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Health
Matters
Ca p i t al & C o a s t D H B s t a f f n e w s
I SSUE 2 • MARCH 2015
The shared
care record
Why aren’t we using it
?
Dr Bryan Betty, GP
equipment
invoices
Leadership
Matters
What every leader
should know
pg 4
Why you shouldn’t be
signing them
pg 3
A Day
in the Life
Mortuary
Technicians
pg 12
Message from ELT:
I
have been asked to
write a few words, as a
member of the Executive
Management Team, to
introduce the March issue
of Health Matters.
catherine
epps,
Executive Director,
Allied Health,
Scientific
& Technical
There is much to
comment on and be proud
of in an organisation that
continues to challenge
and transform itself to better meet
the needs of our consumers within
the resources that we have. This
issue of Health Matters picks up on
several of the key areas of focus for
this organisation at the moment:
clinical improvements, health targets,
and working with our neighbours.
All of these things bring a different
improvement focus to them, and a need
for strong team work to ensure that we
deliver on what is expected of us.
In terms of the workforces I represent,
the Allied Health, Scientific and
Technical (AHS&T) professions will
be contributing to all of the above
workstreams between them. I am also
pleased to share that with the recent
changes to the way we deliver services
across Laboratories, Radiology, Mental
Health, Addictions and Intellectual
Disability services, that approximately
half the AHS&T workforce are now part
of a sub-regional service. This is a huge
Health
Matters
achievement and reflective of the
ability of these professions to continue
to transform the way they deliver
services in order to best meet the needs
of our patients, population, and system.
By coincidence, it is also my turn to
write the executive blog and so I have
written some personal thoughts on
how we deliver the changes to the
health system without unintended
consequences. You are welcome
to read that online as well at
ccdhbcheckinwelcome.blogspot.co.nz
We are all tasked with improving
the way we work, and so I hope this
issue of Health Matters both informs
and inspires you to keep focused
and involved in what we can achieve
together.
Catherine
If you have story ideas or feedback on Health Matters, please
email them to us at healthmatters@ccdhb.org.nz
Weakness, delirium, or fever without a focus
»»Individualise care
»»Be mindful of the prevalence of asymptomatic bacteriuria
»»Seek other causes
Specific UTI symptoms
»»Test or treat as usual
2015 Issue 2 l Health Matters
10-16 March
Brain Awareness week:
www.neurological.org.nz
10 -16 March
Kidney Health Awareness
Week
12 March
Walk To Work Day;
World Oral Health Day
16-22 March
Food and Hydration Week
22 – 30 March
Muscular Dystrophy
Awareness and Appeal
Week
24 March
World Tuberculosis Day
24 – 30 March
Hearing Week
31 March
Staff Forum - 3-4pm
Meeting Room, Kapiti
GET
AR
T
ear
n
Smoking
advice target
February update
93% of inpatients
offered advice
No symptoms of UTI
»»Do not test urine
»»Do not test if a urine test was done by someone else or for ‘routine’
2
Up & coming
Nearly there - keep it up!
Get the
best out
of that
test!
Sharing is
Caring
H
Dr Peter Hicks and
Dr Andre Cromhout using
the Shared Care Record.
ospital clinicians are being called
on to better utilise the Shared Care
Record, as usage statistics show access
has levelled off following its launch
almost one year ago.
Launched locally last year, 43 GP
practices’ representing 80.7 percent of
our DHB population patients are signed
up to the Shared Care Record.
However, statistics show only 13
percent of those records were accessed
by hospital clinicians in January this
year.
This indicates the Shared Care Record
is not being used as well as it could be,
particularly when it comes to avoidable
and unnecessary test duplication.
“The system is in place, now we’re
just asking clinicians to keep it ‘front
of mind’ when patients come to see
them,” says Dr Bryan Betty, Porirua GP
(on the front cover).
“Often it is the most up to date record
of a patient’s medical history. In an
acute situation this information is
obviously quite important for anyone
trying to work through clinical issues.”
letters received from hospitals or other
specialists around the country are sent,
and all blood test and x-ray results, as
well as classifications for any short or
long term conditions they may have.
Knowing what patients have been
prescribed is key when it comes to
avoiding serious medication errors, as
patients may not always be able to tell
clinicians what they’ve been taking, for
a variety of reasons.
Some tests may have to be retaken in
hospital but others may be potentially
wasting resources and time, he says.
“You might have a patient come in
who presents acutely for the first time,
maybe with chest pain or an infection
of some kind. An elderly person may
be confused, so having access to what
they have been prescribed is really
important.” Dr Betty says.
