Allied Health, Science and Technology Council : Challenges of providing services to remote communities.

Hi there, we are Julie and Ciara and we represent the Northern Territory on the Executive of the Allied Health, Science and Technology Council of CSANZ. We both hail from Ireland, completing our BSc in Clinical Measurement Science in 2009 and 2012 respectively. Julie moved to Darwin in 2012, Ciara followed in 2016. We both completed International Board of Heart Rhythm Examiners certification in Ireland, and in Australia, Julie continued her studies to specialise in Echocardiography and Ciara specialised in Electrophysiology.

Since arriving in the Territory, we have both worked for NT Cardiac at Darwin Private Hospital (DPH), as Cardiac Physiologists. NT Cardiac services both private and public patients, across DPH as well as Royal Darwin Public Hospital. DPH has a Catheterisation Lab, where up to five pacemaker / defibrillator devices are implanted per week. Up until very recently, we had a dedicated day for Electrophysiology studies and ablations (Radiofrequency, Cryoablation and 3D Mapping). Unfortunately, this service is temporarily suspended as there is no Electrophysiologist available in the NT.

As part of our role, we service over 25 remote NT communities as part of a multidisciplinary team, consisting of a cardiologist, registrar, cardiac nurse, sonographer and sometimes a pacing trained Cardiac Physiologist. We have assisted with the implementation of new Cardiac Physiologist-led remote pacing clinics, designed to provide a greater level/continuity of service to patients and to ease the burden on the cardiologists on their one or two day remote trips.

Remote clinics present many challenges, some unavoidable. Many communities are often cut off from larger clinics in Darwin for months at a time during the wet season due to flooding. The larger community clinics like Katherine or Nhulunbuy are visited multiple times a year by the multidisciplinary team, however, some more remote clinics might have only 1 visit per year. As a result, providing optimal cardiac management to these patients can be difficult, compounded by the fact that some patients live in different communities depending on the season (wet versus dry season). Our visits sometimes coincide with funerals, cultural ceremonies or sorry business in the local community, which we always try our best to work around.  

To accommodate these challenges, we schedule our pacing patients on a six monthly basis. Ciara has set up a list of patients at each community, and we aim to ensure at least yearly follow-up. Some patients are provided with home monitors at implant or follow-up, this enables us to receive data from remote locations to save medivac flights to Darwin. Remote community patients often lack access to Wi-Fi, often have limited mobile phone signal or access to mobile phones, and possibly intermittent electricity. For this reason, the majority of remote patients have their home monitors left permanently in the community clinic to send information to our clinic in Darwin. This puts added pressure on local dedicated staff that are already extremely busy, but these home monitors become highly useful in the case of emergencies.

Providing echocardiography services to these patients also comes with its challenges. There can be limited facilities available at some clinics, with a lack of adjustable beds and adjustable trolleys for the echo machines. Room availability can be an issue, as there can be multiple visiting teams at the clinic at the one time. We scan a high volume of difficult pathology patients, for example double and triple valve replacements, all of whom are scanned on a portable machine. Patients can often be quite reluctant to come to Darwin, so these echoes in community are potentially their only follow-up scans.

Despite the challenges, the Territory provides a hugely rewarding and unique working experience for allied health professionals. Our remote trips are a wonderful way to experience the NT and to see Territory life from a very different perspective and are a great opportunity to get to know your working team. It provides us with a great opportunity to try to improve systems, protocols and procedures, and therefore make a real impact to healthcare for our patients who live remotely.

Ciara Devoy, Cardiac Physiologist Julianne Pfister, Sonographer

Article recently published in the April On the Pulse – read in full here.

Allied Health, Science and Technology Council : Challenges of providing services to remote communities.

Hi there, we are Julie and Ciara and we represent the Northern Territory on the Executive of the Allied Health, Science and Technology Council of CSANZ. We both hail from Ireland, completing our BSc in Clinical Measurement Science in 2009 and 2012 respectively. Julie moved to Darwin in 2012, Ciara followed in 2016. We both completed International Board of Heart Rhythm Examiners certification in Ireland, and in Australia, Julie continued her studies to specialise in Echocardiography and Ciara specialised in Electrophysiology.

Since arriving in the Territory, we have both worked for NT Cardiac at Darwin Private Hospital (DPH), as Cardiac Physiologists. NT Cardiac services both private and public patients, across DPH as well as Royal Darwin Public Hospital. DPH has a Catheterisation Lab, where up to five pacemaker / defibrillator devices are implanted per week. Up until very recently, we had a dedicated day for Electrophysiology studies and ablations (Radiofrequency, Cryoablation and 3D Mapping). Unfortunately, this service is temporarily suspended as there is no Electrophysiologist available in the NT.

