North East Valley DGP eNews

No 1316: May 29, 2013
eNews is a weekly electronic newsletter sent to all GP practices (with email addresses) within the NEV catchment. The aim is to provide up to date information relevant to GPs and to disseminate the latest activities and resources from the division. All feedback and enquiries welcome and should be addressed to Patty Marshall. You can also visit our website at: http://www.nevdgp.org.au/.
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In this issue:

Editorial                                                Important new recommendations for flu vaccination for people with known adverse reactions or egg allergy     

Chronic Disease Management            Dose Adjustment for Normal Eating, Carbohydrate counting workshop for people on insulin pumps, World Diabetes Congress

Professional Development                 CPD events   

Information Management                  Medical Director, Best Practice & General Computer Tips

Items of interest                                  Heart Foundation launches HEART Online, Importance of Testing for “Reinfection” of Helicobacter pylori, GP Network News

Mental Health                                      Anxiety awareness

News for Practice Staff                       BeAWARE of the warning signs of heart attack and stroke, Orientation Program for Nurses New to General Practice

Paediatrics                                           Paediatric Immigration Health, Oncology and Haematology for GPs

Positions vacant/wanted                  

Fun stuff                                              

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A Word from the Editor

Important new recommendations for flu vaccination for people with known adverse reactions or egg allergy

The recently released 10th edition of the AIH provides new guidelines that now apply:

·         Vaccination of persons who have had an adverse event following immunisation

·         Vaccination of persons with a known egg allergy, Influenza vaccines

A history of anaphylaxis or a severe allergic reaction to eggs has previously been considered an absolute contraindication to influenza vaccination. However, there have now been a number of studies indicating that the majority of persons with egg allergy, including anaphylaxis, can be safely vaccinated with influenza vaccines that contain less than 1 μg of ovalbumin per dose.

More information and instructions are on our website under Latest News.

 

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Chronic Disease Management

Dose Adjustment for Normal Eating

Diabetes Australia – Vic offers DAFNE - a five day diabetes education program designed for adults with type 1 diabetes who are not on an insulin pump. This comprehensive small group program covers topics such as carbohydrate estimation, insulin adjustment, physical activity and the management of illness and hypoglycaemia, as well as sharing type 1 experiences. The next DAFNE course will be in June 2013. Participants have an individual appointment approximately 1-3 weeks prior to the course. Further information for health professionals and people with type 1 diabetes can be accessed at the website www.dafne.org.au or by calling 03 9667 1719.

 

Carbohydrate counting workshop for people on insulin pumps

This is a hands-on half-day workshop presented by Diabetes Australia – Vic. Delivered by experienced dietitians this workshop is for people with type 1 diabetes aged 18 years and over, currently using an insulin pump, or who will be starting on a pump within six months. Note: This workshop does NOT cover operations and features related to various insulin pumps.

Thursday 20 June 9am–1pm at Diabetes Australia – Vic, Level 1 (stairs only), 570 Elizabeth Street, Melbourne. $50 DA–Vic members $75 non DA–Vic members. Bookings are essential. For registration or more information, contact 1300 136 588.

 

World Diabetes Congress

The 22nd International Diabetes Federation (IDF) World Diabetes Congress (WDC) is to be held in Melbourne from Monday 2 to Friday 6 December. The IDF is expecting more than 10,000 delegates to attend.

The early bird registration closing date is Friday 14 June. Registering by this date can result in savings of up to 40%. Potential registrants also need to start thinking about booking accommodation in Melbourne.

Health care professionals (excluding medical practitioners) can book by clicking here. Non-health care professionals can book (for single or multiple days) by clicking here.

 

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Continuing Professional Development

ThinkGP

beyondblue is currently running a national consumer anxiety awareness campaign titled ‘Get to know Anxiety’. You may notice an influx of patients coming in to check anxiety symptoms and to discuss treatment. For more information, education and resources click here

Skin cancer prevention and Vitamin D

This activity will guide GPs through the epidemiology of skin cancers in Australia, including prevention, diagnosis and management. Click here.