The Shared Care Record gives hospital
clinicians access to an inbox where all
Wellington Hospital ICU specialist Dr
Peter Hicks says there are some features
Monthly
$
$
$
$
Financial
UPDATE
to note in particular, such as the icon
which indicates whether clinicians can
access patients’ record information but
its usefulness will be greatly improved
later this year when access is extended
to other Central Region DHBs.
“In the next few months we hope to add
access to broader range of primary care
information by extending our coverage
to records at the MidCentral, Hutt
Valley, and Wairarapa DHBs.”
If you’ve had to sign an
invoice in the last month,
you’re doing it wrong.
T
here are currently over 3000 suppliers
on CCDHB’s database, but you may not
know that 80 percent of all health spending
in New Zealand comes from just 79 of them.
If you’re not ordering supplies through
IPROC, you’re probably being overcharged.
Purchase orders take advantage of the
national contracts we have negotiated to
ensure best value for money. Otherwise
you may be paying more for the same item.
A purchase order also enables us to
instantly check whether you have been
overcharged or if goods have been underdelivered, saving weeks of paper work.
No matter which way you look at it, it just
makes sense. You can access IPROC to log a
purchase order via your Oracle log-in.
Annual leave
Last month we reported
that collectively you took
4764 less days of annual
leave over Christmas and
New Year than last year –
but that’s only about one
less day per person.
So why not take a longlong weekend this Easter?
2015 Issue 2 l Health Matters
3
One call solves all at
dietetic clinic
A
new patient-orientated approach to
bookings by the hospital’s dietetic
clinic has seen a dramatic drop in
appointment non-attendance, from 50
per cent of patients to zero in the last
six months.
Percentage of patients DNA'ed (%)
70
No Clinics in
March
Diabetes Dietitian DNA rates (%)
60
50
New
40
Follow Up
30
Linear (New)
20
Linear ( Follow Up)
10
0
Month
By following up on referrals and calling
patients directly, dietitian Nicole Walker
found that both she and her patients are
getting more out of their appointments.
“The high level of bookings missed
meant clinical time was being wasted
and the waiting list of people who
weren’t being seen was growing.
“By calling the patient directly,
confirming their appointment time,
and what they wanted to achieve, the
patient felt more in control, better cared
for, and also came better prepared to
their appointments.
“I can tell them exactly what they need
to do, whether to create a food diary or
bring in any extra information.
“I went from having 30 to 40 patients on
my waitlist down to zero and patients
only waiting two to ten working days for
an appointment.”
“By creating this relationship the
patients feel more obligated to
show up and like they already know
me, just through one phone call
the appointment became far more
personalised.”
Nicole says that it takes her about 30
minutes to call her patients per week,
but she estimates that she’s saving
two to three hours a week through the
reduction of non-attendances.
“If they have any simple enquiries that
can be attended to over the phone I
can help them on the spot, rather than
having them come all the way into the
clinic.
“It also allows me to discover who
physically cannot attend appointments
and refer the community dietetic
service.”
Feedback from patients has been
very positive and the system is now
being used by the General Outpatient
Dietitian in Wellington to contact her
urgent patients.
“Some people may see it as ‘another
thing to do’ and it takes a while to get
the hang of, but the results are so good
and the relationship with the patients
becomes far stronger,” Nicole says.
“Hopefully as we progress we could look
at other places in the hospital with high
DNAs to see if this system could help
them.”
‘Leadership Matters’
website launched to
support staff
Hospital leaders can enjoy some extra
support thanks to a new internal
website, ‘Leadership Matters’, that
was launched this month by HR.
The website contains practical advice
on essential management processes
such as giving and receiving feedback,
and the role of leaders in promoting
open communication.
“Fundamentally, the site is to support
and inform leaders to help them
work more effectively with their
teams”, Mike Hughes, organisational
development consultant and team
leader, says.
“We’re not trying to dictate what
managers should do, but instead we
want to provide people with some
processes, structures and models to
support their work.”
The website will be updated monthly
with documents produced both inhouse and from outside organisations
that will be tailored to suit the needs
of the 3DHBs and healthcare.
“We hope it will aid managers at
all levels of the organisation as
well as those staff who are moving
from technical roles into their first
managerial positions, helping them
to avoid common pitfalls, as well as
providing them with pathways to
success.”
You can find a link to ‘Leadership
Matters’ on the front page of the
intranet.
If you have any feedback on
the website or suggestions for
future content you can direct it to
leadershipmatters@ccdhb.org.nz.