As part of our role, we service over 25 remote NT communities as part of a multidisciplinary team, consisting of a cardiologist, registrar, cardiac nurse, sonographer and sometimes a pacing trained Cardiac Physiologist. We have assisted with the implementation of new Cardiac Physiologist-led remote pacing clinics, designed to provide a greater level/continuity of service to patients and to ease the burden on the cardiologists on their one or two day remote trips.

Remote clinics present many challenges, some unavoidable. Many communities are often cut off from larger clinics in Darwin for months at a time during the wet season due to flooding. The larger community clinics like Katherine or Nhulunbuy are visited multiple times a year by the multidisciplinary team, however, some more remote clinics might have only 1 visit per year. As a result, providing optimal cardiac management to these patients can be difficult, compounded by the fact that some patients live in different communities depending on the season (wet versus dry season). Our visits sometimes coincide with funerals, cultural ceremonies or sorry business in the local community, which we always try our best to work around.  

To accommodate these challenges, we schedule our pacing patients on a six monthly basis. Ciara has set up a list of patients at each community, and we aim to ensure at least yearly follow-up. Some patients are provided with home monitors at implant or follow-up, this enables us to receive data from remote locations to save medivac flights to Darwin. Remote community patients often lack access to Wi-Fi, often have limited mobile phone signal or access to mobile phones, and possibly intermittent electricity. For this reason, the majority of remote patients have their home monitors left permanently in the community clinic to send information to our clinic in Darwin. This puts added pressure on local dedicated staff that are already extremely busy, but these home monitors become highly useful in the case of emergencies.

Providing echocardiography services to these patients also comes with its challenges. There can be limited facilities available at some clinics, with a lack of adjustable beds and adjustable trolleys for the echo machines. Room availability can be an issue, as there can be multiple visiting teams at the clinic at the one time. We scan a high volume of difficult pathology patients, for example double and triple valve replacements, all of whom are scanned on a portable machine. Patients can often be quite reluctant to come to Darwin, so these echoes in community are potentially their only follow-up scans.

Despite the challenges, the Territory provides a hugely rewarding and unique working experience for allied health professionals. Our remote trips are a wonderful way to experience the NT and to see Territory life from a very different perspective and are a great opportunity to get to know your working team. It provides us with a great opportunity to try to improve systems, protocols and procedures, and therefore make a real impact to healthcare for our patients who live remotely.

Ciara Devoy, Cardiac Physiologist Julianne Pfister, Sonographer

Article recently published in the April On the Pulse – read in full here.

Spotlight on Dr Nilufeur McKay, DNP, RN, ANP-BC, Grad Cert (Edu)

Dr Nilufeur McKay, Senior Lecturer, Course coordinator, Master of Nursing (Nurse Practitioner) Program at Edith Cowan University, Cardiology Nurse Practitioner, Omni Corde Rhythm Services, WA, CSANZ ASM Scientific Committee Multidisciplinary Stream Representative for 2024 in Perth.

A career in nursing has provided me the opportunity to travel and work in some of the most prestigious international healthcare institutions. In 2000, I completed my Bachelor of Science (Nursing) at Curtin University and took my very first job at Royal Perth Hospital in the Cardiothoracic surgery unit and later progressed to the Coronary Care unit. At that early stage, I knew advanced heart failure and transplant was an area I wanted to learn more about. In 2003, I sat the NCLEX licensure exam and ventured over to Arizona, USA.

In 2005, I started my Master of Nursing (Adult Nurse Practitioner) degree at Arizona State University while working in a surgical ICU taking care of post op cardiac surgery patients. The experience of working in a critical care setting managing labile haemodynamic and labile cardiothoracic surgeon prepared me well for my career as a cardiology nurse practitioner (NP)!

I commenced my first outpatient cardiology NP job in 2008, which is when I saw the value of –“continuity of care” of the same patients and the contribution I could make to their quality of life. From 2011 to 2017, I was fortunate to work at Mayo Clinic on a busy inpatient heart failure and transplant service. My responsibilities involved admissions, daily rounds, and discharging patients from the hospital. I was also a key member of the outpatient cardiology practice seeing heart failure patient to reduce preventable heart failure readmissions. As a NP my practice involved a combination of independent and collaborative practice with physicians to care for patients with various cardiovascular diseases. Additionally, I coordinated ongoing NP student clinical placements for a dozen specialties throughout the organisation. During my tenure at Mayo, I concurrently completed a Doctor of Nursing Practice degree through Johns Hopkins University in 2014 for which I led a research project and coordinated an interdisciplinary team to achieve positive statistically significant outcomes directly related to improving patient care. I contributed to various ongoing quality improvement initiatives at Mayo, some which are still in place today.

