Western Bay Edition - September 2018

At Tauranga Hospital patients needing long term heart monitors implanted are having the procedure much sooner through a nurse led initiative which is a first in Australasia .

Cardiac Catheter Laboratory ( Cath Lab ) nurse , Adrianne Escondo became certifi ed to insert implantable loop recorders ( ILR ) in heart patients last year . And since then he has carried out 20 of these procedures without complication .

Implantable loop recorders are small heart monitoring devices implanted just under the skin in the chest . They are patient or automatically activated and are typically used for patients with unexplained heart palpitations , sudden light-headedness , dizziness or fainting that are suspicious of irregular heart rhythms . Information captured is used by Cardiologists to determine diagnosis and develop a treatment plan .

The idea of a cardiac nurse doing the procedure stems from the UK . Several NHS hospitals have

In this issue of Health Matters , I want to focus on how we can each take an easy step to improve our health – give up or at least cut back on sugary drinks , choose water the healthy option .

Recently there has been much focus on the detrimental impact of sugary drinks both here in New Zealand and internationally . There is ample evidence that sugary drinks increase the risk of developing serious health problems - obesity , Type 2 diabetes and tooth decay are three that spring straight to mind . Latest OECD health fi gures show New Zealand has the third highest rate of obesity in the world , topped only by USA and Mexico . And fi ndings from research released earlier this year found 52 percent of drinks purchased in this country contained added sugar , compared to 42.2 percent in Australia , 42.8 percent in Canada and nine percent in the UK . The World Health Organisation recommends our daily intake of free sugar ( added to foods by the manufacturer , cook or consumer ) to be 5 percent of our daily calorie intake . For an adult with an average body mass index ( BMI ) that works out to about six teaspoons , and for a child , it ’ s about three teaspoons . One can of soft drink has about nine teaspoons of sugar – three days ’ worth of sugar for a child . Yet for some adults and children drinking more than one can of fi zzy drink a day is not unheard of . Of course it ’ s not just the fi zzy drinks that are high in sugar . Many of the so-called ‘ health ’ drinks such as fl avoured milk ,

Sally Webb , Chair Bay of Plenty District Health Board

fruit juices and sports drinks are also high in sugar . Through clever marketing , they are perceived to be healthy options . The Bay of Plenty District Health Board ’ s vision is ‘ Healthy , thriving communities , Kia Momoho Te Hāpori ōranga ’. And recently we ’ ve produced great resources to encourage our tamariki to develop healthy habits . You can read about the new 5210 package of resources here in Health Matters . The resources are a simple reminder to eat fi ve vegetables and fruit a day , cut down kids screen time to less than two hours , be active for an hour or more each day , and have zero sugary drinks . So my challenge to all of you is to be mindful about what you ’ re consuming and talk to children about it too . Drink water and encourage your tamariki to do the same . They are at the heart of ‘ Healthy , thriving communities , Kia Momoho Te Hāpori ōranga ’. Our children are our future – take care of them .

Kia kaha Sally Webb

cardiac nurses inserting the long term heart monitors , a procedure traditionally carried out by cardiologists in theatre .

In about 3-5 minutes the heart monitor is implanted in the patient ’ s chest under local anaesthetic . It ’ s a low risk procedure and the advantages of a nurse carrying out the procedure are plenty .

“ It ’ s freeing up our theatres and Cardiologists to concentrate on more specialist procedures such as pacemaker , ICD , CRT-D implants and Coronary Angiography . Those patients are being seen much sooner as are the patients needing an ILR .”

Adrianne says doing the procedure in the Day Stay area rather than theatre is

Cardiology Clinical Nurse Manager Jason Money acts as ‘ the patient ’ as Cardiac Nurse Adrianne Escondo and Cardiac Physiologist Tracey Cumming demonstrate where the procedure is carried out in a non-theatre environment .

A Tauranga Hospital healthcare initiative has been recognised for its excellence at an international conference held in Australia .

A team from the BOPDHB travelled to the International Forum on Quality and Safety in Healthcare , in Melbourne earlier this month , to present on its Assessment Planning Unit ( APU )/ Acute Flow work . The work focusses on moving patients through or out of the hospital system as quickly as possible particularly the elderly , to prevent them from deconditioning . More than 400 posters and videos of healthcare quality improvement projects from countries such as Australia , New Zealand , Singapore , Hong Kong and many more were on show and the Tauranga team emerged triumphant . “ This whole project begins and ends with the wellbeing of our patients ,” says Dr Kate Grimwade . “ It ’ s what initiated it and what has sustained all the hard work which has

Dr Kate Grimwade ( third from left ) receives the winner ’ s award on behalf of the BOPDHB team at the International Forum on Quality and Safety in Healthcare , in Melbourne .

also having a positive impact on patients .

“ For some , the prospect of going to theatre raises anxiety levels , especially when the heart ’ s involved . There is comfort in having the procedure done in a non-theatre environment .”

The Cath Lab opened at Tauranga Hospital 18 months ago . Described as a one-stop shop for heart patients , around 1600 cardiac procedures including inserting pacemakers , defi brilallators ( shock boxes ) and stents , have been performed onsite . That ’ s boosted our cardiac procedures by 20 % and has reduced the need for our patients to travel to Waikato for these specialist services .

The Tauranga Hospital nurse led initiative recently won an award at the annual Cardiac Society of Australia and New Zealand ( CSANZ ) scientifi c meeting . gone into it , and continues to go into it . This is really recognition of those efforts by everyone .” From the posters and videos entered three were shortlisted to appear before a three-judge panel modelled on TV shows like Dragons ’ Den and Shark Tank . Dr Grimwade represented the BOPDHB against a nurse from Japan , who had developed a safety checklist for ICU nurses , and a paediatrician from Victoria , who had introduced a telehealth system into rural Gippsland . The BOPDHB ’ s work was chosen as the winner and fi ve posters detailing the work were selected for display at the conference . This was not the only highlight as the team ’ s video also featured in the conference ’ s opening ceremony . “ I ’ m still taking it all in to be honest ,” says Dr Grimwade . “ I think the biggest thing for me was having our video played at the opening ceremony , so it was seen by everyone , around 1600 delegates . It ’ s wonderful when the work of so many people gets showcased like that . It makes you really proud .” The innovative work centred on the speed and quality of care for older patients . A similar project is being undertaken at Whakatāne Hospital . “ Older people can decondition very quickly when they ’ re in hospital so we do as much as we can to prevent that ,” says Dr Grimwade . “ We replaced some beds in APU with ‘ red chairs ’ so that patients are not being put into bed needlessly ; we keep people in their own clothes as much as possible which is all to do with the psychology of being a ‘ patient ’; we take people referred from GPs straight to APU so they don ’ t have to wait in ED ; and we have an inter-disciplinary team which actively seek out frail patients so a close eye is kept on them .” BOPDHB Executive Director of Allied Health , Scientifi c and Technical Martin Chadwick says it was a great opportunity to demonstrate the innovation going on in the Bay of Plenty to an international audience . “ As a member of the Executive attending the conference I was incredibly proud to see everyone ’ s efforts recognised in this way . More importantly this was a demonstration of the continued development of better care for our patients and communities .”