Nicole Walker in her clinic
4
2015 Issue 2 l Health Matters
”
Kenepuru Hospital
“
Took Deb to Kenepuru Hospital for
minor surgery on her hand. Staff were very
friendly, a volunteer noticed we were lost
and helped. Great place.
Kenepuru Hospital
”
“
Hello, our family wishes you to know
that our 90 plus father had to visit the
clinical measurement team on Tuesday 17
Feb. The first contact was with Ash who
bent over backwards to get an appointment
which suited. Unbelievable manner and
kindness shown to us.
ED Target statistics
91.4%
7.5
4400
6
We both enjoyed everybody we met and
can’t say enough great things about the
treatment that was given. We would like you
to know that it is much appreciated.
Clinical Measurement Unit
“
”
My wife was transferred to Wellington
hospital from Palmerston North to have
an angioplasty. We cannot fault the
service and care she received, it certainly
instilled my faith in the capabilities and
professionalism of Wellington Hospital staff
and doctors.
”
Interventional Radiology Ward
CLOSE
performance against 6hr target for February.
hours to discharge 95% of ED patients
patients presented and completed their care 379 less patients than February last year
More patients per day were needed to be discharged
within 6 hours to attain the 95% target
Staff Profile - Matt Kelly
Subregional Infection Specialist
Next person was a lovely ECG male Tech
- who ever hired this lovely person - take
a bow!!!!! He treated my dad with such
kindness, respect and dignity, my dad was
blown away. While waiting to see the Cardio
registrar, dad went on about how happy he
was, and what a nice boy he had just seen,
and how he had made his day.
Then the registrar, he was AWESOME!!!
Dad suffers from dementia and this person
talked to dad and included him in all
conversations. This is a gift sadly lacking in
many medical personnel. He even pulled
me up when I was trying to explain Pradaxa,
as ‘rat poison’. He explained that this could
frighten dad to not take the medication that
he needs. As we were leaving dad wanted to
know when we would be coming back here,
as everyone was so nice to him.
SUC
CE
S
“
Thank you Kenepuru Hospital. Had a
small op there yesterday and the service
was great. Pleasantly surprised to receive
follow up call from the nurse today – thanks
Lynley.
S!
H
-O
UH
Compliments
What is your background
in Healthcare?
I graduated from Otago University
in 2002 and began working as a
house surgeon between Wellington,
Hutt and Wairarapa. I did this for
two years until 2005, when I did
some brief work in India at a charity
hospital. In 2008 I travelled to
Liverpool, where I studied a Diploma
in Tropical Medicine. This allowed
me to work in Malawi for 15 months.
Not long after that I returned to
Liverpool where I did my fellowship
year, returning to Wellington
to finish my training in general
medicine and infectious diseases.
Could you explain your
role as an infectious
diseases physician?
The position was created in 2013 by
Hutt Hospital to provide consistent
infectious diseases expertise in the
region. The role links in closely with
some of the broader aims that are
held by the Hutt in the 3DHB project.
I am based out of the Hutt but my
work is part of the subregional
3DHB infection team. I also spend
half a day every week in Wellington
working with the Capital and Coast’s
Infection Services. Most of my
time is spent helping people treat
complex infections and working with
the infection prevention and control
team to prevent healthcare-acquired
infection. I also spend my time
helping to educate staff on topics
such as how to use antibiotics wisely.
Wow. That sounds quite
full on.…
It is but I love how broad the role is.
My days are extremely varied and
my work spreads across almost every
department in the hospital. I have
found everyone I’ve worked with to
be extremely supportive.
What’s your ideal
weekend?
At the moment? A weekend away
from the kids with my wife.
Favourite music?
Alternative rock like the Killers and
Kings of Leon.
Favourite movie and
why?
Braveheart, no explanation needed.
2015 Issue 2 l Health Matters
5
ital
p
s
o
h
o
ered t ebruary, and
v
i
l
e
d
s
duate eir graduation in F.
a
r
g
e
f
i
h
rated t
h e DH B
Midw
s celeb
th e se
t with t
ive
en
guide
w midw
placem
e
ir
n
e
r
ow help
h
u
n
t
o
l
n
il
F
t just
a
w
g
e
e
b
em , “no
s sh
y
h
t
a
s
e
,
k
r
a
o
to m
ducat
the aim t midwives”.
idwife e
h
m
it
l
a
w
ic
y
e
n
lin
m,
ir journ
confide
Kath , c
e
t
h
u
t
b
,
n
for the
s
o
g
e
s
in
iv
e
it
t
w
c
a
x
id
u
grad
rd t o
ent m
g a nd e
k forwa
com pet
o
allengin
o
l
h
c
e
ly
w
e
s , bu t
xtrem
ay.”
