and early intervention and enhance mental health and wellbeing of older Australians. It will describe a project currently being undertaken by the Australian College of Mental Health Nurses - including the Framework for response and the models being tested in two PHN pilot sites.

Peta Marks is the Professional Development Manager for the Australian College of Mental Health Nurses and the National Project Manager for the ACMHNs workforce development project.

Transitioning research into clinical practice remains challenging. Use of a single strategy to support the implementation of research into practice more often than not results in failure to achieve the desired changes. Health service and Implementation Science literature proposes the use of theory to underpin any implementation strategies, frameworks to guide the process, and multilayered approaches including behaviour change to achieve successful change implementation [Rangachari et al 2018]. We describe the application of an integrated approach to implementation of evidence based aged care research.

Tracy is a registered nurse, credentialled diabetes educator (CDE) and Senior Clinical Nurse Advisor (SCNA) working across clinical quality, research, education and policy, as part of the Care Innovation team at Bolton Clarke. The SCNA position has a national focus across community and residential aged care delivery. In addition, Tracy has experience working in the General Practice setting as part of hospital admission risk programs and in private practice as an RN-CDE.

The aim of this research was to determine the barriers and facilitators of graduating nurses selecting a career pathway in primary health care immediately after graduation. Study participants were recruited from the University Of Newcastle and were required to complete a 16 item online survey.

Kyle Gibbs is currently the National Nursing Manager of Primary Health Care Limited. He has been working within Primary Health Care field for the last 9 years as a Practice Nurse and nursing manager. 
Kyle is currently completing this nursing honors at the University of Newcastle.

A change is required if we are to alter the health outcomes for our contemporary veteran community.  A large percentage of this cohort suffers with PTSD, adjustment disorder, anxiety, depression and many physical injuries and musculoskeletal issues. If we don’t act as an agent of change, this large group of “broken” men and women will follow the path of chronic illness as the veterans before them.
Veterans need to be understood, appreciated for their service and supported to learn how to reintegrate back into a civilian life that they know very little about. They need assistance physically, psychologically, emotionally and most importantly they need to establish trust with their care providers. 
At GO2 Health we provide these services by actively engaging the GP Management planning and collaborative Team Care Arrangements, together with a very comprehensive Coordinated Veteran Care Program. We have utilised these programs to develop relationships with our patients to ensure they feel safe enough to pick up the phone and ask for help when the darkness comes. In a cohort or patients with a suicide risk being high, we pride ourselves as never having lost one of our veterans to suicide in the history of the company.

Jenny is currently the Business Manager  and Senior Practice Nurse at GO2 Health, the number one provider of collaborative health care for veterans and the wider defence community. GO2 Health is a large multi-modality collaborative clinic (in excess of 30 teams members) servicing the unique demographic of the young contemporary veteran.
Jenny established the Coordinated veteran care program for gold card holders within the practice - there is currently 95 patients participating in this program. She is responsible for training, management and coordination of the medical team
Jenny has now taken on the role of business manager and "Overseer of all things" The clinic consists of GP's, physio's, EP's, Dietitians, Psychologists, Acupuncturists and Remedial Massage therapists. Her roles are many and varied and 150 words is not sufficient to describe them all.

In this presentation we will explore strategic lessons learned from a New Zealand-based PHC nursing integration project that has resulted in the development of a model of shared care. This model is currently being scaled to other nursing roles and sites in the region. These lessons will be relevant for PHC nursing integration projects and demonstrate the benefits of co-production with patients' experiences at the centre. In addition, we will describe how the shared care model that crosses service boundaries enables nurses to release time to care, work to the top of their scope, and best use the total PHC nursing workforce.

I am currently the project manager for the PHC nursing integration project, a collaboration between the MidCentral District Health Board, the Central Primary Health Organisation and a number of PHC services. I am also a researcher at Massey University, with a background in PHC nursing and PHC nursing education.



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