June - APNA

Primary Times
Supporting nurses in primary health care Volume 13 Issue 2 2013
THIS ISSUE
Movers and Shakers
Best Practice Nursing Awards 2013
Modern Nurses Award explained
Rising demand for telehealth services
ISSN 1838-0840

When a baby needs comforting…
NEW
Suitable from birth as a sole source of nutrition for formula
fed babies, and as part of a mixed diet from 6 months.
FOR BABIES WITH CONSTIpATION:
1.3 more poos per day at day 7
vs 0.7 with standard formula,
in babies up to 4 months of age 1
WORkS TO EASE COlIC:
70% reduction in colic episodes
within 14 days compared
to 40% with standard formula,
in babies up to 4 months of age 2
For more information or for products for evaluation please contact:
1800 258 268 or visit www.nutricia4professionals.com
Breast milk is Best for BaBies: Professional advice should be followed before using an infant formula. Introducing partial bottle feeding could negatively affect
breast feeding. Good maternal nutrition is important for breast feeding and reversing a decision not to breast feed may be difficult. Infant formula should be used as
directed. Proper use of an infant formula is important to the health of the infant. Social and financial implications should be considered when selecting a method of feeding.
references: 1. Savino F et al. Acta Paediatr Suppl 2005; 94:120–124.
2. Savino F et al. Eur J Clin Nut 2006; 60:1304–1310.
FOR HEALTHCARE PROFESSIONALS ONLY
Nutricia Australia Pty Limited, Level 4, Building D, 12–24 Talavera Road, Macquarie Park, NSW 2113. NBM1522-18/03/13-ANZ. 11091-PT

contents
Primary Times
The Primary Times is the official publication of the
Australian Practice Nurses Association (APNA) and
is published four times a year in March, June,
September and December.
APNA is the peak national body for nurses working
in primary health care, providing representation,
professional development and support at a local,
state and national level.
AUSTRALIAN PRACTICE NURSES
ASSOCIATION INC.
Level 2, 159 Dorcas Street
South Melbourne VIC 3205
ABN 30 390 041 210
T: (03) 9669 7400 F: (03) 9669 7499
www.apna.asn.au
Editor
Stephanie Hille
editor@apna.asn.au
Advertising
Matt Hall
advertising@apna.asn.au
APNA EDITORIAL BOARD
Jessica Danko
Assoc. Prof. Elizabeth Halcomb
Susan Halsey
Anne Matyear
Ruth Mursa
Cathy Pearson
Jacqui Young
DESIGN
Perry Watson Design
Front cover: Professor Sue Cross (UK) delivers her
keynote address on ‘What is leadership’ at the
APNA national conference, Movers and Shakers.
GENERAL DISCLAIMER
The views expressed in articles are those of the
contributors and not necessarily those of APNA.
Statements of fact are believed to be true, but no
legal responsibility is accepted for them. Primary
Times reserves the right to edit, or not publish, any
material submitted for publication. APNA takes no
responsibility for the advertising content in Primary
Times and does not necessarily endorse any
products or services advertised. © Australian
Practice Nurses Association Inc, 2013. No part of
Primary Times may, in any form, or by any means,
be reproduced without prior written permission from
the Chief Executive Officer.
Platinum partners
Contents
APNA NEWS
2 Eighteen months into the PNIP journey –
how are we travelling
3 An association close to our hearts
4 APNA Board
5 Members vote to change APNA’s name
17 CPD update
6
APNA National Conference Movers and Shakers
24
FEATURES
6 Movers and Shakers
11 2013 Best Practice Awards
NEWS
18 Key role for nurses in improving patient
mental health care
19 How to read the Nurses Award
20 Three steps to reduce the burden of chronic
disease for your patients
21 Opportunistic family planning services
23 Update: Flinders Program training for
veterans
24 Are you prepared for an increased demand
for telehealth services
26 RDNS working together in the community
Volume 13 Issue 2 | Primary Times | 1

CEO’S MESSAGE
Eighteen months into the PNIP
journey – how are we travelling
I’m sure most readers would
be aware that the Practice
Nurse Incentive Program (PNIP)
was introduced by the Federal
Government at the beginning of
2012 as a new way of incentivising
nursing in general practice.
Under the PNIP, every accredited practice (and those
registered for accreditation) became eligible to receive
block funding for services provided by practice nurses. The
funding is based on a combination of the practice’s patient
load as measured by the Standardised Whole Patient
Equivalent (SWPE), and practice nurse hours. Practices are
eligible to receive $25,000 each year, per 1000 SWPEs
where an RN or allied health professional works at least
12 hours 40 minutes per week; and $12,500 for the same
workload and hours where the service is provided by an
EN or Aboriginal Health Worker. The payment is capped at
$125,000 per practice, which is equivalent to 5000
SWPEs and 63 hours 20 minutes of RN time.
When the PNIP was introduced, several practice nurse
item numbers under the Medicare Benefits Schedule
(MBS) were discontinued, particularly those relating to
immunisation, wound management, and Pap smears. The
intention was that nurses working in general practice
could continue to undertake this work, but it would be
paid for through the new PNIP funding rather than fee for
service.
The thinking behind the PNIP, more broadly, was that
the new funding model would help enable nurses to utilise
their full scope of practice, rather than being restricted to
activities attracting specific MBS item numbers. While
nurses could still undertake activities such as
immunisation, wound care, and Pap smears, the new
funding was intended to enable practices to be
reimbursed for broader activities undertaken by nurses,
such as lifestyle management, health coaching, infection
control, accreditation, patient education and so on.
So what impact has the new funding model actually
had on the scope of work nurses do in general practice,
and the roles they fulfil in their practice teams
In the middle of last year, a few months after the
introduction of the PNIP, we asked our members for their
feedback. At that point we heard some positives, such as:
One of the greatest things the PNIP has done is
free up some nurses to educate doctors and nurses
how to enhance primary health care for our
patients.
I am happy to say that the PNIP has not changed
how we work in our practice but has been easier
as the focus has been less on nurse item numbers
but just a continuation of quality care for our
patients.
But we also heard some concerns from members, with
typical comments being:
We have found in our clinic that the PNIP has
decreased our work in immunisations, due to an
erroneous belief the nurses are not getting paid
anymore. We now are using the GPs to claim level
A consults. Which is a waste of their time when
they should be diagnosing clients.
Since the introduction of the PNIP my scope of
practice has decreased. The doctors now feel that I
should no longer be allowed to do the immunisation
clinics on my own as I have done previously. They
now want the patient to be seen by the doctor
before seeing me to do the flu shot. Their reasoning
behind this is so that they can charge a Medicare
item number as well. By doing this it has increased
their workload and decreased mine. It is the same
story with wound care and Pap smears.
This feedback indicates that some practices have not
come to grips with the intent and potential of the PNIP.
In several cases the response was to reduce nurses’
scope of practice and bring GPs back into areas of care
which had previously been nurse-led. We provided your
feedback to the Federal Government at the time.
Late last year we also asked you about the PNIP in our
Salary and Conditions Survey. Some of the questions
were about how the PNIP had affected your scope of
practice, and your autonomy. The responses were quite
mixed. Nearly seven in ten respondents said the PNIP had
made little or no difference to either scope of practice or
autonomy. About one in five said their scope of practice
had increased, and fewer than five per cent said it had
decreased. About one in six said their autonomy had
increased, but one in six said it had decreased. Others
were unsure of the impact of the PNIP.
In terms of the range of nursing services offered by the
general practice, six in ten said there had been no real
change, but one in four said the range of services had
expanded. A minority, seven per cent, said the range
had reduced, and five per cent were unsure.
So it seems the jury is still out.
We certainly hear some good news stories. In the last
issue of Primary Times Karen Booth wrote about the
‘liberating’ impact the PNIP has had at Leichhardt General
Practice. The practice reviewed the business plan for the
nurse utilising the PNIP, and realised there was a strong
case for expanding the space and workforce for nursing
services. This expanded capacity has helped to increase
patient access to many services, including immunisation,
health checks, and chronic disease management. Nurses
are now able to do more home visits as well.
On the other hand, we are still being contacted by
some members whose practices are not embracing the
PNIP in this positive way, and who are experiencing real
difficulties and frustrations.
The Federal Government will be undertaking a full
review of the PNIP next year and we will of course provide
input. In the meantime, we at APNA are keen to keep
hearing your feedback about the PNIP and taking this to
Government. If you have a ‘good news story’ please tell
us. And if you have concerns, we really need to hear
those too. Most of all we need your suggestions about
what needs to happen next – are there improvements
you can see need to be made Is there still a need for
more information and communication to practice
managers, GPs and nurses about the PNIP What else
needs to happen
Please email me your comments at kathy.bell@apna.
asn.au. I’m really keen to hear from you and will reply to
each of you, and we at APNA will take your views to
Government so that together we can help influence future
developments.
Kathy Bell
APNA Chief Executive Officer
2 | Primary Times | Volume 13 Issue 2

PRESIDENT’S MESSAGE
An association close to our hearts
Welcome to the Winter 2013 issue
of Primary Times.
The recent 2013 APNA Board nominations and ballot
brought strong interest with four nominations for three
board positions. This very positive sign demonstrates great
interest in supporting APNA as an APNA Board member.
I would like to pay tribute and thank Cathy Pearson
who has this year stepped away from the APNA Board.
Cathy has demonstrated strong governance and nurse
leadership during her term as a director of APNA and we
have indeed greatly benefited from Cathy’s passion for
primary health care nursing. As a rural enrolled nurse,
Cathy has given further depth to APNA’s strength and
vision. We wish Cathy all the very best in her next
ventures and feel certain she will keep APNA close to her
heart.
Congratulations to Karen Booth who is returning to the
Board and a very warm welcome to new member Jennifer
Lang and recently appointed co-opted director Ken Griffin
who will both bring renewal and fresh ideas essential for a
healthy board.
I personally would like to take this opportunity to thank
the APNA membership for giving me the opportunity to
continue my work as an APNA Board Director for a
further two years.
APNA’s Annual General Meeting held early May was
once again well attended. Our membership voted by
special resolution that in furtherance of its purpose,
Australian Practice Nurses Association Inc. change its
name to ‘Australian Primary Health Care Nurses
Association Inc.’ and make the required amendments to
its Constitution. The APNA Board considered this change
necessary to more accurately reflect APNA’s membership
and purposes.
APNA Movers and Shakers 2013
APNA has once more excelled with a showcase
conference that again upped the ante for our members.
On behalf of the APNA Board, conference committee
and staff it was my pleasure to welcome over 450
participants to APNA’s fifth national conference – Movers
and Shakers. We gathered at the Pullman Melbourne
Albert Park, located opposite the renowned Albert Park
Lake and golf course and only a short tram ride from the
Melbourne CBD and all its wonderful attractions.
With each year we see further acknowledgement,
progression and development in the important strategic
role nurses play within primary health care and the
Australian health reform agenda. Each year brings new
opportunities and challenges and we watch with awe and
pride the nurses who are stepping up to these challenges
and meeting them head on. In 2013 we encouraged
delegates to go forward armed with the renewed
confidence and resilience gained last year at our Time to
Shine conference and let Australia know that primary
health care nurses are skilled ‘movers and shakers’
determined to drive APNA’s vision for a healthy Australia
through best practice primary health care nursing.
Delegates were invited to explore opportunities to
‘move and shake’ primary health care nursing, while
networking, learning and growing with their peers.
I sincerely thank APNA’s conference committee, staff
and Board who worked tirelessly organising an array of
preconference workshops where nurses could refresh
or expand their clinical practice, and leadership forums
where participants could commence or confirm their
mantle as a mover and shaker in primary health care.
The plethora of keynotes and concurrent sessions
highlighted what is happening in the primary health care
sector. All the sessions gave delegates much to consider,
learn from and take forward in their career’s as primary
health care nurses.
We were honoured to welcome our outstanding
keynote speakers and international guests, all of whom
we see as role model ‘movers and shakers’ in nursing
internationally and all of whom are good friends of APNA.
Professor Rosemary Bryant, Australia’s first Chief Nurse
and Midwifery Officer and President of the International
Council of Nurses, opened with her vision for the future
of primary health care nursing in Australia and
internationally. Our outstanding international guests
included Professor Jenny Carryer, Executive Director of
the College of Nurses, Aotearoa (NZ), Deborah Davies,
Lead Clinical Primary Health Care Nurse Specialist and
Vice Chair New Zealand College Primary Health Care
Nursing, and from the United Kingdom Professor Sue
Cross, general practice nursing career path architect,
who has been a strong supporter of APNA’s push forward
for a career and education framework for primary health
care nurses.
As always with an APNA conference the networking
was paramount and the familiar happy, noisy vibe
prevailed at every opportunity. The social events and
meet and greet drinks after the APNA AGM were well
attended, with delegates including myself catching up
with now old friends for our annual get together. The gala
dinner was another huge hit with many ‘shaken not
stirred’ in the James Bond themed extravaganza and sore
feet aplenty next day from the best dancing yet!
In closing I must say there are many things I love about
APNA and many things about APNA that I am extremely
proud of. The one thing that is very special is it has been
a strong, safe and comfortable vehicle, which has brought
many of us together to share our lives and work and to
forge deep friendships, trust and respect for our common
experiences. All of this we will keep close to our hearts
forever.
As always, APNA needs to hear your views. Please
email your thoughts, comments and concerns via
admin@apna.asn.au or president@apna.asn.au.
Julianne Badenoch
APNA President
Volume 13 Issue 2 | Primary Times | 3