if ficultie step of the w
will be e
d
r
t
a
u
e
o
y
h
“This
every
not wit
g them
h s a nd
in
ig
t
h
r
o
f
p
o
full
a n d s up
helping
A fresh delivery of mi
dwife graduates enjoye
d a morning tea
as they met their new
team
Vicky’s Book
Three and a half years ago, oncology patient
Vicki Joy Wal sh couldn’t remember how
to put on her shoe. She had no idea this
y
Da
was
’s
just the start of a long battle with
ildren
Hospi celebrates National Ch
an aggressive brain cancer known as
onal Children’s Day with
Nati
d
ate
ebr
cel
we
nth
Gliob
mo
astoma Multiforme (GBM), which
s
Thi
.
e of our youngest inpatients
som
for
s
bag
die
goo
and
e
cak
can double in size within three to four weeks.
has been providing a home
Wellington Children’s Hospital
r
ove
t
jus
injured children for
GBM is almost always fatal but her cancer has been
away from home for sick and
dorm ant
since
rs.
March 2012, and Vicki has since self-published
yea
100
a book
called ‘Don’t be afraid – The journey is just the begin
cared for just over 5000
tal
spi
Ho
n’s
ldre
Chi
ning’
the
r
,
yea
Last
these kids come from as far outlining her experience from diagnosis.
l,
pita
hos
y
tiar
ter
a
As
n.
childre
ke’s Bay, to Marlborough in
nor th as Taranaki and the Haw
CCDHB neurology clinical leader Mr Andrew Park
er says
the South Island.
patients with GBM usually present with headache
s,
seizures or
in charity par tner, the
progressive neurological deficits, depending on wher
Special thanks also to our ma
e the tumour
tion and HOSPI for their
is growing in the brain.
Wellington Hospitals Founda
’
lars
dol
of
nds
usa
tho
of
ds
suppor t and the many hundre
e raised with generous
Mr Parker says the long-term aid of therapy is
worth of equipment they hav
to reduce GBM
s.
kid
our
p
hel
from
to
what was once a fatal condition to a chronic disea
t
por
community sup
se, and
allow patients who are frequently young and highl
y productive, to
get on with their lives.
“The fact that Vicki is still alive marks her as spec
ial. At the start
of her treatment she was just another perfectly
ordinary patient,
and that’s what’s inspiring. If she can make it, then
so can the
others who follow.”
6
al Child
on Nation
s
g
a
b
ie
d
ds o u t g o o
Hospital
Hospi han
Children’s
2015 Issue 2 l Health Matters
th
rens Day in
e
for the central
Nora Thompson standing with course materials
which was
region’s new Certificate of Healthcare Capability
looks to integrate
launched this month. The seven month course
y into health
the Treat y, Tikanga Māori, and cultural competenc
accessible. If you
care practices and to make Māori learning more
g any further
would like to find out how you can join, or are seekin
ll@ccdhb.org.nz.
information please email katherine.reweti.russe
Māori nursing stude
n
awarded scholarship ts
s
ps stand
i nursing scholarshi
Recipients of Māor
ea McCance
proudly with Andr
27 young Māori nursi
ng students were aw
arded scholarships to
Whitireia’s nursing sc
hool from CCDHB las
t week.
This is the first year th
e scholarships have be
en awarded since th
were created in a pa
ey
rtnership between th
e CCDHB and Whitire
Bachelor of Nursing
ia’s
Maori, aiming to enco
urage more Maori to
join
the health workforce
.
“Currently Māori ma
ke up 13 percent of th
e district ’s population
only six percent of ou
but
r nursing staff. These
scholarships are a ste
stone to creating a he
pp
ing
alth work force more
representative of the
people that we treat,
and improving the he
alth of our communitie
Andrea McCance, CC
s,”
DHB’s Director of Nu
rsing and Midwifery
says.
