National Service Guidelines. for the Management of Dialysis and Kidney Transplantation in Remote Australia July 2006
|
|
- George Lester
- 7 years ago
- Views:
Transcription
1 National Service Guidelines for the Management of Dialysis and Kidney Transplantation in Remote Australia July 2006
2 This report is published by the Northern Territory Government on behalf of the Australian Health Ministers Conference. Readers are advised that this document might contain pictures of Aboriginal Australians and Torres Strait Island people that may offend. All people portrayed in this document have given permission for their image to be used before and after their death. July
3 National Service Guidelines for the Management of Dialysis and Kidney Transplantation in Remote Australia July 2006 i
4 Forward Kidney disease is a significant health issue for Aboriginal Australians and Torres Strait Islanders, particularly for those who live in remote Australia. Prevention of chronic diseases including chronic kidney disease (CKD) is of critical importance. In addition limited access to dialysis and transplantation has a devastating impact on clients and families residing in remote Australia. This prompted the inclusion of remote area end stage kidney disease (ESKD) service provision as an area for potential reform and a specific item in the National Health Reform Agenda, associated with the development of the Australian Health Care Agreement Consequently, in 2004 a comprehensive review of renal services for Aboriginal Australians and Torres Strait Islanders was undertaken. This included consultation with a broad range of stakeholders, including consumers and government and non-government providers of remote area renal services. This work informed the development of a set of nationally agreed principles and strategies to benchmark and guide future renal service development in remote areas. These principles and strategies were endorsed by the Australian Health Ministers Conference in July The strategies included a recommendation to develop a national consensus document on guidelines for remote area renal services as this was considered to be a priority action. The Guidelines, which follow, were subsequently developed in late 2005 by a crossjurisdictional government working group that included a range of clinicians and policy makers from each state (apart from Tasmania) and the Northern Territory. Membership was on the basis of expertise and experience in remote area renal service development and delivery. The working group consulted a wide range of remote health and renal service providers, including relevant government agencies, the Aboriginal community-controlled health sector and professional groups during the development phase. The draft Guidelines were distributed widely within each jurisdiction, the feedback collated, and further refinement of the document undertaken. In February 2006 the document content was analysed and redeveloped at a workshop with key stakeholders. Participants included representatives of Aboriginal Community-Controlled Health Services (ACCHS), consumers, non-government agencies and jurisdictional representatives from each state and the Northern Territory. The document was then distributed for final comment by jurisdictions and relevant feedback incorporated into the document. The Guidelines identify best practice and include performance measures thus enhancing the capacity to address shortfalls in service delivery. They provide operational guidelines for clinicians and indicate likely resource requirements for service planners. This will promote improved clinical outcomes for residents of remote Australia particularly Aboriginal Australians and Torres Strait Islander people and has the potential to have a significant impact on their quality of life. Australian Health Ministers Conference, July ii
5 Acknowledgements The Australian Health Ministers Conference (AHMC) gratefully acknowledges the members of the following working groups who not only contributed greatly to the development of these Guidelines but also ensured that there was broad consultation within their own jurisdictions. Technical Working Group Ms Julie Barnes NT (Project Team) Ms Gillian Gorham NT (Project Team) Dr Matthew Jose NT (Project Team) Ms Meredith Neilson NT (Project Team) Dr Peter Chapman SA Dr Alex Disney SA Ms Katrina Duff Qld Ms Wendy Washington Qld Dr Alison Latta NSW Dr Paul Snelling NSW Dr Kathy Paizis Vic Ms Gillian Smith Vic Remote Area Renal Working Group Ms Meribeth Fletcher NT (Project Manager) Dr Rosy Warden NT (Project Manager) Dr Peter Chapman - SA Dr Roger Brown - Qld Ms Rebecca Hanna - Qld Mr Ken Wyatt - NSW Dr Graeme Maguire - WA Dr Patricia Fagan - OATSIH Ms Helen Mc Farlane - OATSIH Ms Shona McQueen - OATSIH Ms Joy Savage - OATSIH Ms Delia Perret WA Dr Mark Thomas WA In addition AHMC would like to thank Kidney Health Australia (KHA) for their support and ongoing sponsorship of the Guidelines by their willingness to maintain the Guidelines on the Kidney Health Australia website. iii