GOVERNANCE
APNA Board
The APNA Board has between five and eight members; five elected members and
up to three co-opted members. In each odd-numbered year three Board members
must be elected for a two-year term, and in each even-numbered year two Board
members must be elected.
An election took place in April with four candidates nominating for three board
positions. Voting was close as always. Julianne Badenoch and Karen Booth were
reinstated for a further two years, and new member Jennifer Lang joins the Board.
Stepping down
In 2013 APNA says thank you to two Board
Members; an EN and a GP who brought
unique perspectives to the governance of
the Association.
Cathy Pearson
Cathy was the first enrolled nurse to serve on the Board
and brought a wealth of experience from working in a
rural general practice in South Australia for 12 years.
Cathy joined the Board in 2011 and last year became
Chair of the Editorial Committee, as well as being
awarded Medical Observer’s Primary Health Care
Nurse of the Year in 2012.
On the Board and in her professional life Cathy is a
proponent for enrolled nurses and strives to have ENs
working in primary health care validate themselves, and
be validated. She feels the issue of supervision means
ENs are not confident in what they perceive they can and
cannot do. Cathy hopes to see ENs who are specialists in
primary health care be acknowledged for what they bring
to the profession.
Cathy decided not to renominate for the Board this
year to turn her attention to family commitments. We wish
her well and perhaps will see Cathy again in APNA’s
future.
Cathy Pearson
Dr Tony Hobbs
Dr Tony Hobbs, a rural GP obstetrician from Cootamundra
in New South Wales, brought an enormous amount of
experience in primary health care and primary health
reform agenda to the APNA Board. Tony has been a
strong advocate for primary health care nurses,
particularly practice nurses, for many years and is
considered ahead of his time.
Whilst on the APNA Board Tony also Chaired the
Murrumbidgee Medicare Local and was awarded the
inaugural National Medicare Local Award for Individual
Distinction/Leader in November 2012 for his grasp of and
commitment to the broadest aspects of general practice
and primary health and his vision and leadership to
pursue an improved primary health care sector in
Australia.
We wish Tony all the best in his new role as Principal
Medical Adviser with the Therapeutic Goods
Administration.
Tony Hobbs
Welcome
APNA welcomes Jennifer Lang from
Queensland to the APNA Board, having been
voted in by members in the May election.
We’re also very pleased to have Ken Griffin
join as a co-opted Board Member.
Jennifer Lang
As a registered nurse for over 16 years Jennifer has
fulfilled a variety of nursing roles including Indigenous
and remote area nursing, third world nursing, military
nursing, the Royal Flying Doctors Service, infection
control, neonatal nursing and midwifery. Jennifer’s
experience is supported by various formal qualifications,
most recently completing a Graduate Diploma in Primary
Health Care Nursing in 2013. Jennifer currently works as
a practice nurse in the Queensland University of
Technology Medical Centre.
Jennifer is passionate about supporting the
progression of primary health care nursing as a specialty,
and the sub-specialities within, to provide the basis for
formal recognition of skills and knowledge by other
professions.
Jennifer Lang
Ken Griffin
Ken has more than 16 years marketing and
communications experience in the healthcare, not for
profit and pharmaceutical sectors. He has worked in the
United Kingdom and Australia, managing and directing
high profile campaigns for the pharmaceutical industry
and patient organisations.
Ken brings significant media and marketing capability
to the APNA Board. He is a determined and passionate
supporter of primary health care nursing and has
supported APNA since 2006, having done pro bono work
for the Association.
Ken is passionate about our cause – his mum is a
practice nurse – and will be a great asset to APNA.
Ken Griffin
4 | Primary Times | Volume 13 Issue 2

GOVERNANCE
Members vote to change
APNA’s name
APNA started life 11 years ago now as the
professional association for ‘practice nurses’,
but over the years our purpose has broadened.
Members voted back in 2009 for changes to
APNA’s Constitution, so that the purpose of APNA is
now ‘to be the peak national body for nurses working
in primary health care, providing representation,
professional development and support at a local,
state and national level.’
The APNA Board put forward a special resolution
at the Annual General Meeting on 2 May 2013, to
change our organisation’s official name to ‘The
Australian Primary Health Care Nurses Association
Incorporated’.
The name change reflects both the broadening
base of our membership, which includes nurses
working in a range of primary health care settings
including general practice; and the preference of the
majority of our members to be known as primary
health care nurses, reflecting their aspirations to
achieve better health for all through holistic, team
based primary health care.
We needed a quorum of 140 members to vote on
the resolution to make it valid – and we got there!
Members sent in 120 proxy forms, of which 114 were
in favour of the name change. Of the 56 members
who attended the Annual General Meeting, 51 voted
in favour of the name change. So we had a total of
165 votes in favour of changing APNA’s name to the
Australian Primary Health Care Nurses Association
Inc, and the resolution was passed.
To make the name change official, we now need to
go through a process which initially involves making
an application to the Registrar of Associations in
Victoria to legally change our name. We’ll keep you
posted with progress.
The plan is that our everyday abbreviated name
will still be APNA, the short name that our members
know and love – but the ‘P’ will now stand for
‘Primary Health Care’ instead of ‘Practice’.
Congratulations to all APNA members who
participated in this historic vote!
Compliance and effective monitoring…
…two essential components for optimising oral anticoagulation therapy
Compliance and monitoring - inter-related factors in oral anticoagulation
The importance of compliance
• Compliance rate with long-term medication in general has been estimated at between 50% and 60% 1
• Evidence shows that INR monitoring improves the quality of oral anticoagulation between 50% and 85% 2
Warfarin – a particular case in point
• It is increasingly prescribed as lifelong therapy for patients with mechanical heart valves, atrial fibrillation or thrombophilic disorders,
effectively preventing arterial embolism in a wide range of conditions 3
• Maintaining INR within its therapeutic range is effectively achieved through monitoring
• Patients on warfarin who have had a heart valve replacement there was a 32% difference in survival at 15 years between patients with low
and high variability in anticoagulation control 4
The obvious choice is partnering VKA and CoaguChek ® XS Systems for improved compliance
Roche Diagnostics Australia Pty Limited.,
31 Victoria Ave Castle Hill NSW 2154,
Phone: 02 9860 2222 ABN 29 003 001 205
CoaguChek ® XS systems
- the smart way to test INR
INR monitoring has never been made so
easy for immediate therapy adjustment
References:
1. DiMatteo MR. Formulary 1995; 30: 596–8, 601–2, 605. 2. Heneghan C, Alonso-Coello P, Garcia-Alamino JM, Perera R,
Meats E, Glasziou P. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. Lancet 2006;367:404-
411. 3. Ansell J et al. Int J Cardiol 2005; 99: 37–45. 4. Butchart EG et al. J Thorac Cardiovasc Surg 2002; 123: 715-23.
LIFE TIME
WARRANTY
COAGUCHEK, BECAUSE IT’S MY LIFE are trademarks of Roche.

APNA NATIONAL CONFERENCE
Movers and Shakers
Leadership, clinical excellence and
working together in professional
teams were the burning themes of
APNA’s fifth national conference
held in Melbourne in May.
Congratulations are due to all the ‘ Movers and
Shakers’ who attended yet another successful APNA
conference. Over 450 participants from all corners of
Australia arrived in full steam, ready to take on three days
of professional development, networking and laughs.
The Exhibition Hall was bursting with innovative clinical
information from over 50 booths all willing to share
knowledge — often over a ‘real’ coffee or while enjoying
a bonus massage.
The vibrant program included 100 speakers, and with
105 presentations on offer, delegates could choose from
a vast array of clinical and professional topics. Many of
the presenters were front line nurses, including nurses in
general practice, school nurses, rural nurses, specialist
practice nurses, immigration detention healthcare
workers, and more. There was also a strong presence
from national and international experts, including
professors and leaders in nursing from Australia, New
Zealand, and the United Kingdom.
The program opened with pre-conference workshops
on Thursday 2 May, followed in the evening by APNA’s
Annual General Meeting and the conference Meet and
Greet function. This year there were 10 pre-conference
workshops on offer, covering a great range of clinical and
leadership topics, and the feedback has been great.
Membership votes at the Annual General Meeting
confirmed support for APNA to change its name from the
‘Australian Practice Nurses Association Inc.’ to the
‘Australian Primary Health Care Nurses Association Inc.’.
Upon registration, delegates had been presented with a
conference bag with the historic name embossed on it,
which APNA President Julianne Badenoch rightly
described as ‘vintage and hip’, given APNA’s proposed
name change. All agreed that the Meet and Greet
function on the Thursday evening provided a fantastic
opportunity to networks with peers, exhibitors, APNA
staff and Board Members.
6 | Primary Times | Volume 13 Issue 2

APNA NATIONAL CONFERENCE
The breakfast sessions on Friday 3 May offered
delegates updates on COPD screening in primary care,
and constipation, colic, and reflux/regurgitation in babies.
The conference opening ceremony followed. Stan
Yarramunua set the vibe with his exceptional and heart
lifting Welcome to Country performance. Following a
welcome to delegates by APNA President Julianne
Badenoch, Master of Ceremonies Stuart Constable
introduced Shadow Parliamentary Secretary for Regional
Health Services and Indigenous Health Dr Andrew Laming
MP who gave an energetic talk stressing the need to keep
gathering evidence about the impact nurses make in
primary health care.
The Commonwealth’s Chief Nursing and Midwifery
Officer Dr Rosemary Bryant discussed the future of
primary health care nursing in Australia and
internationally, and urged nurses to play a strong role in
the future development of primary health care. Keynote
speaker Professor Jenny Carryer, from Massey University
New Zealand, gave a frank assessment of the role of
nurses in the primary health care team, and exhorted
nurses to assert their place and show their value.
Throughout the conference program, leadership was
included as a key theme. The Thursday afternoon plenary
included keynote talks by Professor Sue Cross from the
UK and Karen Cook from Health Workforce Australia,
followed by a panel discussion on leadership facilitated
by Dr Tony Hobbs. The panel provided an honest forum
focusing on the strengths of primary health care nurses,
as well as the challenges faced by the profession. Nurses
were encouraged to reach their potential, build on the
positive work currently being undertaken and, most
importantly, work to be seen as equal professional
partners in the delivery of patient-centred care.
Those keen to combine learning with fun and laughter
dressed in Diamonds Are Forever costumes and had a
thunderball of a time at Friday night’s James Bond
themed Gala Dinner. The 2013 Best Practice Awards
in nursing were announced, with nurses being
acknowledged by representatives from each Award
sponsor. Friendships were clearly formed over the
conference as highlighted by the numerous 007 poses in
front of the James Bond picture screen. Following the
three course dinner, attendees were given a licence to kill
on the dance floor and boogied the night away.
On Saturday, breakfast sessions covering primary care
in cancer control and the role of nutrition in keeping older
people on their feet, prepared nurses for their final day of
learning at the conference. The morning plenary session
on Saturday 4 May provided an update for delegates on a
number of new health care guidelines, presented by
experts from each field, and was very well received.
Among the many outstanding concurrent sessions held
throughout the conference was a session on Saturday
morning focusing on the need for an education and
career framework for nurses working in general practice
in Australia. Professor Cross provided an insider’s
account of the development of a career framework for
general practice nurses in the UK, explaining that the
intention behind the framework was to improve quality
care for patients, and to attract and retain nurses in the
sector as a career choice. Deborah Davies offered a New
Zealand perspective, outlining the work that has been
done by our neighbours across the Tasman in this area.
APNA Board Member and Policy Development Committee
Chair Ian Watts outlined the foundation work that has
been undertaken by the APNA Policy Development
Committee on this area. This was an important policy
session and, though time was short, it provided an
opportunity for initial consultation with the membership
on this key advocacy issue.

