No 0911: April 9, 2009
eNews is a weekly electronic newsletter
sent to all GP practices (with email addresses) within the
Editorial PIP eHealth Incentive
Aged Care A Good Death in Residential Aged Care
Chronic
Disease Management Helping
your patients prevent type 2 diabetes
Professional Development CPD events
HMR New
changes to S8 requirements, GP
Pharmacotherapy Training Program for Opioid
Dependence
Immunisation Measles Alert, Hepatitis A Alert, HPV – Changes to Dates, HPV register, History of vaccines in Australia, Rotavirus News, Immunisation Question
Information
Management General Practice eHealth Incentive Program, General Computer Tip, Medical Director Tips and New on the Web
Items of interest Assessing
Cardiovascular Disease, RACGP Kit for GPs in Violent Situations, GP Network News, BECC waiting times
Mental Health Veterans
and Veterans Families Counselling Service
News for
Practice Staff Nurses Training Subsidy
Reimbursement, Wound Awareness Campaign, Evidence Based Practice workshop,
Conference Update
Paediatrics Eat Well Play Well - Childhood Nutrition Education Program
Women’s Health Cardiovascular disease in women and the importance of risk perception, Natural Fertility Enhancement, 24-Hour National Breastfeeding Helpline
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We keep getting many enquiries re the Application Form for the PIP eHealth Incentive. The deadline for submitting the application form is Friday April 30, 2009, so get this in now ticking that you meet all requirements. Make sure you have applied for PKI keys for all GPs before April 30. Our advice is still the same as expressed in the editorial of eNews 0909. You will have received a letter from the eTherapeutic Guidelines stating it is the Key Electronic Clinical Resource that meets the Category criteria for: ‘Concise, evidence-based guide to recommendations about patient management that covers all common disorders seen in general practice (latest edition).’ (Table 1). Our advice is don’t buy this product at this stage – wait until we get clarification on this at the CPD meeting on April 23 – being the Key Electronic Clinical Resource doesn’t mean it is the only resource.
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Many people die in comfort and with dignity in aged care homes across
The Good Death in Residential Aged Care project is funded by the Australian Government Department of Health and Ageing under the Encouraging Best Practice in Residential Aged Care (EBPRAC) program
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Alphington Sports Medicine is running a Life! course shortly: on Friday mornings at 9:30am.
To be eligible for the course, participants must: Be aged 40 years or above; Score 15 or more on the AUSDRISK test; Have diabetes excluded in the past 12 months
The AUSDRISK test and Life! Program referral forms are available from www.diabeteslife.org.au
or by calling 13 RISK (13 7475). Fax completed
referral forms to Emma Hall on 9481 3135.
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An invitation to Practice Managers & their General Practitioner
Principals on Thursday 23rd April, 6:30pm – 9.00pm (Dinner Provided) at John
Scott Meeting House. La
Austin Health - Division
of Medicine Grand Round
“Disorders of sex
development: current understanding and continuing controversy” Speaker: Professor
Garry Warne, Royal Children’s Hospital.
Wednesday 15th
April, 12:10pm
at John Lindell Lecture Theatre, Level 4,
The Teamwork for Better Health Conference has been convened to provide an
opportunity to explore and showcase real life examples and stories on how to
build effective teams and how to sustain them in health practices. 8 - 9 May in
Saturday 9 & Sunday 10 May at
16 & 17 May - 2 day interactive workshops covering treatment options for NMSC, melanoma management and dermoscopy. Also includes practical sessions for delegates using pig trotters, introducing surgical techniques with simple flaps. Workshop attracts 40 Cat 1 RACGP points and 25 ACRRM points. Registration form.
Please contact the College for additional information: www.skincancercollege.com, email admin@skincancercollege.com or 0414 910 355
There will be no lecture next week.
For full term 2 Tuesday lecture program click here
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Schedule 8 Permit and Notification Requirements from 1 March 2009 can be found here
The GP Pharmacotherapies Prescriber Training Project is nearing its end. There are 3 remaining opportunities for GPs to train to prescribe methadone and buprenorphine, the most effective treatments of opiate dependence. There is a shortage of prescribers, especially rurally, so any additional prescribers would be gratefully received. Prescribers can control the number of clients they take on (from 1 to however many they like). The 1 day training course is free and elements of it attract CME points. See flyer for more information & registration form.