Less hear t s
rheum atic fe tops as
ver drops
The rheum a
tic fever pre
vention prog
a big th ank y
ramme wants
ou to all DH
to extend
B staff a s da
month h a s s
ta relea sed th
hown a 14 pe
is
rcent decrea
hospitalisati
se in rheum a
on in New Z
ti
c
fever
ealand since
the commen
the better p
cement of
ublic service
target in 20
12.
a stand
d Francesca Au man
an
e
yn
Ha
lly
Ho
s
Intern pharmacist
ote better patient
l’s atrium to prom
ita
sp
Ho
on
gt
in
ell
in W
d their safety, as
es to medicines an
m
co
it
en
wh
g
in
macy Week,
understand
for better care Phar
AN
PL
t’s
Le
’s
SC
part of the HQ
22 - 28 February
New ‘Hip’ videos
Brave nurses Lesa, Pravina and Kara stand outside
ED after shaving their heads for cancer
TOP 5 intranet stories
for February
1039 views Health Matters Issue 1
666 views
Sharpening up on Phlebotomy
542 views
New 3DHB MHAIDS launched
413 views
Pharmacies provide sharp relief
316 views
Busy People Boot Camp
A new video series on hip and knee replacement
surgery
was launched by the Ministry of Health last mont
h, aiming
to help better prepare patients for surgery.
The videos were developed between the Waitemat
a DHB
and the National Orthopaedic Enhanced Recovery
After
Sugery team (ERAS), and are now available on both
the
Ministry’s website and youtube account for publi
c access.
A key part of ERAS is involving patients in the prepa
ration
for surgery. If people know what to expect, they
are better
prepared, recover faster, have fewer complicati
ons, and
can get out of hospital quicker.
Last year there were
407 joint replacement
surgeries at Wellington
hospital.
You can find the videos at
www.health.govt.nz.
2015 Issue 2 l Health Matters
7
Immunisation looking sharp
I
ON
mmunisation rates have continued to
boom in the Capital and Coast as 97
percent of eight month olds had their
primary course of immunisation on time this
February.
This exceeds the Ministry of Health target of
95 percent.
This success has come about thanks to
the combination of a highly targeted
effort by our PHOs, a focus on seamless
communication between healthcare
providers, and a shift in the culture around
immunisation by hospital staff, says Helen
Hartley, CCDHB immunisation facilitator.
“One of our major aims has been to see a
change in the workforce so that anytime
contact is made with a healthcare provider
parents are prompted to immunise their
child.”
“With the development of the National
Immunisation Register we have a list of the
immunisation status of every child born
since 2005. This information is faxed daily
to the Children’s wards and a weekly list is
sent to Childrens Outpatients department,
identifying booked children who are overdue
for immunisations.”
The National Immunisation Register also
communicates and updates information
everyday about childrens’ immunisation
status to GPs, PHOs, and community
outreach providers, as well as maintaining
linkages with Plunket and Tamariki providers.
Let’s celebrate and pay tribute to
those individuals and teams of
volunteers who make a difference
to New Zealanders’ health.
calling for
nominations
for the 2015
Minister of Health
2015 Minister of Health
NomiNaTioNs oPEN
volunteer
awards
Health volunteers make extraordinary
contributions, to an extraordinary number of
people, in an extraordinary number of ways.
These awards celebrate health volunteers from
all walks of life and give New Zealanders
the opportunity to recognise and celebrate the
inspirational commitment of health volunteers.
Nominations
open
1 March to 31 March 2015
8
Nominate
someone today
http://volunteerawards.health.govt.nz
2015 Issue 2 l Health Matters
Combined with
a highly targeted
effort by PHOs and
outreach providers,
the disparity
between the
immunisation rates
of Māori and Pacific people and other ethnic
groups has all but disappeared.
TARGE
T
“Historically, PHOs may have sent letters
to remind parents about immunising
their child only after they had become
overdue. Providers are now working in a
very proactive way by getting families on
board early as an enrolled patient, as well
as offering them services such as home
immunisation if they cannot make it to a
clinic.”
Midwives and Lead Maternity Carers are
also offered immunisation education
opportunities to ensure new parents receive
the best information possible.
Immunisation
Statistics
3379
eight-month
olds were
immunised at CCDHB in
the past year.
96%
of eight-month
olds were
fully immunised in the
last three months. This
compares to 91 percent
of eight month olds
immunised in the same
period last year.
95%
is the
immunisation
target for eight-month
olds this year.
With the addition of the 50 immunisation
champions working with Occupational
Health and Safety Services in our hospital,
there are now a number of chances to
provide immunisation opportunities to
parents.
“This means that at every stage of a family’s
journey through the hospital they can be
reminded to immunise.”
“It’s just about everyone chipping in,” says
Helen.
Volunteer Awards now open
N
ominations are now open for the
2015 Minister of Health Volunteer
Awards.
http://volunteerawards.health.govt.nz/
Whether it’s offering a cup of tea
to patients in hospital emergency
departments, driving cancer patients
to appointments, fundraising or simply
lending a helping hand and support,
the 2015 Minister of Health Volunteer
Awards are an opportunity to recognise
the many volunteers who generously
give their time, skills, experience and
care to help others.