100% of
your recommended
weekly intake.
The Heart Foundation recommends six eggs a week as part of your healthy
balanced diet, low in saturated fat. Learn why at www.enc.org.au
CERT TM used under licence. People with health concerns should seek dietary advice from their doctor or dietician. AECL00122

APNA NATIONAL CONFERENCE
Movers and Shakers
Thanks to our conference partners
APNA would like to thank the following sponsors and exhibitors for supporting Movers and Shakers in 2013
Gold Partner Gold Partner Gold Partner
There was not one dry eye as delegates were treated
to a wonderful performance from comedian Denise Scott
in the closing plenary session. Denise had the audience
‘moving and shaking’ with laughter. With 110 first time
nurses attending and hundreds returning who have
attended previous APNA conferences, the conference
ended as it began — on a high note.
Many thanks must go to the hard working Conference
Committee chaired by APNA Board Director Jane
Butcher, with Julianne Badenoch, Marie McWhinney,
Liz Meadley, Matthew Middleton, Cathy Pearson, Roslyn
Rolleston, Samantha Moses and Lynne Walker; APNA
staff including Professional Development Coordinator Brie
Woods (who soldiered on gamely despite breaking her leg
one week before the conference!); our wonderful MC
Stuart Constable; and conference organisers Liz and Gary
Baldwin with Louise Robertson and Cara Robertson.
A huge amount of energy and effort went into this
event, and it was successful because you, our members,
came along and participated. From all of us at APNA we
would like to thank delegates for your contribution in
making Movers and Shakers such an enormous success,
and we hope to see many familiar and new faces at our
next conference in Sydney in 2014.
Thanks to our conference
partners
APNA is enormously grateful for the continued support of
our loyal sponsors and exhibitors who have been with us
over several conferences, and we were also delighted to
welcome new sponsors to Movers and Shakers in 2013.
It is the generosity of these sponsors that enables us to
keep the cost of our conferences reasonable and
accessible to primary health care nurses. The feedback
from exhibitors is always that our delegates are
genuinely interested in the trade display, actively seek
out information, and are great fun to share a conference
experience with. Thanks to our conference partners and
we hope to see you all again in 2014.
Breakfast Partner
Media Partner
2013 EXHIBITORS
• AGPAL
• Andrology Australia
• APNA
• AstraZeneca
• Australasian Society for HIV
Medicine (ASHM), NSW STI
Programs Unit
• Australian College of Nursing
• Australian Indigenous
HealthInfoNet
• Australian Medicare Local
Alliance
• Australian Medicines Handbook
• Australian Mushroom Growers
Association
• bioCSL
• Boehringer Ingelheim
• Brightsky
Silver Partner
Breakfast Partner
Research Partner
Silver Partner
Breakfast Partner
Technology Partner
• BUPA Health Dialog
• Burnet Clinical Research Unit –
Royal Melbourne Hospital
• Cancer Council
• Cancer Institute NSW/EviQ
• Care Australia
• CH2 Clifford Hallam Healthcare
• Department of Veteran Affairs
• Diabetes Australia
• DOHA (Immunisation Department)
• GlaxoSmithKline (GSK)
• Guild Insurance
• Health Direct Australia
• Hydration Pharmaceuticals Trust
• Independence Australia
• Key Pharmaceuticals
• Kimberly-Clark
• md Briefcase Australia
Breakfast Partner
Leadership Partner
• Meat & Livestock Australia (MLA)
• Molnlycke Health Care
• MSD
• National Heart Foundation
• Neilmed Pharmaceuticals
• Nestle
• Nipro Australia
• Novartis
• NPS MedicineWise
• Nutricia Australia
• On The Line Australia Inc
• Pfizer
• QUT – PEPA
• Remote Area Health Corps
• Sanofi Pasteur
• SCA Hygiene Australia / TENA
• Telehealth Consortia
• Vision 2020 Australia
Volume 13 Issue 2 | Primary Times | 9

Sexual health
Enhancing sexual health care in practice
Primary health care nurse consultations can provide
an ideal opportunity and setting to encourage open
discussion about sexual health care, specially testing for
sexually transmitted infections (STI) in asymptomatic
patients.
In 2012, the NSW STI Programs Unit (STIPU)
interviewed primary health care nurses about sexual
health care provided at their practices. The nurses
reported on their varying roles in relation to sexual
health care, including undertaking consultations with
patients after GP referrals, organising specimen
collection, distributing health information resources,
providing sexual health education and undertaking
sexual health screening.
While nurses expressed an interest in attending
sexual health training and being involved in sexual
health care, barriers such sexual health care not being
supported within their scope of practice by employers
or competing priorities limited their accessibility.
Nurses highlighted the value of developing sexual health
competency standards as a path to endorse sexual
health care in general practice.
Carolyn Murray, Manager NSW STIPU, launched the
Sexual Health Competency Standards for Primary
Health Care Nurses recently at the APNA – Movers
and Shakers Conference in May. These Competency
Standards were adapted from the ASHHNA
Competency Standards for Sexual and Reproductive
Health and HIV Nurses (2nd Edition) and developed
through the collaborative efforts of the Australasian
Society for HIV Medicine, Australasian Sexual Health
and HIV Nurses Association, Australian Practice Nurse
Association, Family Planning NSW, Sydney Local Health
District, NSW Sexual Health Infoline and NSW STIPU.
The Competency Standards have been developed to
support primary health care nurses’ practice in sexual
health care, as a professional development resource to
increase scope of practice, and for use as an advocacy
tool. Competence against the standards can be
measured by self assessment, peer assessment,
specialist assessment, GP assessment or a
combination of these methods.
The Competency Standards identify seven
domains for development: effective communication;
assessment, care planning and clinical management;
health promotion and patient education; research;
legal and ethical nursing practice; collaborative care
and partnerships; and leadership and development
of the role.
To support the development of competencies in
sexual health, primary health care nurses can access
various training resources that are outlined in the
Competency Standards. Support is also available
from local sexual health services.
Further information about the Competency
Standards is available on the STIPU website at www.
stipu.nsw.gov.au or email nswstipu@gmail.com. Hard
copies are also available. Contact Michelle Bonner,
Manager GP and Sexual Health Project, STIPU, at
nswstipu@gmail.com or on (02) 9382 7525. Health
professionals in NSW requiring information about HIV
and other STIs can also contact the NSW Sexual Health
Infoline on 1800 451 624.
Epaderm ® . Pure, simple and
effective.
Pure: Less sensitisers and irritants than other
leading brands. 1
Simple: Available as a 3-in-1 ointment or 2-in-1
cream, Epaderm removes the need to buy, store
and use multiple products.
Effective: Epaderm range is highly effective at
managing eczema.
Epaderm ®
For Eczema,
Psoriasis
and other dry
skin conditions
Reference: 1. Potential skin sensitisers in Emollients, MIMS March 2011 and manufacturers’ SmPCs/PILs.
Pure Simple Effective
www.molnlycke.com
Mölnlycke Health Care Pty Ltd, Suite 1.01,10 Tilley Lane, Frenchs Forest NSW 2086,
Ph: 1800 005 231. The symbol and the word mark are both registered trademarks or
trademark pendings of Mölnlycke Health Care. 146307

BEST PRACTICE NURSING AWARDS
2013 Best Practice
Awards
Six practice nurses have been acknowledged for their exceptional
contribution to general practice as part of the 2013 APNA Best
Practice Awards.
Winners of the Awards were announced at a gala
awards ceremony hosted at the APNA National
Conference in Melbourne on Friday 3 May.
The Awards were given for best practice in the areas
of chronic disease management, continence care,
immunisation and sexual health, and to nurses who
have demonstrated innovation or quality improvement
in their practice.
APNA congratulates all of the Best Practice Nurse
Award winners and highly commended, and thanks
all nurses who nominated for taking the time to share
their story with their colleagues.
APNA President Julianne Badenoch said, now in its
seventh year, the annual awards celebrate individuals,
and practices, making remarkable improvements in
primary health care and general practice.
Ms Badenoch said, ‘Each year we see further
progression and development in the important role
nurses play within primary health care.
‘These awards acknowledge nurses who are
stepping up to new opportunities and challenges
and who are truly moving our profession forward.’
Each winner receives $5000 towards their
professional development thanks to generous
sponsorship. Most plan to use their prize to attend
conferences and courses, or to enable them to
experience primary health care in a different setting.
The judging panel for the awards comprised APNA
and the Award sponsors Australian General Practice
Accreditation Limited, Australian Society for HIV
Medicine, Bupa Health, CSL Biotherapies, General
Practice Victoria, MSD, NSW Sexually Transmissible
Infections Programs Unit, and TENA.
APNA encourages nurses to nominate themselves
or a colleague for the Best Practice Awards in 2014.
Keep an eye on the eNews and other APNA
communications later in the year.
AGPAL Best Practice Award for
Quality Improvement
Susan Nunn (Tas)
ASHM / NSW STIPU / GPV
Best Practice Award for Sexual Health
David Youds (Qld)
bioCSL Best Practice Award for Immunisation
MSD Best Practice Award for
Chronic Disease Management
Carolyn Ronan (SA)
Lois Mitchell (NSW)
TENA Best Practice Award for Continence Care
Shani Hill (Vic)
Bupa Health Dialog Best Practice Award in
Nursing for Innovation
Tahlia Kinnane (WA)
Volume 13 Issue 2 | Primary Times | 11

BEST PRACTICE NURSING AWARDS
2013 Best Practice Awards
TENA Best Practice Award in
Nursing for Continence Care
Shani Hill
Shani Hill was awarded the TENA
Best Practice Nurse Award for
Continence Care for her
determination to deliver evidencebased,
best practice care and
education to all clients who attend
the clinic for assessment and
ongoing management of continence
issues.
Shani, who works under the
community umbrella of Barwon
Health, a large institution in Geelong,
Victoria, is a Continence Nurse
Consultant with over 25 years’
experience. She is the team leader
at her clinic and has demonstrated,
over many years, a commitment to
improving the service to ensure the
needs of clients are met in a timely
manner.
Shani said that, ‘Primary health
care is special because we are often
the first line of contact for our clients
within the health system’.
‘It’s rewarding to see the improved
difference that our education can
make to our client’s everyday lives.’
Shani has driven various initiatives
at the clinic, which have included
canvassing senior management to
increase the continence
physiotherapy hours to support the
level referral demand for the service.
This resulted in a decrease in
practice waiting times for continence
physiotherapy from 13 weeks to two
weeks.
Shani said that clinic had too many
referrals and not enough hours of
physiotherapy.
‘After a long search we employed
a second continence physiotherapist
part-time for our antenatal and
postnatal clients.’
Shani demonstrates a passion for
working with continence and
recognised the need to deliver an
educational program for staff, clients
and carers at her practice. She also
supports continence nurses working
in smaller rural services who have
difficulty accessing training.
Shani strives to ensure the service
at the clinic provides quality care,
and this is evident through client
satisfaction surveys. The clinic, under
her leadership, is recognised as a
service that delivers a high standard
of care.
Shani plans to use the prize to
attend an International Continence
Conference in Barcelona in August.
Shani said, ‘My primary attraction
at the Barcelona conference is the
Nurses Forum, I have attended a
number of these on a National level
and was attracted to the idea of an
International forum’.
MSD Best Practice Award in
Nursing for Chronic Disease
Management
Lois Mitchell
Lois Mitchell was awarded the MSD
Best Practice Nurse Award for
Chronic Disease Management for
her work in setting up the innovative
weight management program
‘Change of Life’.
Lois began to tackle the issue
of obesity in her work with Nexus
Healthcare Group in early 2011.
Drawing on her considerable skills
and experience in chronic disease
management and the promotion
of behavioural change through
neuro-linguistic programming
technique, she designed the Change
of Life program.
Lois said, ‘Seeing patients over a
period of time and getting to know
them I realised there was real
potential in most of them but they
did not know where to go to get
assistance.
‘A weight loss program covers
most diseases, with nearly all of them
having better outcomes with weight
loss and exercise, so it was a good
place to start.’
The Change of Life program
involves an initial patient screening
visit, where they are educated about
energy imbalance and their readiness
to attempt behavioural change is
assessed. Homework is then set,
which includes keeping a journal of
personal goals and a record of
dietary and physical activity habits.
Patients who show a commitment
to change are invited to continue the
program, which includes eight clinic
visits over 12 weeks. Education and
motivation is provided throughout the
program by the nurse, with the
assistance of the GP, and where
appropriate, a dietitian and/or
exercise physiologist.
To date, 203 obese patients
(BMI >30kg/m2) have been referred
to the program and 149 have
attended clinic sessions. The average
weight loss in the group was 5 kg
— a clinically significant amount.
The Change for Life approach was
incorporated in the recent publication
of the National Health and Medical
Research Council (NHMRC)
Guidelines for the Management of
Overweight and Obesity, officially
recognising this approach as best
practice. The Guidelines recommend
that weight management in primary
care is best achieved through a
12-week intensive intervention in
patients who have been assessed
as ready to take on the necessary
behavioural changes.
Lois plans to use the prize to
attend the Australian and New
Zealand Obesity Society conference
in Melbourne in October and to
undertake an online obesity nutrition
course.
Highly commended: Jude Collier
Highly commended: Diane Bundellu
Volume 13 Issue 2 | Primary Times | 13