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There have now been 30 cases of measles notified to DHS this year with a number of these cases having multiple visits to GPs and or hospital emergency departments before a diagnosis was made. The Communicable Disease Prevention and Control Unit of DHS has asked general practice to think measles in patients who present with a febrile rash illness. A link to the current public health alert Measles Alert for General Practitioners is available here.
The Victorian Department of Human Services has recognised an increase in the number of hepatitis A cases across the state. GPs are asked to consider the diagnosis of hepatitis A in any person presenting with acute hepatitis. Patients may present with symptoms such as loss of appetite, nausea and vomiting, tiredness, fever, abdominal pain, dark urine, pale faeces and jaundice. The incubation period is 2 to 8 weeks, and transmission occurs via the faecal-oral route, through the ingestion of contaminated food or water, or through direct hand-to-mouth contact with the faeces of an infectious case. Cases are infectious two weeks before and one week after the onset of jaundice/dark urine (whichever is first). The full alert is available on the GPV website. Further information about hepatitis A is available here or from the Communicable Disease Prevention and Control Unit: 1300 651 160
The availability of free vaccine for 18 to 26 year old women has been extended by 6 months. All females in this age group who are as yet un-immunised need to receive their first dose of the vaccine by 30 June 2009, and must complete all three doses by 31 December 2009.
Note: HPV will continue to be provided free to Year 7 girls only from 2010
onwards as part of the National Immunisation Program schedule in
This change adds 6 months life to the Gardasil searches of the PEN Clinical Audit Tool. Use the CAT to find those patients who have not had their first injection and recall them so that the first injection occurs before the end of June 2009.
More than 74% of GPs have
registered with the HPV Register and many have sent in their data. The HPV Register
is in the process of sending patients their completion or history letters.
General practice should be receiving ‘log on’ details to be able to check their
patient’s history as the register becomes interactive. Practices will be able
to access the register information by May this year.
Details about the HPV register are available online at www.hpvregister.org.au or call 1800 478 734.
Providers are
able to find out if a patient was likely to be part of a funded vaccine
campaign or able to access vaccine by checking the NCIRS Fact Sheet
site. This can be very helpful to determine the immunisation
status of people in an epidemic area or for those about to travel. An example
is the release of the live attenuated Measles vaccine in 1968 or when rubella
and mumps were added and available as the MMR funded vaccine.
The 2 funded rotavirus
vaccines, Rotateq® and Rotarix®
have been available for more than 12 months as part of the National Immunisation
Program. The choice of vaccine has been made by the state and territory
governments. For those jurisdictions using Rotarix®
there is now a new liquid formulation available on the NIP. The new liquid
formulation of Rotarix® is an oral suspension of 1.5 mL in an ORAL applicator and is to be delivered in the same
time frames as the existing powdered formulation. That means the new liquid
ORAL Rotarix® still has 2 doses: a) The first dose
given at 6 to 14 weeks of age; b) The second dose given at 14 to 24 weeks of
age. For both Rotavirus vaccines, timeliness is very important. There is no
catch up period and the doses must be delivered according to the schedule.
Question: A 12yo boy and his mother attended my practice. He had not had any routine vaccinations. His mother is now reconsidering. She asked me if there was one in particular that we would start with if she was going to vaccinate. I said start with tetanus. Any thoughts?
Answer: Catch-up vaccination for 12 yr
old
If the parent consents to 1 vaccine
only (regardless of components), then Hexa gives some
protection against 6 diseases but is not licensed for use after 8 yrs of age,
but Adolescent/adult DTPa covers 3, so does MMR.
Disease prevalence/lifestyle risk/contacts should be taken into account (e.g.
Men C is much less common in WA than Vic/Tas), Measles
outbreaks have occurred this year, Pertussis is in
epidemic, etc.
Therefore, I would agree with you
& give adult DTP followed by MMR & take it from there.