6 Contents Forward Acknowledgements ii iii Summary 1 Guidelines Flow Chart 2 Using the Guidelines 3 Guideline One: Primary Care Area 4 Aim + Objective 4 Rationale 5 Markers of Good Practice for Primary Care Area 6 Guideline Two: Rural and Remote Dialysis Units 8 Aim + Objective 8 Rationale 8 Markers of Good Practice for Rural and Remote Dialysis Units 9 Guideline Three: Regional Dialysis Units 11 Aim + Objective 11 Rationale 12 Markers of Good Practice for Regional Dialysis Units 13 Guideline Four: Tertiary Renal Units and Transplantation Units 16 Aim + Objective 16 Rationale 17 Markers of Good Practice for Tertiary Renal and Transplantation Units 18 Resource Capability Matrix 22 Acronyms 25 Glossary 26 Reference list 28 Strategies, Reviews and Corporate Documents 31 iv
7 Summary A consensus document was developed for the management of end stage renal disease services in Remote Australia. This is the final phase of the project aimed to improve access, choice of services, reduce inequalities, enhance the quality of dialysis and transplantation services available for Aboriginal Australians and Torres Strait Islanders residing in remote and rural areas. This consensus document for National Service Guidelines for the Management of Dialysis and Kidney Transplantation in Remote Australia (for the purpose of this document will be referred to as the Guidelines), encompasses clinical care and features a holistic approach to managing end stage kidney disease including client and family education and support and cultural security. The Guidelines cover chronic kidney disease management, haemodialysis, peritoneal dialysis and kidney transplantation as they are delivered across primary care settings, rural and remote dialysis units and tertiary renal and transplantation units. They identify markers of good practice across this spectrum of services for; clinical processes workforce development client education and support systems and infrastructure The Guidelines are underpinned by the principles and strategies developed in phase two of this project and are intended to improve the quality and timeliness of treatment and facilitate the holistic care of Aboriginal and Torres Strait Islander people living in remote areas of Australia who require renal replacement services. A Resource Capability Matrix has also been developed to support these guidelines. 1
8 Guidelines Flow Chart Principles underlying and connecting each Service Guideline Client and family education Cultural safety Consumer participation Workforce development Improved access Treatment close to home Communication and coordination 2
9 Using the Guidelines The Guidelines identify the operational and resource requirements necessary to provide accessible, high quality end stage kidney disease services in rural and remote Australia. They have emerged out of a determination to develop a national consensus statement on best practice in order to benchmark current practice and to guide service development activities for organisations. The Guidelines are based on a hybrid of publicly available national and international standard and guideline documents. The markers of good practice are derived from the published research literature in addition to local, national and international renal reviews, strategies and standards (see bibliography). They are aligned with the resource capabilities of the service delivery areas and should be used as performance measures by individual jurisdictions to assess and monitor their ability to meet the Guidelines. The Guidelines cover the treatments: Chronic kidney disease management Haemodialysis Peritoneal dialysis, and Renal transplantation as they are delivered across the following service delivery areas: Primary care Rural and remote dialysis units Regional dialysis units, and Tertiary renal and transplantation units. The Guidelines are presented as service delivery area guidelines rather than a guideline for each treatment, as service delivery area development is the key to improving treatment outcomes. The Guidelines identify markers of good practice that address clinical processes, workforce development, client education and support, and systems and infrastructure. They represent the aim for each service delivery area. Available resources will determine implementation time frames. 3
10 Guideline 1 Primary Care Area Aim Primary care staff are aware and support the conditions, activities and services necessary to improve access and health care for people with various stages of kidney disease residing in rural and remote areas. Objective To ensure: People receive timely and appropriate education, nephrology referral, medical and surgical management to minimise chronic kidney disease progression and complications. Individuals and their families are supported to make informed decisions regarding renal replacement therapy. Primary care staff work collaboratively with renal services to effectively manage the primary care needs of all renal clients including transplanted clients, undertaking renal replacement therapy in the local community. Health care providers in rural and remote locations support peritoneal dialysis as a treatment option when clinically and socially appropriate. The primary care area will be supported by renal services in the management of peritoneal dialysis clients through ongoing education, training and assistance to clients, carers and health care providers. Clients with a transplant and renal clients on the active transplant list are not disadvantaged by distance or location through the establishment of sound communication pathways and protocols between the primary care area and tertiary renal services. 4