BEST PRACTICE NURSING AWARDS
2013 Best Practice Awards
Bupa Health Dialog Best Practice
Award in Nursing for Innovation
Tahlia Kinnane
bioCSL Best Practice Award in
Nursing for Immunisation
Carolyn Ronan
Tahlia Kinnane from Derbarl Yerrigan
Health Service, in WA, was awarded
the Bupa Health Dialog Best Practice
Award in Nursing for Innovation for
her work in helping facilitate the
launch of The Daisy Petals Program,
designed specifically to improve
Aboriginal women’s health.
The Program aims to raise the
profile and awareness of women’s
health issues in the Aboriginal
community who are at increased risk
of a range of health issues, including
communicable diseases, cardiovascular
disease, and ear and eye
health, and who are experiencing
less satisfactory health outcomes
compared to women in the wider
community.
Tahlia said, ‘Primary health care
nursing is special because as a
member of a multidisciplinary team
we have the opportunity to contribute
to the care of clients with a variety of
presenting complaints, assist with
chronic disease management and
embrace health promotion
opportunities.
‘Aboriginal primary health care is
especially rewarding as we attempt
to address the multi factorial causes
of ill health and premature death
amongst indigenous individuals.’
The Program offers women a
health assessment based on the
analogy of a daisy — women are
likened to daisies and come in all
shapes, sizes and colours and need
to be nurtured in order to bloom.
Stations are set up to conduct
the various health checks and include
the following:
Petal 1: Weight, height and waist
measurement
Petal 2: Blood pressure,
haemoglobin and blood
sugar testing
Petal 3: Smoking
Petal 4: Alcohol and other drugs
Petal 5: Social and emotional
wellbeing
Petal 6: Diet and physical activity
Petal 7: Sexual health
Petal 8: Breast and cervical
screening
Petal 9: Dental health
Nurses and Aboriginal health
workers are equipped with health
promotion material to promote
education and awareness on topics
including healthy diet, Pap smears,
heart health and so on.
The presence of this Program at
events provides an opportunity for
women to come together in a relaxed
and culturally sensitive environment.
In addition to providing health checks,
support and guidance is given to
the women in seeking appropriate
medical care and advice.
Tahlia plans to use her prize to
attend the 8th International Council
of Nurses, International Nurse
Practitioner/Advanced Practice Nurse
Conference in Helsinki Finland in
2014.
Carolyn Ronan was awarded the
bioCSL Best Practice Award in
Nursing for Immunisation for her
work in raising the immunisation rate
of Indigenous children in her region.
Working at the Ceduna Koonibba
Aboriginal Health Service Aboriginal
Corporation led Carolyn to try various
strategies to improve the awareness
of disease preventable vaccinations
among Aboriginal and non-Aboriginal
families and children. These
strategies have resulted in an
increased vaccination rate from
83.4% to 94.4% in just over 12
months.
When Carolyn commenced at this
Community Controlled Aboriginal
Health Service in February last year
there was no regular recall system for
childhood vaccinations. Working one
day per week offering a childhood
immunisation service, Carolyn
devised a range of strategies to
improve the awareness of disease
preventable vaccinations to Aboriginal
and non-Aboriginal families and
children.
Carolyn said, ‘Every child has the
right to be offered protection from
debilitating diseases through disease
preventable vaccinations’.
Strategies included partnership
building between Aboriginal health
workers and Aboriginal community
members and other agents, so that
unique opportunities to connect
with families in a culturally safe
environment are not missed.
The success of the program can
also be attributed to setting up and
trialling recall systems tailored
specifically for ‘childhood
immunisations’. The most novel
system was the trial of a recall
system using the mother’s first name
and the attachment of all her children
in age order with the next due
vaccinations highlighted. This
provided a quicker reference than
listings according to the individual
antigen due.
Carolyn said, ‘To be recognised
for something that I passionately
believed in and value is truly savoured
and treasured.
‘Gaining this award is also about
recognising the whole team effort
with the collaborative focus to build
strong healthy babies and families
through a safe vaccination program.’
Carolyn hopes to use her prize to
attend the South Australian
Postgraduate Medical Education
Association’s Sleep Matters of infants
and toddlers one-day seminar, in
Adelaide in August, as well as the
National Immunisation Conference in
Melbourne in June 2014.
Highly commended: Karen Blackmore
14 | Primary Times | Volume 13 Issue 2

BEST PRACTICE NURSING AWARDS
ASHM/NSW STIPU/GPV Best
Practice Award in Nursing for
Sexual Health
David Youds
David Youds received the ASHM/
NSW STIPU/GPV Best Practice Nurse
Award for Sexual Health for his
work in providing a continued best
practice approach and continuity of
care in a primary care setting to
improve sexual health patients’ care.
David has been working in general
practice for the last 12 years, initially
as an HIV clinical trials nurse and
then as a practice nurse, and more
recently as a Credentialled Mental
Health Nurse. His current role
incorporates all of these functions.
David’s practice has a high
proportion of gay, lesbian, bisexual,
transgender and intersex patients of
which a large number of this
population is HIV positive, and there
is an increasing number of patients
becoming hepatitis C co-infected.
The knowledge and experience
gained from this role have provided
him with a better understanding of
issues related to HIV/hepatitis C virus
co-infection and the effects on newly
diagnosed patients.
A few years ago, David conducted
the ‘Help us to Help you’ survey
to determine whether patient
information needs were different
to what clinicians thought they
should know. This resulted in a
comprehensive education package,
including a number of plain English
brochures, and a database of
services that have no issues with
blood borne disease management.
In addition, the majority of newly
diagnosed patients are given
sessions with David to elicit their
concerns and explain what is likely to
happen in a general practice setting.
He also carries out GP management
plans and team care arrangements
whereby specific care needs can be
assessed.
David said, ‘All patients are unique
individuals and even though many
may present with the same medical
diagnosis, by forming a rapport with
and getting to know them your
interventions can be individualised
within best practice guidelines’.
David hopes to use his prize to
travel to Kuala Lumpur, Malaysia,
for the 7th International AIDS
Conference in July and to attend
the ASHM Conference in Darwin in
October.
AGPAL Best Practice Award in
Nursing for Quality Improvement
Susan Nunn
Sue Nunn from Summerdale Medical
Centre in Tasmania was awarded
the AGPAL Best Practice Award in
Nursing for Quality Improvement for
her ongoing commitment to quality
improvement and innovation at her
practice. Her commitment has
resulted in a dramatic growth and
development of the services provided
by the nursing staff at her practice,
where she has a combined
management and clinical role.
Sue believes in the importance
of offering flexibility to staff and
embracing their specialist experience,
including their backgrounds as
midwives, medical nurses or in aged
care and emergency medicine.
All staff are encouraged to bring
new ideas to the practice to ensure
ongoing improvement.
Sue ensures a strong emphasis is
placed on ongoing education, so that
all staff can provide the same, high
level of care for patients. All new
registered nurses are encouraged
to undertake a facilitated nurse
immuniser course and cannulation
accredited training. In addition, as the
practice provides extensive wound
care, all nursing staff attend a wound
seminar in work time. This ensures all
staff are current and consistent with
their management of wounds.
One hour of self-directed learning is
also offered on a monthly basis to
each staff member during their
normal work day.
Sue said, ‘Primary health care
nursing is very important; we as
nurses are able to make a difference
to our patients and to help improve
their outcomes.
‘Therefore it is important to look at
ways of continual improvement and
ensuring that knowledge is current to
be able to provide best practice to
our patients.’
Sue regularly conducts audits
through the treatment room,
identifying areas of inefficiency and
areas to be improved. This has
resulted in an increase in the nurse
staffing and improvements in the
delivery of patient care. For example,
Sue implemented the ‘nurse time’
concept at her practice. One GP is
allocated to work with the nurses for
the morning. They have no routine
appointments — they can check
dressings, write orders for
medications to be administered,
check INRs, check vaccinations,
provide the incidental scripts that the
patients require, and attend to all the
emergency fit-in patients that attend
on most days, allowing the other
GPs to see their patients without
interruption. This system has worked
extremely well enabling the nurses
to see many more patients.
Sue said this award will allow
her to undertake professional
development opportunities that she
would have never been able to
consider before.
Highly commended: Trish McCarron and Peta Niven
Volume 13 Issue 2 | Primary Times | 15