 

Hepatitis B related liver cancer prevention

This seminar is presented by Cancer Council Victoria. Topics include research on: Increasing diagnosis of hepatitis B in general practice: piloting a desktop software system; and Understanding perceptions about liver cancer and hepatitis B in the Chinese community.

Monday 24th June 11:30am – 12:30pm at Cancer Council Victoria, Carlton. For more information and to register click here.

 

Skin Interest 2013 ACCO Annual Conference

Australasian College of Cutaneous Oncology is holding their Annual Conference at The Langham Hotel on August 23rd, 24th & 25th. All Practitioners with a Skin Interest are invited to attend. 

International Keynote Speaker: Dr. Christiane Voit, Dermatology, Berlin, Germany.

Please visit our website www.acco.org.au for all information or phone Melinda Harrap on 0408 754 362 or click here to register.

 

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Information Management

Medical Director Tip - Adding structure to Progress Notes

There are 2 sets of keyboard shortcuts to put in headings that support a structured approach to the progress notes:

1.      SOAP protocol (Subjective, Objective, Assessment, Plan)
Typing s: places the Subjective heading into the notes (include the colon)
Typing o: places the Objective heading into the notes (include the colon)
Typing a: places the Assessment heading into the notes (include the colon)
Typing p: places the Plan heading into the notes (include the colon)

2.      History, Examination, Reason for contact, Plan
Typing hx (no colon) places the History heading into the notes
Typing oe (no colon) places the Examination heading into the notes
Typing dx (no colon) places the Reason for contact heading into the notes
Typing mx (no colon) places the Plan heading into the notes

Remember: Don’t free type the reason for contact, rather use the Reason button and enter a coded item.

 

This week’s MD problem - How to remove tabs

Question: There are some tabs on the MD patient screen which I never use. Can I get rid of them?

Answer: Two tabs you may wish to get rid of are the Correspondence screen and the Acupuncture screen. You do this by:

1.      Go to the Main Screen (no patient record open).

2.      From the Tools menu select Options > Clinical.

3.      Remove the ticks from Show Acupuncture page and Show Correspondence page/

 

Best Practice Tip - Today’s Notes – Typing shortcuts

Rather than using the menu buttons here are some simple keyboard shortcuts after you highlight the text:

·         Bold                       - Control + B

·         Italic                       - Control + i

·         Underline               - Control + U

·         Font size larger      - Shift + Control + >

·         Font size smaller   - Shift + Control + <

To “untoggle” the shortcut, simply use the same key press, e.g. Control + B will “unbold “an already bolded word.

 

Best Practice problem – How to modify a non-working field

Question:  I have imported some MD templates and notice some of the fields don’t work. How do I fix this?

Answer: This is quite easy and the following instructions are based on the presumption that you have downloaded a template and it has been saved as an imported template

1.      Open a New Letter

a.      Patient record open  - select New Letter icon from the toolbar
OR

b.      No patient record open - from Utilities menu, select Word Processor (or <F4>), or click on the Open word processor icon on the toolbar

2.      From the Templates menu select Edit template

3.      Locate the template and open it

4.      The fields are indicated by text between an arrowhead  bracket (e.g. <PMALL>.  A field that isn’t working will allow you  to insert the cursor into the text.

5.      Highlight the non-working field (e.g. <CurrentRx>) and delete it. Choose the equivalent data field from the data toolbar on the left of BP screen.  Some examples are given in the example.

6.      From the File menu select Save and you can overwrite the existing template name.

 

General Computer Tips - Changing all caps to lowercase

Also known as curing the dreaded capslock disease. Sometimes you accidently have the capslock key on and your text comes out as all capitals. Don’t be embarrassed, it happens to everyone. Don’t delete and then retype. Highlight the offending text and then press Shift + <F3> (make sure F Lock is on). This will toggle between all caps, lowercase and sentence case. Try it now!

You may also start a sentence without a capital. If you notice this, simply complete the first word and before you press the spacebar type Shift + <F3> - this will capitalise the first letter.