11 Guideline 1 Primary Care Area Rationale The burden of chronic diseases is greater in Aboriginal Australians and Torres Strait Islanders but there is also a significant difference between urban and remote populations the latter suffering excessive rates of kidney disease. The cost of managing chronic diseases is high not only for health services but also for family and communities in terms of decreased education, disrupted employment opportunities, social engagement and an increase in the need for carers. 1,2,3,4,5,6,7,8,9 Early identification and management of CKD reduces morbidity and mortality and promotes treatment choice and resource utilisation. Renal outreach programs that support the primary care area in identification and management of renal disease have significant benefit. 10,11,12,13,14,15,16,17 Multidisciplinary management for Aboriginal Australians and Torres Strait Islanders relocating for treatment is necessary to improve outcomes through the 18,19,20, 21,22 promotion and improvement of psychosocial preparedness for treatment. Peritoneal dialysis (PD) offers the best opportunity for people to return to their communities with minimal infrastructure, cost and supports. 23,24 Home based therapies, regardless of location are less expensive than satellite or in-centre dialysis. Clients, families and community members require appropriate education and ongoing support. 25,26,27,28,29 Community consultation, negotiation and education with clinic, council, store, ambulance and traditional owners, prior to establishing home and/or community based therapies, engenders appropriate levels of support for the clients. 30,31,32,33,34,35 Regular on site visits to clients undertaking home-based therapies to assess technique, review procedures and provide education to family, community and health staff are necessary to achieve adequate and appropriate support for isolated clients. 27,23,24 Aboriginal Australians and Torres Strait Islanders have the lowest rate of kidney transplants in the ESKD population and have greater difficulty in attaining and maintaining active transplant waiting list status. 36,37,38,39,40,41 Aboriginal Australians and Torres Strait Islanders living in remote regions are disadvantaged by distance in terms of completing regular tests to maintain active transplant status and extended cold ischaemic times as a result of available travel options. 42,43,44 Undetected mis-communication between health professionals and Aboriginal Australians and Torres Strait Islanders occurs frequently. Poor understanding is linked to a reduced uptake of services and sub-optimal disease management and therefore poor outcomes. 36,45,46,47,48,49,50,51,52 Culturally appropriate education improves understanding, uptake of services and outcomes. 46,52,53,55 Under serviced and vulnerable populations such as Aboriginal Australians and Torres Strait Islanders living in remote areas, are at greater risk of adverse health outcomes. Effective information and communication technology can improve outcomes through increased access to specialist and linguistic services, educational opportunities, enhanced social support and cost-effective client management. 55,56,57,58 5
12 Guideline 1 Primary Care Area Markers of Good Practice Clinical Processes Guidelines for kidney disease screening and client information systems to facilitate age appropriate periodic recall for chronic disease testing are in place. Management protocols for early and established kidney disease are developed locally in conjunction with renal units and based on accepted best practice guidelines. All known chronic kidney disease (CKD) adults are considered for referral to a renal service in line with Caring for Australians with Renal Impairment guidelines. All known children with kidney disease are considered for referral to a paediatric nephrologist or renal service as per current accepted guidelines (CARI guidelines or minimum standards). Staff facilitate regular client reviews either onsite or via telemedicine. Client Education and Support Culturally and age appropriate, locally designed educational material is developed to cover pre-dialysis management modalities including no treatment, pre-emptive transplant therapy and access preparation. Interpreter services are available to assist with client consultations. Individuals and their families are actively encouraged to participate in the development of management plans and are supported in treatment choices including options for palliation. Specifically, primary care staff through liaison with renal services: Are aware of all renal replacement therapy (RRT) clients living in their service area including renal clients attending satellite units and maintain information systems in order to successfully manage their primary health care needs such as cervical cancer screening and vaccinations. Assist RRT clients to manage their treatment by maintaining adequate stock levels of specialised medication, provide medication dispensing services and preparation and delivery of blood samples. Understand and implement specific and appropriate clinical protocols (eg peritonitis and exit site infection management) in conjunction with the renal team. Assist clients on the active transplant waiting list to complete periodic tests and procedures necessary to maintain active status. Have prepared procedures for urgently locating and evacuating clients and their pre-identified escorts in the event of notification of an available kidney. 6