Online education for practice nurses on the move
Immunisation for registered nurses
This course is designed for RNs working in health areas where administration
of immunisation is part of their role and for RNs who wish to enhance their
career opportunities. Successful completion of this course enables you to
administer vaccinations without the direction of a medical officer within NSW,
Victoria and Tasmania.
CPD Hours: 100 hours
Principles of emergency care (registered and enrolled nurses)
This course will provide the knowledge underpinning the skills needed
for attending to first-line emergency care and ongoing assessment and
management of patients in an emergency / critical situation.
CPD Hours: 150 hours
E-Learning Training Package to support Medicare Item 10997
Developed in collaboration with expert health organisations, the e-Learning
training package will help you to efficiently monitor and support patients with a
chronic disease care plan.
CPD Hours: 30 hours
www.acn.edu.au
1800 COLLEGE (265 534)
ssc@nursing.edu.au
Caring for your career
ACN membership benefits
can help you grow!
Australian College
of Nursing
AGPAL
AGPAL
ACN APNA CPD 210x140 Apr 2013.indd 1
AGPAL
AGPAL
M IP AAPM & AAPM PRESENT
QIP AAPM AAPM & PRESENT & QIP QIP & PRESENT & QIP PRESENT QIP PRESENT
AAPM & QIP PRESENT
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
24/04/13 3:58 PM
L
AGPAL
AGPAL
AGPAL
AGPAL
M AAPM IP & PRESENT QIP AAPM & PRESENT QIP PRESENT QIP & QIP PRESENT
TAAPM P & PRESENT QIP AAPM & PRESENT QIP AAPM & PRESENT QIP & PRESENT QIP PRESENT
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
l International
e al
The The International
T
P AAPM & PRESENT
QIP AAPM AAPM
The
& PRESENT QIP AAPM & PRESENT QIP QIP
International
& QIP PRESENT PRESENT
l The tional Care
l
Health Care The Health Care
International
Care
The The Health Care
The International Care
ence The e Health Care
al
Conference
Care The Health re
Care Conference
The
Health Care Care
International
Care Care
Care Care Care
ence
h re
Care
Health Conference
Care Care
Care Care
e
Conference
Conference
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
AGPAL
ake s – ifference QUALITY it Does QUALITY make a difference – it Does QUALITY make a difference – it – Does – make Does a – difference Does – it Does it make a it make difference
it make it a make a difference a difference
a a difference
Registrations Registrations QUALITY Registrations are – Registrations now are Does now open. are Registrations it open. make now Register Registrations are Register open. a now difference
today! Registrations are Register open. today! now are Register open. today! now are Register open. today! now Register open. today! Register today! today!
2013, 3, 8 ney r 25-28 2013, September Sydney 25-28 2013, September Sydney 25-28 September www.cdesign.com.au/aapmqip2013
www.cdesign.com.au/aapmqip2013
2013, Sydney September 2013, Sydney 2013, Sydney 2013, Sydney
Sydney
25-28 September 2013, Sydney
gister ow
– s
en. today!
ake QUALITY difference
Registrations are
Does it
open. Register
make a
now today!
– difference
QUALITY it
are
Does
Registrations Register open.
make a
now today!
– difference
are
Does
Registrations
it
Register open.
make a now today!
difference Does – it
are Registrations
Does
are open. Register
make a today!
difference
now it Registrations make are
it
Register a make
open. today!
difference
now Registrations are open. Register a
today! now
difference
Registrations are Register open. now today! are Register open. now today! are open. Register now today! Register open. today! Register today! today!
apmqip2013
y!
fference
QUALITY tions egistrations f gers r open.
e it e Does stralian egister Association Practice The .au/aapmqip2013
today! Managers now
make a difference – patient Australian
Registrations of are
QUALITY
Register The open.
it Does
Practice Association
today!
Managers now
make a difference
The outcomes, patient Registrations
–
of are
QUALITY
Australian Register
it
open.
Does
Practice Association
today!
make Managers now
a – difference
outcomes, patient of
Registrations infection are
Does
Register
it open.
Practice
today!
make a
Managers
Association now
– difference
outcomes, patient infection Registrations
of
are
it Does
control Register open.
make
Practice Managers
today!
now
a difference
outcomes, patient of and Registrations infection are
it
control of Register open.
make a
Managers communicating
today! Practice now
difference
outcomes, patient and Registrations are infection control Register open.
a communicating
today! now
difference
The Australian Association of of Practice Managers
outcomes, Managers and infection are control Register open. www.cdesign.com.au/aapmqip2013
communicating
today! now infection and are control Register open. today! communicating
now and control Register open. communicating
today! and Register communicating
today! today!
dney
8
patient
25-28 3, 2013, September Sydney
outcomes, Ltd September 25-28 2013, Sydney
infection
(AAPM) 2013, Sydney September and 2013,
control
Quality Sydney
and
2013, Sydney 2013,
communicating
Sydney
APM) vation y!
fference
re
QUALITY
erformance com.au/aapmqip2013
tions egistrations ty
Does r open.
e it e d Ltd Quality Innovation in (AAPM) and Performance
a multicultural Quality Innovation Ltd in and Performance
a (AAPM) multicultural Innovation Quality in practice. Performance
a and multicultural Innovation Quality practice. in Performance
a multicultural Innovation in practice. Performance
a multicultural in practice.
a Performance
multicultural in practice. a multicultural practice. in a multicultural
in
practice.
a in a multicultural practice.
in 3
egister today! now
make a difference –
Ltd Ltd Registrations are Register
a multicultural it (AAPM) open.
it Does QUALITY today! now a difference
Registrations
–
are
QUALITY
Register
it and open.
Does today!
make
now – Quality Registrations are
Does
practice.
Register
it
open. today!
make a
now
– difference
Innovation Registrations are
it Does Register open.
make
today! now
a difference
Registrations are
it Register Performance
open.
make a today! now Registrations are Register open.
a
today! now
difference
The make Australian a difference
– Association Does it it make of Practice a difference
Managers are www.cdesign.com.au/aapmqip2013
Register open. today! now in are Register in open. a a today! multicultural now Register open. today! practice.
Register today! practice. today!
25-28 2013, September Sydney 25-28 2013, September Sydney 25-28 September 2013, Sydney September 2013, Sydney 2013, Sydney 2013, Sydney
Registrations
Sydney
are now open. Register today!
Registrations Registrations Registrations are Registrations now are open. are now now are Register are open. now open. now open. Register Register open. today!
Register Register today! today!
today! today!
Registrations
www.cdesign.com.au/aapmqip2013
www.cdesign.com.au/aapmqip2013
www.cdesign.com.au/aapmqip2013
are now open. Register today!
www.cdesign.com.au/aapmqip2013
The International Health Care Conference delivers an Registrations action-packed Registrations program are Registrations now focusing are open. now are on are open. improving Register now now open. Register open. safety today!
and Register today! today! today!
quality in primary health care and professional development. Registrations Registrations
patient outcomes, patient
patient The lively patient Registrations
outcomes,
outcomes, patient are
infection and outcomes, now information
outcomes, Registrations
infection control are infection open. www.cdesign.com.au/aapmqip2013
now infection are program
and control infection Register open. control now are
communicating
control includes open. Register
and
and control now today!
communicating
communicating
and Register and open. today! communicating Register today! today!
stimulating plenary sessions, interative presentations Registrations and hands-on Registrations patient
workshops. Registrations are now Registrations are You open. now will are benefit
www.cdesign.com.au/aapmqip2013
Register open. now are from open. Register now today! attending!
Registrations outcomes, infection are now control open. and Register open. Register communicating
today! Register today!
today! today!
(QIP) (QIP) Ltd are are (AAPM) partnering are partnering and to Quality to host to host a Innovation a joint a joint International
Performance in a multicultural practice.

PROFESSIONAL DEVELOPMENT
CPD update
Join the 4,768 healthcare professionals using APNA Online Learning
to access up to date relevant and professionally delivered education.
New courses
Influenza Prevention 2013
This course has been updated to meet the standards
within the Australian Immunisation Handbook 10th
Edition released late March 2013. This course provides
primary health care nurses with concise, practice-based
information to support the safe administration of
influenza vaccines to individuals >6 months of age.
By increasing vaccination rates, this program aims
to reduce the burden of influenza in the community.
This course includes three modules, which cover the
impact of influenza, influenza vaccination and vaccine
administration technique and safety.
ANTT – Foundation
This course provides official accreditation for Aseptic
Non Touch Technique (ANTT) theory applied to clinical
practice. ANTT is a widely used clinical practice
framework for aseptic technique in healthcare and
provides a universal practice language for this critical
clinical skill. It teaches healthcare workers how to
apply the ANTT Clinical Practice Framework to clinical
practice using the ANTT approach.
Reducing Risky Drinking
This course provides an introduction to Screening,
Brief Intervention and Referral to Treatment (SBIRT) for
addressing risky alcohol use in primary health care. This
course will increase your understanding of risky drinking
and its harms, how to advise patients on standard drinks
and the National Health and Medical Research Council
(NHMRC) alcohol guidelines and engage patients about
their drinking. You will learn how to conduct SBIRT in
your practice, support your colleagues to conduct SBIRT,
and champion alcohol awareness in your clinic.
CPD eNews
The monthly APNA CPD eNews keeps you up to date
with APNA professional development and external
education opportunities. The CPD eNews is free and
will discuss education available now, where to source
state-based and local resources and specialised
educational avenues. Sign up to the APNA CPD
eNews in the right hand column on the website,
www.apna.asn.au.
Chronic Disease Management
State Conferences
Chronic conditions are among the most preventable health
conditions. Primary health care nurses can assist in the
development of integrated and coordinated services to
improve the patient journey. APNA will facilitate Chronic
Disease Management State Conferences between June and
November 2013. The two-day state conferences will cover a
range of topics including motivational interviewing, health
promotion approaches, health risk factors, communications
skills, care planning, working in multidisciplinary teams,
organisational change technique and conducting practicebased
research. The state conferences will include content
delivered by leading Australian chronic disease management
organisations on cardiovascular care, kidney health and
diabetes management.
The Chronic Disease Management State Conferences have
been endorsed by APNA according to approved criteria.
These conferences entitle eligible participants to claim up to
12 CPD hours.
Why should I
look for the APNA
Endorsement tick
APNA Endorsement aims to:
• Guide activity organisers in the standards
required by the profession
• Encourage providers to adopt best practice
educational principles when developing CPD activities
• Recognise APNA members’ commitment to CPD and
guide participants in the allocation of appropriate CPD
hours for the purpose of meeting National Registration
requirements
• Provide the opportunity for education providers to
receive feedback from APNA, ensuring endorsed
activities accurately reflect the primary health
care nursing context and scope of practice.
For more information on APNA Endorsed education or
to find out how to have your training or activity endorsed
by APNA, contact education@apna.asn.au or visit
www.apna.asn.au/endorsed.
Volume 13 Issue 2 | Primary Times | 17

MENTAL HEALTH
Key role for nurses in improving
patient mental health care
Mental Health Professionals Network (MHPN) provides two
opportunities to help primary health care nurses use their unique
position at the forefront of service delivery to improve patient outcomes.
MHPN promotes and encourages collaborative mental
health care practices amongst a variety of practitioners
involved in patient care through its two core programs
– MHPN networks and professional online development.
Recognising the key role primary health care nurses
play in ensuring patient continuity of care, APNA is
keen to encourage involvement in these collaborative
care forums.
How MHPN networks benefit
practitioners and patients
By providing a forum for a range of practitioners engaged
in providing mental health services to get together,
MHPN networks help build relationships, exchange
knowledge and share experiences. Network meetings
are attended by a range of health professionals including
nurses, general practitioners, occupational therapists,
psychologists, psychiatrists, social workers, along with
other practitioners involved in delivering mental health
care services.
More than 450 networks meet regularly throughout
Australia and, while each determines how their meetings
will run, a typical meeting is very interactive and might
include a guest speaker or discussion of a case study.
A small but growing number of networks have chosen
to concentrate on a shared area of specific interest. Often
these may be of particular interest to primary health care
nurses as they often cover topics where mental health
intersects with physical health issues such as in cases of
diabetes management, ongoing pain management and
heart-related illnesses.
Meetings encourage attendees to learn more about
each other’s areas of expertise, as well as provide the
opportunity to enhance referral pathways and discuss
any issues that are particularly relevant to your local
community.
Getting involved is easy – visit www.mhpn.com.au and
use the mental health network map to see what networks
are in your area.
If there’s not a network already in your area, starting a
new one is easy, particularly as you’ll be fully supported
by MHPN’s project team. Call the MHPN project team on
1800 209 031 to learn more.
Mental Health
Professionals Network
APNA CEO Kathy Bell recognises the practical
insights that MHPN webinars can provide.
‘They are an easy way to gain insight into case
management from the perspective of a range of
disciplines. I’d encourage everyone to take a few
minutes to have a look at the webinar series.’
‘I’d like to personally encourage all APNA members
to consider becoming involved in MHPN programs.
These programs provide an important opportunity
to help us promote awareness about the key role
primary health care nurses play in managing
patient’s mental health care.’
Online professional development
that’s free and easy to access
APNA members can access a unique series of free
MHPN webinars featuring panel discussions of a case
study by leading experts from a range of disciplines
about current mental health issues.
Topics covered so far this year include, hoarding,
supporting families with parental mental illness and
collaborative care for complex trauma presentations.
Each webinar:
• has been developed with an interdisciplinary audience
in mind
• is available 24/7 so you can stream to view straight
away or download to watch later
• aims to identify the role of different disciplines in
contributing to the diagnosis, assessment and
treatment of the mental illness, and to explore tips
and strategies for interdisciplinary collaboration in
supporting people with mental illness.
APNA members are invited to register to participate
in future live webinars, as well as view or download past
webinar recordings.
Visit www.mhpn.org.au to learn more.
The Live Well Plan
The Live Well Plan is a higher protein, low GI
weight loss plan for adults up to 50 years.
The eating plan has been developed by Meat & Livestock Australia with
the support of nutrition experts and consumer insights, ensuring it is a
practical plan that reflects the latest scientific evidence.
Please find your free copy of The Live Well Plan enclosed in this issue of
Primary Times. To order up to 50 additional free copies for use with your
patients, please call 1800 550 018.
Chris Gibbs
CEO Mental Health
Professionals Network
18 | Primary Times | Volume 13 Issue 2

