RDNS 2008 Annual Report - Royal District Nursing Service

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strategic
objective
our clinical quality
RDNS delivers high quality, individualised
healthcare based on best practice.
The RDNS Helen Macpherson Smith Institute of Community Health
continued to capitalise on its strong research capacity, undertaking
a number of innovative research projects throughout the year. The
aim of our research is to promote and develop evidence-based
practice to improve clinical care for clients. With over 10,000 clients
during the year receiving wound care from RDNS, research into
best practice wound management continued to be an important
area of our work. Our Clinical Leadership Groups provided expert
input and leadership into research projects, education programs
and enriched our evidence-based framework for clinical practice.
Providing adequate resources (staff and material) for research
projects remained a constant challenge. Recruiting clinical staff
from the field to assist with projects has an impact on clinical staff
resources. However, such opportunities add to the experience and
skill development of clinical staff, provide valuable clinical support
for research activities and assist in the retention of staff at RDNS.
The Angior Initiative, a major research project aimed at improving
the care and outcomes of clients living with chronic lower leg
ulcers, was completed in 2008. This initiative was funded by the
Angior Family Foundation, the RDNS Foundation and the Victorian
Department of Human Services (DHS). It involved a three-pronged
research study, the major component of which was a controlled
trial which compared two types of antimicrobial dressing on leg
ulcers. The trial was conducted in collaboration with Silver Chain
Nursing Association in Western Australia. RDNS also undertook
a qualitative study considering nurses’ perceived barriers to
applying compression bandaging and a wound best practice
education and evaluation program.
Also of note during the year was the implementation of an Active
Service Model Project with Banyule City Council. Funded by the
Department of Human Services, the model enhanced clients’
functional capacity and independence in the management of
their continence issues. The result was that the vast majority of
these previously housebound clients improved the management
of their continence, became more active at home and socially
and required less personal care than before the project.
During the year, development commenced on an on-line
Cardio-Pulmonary Resuscitation (CPR) training package that will
provide convenient access to this mandatory training module
for our clinical staff. This is the first on-line training package to be
developed by the RDNS e-learning team and key learnings will
inform future work in this area of education and training.
During the year, 229 complaints from consumers were received.
Complaints related primarily to accessing RDNS services. In
response, several process and technology improvements were
implemented at the Customer Service Centre to improve the grade
of service. At the time of writing it is pleasing to see a reduction in
the number of these complaints.
Like most healthcare organisations, we require the reporting of
all incidents involving clients and staff: 558 incidents were
reported for the year, which equates to one incident for every
2,881 visits. The most significant issue during the year concerned
the administration of medication. The challenges associated with
managing client medication in the healthcare sector are well
known, with medication errors contributing to 26% of hospitalrelated
incidents as reported via the Australian Incident
Monitoring System (2003).
To help address this issue we completed a Medication
Management Review Project during the year which will see
new initiatives implemented across the organisation during
2008–2009 to improve systems and processes for the safe
administration of medication.
Several papers were published and presentations delivered on
this initiative, which was a runner-up in the Victorian Primary and
Community Health Network Awards for Innovation and Excellence
in the category of Research and Development in 2007. Most
importantly, guidelines and recommendations for clinical practice
have already been, and will continue to be, considered at RDNS
and by other health services to improve the care of, and outcomes
for, people living with a lower leg ulcer.
8 RDNS Annual Report 2008 Operational report