All nominees receive formal recognition
of their contribution. In addition, awards
category winners and the overall Health
Volunteer(s) of the Year are invited to a
special awards presentation where they
receive framed certificates.
You can nominate someone by
completing a nomination form online at
Nominations close at 5pm on Tuesday
31 March 2015.
The 2015 Minister of Health Volunteer
Awards will be presented during
National Volunteer Week from 21–27
June 2015, New Zealand’s largest
celebration of volunteering.
Long Service: Elizabeth Tough
Professional and Technical Advisor, Haemotology
Hospi Update
What are some of the
changes you’ve seen?
There’s a lot more automation
in the lab now, especially in
microbiology. I’m glad that I chose
haematology because it is still
quite hands on. I’ve always enjoyed
the more active tasks rather than
dealing with numbers.
T
his month Elizabeth celebrates
her 48th year with CCDHB.
Elizabeth started her training at
Wellington Hospital Pathology
Laboratory in 1967 and has been
working in the hospital labs
specialising in haematology
ever since.
Why haematology?
I’ve always enjoyed the level of
attention to detail that it requires,
you have to be very observant and
able to pick out minute patterns.
Dear Debbie...
Still enjoying it?
Absolutely! Every day there is
something new and interesting,
a patient who has a different
pathology that we haven’t seen
before and fascinating diagnoses.
Any thoughts of
retirement?
Not currently, I could retire
whenever I want but I still enjoy the
work so I see no reason to stop.
the
ve me an update on
Could you please gi
Executive?
Wellington Hospitals Foundation
presented two state of the art ‘Alcotest
Units’ costing $7,000.00 each to the
Emergency Department. These Units
will enable quick, safe and repeatable
testing of intoxicated patients
presenting to Wellington Hospital’s
Emergency Department, and are
believed to be a first for a New Zealand
hospital.
Chief
recruitment of our
Tony
Hi Tony,
New Tool to Assess
Intoxicated Patients
the Interim
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beyond this date th
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DHB continues on
Have You Seen HOSPI’s
Pawprints?
Special HOSPI pawprint paths to help
patients and vistiors find their way to
Wellington Children’s Hospital lead
from the Hospital Atrium, Emergency
Department and Theatre. The pawprint
paths include Hospi graphics in varying
states of adventure (parachuting,
skateboarding and riding a penny
farthing bicycle).
is appointed.
Kind regards,
Debbie
2015 Issue 2 l Health Matters
9
antibiotic of the month: Rifampicin
R
ifampicin should always be
prescribed in combination with
another antibiotic as rifampicin
resistance develops quickly.
Is used for the treatment of
tuberculosis and other serious
staphylococcal infections.
Has a role in the treatment of
implant infections as it is one the
limited number of antibiotics with
greater activity against bacteria in
biofilms.
Has great oral bioavailability. IV =
ORAL – only use the intravenous
route if the oral route is unavailable.
Achieves extensive distribution into
tissues and bodily fluids including
urine, tears, sweat and aqueous
humor, resulting in an orange-red
discolouration of these body fluids.
Pre-warn your patients!
Is generally well tolerated. The most
common side effects are GI upset
and cutaneous reactions such as
flushing or mild skin rash that are
usually mild and self-limiting.
Can result in elevation of serum
hepatic transaminase levels which
is often self-limiting. In rare cases
severe hepatitis can occur requiring
discontinuation. For this reason
close monitoring of liver function
tests is recommended during the
first 2 months of therapy.
Is a potent CYP3A4 inducer
and therefore can increase the
metabolism of other drugs that
are metabolised by this pathway,
leading to sub-therapeutic levels
of these drugs. Examples include
warfarin, oral contraceptive pill,
corticosteroids, methadone and
many other drugs. Close clinical
monitoring, therapeutic drug
monitoring, and selection of an
alternative drug maybe required. If
you are unsure if a drug interaction
exist then check with your ward
pharmacist.
Is a restricted antibiotic on the
Hospital Medicines List. Respiratory
or Infectious Diseases/Microbiology
approval required.
This information is brought to you by
the CCDHB Antimicrobial Stewardship
Committee. If you have questions or
concerns about antibiotic use, please
contact:
Dr Mark Jones,
Clinical Microbiologist (#6574)
Dr Nigel Raymond,
Infectious Diseases Physician (#6406)
Dr Matthew Kelly,
Infectious Diseases Physician (Hutt
Hospital)
Brijul Morar,
Infectious Diseases pharmacist (#6114)
Royal farewell for Vicky Noble
A
room packed full of staff from
across the hospital shed a few tears
saying goodbye to Vicky Noble last
month, as she was inundated with gifts
and gratitude.