SALARY AND CONDITIONS
How to read the Nurses Award
The minimum wages and conditions of most practice nurses are set out
in the modern Nurses Award 2010.
The award defines the classifications (‘descriptors’)
that attach to the minimum pay rates, setting out the
indicative duties for the different types and levels of nurse.
As the award sets out the safety net for most nurses in
Australia, the descriptors are necessarily general as they
need to apply to various sectors of nursing. In the case of
practice nursing, the descriptors are not detailed enough
to refer to the specific duties that practice nurses
commonly perform. Members of APNA and the Australian
Nursing Federation (ANF) frequently ask for advice on
where they fit in the award structure.
It is not possible to give categorical advice as to where
particular nurses should be classified. However, we can
provide some indicators that are relevant.
In relation to registered nurses, the award sets out five
levels (RN1 to RN5). The most important descriptor to
note in RN level 1 is that ‘an employee at this level
performs their duties… under the general guidance of,
or with general access to a more competent registered
nurse (RN) who provides work related support and
direction’. The ANF is aware that some practices consider
that access to a doctor is sufficient to bring an RN within
this classification, however this is incorrect. As many
practices have only one RN on duty at any particular time,
this means that in many cases RNs should be classified
as RN2 or higher.
Whether a particular practice nurse is RN2 or RN3 is
more difficult to determine and the whole range of duties
performed by the nurse needs to be taken into account in
reaching a conclusion, however some general comments
can be made.
Nurses at RN2 are more engaged in using assessment
tools and clinical procedures. They will often work
autonomously and may have postgraduate qualifications.
Nurses at RN3 deliver more complex care, information
and advice, and will almost always have postgraduate
qualifications, however there may also be some who have
learned relevant skills on the job.
Nurses are more likely to be properly classified at RN
level 3 if they prepare chronic disease care plans
(diabetes education, asthma education, coronary care) or
provide women’s health advice (sometimes including Pap
smear provision depending on the level of advice
provided) or external immunisation clinics. The key point
is that in most cases the nurse at this level will be
performing complex work independently, without the
direct supervision or attendance of the doctor (subject
to the normal collaborative arrangements).
The ANF is aware that some practices consider that access to
a doctor is sufficient to bring an RN within this classification,
however this is incorrect.
The award specifies five pay points for enrolled nurses
and provides that progression to the next pay point is
annually, or in the case of a part-time or casual employee
upon 1786 hours of experience. Importantly, the ANF’s
view is that years of experience refers to experience in
the industry of nursing, not practice nursing and not
experience with the particular employer. The award
makes no allowance for ENs who can administer
medications or who have supervisory responsibilities
beyond the usual EN role. We strongly urge ENs with
these qualifications or responsibilities to negotiate a
higher rate of pay with their employer.
The ANF’s recent application to the Fair Work
Commission for an authorisation to bargain on behalf of
practice nurses has not been finally determined, however
the application has led to fruitful negotiations with several
employers for an enterprise agreement to apply to their
practice nurses. In-principle agreement between those
employers and the ANF has been reached and (at the
time of writing) the agreements should be voted on by
employees soon.
These agreements have produced classification
structures more suited to the practice nurse sector.
For example, the (in-principle) Healthscope agreement
sets out four levels of registered nurse and states that
‘Level 3 [the lowest RN level] is effectively a Treatment
Room Practice Nurse, encompassing the broad range
of knowledge and skills necessary to effectively function
in general practice, including but not limited to triage,
assisting with minor procedures, wound management,
basic health assessment and promotion, ear syringing
and immunisations/injections under supervision’
and ‘Level 4 [Advanced RN] perform[s] duties of a
specialised nature (especially in relation to Chronic
Disease Management)’.
The agreements additionally provide affected nurses
with a clearer career path plus wages closer to those of
nurses performing comparable duties in the acute sector.
For example, the Healthscope agreement will provide
rates from mid-2013 as follows:
• Enrolled nurses: approximately $22-$25.50 per hour
• Registered Nurse (treatment room): approximately
$29-$34 per hour
• Registered Nurse (advanced): approximately
$37-$40.50 per hour
• Nurse Practitioner: $50.75 per hour
• This accords with evidence given during the case in
the Fair Work Commission that better employers pay
around these rates. These agreements demonstrate
the value of entering into enterprise agreements with
your employer. Not only can agreements deal with
wages and classification structures, but they can deal
with conditions as well, e.g. leave, professional
development.
For further information on agreement-making, or for
interpretation of the modern Nurses Award, contact APNA
or the ANF.
You can download the Nurses Award 2010 in the
Careers section of the APNA website.
Andrew McCarthy
Federal Industrial Officer
Australian Nursing Federation
Volume 13 Issue 2 | Primary Times | 19

CHRONIC DISEASE
Three steps to reduce the burden of
chronic disease for your patients
‘Prevention is better than cure’ is
an intuitive concept familiar
to most of us.
It is why we brush our teeth, wear a seatbelt and a
bicycle helmet. But are we missing the greatest
opportunity for prevention in primary health care
Can you be doing more to assist patients in your practice
to prevent the development of chronic diseases
The opportunity for
prevention of chronic disease
Chronic diseases are the leading cause of death and
disability in Australia. Over the past decade the
prevalence of chronic diseases such as diabetes and
cardiovascular disease has escalated. More than seven
million Australians now have at least one chronic
condition.
The burden caused by these diseases is expected to
continue to grow due to the ageing Australian population
and the increased prevalence of lifestyle risk factors.
About 99 per cent of Australians have at least one risk
factor for chronic diseases, such as poor nutrition,
excess body fat and high blood pressure. Perhaps
more worryingly, it is estimated that 52 per cent of
Australians have more than two or three risk factors.
But there is good news. Up to 80 per cent of
premature deaths caused by heart disease, stroke and
diabetes, and 40 per cent of cancer-related deaths, could
be prevented by reducing the prevalence of risk factors.
So how can you help
1. Review your patients to assess their
risk factors
Up to 60 per cent of practices employ a nurse who can
play a vital role in preventing chronic disease. Practice
nurses can review, identify and recall people who may
benefit from preventive activities, such as those at risk of
Use the 5 As to support
prevention of chronic disease
1. Ask about lifestyle risk factors (e.g. provide a
survey in the waiting room)
2. Assess health literacy (e.g. ask brief health
literacy screening questions)
3. Advise about interventions that may help
(e.g. Quitline)
4. Assist understanding of health information
provided by GPs or other staff
5. Arrange follow-up for patients to ensure
meaningful changes in behaviour
developing diabetes or cardiovascular disease.
When assessing your patients, remember the
synergistic effect of multiple risk factors. Two useful risk
assessment tools that consider the contribution of
multiple risk factors for chronic disease are the Absolute
Cardiovascular Risk Assessment and the Australian
Type 2 Diabetes Risk Assessment Tool (AUSDRISK).
Consider your patients from certain population groups
who may benefit more from preventive activities,
including:
• Aboriginal and Torres Strait Islander peoples
• refugees
• people from low socioeconomic groups
• people with a disability.
2. Only recommend medical tests that
will benefit your patient
Many tests performed during a health check may
detect chronic disease early and benefit your patient.
Recommended tests include measuring blood pressure
and lipids, and screening for cancer using Pap tests,
mammograms and faecal occult blood tests (FOBT).
However, some tests are not recommended for routine
testing in asymptomatic healthy people because they
have no proven benefit and may cause harm.
For example, in the absence of symptoms vitamin D tests,
thyroid function tests and prostate cancer screening have
no proven benefit.
Harm can be caused when a false-positive result leads
to patient anxiety, followed by expensive and invasive
follow-up tests. Overdiagnosis can occur when a clinically
insignificant disease is detected that would never cause
the patient harm or symptoms, but is treated
unnecessarily, which can cause side effects.
Only perform tests in a health check that are
recommended in the RACGP Guidelines for Preventive
Activities (the ‘red book’). Be aware that some tests are
only recommended for people after they reach a certain
age; performing tests outside these age groups may also
put people at risk of overdiagnosis.
3. Discuss the approach to preventive
activities in your practice
Start the conversation today with the staff in your
practice to see if you can improve the long term health of
your patients. The best model of care for preventing
chronic disease has two parts:
• opportunistic preventive healthcare for patients when
they are in your practice for other reasons
• planned preventive health checks that are targeted at
individuals’ life stage, and for those at higher risk.
The RACGP guideline on putting prevention into
practice, the ‘green book’, is a useful resource. It outlines
how practices can set up a framework for prevention and
plan processes that are time-efficient and effective for
your patients.
NPS MedicineWise resources
For more information on preventive health, visit the NPS
MedicineWise website at www.nps.org.au/preventivehealth
or the Medicinewise News: Which tests are best
for assessing risk in preventive health at www.nps.org.
au/MWnews-testing-times.
A fully referenced version of this article is available by
emailing editor@apna.asn.au.
20 | Primary Times | Volume 13 Issue 2

FAMILY PLANNING
Opportunistic family planning
services
APNA is pleased with the success
of the Practice Nurse Family
Planning Capacity Building Project
(Family Planning Project) having
released a four-hour online
learning course and delivered
21 face to face workshops
throughout Australia.
Effective family planning is recognised globally as a
priority health issue. Critical for women’s overall health
and wellbeing, it enables women to choose the timing
and number of children they wish to have. Effective
family planning promotes better health outcomes for
mothers and babies, increases access to education
especially among young girls, reduces poverty, and
promotes human rights and gender equity.
The Family Planning Project covered both aspects
of family planning; contraception and planning for
pregnancy. Australian research highlights the extent of
unmet family planning need in Australia and the impact of
health inequity on women’s capacity for family planning.
Research shows that around half of all women will
experience an unplanned or mistimed pregnancy. One in
six couples will experience infertility at some point in their
reproductive lifetime. Most unplanned pregnancies are
believed to result from non-use or inconsistent use of
contraception. Poor lifestyles – being overweight/obese,
smoking, etc. – are considered significant contributing
causes of infertility. Both unplanned pregnancies and
infertility are potentially avoidable.
Common family planning scenarios taken from the
general practice setting were used to illustrate Australian
research findings that show 40 per cent of women were
not using contraception at the time of their unplanned
pregnancy. While 80 per cent of women did not seek
emergency contraception, following unprotected sex.
Only 13 per cent of infertile women understand the
fertile window of the menstrual cycle. Most men fail to
appreciate the impact of poor lifestyle on their fertility,
and only around half of women had a pre-conception
health check prior to becoming pregnant.
The Family Planning Project outlines simple nurse
interventions ranging from the importance of folate
supplementation to increasing awareness of emergency
contraception that is available over the counter at
chemists. Content from the Family Planning Project
includes information about healthy lifestyles increasing
the chance of natural conception, and how to support
men and women achieve better health.
As part of the Family Planning Project, Kerry Hampton
shared her knowledge on family planning. Kerry identified
quick interventions that could take place, for example,
while undertaking a Pap test or taking blood. Kerry
recognises that general practice nurses are ideally placed
within Australia’s health system to make a substantial
contribution to prevention in healthcare. Kerry believes
family planning is one area where the potential of practice
nurses is yet to be fully realised.
One participant in the Family Planning Project, Di Van
Vliet, completed the online learning course and attended
a workshop in March 2013. Di’s interest in family
planning began after completing her general nurses
training in the 70s while undertaking a Naturopathic
Diploma. Di’s view was that for her, ‘it just didn’t feel right
to take the oral contraceptive pill’. Further investigation
led her to the Billings Method and Di became a teacher
of the sympto-thermal methods of identifying body
symptoms of ovulation. Di personally used this method for
both contraception and conception for many years. In the
80s Di met Francesca Naish author of two bestselling
books – Natural Fertility and Better Babies. Di continues
to incorporate her learnings to empower women to have a
natural curiosity about the workings of their body and use
this information for family planning.
A visual representation
of a jigsaw female
reproductive system.
The puzzle is yet to be
completed, much like
nurses trying to pull
all of the pieces of
knowledge together.
With her wealth of previous knowledge, Di was
amazed at the latest research and enjoyed learning of
new evidence-based information. Di commented that the
online course ‘topics were followed up with supporting
websites and the best handouts sourced from many
varied locations’. Di hadn’t planned to attend a workshop
thinking that the online course was sufficient. Di was
pleased that she did attend a workshop where Kerry’s
‘generosity and knowledge enhanced her learning’ above
the online course. Di increased her understanding of
contraception, infertility, fertility awareness and lifestyle
impacts. Di recognised that nurses performing ‘well
women’s clinics and general health assessments can talk
about reproductive health, the holistic assessment and
lifestyle with patients’.
A number of practice nurses who attended this
workshop have formed a network group to continue
gaining knowledge and incorporate it into their practices.
The Family Planning Project aimed to engender an
interest in family planning among practice nurses. The
Family Planning Project has encouraged practice nurses
to provide opportunistic and comprehensive family
planning services to their patients. APNA is pleased that
Federal Health Minister Tanya Plibersek has agreed to
provide further funding for family planning projects such
as this. APNA aims to develop further family planning
education through online courses and face to face
workshops. This blended learning approach enables
users to gain a base understanding of the topic prior to
attending a workshop.
Volume 13 Issue 2 | Primary Times | 21