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General practices seeking to be eligible for the new Practice Incentives Program
(PIP) eHealth Incentive are advised that Therapeutic
Guidelines eTG complete is the Key Electronic
Clinical Resource that meets the Category criteria for: ‘Concise, evidence-based guide to recommendations about patient
management that covers all common disorders seen in general practice (latest
edition).’
To order eTG complete or to obtain further information, please contact Therapeutic Guidelines Limited on 1800 061 260, email sales@tg.org.au or visit the website.
Editors note: At this stage eTG complete is not the only guideline that meet the requirement. This will be addressed at the division’s session on 23rd April (see under CPD).
There is a simple and easy keyboard
shortcut to increase or decrease font size in Microsoft products.
1. Highlight
the text you wish to increase/decrease the size.
2. Press
Shift + Control + > to increase font size
Press
Shift + Control + < to decrease font size
Watch in amazement as the text gets bigger
bigger bigger, then smaller smaller
smaller
Sometimes you use a referral template which includes a table of past history items or a medication list and these tables may be irrelevant to the person to whom you are referring (such as certain allied health providers). The easiest way to fix this is to delete the table. If you only delete the text within the table you still leave the blank columns and rows in place.
1. Click anywhere in the table (don’t try and highlight).
2. From the Table menu select Delete and then Table – this will highlight the table and a small space above the table.
3. Press the Delete or Backspace keys to obliterate the table but leaves the table heading.
4. Type “N/A” under the Past History or Medication heading.
Last week I published the method of finding all patients on proton pump inhibiters (PPIs) who are also taking clopidogrel (Plavix/Iscover). Unfortunately the Search for this DOES NOT work in MD3. In MD2 it works fine. I have contacted HCN and laboriously showed them how it doesn’t work in MD3. They are now looking into it. Watch this space!!
Question: I know I should be using coded items when recording “Reason for contact” but when I have a patient with a “stent LAD or circumflex” the only coded items
listed are:
Stent – coronary artery
Stent – ureter
For this reason I use the Free text because I can then write “coronary artery stent LAD or circumflex”. In this way the person to whom I am referring gets a better picture of the patient condition.
Answer: Bad, bad, bad person! You can use the coded diagnosis “Stent – coronary artery” and then use the Comment area at the bottom of the “Reason for contact” dialogue box to specify LAD or circumflex. You will need to modify the referral template so that the comments are included in the PMH list.
1. Open LetterWriter and from the File menu select Modify template.
2. Locate and open the referral template.
3. Right click on the <<Clinical Details:History List>> field and select Properties.
4. Place a tick in the Include Comments? Box
From now on the referral will contain both the condition and the comment.
1. New changes to S8 requirements – found under Home Medicines Review
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Australian guidelines for assessing absolute
cardiovascular disease risk are now available for GPs. Developed by the
National Vascular Disease Prevention Alliance (NVDPA) and approved by the
NH&MRC, the guidelines make recommendations for assessing absolute CVD risk
in adults aged 45-74 years (35 years and above for Aboriginal or Torres Strait
Islander adults). Click here to
access the guidelines and associated publications. The Australian Absolute Cardiovascular
Disease (CVD) Risk Calculator is based on recommendations in the guidelines. Click here to access the online
calculator.
Over the past year, the RACGP has developed a resource kit to help GPs
prevent and deal with violence in the general practice setting. The kit was
launched on 30 March, and will be available to practices throughout
This week’s edition includes: AMA: don’t abandon families Mr Rudd, AMA: medical care just as important as disaster planning, Diabetes pilot program: Diabetes Medication Assistance Service, GP safety.
Waiting times for new referrals to Bundoora Extended Care Centre Inpatient Admissions are currently approximately Gem 0 - 2 days, Rehab 0 - 3 days as of Monday 6th April. Any queries regarding our waiting times please contact Access BECC on 9495 3109
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If you see patients with a Defence Force /Military background you may wish to consider VVCS. This is a specialised, confidential community mental health service that provides nation-wide counselling and support to Australian veterans, peacekeepers, their families and eligible ADF personnel. VVCS staff are qualified psychologists and social workers experienced at working with veterans and their families on a range of mental health and relationship issues. VVCS provides a range of counselling services, referrals, information & education. VVCS welcomes referrals from GPs and also directly from patients who can self refer. For further information please call the Melbourne VVCS office on 1800 011 046.