 

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Items of Interest

Heart Foundation launches HEART Online

Do you find it difficult finding up-to-date information for heart failure management and cardiac disease prevention and rehabilitation?  Heart Education Assessment and Rehabilitation Toolkit (HEART) Online is a national website that has been developed by clinicians for clinicians. It links health professionals to education and rehabilitation tools, such as evidence-based guidelines, templates, protocols, calculators, patient resources and videos to support best practice. For more information, please visit www.heartonline.com.au

 

Importance of Testing for “Reinfection” of Helicobacter pylori - Dr Alfred Tay, Professor Barry Marshall

Reinfection is defined as a second infection that follows recovery from a previous infection by the same causative agent. In developed countries, reinfection of H. pylori among adults is uncommon, and recurrence usually represents failure of primary eradication rather than a new infection. Some cases of reinfection do occur, however, but these most likely occur in areas where there is high prevalence of infection and poor hygiene. The increasing prevalence of antimicrobial resistance jeopardizes the success of therapeutic regimens aimed at the eradication of the infection. Only the true H. pylori eradication is known to reduce the risk of developing gastric cancer in patients who have atrophic gastritis and patients who have received successful endoscopic mucosal resection of early gastric cancer. However, while a patient may feel “cured” due to the impact of therapies, the reality is that it is important to test 4 weeks after eradication therapy using a breath test to confirm.

 

GP Network News

This week’s edition includes: AMA Appoints New Secretary General; AMA Backs Moves to Strengthen School Immunisation Requirements; JABBED – Love, fear and vaccines; Mental Health Nurse Incentive Program – submit your claims before 14 August; New DVA website – At Ease Professional; New anti-tobacco campaign launched - Stop before the suffering starts; Australian Medicine; Remote Vocational Training Scheme – applications now open.

 

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Mental Health

Anxiety awareness

See under CPD - ThinkGP.

 

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News for Practice Staff

BeAWARE of the warning signs of heart attack and stroke

Free online training for non-clinical staff to promptly identify patients with warning signs of heart attack or stroke. Click here.

 

Orientation Program for Nurses New to General Practice

This two day workshop will support nurses who have been working in a medical practice for up to 12 months, as well as general practice nurses of varying experience that would benefit from an overview of nursing in general practice.

Tuesday & Wednesday 25 & 26, June, 9am- 4:30pm (Registration 8:30am) at General Practice Victoria, 4th Floor, 458 Swanston Street, Carlton. Click here for further information and to register.

 

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Paediatrics

Paediatric Immigration Health, Oncology and Haematology for GPs

Tuesday June 4th at The Royal Children’s Hospital. For more information and to register online click here.

 

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Positions vacant/wanted

Please note: only new ads or resubmitted ads will be posted here. All other ads can be found on the website

 

Positions vacant

Doctors

Thornbury - VR GP Required full time or part time for our busy, accredited, computerised & long established practice. We have a friendly & professional working environment with dedicated staff & excellent nurse support. For enquiries, please contact Dr Danny Lipson or Rose - Practice Manager on 9484 2007.

 

Watsonia - Rosanna Medical Centre is seeking a PT/VR GP. A computerised, accredited, mixed billing, long established practice. Friendly supportive team. Please call (03) 9435 1191.

 

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Humour

Getting old

Have you ever been guilty of looking at others your own age and thinking, surely I can't look that old?
I was sitting in the waiting room for my first appointment with a new dentist. I noticed his dental diploma, which bore his full name. Suddenly, I remembered a tall, handsome, dark haired boy with the same name had been in my secondary school class some 40-odd years ago.  Could he be the same guy that I had a secret crush on, way back then? Upon seeing him, however, I quickly discarded any such thought. This balding, grey haired man with the deeply lined face was far too old to have been my classmate. After he examined my teeth, I asked him if he had attended Morgan Park Secondary School. 
“Yes, yes I did.” He beamed with pride. 
“When did you leave to go to college?” I asked 
He answered, “In 1965. Why do you ask?” 
“You were in my class!” I exclaimed.
He looked at me closely. 
Then the ugly, 
old, 
bald, 
wrinkled, 
fat arsed
grey haired, 
decrepit, 
bastard asked..
 
“What did you teach?”

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And remember

 

            Nostalgia isn't what it used to be.