The Coordinated Veterans’ Care (CVC) Program
is a coordinated care program for nurses and
general practitioners which aims to improve the
health of veterans with chronic and complex
health conditions.
Module One: Coordinated Veterans’ Care –
Is your service ready
Module Two: Care planning and
coordination with the Flinders Program
Module Three: Managing Care Plans with
disease-specific elements
Module Four: Veterans’ social isolation,
mental health and wellbeing
Workshops supporting the program will be
offered through to early 2014. Come to a
workshop to review how your existing care
planning meets the CVC Program requirements.
Workshops include a guided opportunity to
practice with a volunteer using the Flinders
Program care planning tools. Workshops are
optional and fully funded by the Department
of Veterans’ Affairs. For the best workshop
outcomes, complete Module Two first.
The workshops also provide the opportunity
to meet with other health professionals from
your local primary health care network.
Care Planning and Coordination Workshop Programs: May–October 2013
Delivered for Date Location State
South Western Sydney ML Tuesday 7 May Bankstown NSW
Central Coast NSW ML Thursday 9 May Gosford NSW
West Moreton – Oxley ML Wednesday 15 May Springfield QLD
Wide Bay ML Saturday 18 May Bundaberg QLD
South Eastern Sydney ML Friday 24 May Gymea NSW
Perth Central East Metro ML Friday 24 May Perth CBD WA
South West WA ML Saturday 25 May Busselton WA
Lower Murray ML Wednesday 5 th June Mildura VIC
Central Adelaide & Hills ML Friday 21 June Eastwood SA
Metro North Brisbane ML Thursday 27 June North Lakes QLD
Gold Coast ML Friday 28 June Southport QLD
Greater Metro South Brisbane ML Saturday 29 June Logan QLD
Sydney North Shore and Beaches ML Friday 5 July St Leonards NSW
Eastern Sydney ML Saturday 6 July Rosebery NSW
Bayside ML Wednesday 17 July East Bentleigh VIC
Northern Sydney ML Thursday 18 July North Ryde NSW
Hunter ML Friday 19 July Newcastle NSW
Frankston – Mornington Peninsula ML Friday 19 July Mornington VIC
Inner East Melbourne ML Saturday 20 July Burwood VIC
Wide Bay ML Friday 2 August Bundaberg QLD
Perth Central & East Metro ML Thursday 8 August Perth CBD WA
South West WA ML Saturday 10 August Bunbury WA
Central Coast NSW ML Wednesday 14 August Gosford NSW
Inner West Sydney ML Saturday 17 August Ashfield NSW
New England ML Saturday 24 August Tamworth NSW
South Eastern Sydney ML Thursday 5 September Sutherland NSW
Tasmania ML Thursday 5 September Launceston TAS
North Coast NSW ML Saturday 7 September Lismore NSW
Australian Capital Territory ML Saturday 14 September Canberra ACT
South Western Sydney ML Wednesday 18 September Campbelltown NSW
Illawarra Shoalhaven ML Friday 20 September Wollongong NSW
Frankston – Mornington Peninsula ML Saturday 12 October Mornington VIC
Central Adelaide & Hills ML Wednesday 16 October Bedford Park SA
Hunter ML Thursday 24 October Newcastle NSW
Greater Metro South Brisbane ML Tuesday 29 October Logan QLD
Metro North Brisbane ML Thursday 31 October Lutwyche QLD
Locations to be confirmed please check website. Additional workshops may be scheduled subject to demand.
Authorised by the Australian
Government, Capital Hill, Canberra.
CVC Program partners acknowledge the financial support of the Australian Government Department of Veterans’ Affairs

DVA CVC PROGRAM
Update: Flinders Program
training for veterans
The Coordinated Veterans’ Care
(CVC) Program commenced in
2011 for Department of Veterans’
Affairs (DVA) Gold Card holders
who have chronic conditions and
complex health needs.
The program is supported by the provision of free
accredited training consisting of four modules that
incorporate the latest clinical evidence in the provision of
multidisciplinary care in the primary health environment.
The training materials have been developed by the Flinders
Human Behaviour and Health Research Unit for health
professionals in primary care who support the veteran’s
involvement and self-management of their health
condition/s and general wellbeing.
These materials have been designed to accommodate
flexible, self-paced learning and are presented in a range
of online, hardcopy and DVD formats. A one day CVC
Program workshop has been designed to support health
professionals undertaking Module Two: Care Planning
and Coordination with the Flinders Program. To date,
these workshops have been attended by a range of health
professionals including practice nurses, community
nurses, general practitioners and Aboriginal health
workers. A modified workshop format for 2013 has the
first session of the day now open to anyone involved in
general practice (including practice managers and allied
health professionals) and provides an overview of the
health service aspects of the CVC Program. The day
provides the opportunity for participants to review their
existing care planning and how this meets the CVC
Program requirements. Feedback from workshops
delivered to date has been overwhelmingly positive, one
participant commented, ‘It suddenly all makes sense and
doesn’t seem too hard to do’. Another stated, ‘I learn by
seeing, not by reading so thank you for the opportunity’.
All four modules have been developed to meet a wide
range of learning needs and the participant feedback we
receive is highly valued. In response to this feedback, the
online modules have been updated to improve access to
resources and navigation. Recent module evaluations
have included comments such as ‘easy format to follow’
and ‘video links give a visual as well as the readings
which for some make learning easier’.
Modules One and Two can be completed online or by
working with a DVD or a hard copy manual. Module Two
completion is also supported by attending a workshop
which includes an opportunity for facilitated practice
using the Flinders Program care planning tools and to
develop a comprehensive care plan. Modules Three and
Four can be completed online or with a DVD. Some
learners are using a combination of online and offline
modes to complete the training in any or all four modules.
As each module is self-contained, learners can choose
the order in which they commence and progress.
Evaluation comments about the training received from
online participants have included the following:
It has helped with skill development and there is
now the ability to be proactive, and improve quality
of care to our patients.
Another participant reflected on the relationship
between the patient and the health professional by
saying:
The Flinders Program approach to care planning
and coordination illustrates how confusion can
occur between different agencies involved and
the need for horizontal communication.
We continue to actively encourage nurses and other
health professionals to access these accredited education
and training resources. Further details about the
Coordinated Veterans’ Care Program including the
training modules and other training resources can be
found at www.cvcprogram.net.au.
For further information, including workshop dates
and locations, see advert on opposite page.
Workshop participants in Ipswich
Workshop participants in Newcastle
Volume 13 Issue 2 | Primary Times | 23

TELEHEALTH
Are you prepared for an increased
demand for telehealth services
With the expected completion of the National Broadband Network
(NBN) roll out in 2020, whereby 93 per cent of homes, schools and
business will have access to the NBN capable of providing broadband
speed of up to 1 gigabit per second, telehealth is anticipated to be one
of the major changes to healthcare consultation delivery in the next
decade.
Telehealth is consultation between a health consumer, a
primary care provider such as a nurse, nurse practitioner,
midwife, Aboriginal health worker or general practitioner
and a specialist healthcare provider through the use of
audio and visual connection.
To promote the uptake of telehealth usage, new MBS
item numbers have been created and incentive payments
instituted for midwives, nurse practitioners and general
practitioners. Incentives have been in place since 2010
and will cease in 2014.
Consumer demand
In regional, rural and remote areas there is a predicted
expectation from consumers that a telehealth service will
be provided at the clinic they attend. According to MBS
statistics, at 30 September 2012 specialists provided
26,680 services via telehealth with the majority of those
services taking place in Queensland and New South
Wales followed by Victoria. General practitioners have
claimed 15,832 services via telehealth. Claims made for
practice nurses whereby they sit in on the consultation
on behalf of a general practitioner numbered 2,926 at
the same point in time. While the uptake by nurses in
general practice has been slow to date, it is anticipated
that the numbers will grow as nurses become familiar
with the technology and at ease with participating in a
telehealth consultation on behalf of a general practitioner.
Preparing nurses, midwives and nurse
practitioners
An online education package has been developed by the
Nursing and Midwifery Telehealth Consortia to prepare
practice nurses, nurse practitioners and midwives for the
anticipated consumer demand for telehealth. The package
is designed to help health professionals gain confidence
and understanding of all aspects of telehealth online video
consultation and to help prepare them and their workplace
to be able to offer this form of consultation.
CPD hours/points
The online education is divided into nine small modules.
On the completion of the ninth module a final certificate
will be issued that lists the module content and credits
the participant with four CPD hours, or points in the case
of midwives.
Education online
Each of the education modules has interactive
components, including online video interviews with
nurses, midwives and other health practitioners currently
using telehealth. These interviews provide an insight into
how telehealth can be adapted to your workplace as
another way to help your patients. Several case studies
have also been developed to illustrate a variety of clinical
situations in which telehealth can be used. Each module
builds on the previous one for the nurse and midwife to
gain knowledge and skills.
Modules one to three
Module one starts with a pre-course survey to help
identify where the participant may need further
information about telehealth. This module also covers the
aims and objectives of the project. The second module
details MBS item numbers specific to nurses, nurse
practitioners and midwives, and scenario-based
questionnaires promote further understanding of how
telehealth can be applied to the clinical situation. In the
third module, the various settings in which telehealth can
be utilised and patient suitability is covered. Telehealth
consultations are also discussed in terms of clinical and
psycho-social factors impacting on patient suitability.
Module four
Module four develops information on the tools used for
telehealth. Questions covered in this very interactive
module include:
• What is a video conferencing system
• What is the difference between a ‘diagnostic’ and
‘general’ video consultation
• What is an internet connection speed
• What is bandwidth and what exactly is the new NBN
• What is the difference between a ‘dedicated’ system
and a ‘desktop’ system
• What issues should be considered when sourcing a
camera, microphone, speakers and software
24 | Primary Times | Volume 13 Issue 2