Speakers praised Vicky for her
approachability, leadership, advocacy,
and strong sense of ethics in her
position as the Director of Primary and
Integrated Care Nursing over the past
six years.
10
2015 Issue 2 l Health Matters
Māori, Pacific and disability services
spoke strongly of the positive impact
that Vicky’s work had on primary care
nursing and the community.
Her work has been widely appreciated
across the sub region thanks to
collaborations with the Hutt and
Wairarapa DHBs and outside
organisations including Plunket, Work
and Income, and many youth outreach
programmes.
“I’m so proud to have worked for both
SIDU and Capital and Coast, we’ve been
through a huge amount as a team”,
Vicky says, “Every day presents the
most extraordinary opportunities to
improve our health care services and I
feel it has been a huge privilege to have
been in my position”.
Vicky will be travelling to join her
husband who is currently working in
Myanmar.
!
r
a
t
S
a
e
r
’
You
5 years
Helen Meehan, Radiation Therapist
Clare Couch, Clinical Psychologist
Jethro Donaldson, Medical Physics
Registrar
Katherine Lynch, Midwife
Grace Gorte, Ward 20 Nurse
Sally Jackson, Genetic Associate
Sophie Harley, Staff Nurse
Patricia Cederwall, Administration
Clerk
Alaine Over, Medical Typist
Brendan Young, Dental Surgeon
Noel Mason, Purehurehu
Cara Jones, Ward 19 Nurse
Shiji George, Registered Nurse
Adaline Tohill, Consumer Council
Shona Urquhart, Occupational
Health Nurse
Catherine Birch, Staff Nurse
Julie Kyle, NICU
Karen Barns, Staff Nurse
Clive Cameron, Hospital Advisory
Committee
Robyn Hughes, Hospital Advisory
Committee
Kevin McDermott, Inwards Goods
Christian Kalderimis, Advisory
Committee
Elizabeth Solomona, Consumer
Council
Sisilia Peini, Rangipapa Nurse
January Almendras, Renal Dialysis
Unit
Susan Corin, NICU Nurse
Peter Rintoul, Plumber Workshops
Lynne Cowley, Ward 18 Nurse
Kerry Thornbury, Hospital Advisory
Committee
Rachel Reynolds, ICU Nurse
30+ years
Heta Makiri, Kaiawhina Coordinator
Sesilia Antonio, Laundry Worker
Miria Kapene, Laundry Worker
Judith Spooner, Midwife
Special Thanks and Recognition
The CCDHB would like to give a big thanks to those staff members
who have reached a milestone 5, 10, 15, 20 or more years with the
hospital this month.
10 years
Ruth Ferrer, Ward 5 Nurse
Penelope Flaws, Clinical Coordinator
Shannon Unka, NICU Nurse
Rebecca Mellish, Board Member
Anita O’Boyle, Midwife Educator
Louisa Fruean, Community Nurse
Patrician Martin, Charge Nurse
Manager
Tonie Ikivihi, Community Mental
Health Nurse
Catherine Young, Mental Health
Nurse
Katherine Neas, Clinical Geneticist
Rose Toomaga, Health Care
Associate
Arthur Skelton, Mental Health
Support Worker
Patricia Janes, Scientific Officer
Valerie Spooner, Speech Therapist
Briar Coleman, Senior Anaesthetic
Technician
Isabella Sciascia-Visani, Scientific
Officer
Penelope Wyatt, Clinical Midwife
Specialist
15 years
Dayantha Sananayake, Sterile
Services Technician
Michael Daly, Social Worker
Agadha Wickremesekera, Neuro
Surgeon
Cheowleen NG, Registered Nurse
Kathleen Knowles, Duty Nurse
Manager
Susan Black, Charge Nurse Manager
Cho Kho, Registered Nurse
Lynette Stewart, Charge Nurse
Manager
Robert Nielsen, Community Nurse
Donna Hesp, Staff Nurse
Katrina Bootsma, NICU Nurse
Patricia Henaghan, ICU Nurse
Colleen Peel, Community Nurse
Manager
Fafili Levave, Mental Health Support
Worker
20 years
Victoria Conwell, Staff Nurse
Outpatients
Wynona Elliot, Theatre Support
Assistant
Janet Dunbar, Nurse Clinician
Joanne Gibbons, Community Nurse
Marilyn Gibson, NICU
Denise Braid, Charge Nurse
Manager
Donna Bresaz, After Hours
Coordinator
Janice Lucas, Pathway Nurse
Coordinator
Hilika Lefao, Laundry Worker
Devi Morar, Laundry Worker
Jennifer Wickens, Community Nurse
Fiona Mellars, Clinical Nurse
Specialist
Gilian Hawke, Senior Consultant
Clinical Psychologist
25 years
Lynne Turkington, Medical Records
Coordinator
Rosaline Ahmed, Healthcare
Assistant
Shelley James, Charge Midwife
Manager
Lorna Jennings, Registered Nurse
Joy Herbert, Clerical Assistant
Duncan McPhail, Senior Anaesthetic
Technician
Rosemary Escott, ICU Charge Nurse
Manager
Gerrigje Nicholls, Charge Nurse
Manager
Alan Vekula, Warehouse Supervisor
Elizabeth Tough, Haematology
Technical Specialist
2015 Issue 2 l Health Matters
11
A Day in the Life: Mortuary Technicians
M
ortuary technician David Walker
says people react in different
ways when he tells them what he does
for a living.