13 Guideline 1 Primary Care Area Markers of Good Practice Workforce Education and Training Primary care staff attend 12 monthly kidney disease education through chronic disease educational programs or similar (GP /KCAT programs/chronic Disease Nurse). Primary care staff have access to an established education program on RRT choices, consequences and client support required. All staff participate in cultural safety and cultural respect training. Systems and Infrastructure Refurbished or newly designed community health clinics include potential designated dialysis areas with appropriate plumbing and electrical services in anticipation of future dialysis needs. In consultation with the renal services, initial and ongoing environmental assessments are documented for clients wishing to undertake home therapies, and where appropriate, advocate for and facilitate remedial action. PC staff maintain purposeful communication links (telephone, , video conferencing) with appropriate renal services support staff and multidisciplinary renal team for the monitoring, support and management of all CKD and RRT clients in the community. 7
14 Guideline 2 Rural and Remote Dialysis Units Aim Dialysis facilities in rural and remote locations embrace the activities and functions necessary for the provision of high quality dialysis treatments including the support and monitoring of clients undertaking home-based therapies. Objective To ensure: Units work collaboratively with the primary care area to effectively manage the primary care needs of all renal clients including clients with a transplant, and those clients undertaking renal replacement therapy in the local community. Units promote ongoing staff education and training through a variety of mechanisms including online learning, video conferencing, industry educational packages, staff rotations between units and educational in-services from the multidisciplinary renal outreach team. Renal services offer haemodialysis treatments in environments that have been designed around the individuals clinical, social and cultural needs and ensure the necessary support is in place for people undertaking treatment at home or as close as possible to their home. Rationale People required to relocate to larger centres for treatment suffer cultural, social and emotional dislocation. They are financially disadvantaged and lack the family and community supports necessary to engage in disease management and treatment uptake. 18,59,60,33 Providing access to home dialysis or treatments closer to home has been shown to improve health and quality of life outcomes for individuals, families and the community. Clients are more likely to return to work and engage in social and community activities, utilising the flexibility to attend treatments at a day and time of their choosing. 26,29,34,61,62 Aboriginal Australians and Torres Strait Islanders living in remote regions are disadvantaged by distance in terms of completing regular tests to maintain active transplant status and extended cold ischaemic times as a result of available travel options. 42,43,44 Undetected mis-communication between health professionals and Aboriginal Australians and Torres Strait Islanders occurs frequently. Poor understanding is linked to a reduced uptake of services and sub-optimal disease management and therefore poor outcomes. 36,45,46,47,48,49,50,51,52 Culturally appropriate education improves understanding, uptake of services and outcomes. 46,52,53,54 Under serviced and vulnerable populations such as Aboriginal Australians and Torres Strait Islanders living in remote areas are at greater risk of adverse health outcomes. Effective information and communication technology can improve outcomes through increased access to specialist and linguistic services, educational opportunities, enhanced social support and cost effective client management. 55,56,57,58 8
15 Guideline 2 Rural and Remote Dialysis Units Markers of Good Practice Clinical Processes Units provide high quality maintenance haemodialysis services including regular reporting against CARI guidelines, clinical indicators (adequacy, access evaluation, clinical parameters). Staff facilitate regular client reviews by multidisciplinary renal team either onsite or via telemedicine. Renal staff are aware of clients receiving home based therapies in the local area and have access to protocols in order to assist with trouble shooting. Staff, through liaison and consultation with renal services particularly the transplant RN and nephrologist, are aware of individuals on the active transplant list, either dialysing unit clients or those undertaking home-based therapies and living locally; Assist clients to complete periodic tests and procedures necessary to