TELEHEALTH
Telehealth Checklist
Modules five and six
Modules five and six encompass software selection and
provides a ‘how to’ guide in setting up a telehealth
consultation. Module five is a practical unit where the
participant is encouraged to undertake a video call. There
are ‘how to’ checklists covering the booking of the
consultation, setup and troubleshooting. These guides
and checklists, as well as supportive documents such as
patient information brochures and clinic posters, are all
available to print for participant use from the education
package.
Module six discusses the professional obligations
of the nurse and/or midwife in running telehealth
consultations. Standards and guidelines, insurance,
safety, consent and privacy and security are examined.
Modules seven, eight and nine
Module seven is a practical guide to help prepare you,
your workplace, your client and the specialist for
telehealth consultations. In module eight the participant
is asked to broaden their experience and skills by
conducting a telehealth online consultation. Module nine
enables the participant to reflect on and evaluate the
online education.
Resources for nurses and midwives
All of the resources in the online learning package can
be downloaded. The following fact sheets, posters and
information brochures can be adapted to be relevant to
your workplace:
• Telehealth consultation fact sheet for Nurses, Nurse
Practitioners, Midwives and Aboriginal Health
Practitioners
• Telehealth consultation fact sheet for persons
receiving care
• Telehealth etiquette fact sheet
• Telehealth checklist
• Telehealth sample patient survey
• MBS telehealth numbers fact sheet for Nurses, Nurse
Practitioners and Midwives
• MBS cheat sheets for Midwives, Nurse Practitioners
and General Practice
• Telehealth Promotional Poster – General
• Telehealth promotional poster – Midwives
Frequently Asked Questions
Additional resources are available in the Resources
section of the APNA website under Telehealth – visit
www.apna.asn.au.
Basic equipment required
Computer (where possible have two screens; one to view video, one to view clinical
records/reports/results)
Internet
Webcam
Decide on your software package
Ensure you have the supports required to install/run/troubleshoot your software
Have you done a trial video consultation using this equipment
Ensure room availability to hold your telehealth online video
consultation
Check room for privacy
Check room for safety
Does it have basic telehealth equipment
Are there suitable chairs, enough for each participant
Is lighting adequate
Sound check (inside the room and outside noise levels)
Confirm your appointment
Specialist (obtain a direct contact telephone number in case your audio drops out)
Person receiving care/family/carers (inform them of their arrival time)
Interpreters (if required)
Other health professionals (as required)
Ensure you have appropriate equipment/paperwork for the
telehealth consultation
*Items required will vary depending on individual appointment needs
Imaging or imaging results
Essential clinical equipment:
• Stethoscope
• Sphygmomanometer
• BP cuff
• Dressing packs
• Glucometer
• Doppler
Person receiving care history/file or access to view on screen during consultation
Billing information
Consent forms if needed for Medicare billing
Pathology results
Pathology request forms
Note paper
Other
Follow up appointments
Plan in advance who will be responsible for organising any follow up appointments
(or if consultation does not take place)
Evaluation/feedback
If appropriate, ask person receiving care to complete local evaluation
Volume 13 Issue 2 | Primary Times | 25

COMMUNITY
RDNS working together in
the community
Royal District Nursing Service
(RDNS) sees synergy between
its aims and those of Medicare
Locals: working together in the
community, giving the right care
in the right place at the right time.
The face of healthcare is changing. There are many
reasons for this, among them being individuals taking
a more proactive role in their healthcare and expecting
more from their healthcare providers, healthcare costs
rising, development of medical technology at an ever
increasing rate and the continued escalation in the
population aged 65 years and over, leading to higher rates
Primary Times 210x140 May 2013 OL.pdf 1 07/05/2013 3:09:22 PM
of complex chronic disease states. These factors combine
to place an enormous strain on healthcare providers and
an increasing financial burden on the community.
Collaborative care delivered by a multidisciplinary team
is now actively encouraged, to address both the complex
needs of individuals and to assist them to achieve their
goals. Perversely, the increasing costs and limitations in
funding encourage the further consolidation of ‘silos’,
fragmenting the healthcare system and reducing
communication and integration of care.
Medicare Locals are regional primary health care
organisations introduced to better connect health services
locally and to identify and rectify gaps in the provision of
health services. This is to ensure those in the community
get the health services they need closer to home.
Integration of care is a key area of need across the health
system, and Medicare Locals are uniquely placed to
expand provider support across a wider spectrum of
professional services.
RDNS, the largest provider of home nursing care in
Australia, plays a pivotal role in the continuum of care and
makes a significant contribution to keeping people where
they want to be: in their homes. The aims of the Medicare
Locals and RDNS are well aligned; there are some
obvious areas where collaboration would lead to
improvements in the delivery of healthcare and outcomes
for the people in our care.
RDNS provides in home nursing care to predominantly
older people with complex and numerous healthcare
conditions, including chronic wounds, diabetes and
cognitive impairment. The majority of RDNS clients are
prescribed multiple medicines and many require support
26 | Primary Times | Volume 13 Issue 2

COMMUNITY
to maintain good health and stay living well at home.
Researchers at the RDNS Institute are committed to
identifying improvements in the delivery of care, and
reduce costs and duplication of services across the
primary and homecare sectors in these key areas of
clinical practice and in this vulnerable population group.
Greater collaboration between RDNS staff and clinicians
of all disciplines working in Medicare Locals in the
provision of complementary care provides an opportunity
to achieve this goal.
RDNS is also active in the ehealth space – using this
as a tool to assist in providing care, to share information
efficiently and to eliminate waste. One obvious area of
collaboration with the Medicare Locals is in the
communication of assessment and outcome data of
people accessing services from both organisations. This
would reduce duplication, decrease frustration, and
reduce the risk of errors by ensuring all service providers
have access to the same information. There is also
potential for collaboration in the development of care
delivery models. For example, videoconferencing can
promote effective communication between the individual,
their carer, the RDNS nurse, the general practice and
allied health providers involved in chronic disease
management. Including specialist nurses from RDNS or
the Medicare Local, such as the diabetes educator or
wound clinical nurse consultant on the conference call is
another possibility to enhance communication and
facilitate diagnosis and management. In the future,
linkage with the appropriate specialists should be possible
– the aim would be to have all key clinicians involved in
an individual’s care having virtual case conferences in
the person’s home. This would lead to true collaborative
person-centred care, improve communication, and
ensure efficient use of our finite resources.
Recently there has been a move towards focussing on
illness prevention and maintaining wellness. While the
healthcare system has developed structures for
diagnosing and treating diseases and conditions,
preventive care involves different priorities, new
approaches, knowledge and technologies. This includes
an emphasis on developing processes for the delivery of
person-centred care and the recognition of individuals as
experts in the management of their disease/illness,
improving knowledge by enhancing health literacy and
assisting individuals to achieve their goals. The
development of common approaches to preventive health
care and meeting individuals needs by RDNS and
RDNS, the largest provider of home nursing care in Australia,
plays a pivotal role in the continuum of care and makes a
significant contribution to keeping people where they want
to be: in their homes.
Medicare Locals could lead to improved communication
and easier navigation of the healthcare system, thus,
enhancing their value to the community.
Internet and smartphone technologies and applications
(apps) are increasingly used by individuals to source
healthcare information, manage data and monitor
changes in their own health. This new paradigm of
self-management provides an opportunity to develop a
model of care where health information gathered by an
app and shared with RDNS and the Medicare Local
clinicians could enable the provision of timely feedback
that supports individual’s wellbeing and an opportunity to
prevent negative outcomes.
The primary care reform in the development of the
Medicare Locals provides a real chance to work toward
changing a system that still has entrenched structures,
increasing costs and constrained budgets, which all limit
communication and true innovation. There is an exciting
opportunity to trial and evaluate new technologies and
new models of health service delivery and the associated
costs for their effectiveness on health outcomes and the
efficient use of healthcare funds. This will provide
meaningful and much needed information for policy
makers on how best to allocate our increasingly stretched
health resources.
Further, the development of Medicare Locals provides
a real chance to improve how healthcare providers can
work in partnership to support person-centred,
evidence-based, collaborative care. Given that RDNS and
Medicare Locals have the common goals of providing the
right care, in the right place at the right time, with quality
of care being paramount, working collaboratively is the
next step.
It is now up to us to grasp this opportunity to improve
care delivery and help patients achieve their healthcare
goals.
Dr Rajna Ogrin
Dr Rajna Ogrin leads the Centre of Wound
Management at the RDNS Institute. Her research
interests include evidence-based, patient-centred
inter-professional wound care and translating
evidence into practice.
Dr Dianne Goeman
Dr Dianne Goeman is a Senior Research Fellow at
the RDNS Institute. Her research focus includes the
priorities of those living with chronic illness and the
delivery of optimal health care to this group,
medicines management, airways disease and
cognitive impairment and functional ability.
Volume 13 Issue 2 | Primary Times | 27

APNA CDM State Conferences
Join us to learn more about patient-centred care at the APNA CDM State Conferences.
Book
Now!
Share Decision Making
Learn the facts about Shared Decision Making and
how you can use in your practice. We’ll provide
examples and best use and you’ll be able to
workshop with your peers.
Patient-centred skills
A look at the skills and attributes you’ll need
to deliver CDM in your practice.
Organisational system skills
The nuts and bolts of how to run a clinic including
Medicare items numbers, data management,
opportunistic screening.
Improving Adherence in
Cardiovascular Care
A toolkit designed to raise awareness among health
professionals of the issues affecting patient adherence
to cardiovascular medicines.
Chronic Kidney Disease (CKD)
Management
Provide guidance and clinical tips to help identify,
manage and refer CKD in your practice.
Diabetes Management
Understand that diabetes management requires
day-to-day knowledge of nutrition, exercise, monitoring
and medication.
Perth Friday 21 and Saturday 22 June 2013
Assured Quays Apartment Hotel
Melbourne Friday 19 and Saturday 20 July 2013
Melbourne Convention and Exhibition Centre
Brisbane Friday 30 and Saturday 31 August 2013
Royal Brisbane and Women’s Hospital
Adelaide Friday 13 and Saturday 14 September 2013
Mawson Lakes Hotel
Sydney Friday 25 and Saturday 26 October 2013
Parramatta Workers Club
* Please note sessions may vary from state to state
For more information or to register
contact APNA on (03) 9669 7400 or
education@apna.asn.au
Proudly supported by Bupa Health Dialog
NURSING & MIDWIFERY
SCHOLARSHIPS
An Australian Government initiative
supporting nurses and midwives.
ACN, Australia’s professional organisation
for all nurses is proud to work with the
Department of Health and Ageing as the
fund administrator of this program.
Open 22 July 2013 – Close 13 September 2013
Scholarships are available in the following areas:
Apply online
www.acn.edu.au
freecall 1800 117 262
> continuing professional development for nurses and midwives
> postgraduate for nurses and midwives
An Australian Government initiative
supporting nurses and midwives.
ACN, Australia’s professional organisation
for all nurses is proud to work with the
Department of Health and Ageing as the
fund administrator of this program.

Professional indemnity insurance.
Online application, 24/7. It’s that easy.
No matter where you are, to apply for Guild’s high quality Professional Indemnity insurance all you
need is an internet connection! Morning, noon and night, our online application is the fastest and
simplest way to sign up for the peace of mind that only Guild Insurance can deliver.
guildinsurance.com.au/apna 1800 810 213
Professional Indemnity | Business Insurance | Home & Contents | Car Insurance
Guild Insurance supports your association through payment of referral fees for certain insurance you take out with Guild. The information we have provided here is of a general nature
and does not take into account your personal circumstances or objectives. Before making a decision to apply for any of these products, we recommend you consider (with or without an adviser)
the appropriateness of this information and the contents in the Product Disclosure Statement (PDS) - available by contacting us on 1800 810 213. Guild Insurance Limited AFSL No. 233791

ing Soon!
Helping you
help your patients
Managing medications
in the elderly and in
chronic conditions
Spend an hour thinking, listening and learning about
ways you can help your patients manage their
medications wisely and get the outcomes they expect.
Around two-thirds of Australians over the age of 60 use
four or more medications. 1 One home medicines review
study found that 1 in 10 elderly patients were using
multiple brands or types of the same drug. 1 Although
it is recommended that patients on long-term therapy
stick to their usual brand of medication, a study has
shown that up to 24% of patients had their brand of
medicines switched more than once within a year. 2
s Interactive online module
s Video Q&A with an expert HCP
s Practical tips and quizzes
s CPD points available
s Application for APNA
endorsement pending
How it works
This module will take you about 1 hour to
complete. You may stop or pause at any
time and continue where you left off the next
time you log in. To be eligible to receive a
certificate of completion, please complete
and submit the evaluation form at the end of
the module.
Learning objectives
By the end of this online module you should be able to:
s identify common issues in medication use in the
elderly and in patients with chronic conditions
s advise patients about the similarities and differences
between generic and original brand medicines
s describe the situations where brand substitution
may not be appropriate
s apply strategies to avoid patient confusion over their
medication and adhere to their prescribed regimen
Register your interest by emailing info@vivacityhealth.com.au.
We will then send you the link once the module is available online.
Managing medications in the elderly and in chronic conditions has been developed by education provider Vivacity Health
and sponsored by Astra Zeneca to support improved medication use in the elderly and in those on long-term therapy.
References: 1. Elliot RA. J Pharm Prac Res 2006;36:58–66. 2. Ortiz M et al. MJA 2010;192:370–3.
AstraZeneca Pty. Ltd. ABN 54 009 682 311. 5 Alma Road, North Ryde NSW 2113.
AstraZeneca Medical Information: 1800 805 342. AU-CVS0000171a. April 2013.