“Sometimes they excuse themselves
and don’t want to know about it, or they
become completely fascinated by it and
start asking lots of questions.”
As technical head, he works with
three other mortuary technicians
at Wellington Hospital - Monday to
Friday from 8am to 5pm. The team also
operate an on-call roster for all hospital
and coronial afterhours viewings and
autopsies.
Crime shows like CSI, while lifting
the profile of forensic pathology, are
predictably unrealistic, says David.
“TV CSI investigators examine the
deceased with a scanner of some sort,
determining that the person died, for
example, of heart failure. If anyone’s got
one of those machines please send it to
us – it’d make our job a lot easier!”
In reality, mortuary technicians assist
forensic pathologists at the time of
autopsy by making the initial incisions
and removing the organs for the
pathologist to inspect.
A mortuary technician’s role is similar to
a theatre assistant’s, says Tim Reen.
“Other health professionals are often
amazed at the extent of our practical
skills when it comes to removing organs
and reconstructing bodies.”
The team also provide the hospital’s
‘return to patient service’, returning
tissue samples to live patients or
deceased patients’ families if requested
for cultural or other reasons.
Undeniably the ability to deal with
Mortuary technicians Rachel Kinnaird, Maari Gray, David Walker, and Tim Reen
“raw emotion” is equally important
as the clinical skill, because mortuary
technicians arrange viewings with
families and explain the autopsy
process and the coroner’s involvement,
if necessary.
The first 10 – 15 minute discussion with
families is an important opportunity
for the team to discuss the processes
involved and hopefully make it easier in
some small way for them, David says.
Being mindful of the fact that the
people they deal with have families
and are connected emotionally to their
relatives provides some context to what
is essentially a clinical role, Maari Gray
says.
“When you know family are very much
involved, a human element infuses to
the clinical side. We’re a multi-cultural
society and are often requested to
adapt to different ways of doing things.
Ours is a constantly evolving knowledge
base.”
Maari says working with families and
whānau acknowledges that death is
about the living, and breaks down the
Life should n
ot be a journ
ey to the gra
intention of a
ve with the
rriving safely
in
preserved bo
a pretty and
dy, but rathe
well
r to skid in b
a cloud of sm
roadside in
oke, thoroug
h
ly
used up, tota
out, and loud
lly worn
ly proclaimin
g “Wow! Wh
at a Ride!”
Hunter S. T
h
om pson
12
2015 Issue 2 l Health Matters
FACT FILE
Wellington Hospital’s mortuary
cares for an average of 550
hospital deaths per year, and
an average of 400 people who
have died in the community
and require an autopsy.
Mortuary positions are few
and far between – there
are only around 30 in New
Zealand.
It is not necessary to notify
mortuary staff of a death in
hospital unless family are
wishing to arrange a viewing in
the Bereavement Suites (Ngaio
and Rata).
separation between “us over here and
the family over there”.
“We are neither ghoulish or CSI
lookalikes and want to break down old
and new preconceived ideas about the
mortuary and those who work within
it.”
It is a select profession and two years
of training takes place on the job prior
to gaining eligibility to sit the qualifying
exam. A background in science, nursing,
or funeral directing is helpful but not
essential, David says.
At the end of the day, the team are here
to support each other. Rachel Kinnaird
says it’s a job that requires a strong
stomach, but “you have to care about
people and see them as you would your
own family”.