My experience of completing a doctoral degree at Johns Hopkins was more than just an educational achievement. I was exposed to a high calibre of nursing academics and leaders who fuelled my passion for teaching, leading and being a driver of change in nursing. I attribute my career success to having supportive nursing and physician mentors and most importantly strong family support.

My family and I moved to San Diego, California in 2017 where I then worker as a transplant and LVAD NP at Sharp Healthcare and The University of California, San Diego (UCSD) before returning to Perth in 2020.

I feel extremely privileged to be the course coordinator for the only Nurse Practitioner course in Western Australia. My current research in the Scholarship of Teaching and Learning looks at innovative methods to prepare the nurse practitioner workforce with our most recent project on conducting telehealth visits. I am passionate about advocating for all clinicians to work to the top of their licence and education preparation. I believe encouraging multidisciplinary team-based care will promote value-based healthcare and improve patient outcomes in Australia.

Apply Now for the 2023 CSANZ Indigenous Health Prize

The CSANZ Indigenous Health Prize will be awarded to the best individual presentation in the Indigenous Health Prize session at the 2023 Annual Scientific Meeting.

Abstracts are invited for studies involving Aboriginal, Torres Strait Islander, Māori or Pacific Islander populations. Applications will need to demonstrate engagement with Indigenous leadership, community members or Indigenous stakeholders during the research process, and the contribution of the research to reducing inequity and delivering tangible benefits for communities.

Click here for all the prize details, submission requirements and how to apply. 

Applications close on Monday, 8 May 2023

*New Breakout Session dedicated to nurses and genetic counsellors: Genomics Masterclass 6 May 2023 Melbourne VIC

Victorian Heart Hospital, Blackburn Road, Clayton, Victoria.
Saturday 6 May from 8.30am to 5.30pm – followed by networking drinks and canapés.

A fabulous new program is here that will include: cardiomyopathies, cardiac arrhythmias, aortopathy and CTD, cardiometabolic conditions, congenital and structural heart disease, pregnancy and risk, counselling 101. Learn from the experts and discuss clinical and research pathways.

*New Breakout Master Class session dedicated to the genetic nurse and genetic counsellor with practical processes and learnings and cardiac investigations and reports, drug challenges and medications 101, referral pathways and the approach to running a Cardiac Clinic.

Join in one of four afternoon breakout sessions including: gene and variant curation;  genetic counselling masterclass; and complex case review with panel discussion plus an opportunity for trainee presentations. Additional breakout for a practical Master Class in Cardiology Foundation – processes and learnings.

View the latest Program         Book now: https://www.trybooking.com/CFXES

Save the MBS Heart Health Check

The MBS Heart Health Check is currently due to expire on 30 June 2023, and there are concerns that the Federal Government will not extend this item.

Whilst our partners, the Heart Foundation of Australia and Hearts4heart advocacy efforts appear to have a preliminary result in reversing the government’s decision to cease the Medicare items dedicated to the Heart Health Check.

Until there is something in writing, (such as a pre-budget announcement), there is no guarantee. So, we ask for your support in promoting  the Heart Foundation of Australia’s campaign.

Hearts4heart will continue speaking with MPs and Senators, and they anticipate a formal announcement within the next couple of weeks.

In the meantime, we ask if you could get behind this campaign by sharing on social media and signing the petition here.

Abstract closed for CSANZ NZ ASM

 

Join us for the much anticipated CSANZ NZ ASM. Get the team together and head to Auckland in June for 2.5 days of expert lecturers, hands-on workshops, nursing symposium and a range of scientific sessions that will take your knowledge to the next level!

Catch up with old friends and meet new colleagues at the various social activities.  Boost your career by presenting your research at the 2023 CSANZ NZ ASM – submit your abstract now!

ABSTRACTS CLOSE ON MONDAY 13 MARCH AT 7PM (NZDT)

Ever wondered who was R.T. Hall, the namesake of the Lecture that launches every CSANZ Annual Scientific Meeting?

R.T. Hall came to Sydney from England in 1853 on the vessel “Waterloo”.

He was consumptive but managed to survive the long voyage and made a complete recovery.  His affairs flourished and after he died in 1894, a trust was established initially for: “An invalid home for the reception, cure and treatment of culture for respectable, moral persons, residing in Sydney or its suburbs, and suffering from consumption of the lungs”.

A sanitarium was established in the Blue Mountains in 1909 and was active till the early 1950s when the treatment of tuberculosis radically changed. The trust then looked for an alternative field to support and became involved in The National Heart Foundation. In 1959 and for a number of years, the bequest supported the RT Hall Lecturer.  However, in more recent times, the bequest has supported the RT Hall Prize and the lectureship has been funded by a donation from The National Heart Foundation, for which we are very grateful.

Register for the next CSANZ ASM here

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