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All nurses who wish to claim the 50% subsidy for attending GPV funded courses are encouraged to get their claim forms in to Nicole Toon by the end of May, as all NiGP funding must be acquitted by the end of the financial year. Please forward your claim from to n.toon@gpv.org.au.
The Elephant in the Room wound awareness campaign is nationwide on behalf of The Australian Wound Management Association (AWMA) that seeks to draw attention to the serious problem of chronic wounds, a condition that affects 270,000 Australians each day.Practice Nurses and GPs are being encouraged to sign the online petition to help raise awareness and raise standards of care for all. The link to the Petition is here.
Tuesday 12th May, 6.30pm to 8.30pm (6.15 registration). Workshop for Practice Nurses presented by Judy Evans and Lynne Walker from walkerevans consulting. This workshop will inform practice nurses of the importance of using an evidence based approach to provide safe and effective nursing care. For further information and registration see flyer.
The RCNA are no longer holding a practice nurse conference as such, as the
APNA are now running their own. The RCNA have decided to run their first
conference for PHC nurses - all nurses who work in primary health care, this
includes practice nurses, school nurse, community health nurse etc. If
you would like to submit an abstract for this conference the call for abstracts
are now open. The 2009 RCNA Primary Health Care
Conference - Collaboration, integration and reform – A nursing response
- will be held in
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Paediatric Dietitian Nathalie Cook APD, runs nutrition education sessions for parents and carers of children 0-5 year at the Greensborough and West Heidelberg Community Health Centres. Topics covered include: Introducing Solids; Healthy Eating and Active Play for Toddlers; Nutrition and Physical Activity for Mums after Pregnancy; Healthy Eating and Active Play for Children Starting Kinder of School. The aim of the program is to establish healthy eating early in childhood to prevent overweight and obesity. Cost: A gold coin donation. Call 9490 4222 for session times and dates and to book in.
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The Jean Hailes Foundation for Women’s Health is
holding its next videoconference on April 28. For more information visit
the website.
The Ovulation Method Research and Reference Centre of Australia Ltd, an Accredited Provider with the RACGP will offer a 6 hour Active Learning Module entitled Natural Fertility Enhancement on 4th May 9.30am - 5.45pm, held at Rydges Bell City, Preston. For further information contact OMR&RCA on 03 9802 2022.
A national, toll-free, 24-hour helpline has been launched to provide support
and information to breastfeeding mothers. The Commonwealth Government provided
funds to help establish and run the service and to help train breastfeeding
counsellors and provide education opportunities for other health professionals.
The helpline, 1800 MUM 2 MUM (1800 686 2 686),
is staffed by Australian Breastfeeding Association volunteer’s across
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Please
note: only new ads, paid ads or resubmitted ads will be posted here. All other
ads can be found on the website
Doctors
Northcote – F/t P/T VR GP or Subsequent Trainee GP position. Fully accredited, computerised, long established doctor owned practice in a new purpose built facility with a fabulous work environment. Ancillary Health, Pharmacy and Pathology services on site. Inquiries Diane Cronin (Practice Manager) 9481 1214. Visit our website www.doctorsofnorthcote.com
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Two hillbillies walk into a restaurant. While having a bite to eat, they talk about their moonshine operation. Suddenly, a woman at a nearby table, who is eating a sandwich, begins to cough. After a minute or so, it becomes apparent that she is in real distress. One of the hillbillies looks at her and says,
'Kin ya swallar?'
The woman shakes her head no.
Then he asks, 'Kin ya breathe?'
The woman begins to turn blue and shakes her head no.
The hillbilly walks over to the woman, lifts up her dress, yanks down her drawers and quickly gives her right buttock a lick with his tongue. The woman is so shocked that she has a violent spasm and the obstruction flies out of her mouth. As she begins to breathe again, the Hillbilly walks slowly back to his table.
His partner says, 'Ya know, I'd heerd of that there 'Hind Lick Maneuver' but I ain't niver seed nobody do it!'
(Thanks to local GP for this contribution)
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And remember…
…a fine is a tax for doing
wrong - a tax is a fine for doing well.