maintain active status. Identify and notify tertiary services of any medical or surgical issues that could jeopardise the active status of clients under their care. Have prepared procedures for urgently locating and evacuating clients and their pre-identified escorts in the event of notification of an available kidney. Client Education and Support Vacation and respite dialysis for home and community based dialysis clients are offered by the unit where possible. Culturally and age appropriate, educational resources are available around disease and treatment management. Interpreter services are available to assist with client reviews, consultation and education. Workforce Training and Education All staff participate in cultural safety and cultural respect training. All staff delivering or managing renal replacement therapy clients will have completed at least one unit of theory in an accredited renal course as well as an appropriate practical placement in a regional or urban renal unit. All staff will have access to and receive ongoing renal education at least three monthly (journal club, industry developed educational packages, in-services and demonstrations). Staff competencies in renal replacement therapy will be assessed yearly by a qualified renal nurse. Local Aboriginal Australians and Torres Strait Islanders are employed in the unit in a variety of positions. Local Aboriginal Australians and Torres Strait Islanders are offered support to complete specialised renal training through VET or higher education courses. 9
16 Guideline 2 Rural and Remote Dialysis Units Markers of Good Practice Systems and Infrastructure Remote dialysis units should be promoted for stable clients. Staff maintain client information systems to monitor the primary health care needs of dialysis clients and link with the local primary care area to support the management and review of clients. Staff and clients have access to appropriate electronic and internet facilities to maintain purposeful communication links (telephone, , video conferencing) with renal services and the multidisciplinary renal team for the monitoring, support and management of all clients. Client transport to and from treatment is supported either by unit or through collaboration with local services. Remote dialysis units can provide urgent blood results within one hour (Hb, K +, Ca ++ ) and routine pathology tests within 24 hours. 10
17 Guideline 3 Regional Dialysis Units Aim Objective Regional dialysis units are established in areas where the need for local people to relocate to urban areas for treatment is significant. Regional dialysis units are aware of and strive to develop the activities and infrastructure necessary to offer a more comprehensive service to the local community that moves beyond maintenance dialysis. This would include renal replacement therapy, education, training and support for the primary care area in chronic kidney disease management. To ensure: Services are able to provide the link between tertiary renal services and the primary care area in the management and support of chronic kidney disease and end stage kidney disease clients undertaking home therapies in the local community. Regional dialysis units work collaboratively with the primary care area to effectively manage the primary care needs of all renal clients including transplanted clients, undertaking renal replacement therapy in the local community. Regional dialysis units strive to provide a range of services, including self-care training and onsite clinical reviews, to ensure clients are not disadvantaged in terms of quality of care or access to services as a result of their home locations. Regional dialysis units promote ongoing staff education and training through a variety of mechanisms including online learning, videoconferencing, industry educational packages, staff rotations between units and educational inservices from the multidisciplinary renal outreach team. 11
18 Guideline 3 Regional Dialysis Units Rationale People required to relocate to larger centres for treatment suffer cultural, social and emotional dislocation. They are financially disadvantaged and lack the family and community support necessary to engage in disease management and treatment uptake. 18,59,60,33 Providing access to home dialysis or treatment closer to home has been shown to improve health and quality of life outcomes for individuals, families and the community. Clients are more likely to return to work and engage in social and community activities, utilising the flexibility to attend treatments at a day and time of their choosing. 26,29,34,62,64 Home based therapies, regardless of location are less expensive than satellite or in-centre dialysis. Clients, families and community members require appropriate education and ongoing support. 25,26,27,28 Community consultation, negotiation and education with the clinic, council, store, ambulance and traditional owners etc, prior to establishing home and/or community based therapies, engenders appropriate levels of support for the clients. 30,31,32,33,34,35 Aboriginal Australians and Torres Strait Islanders have the lowest rate of kidney transplants in the ESKD population and have greater difficulty in attaining and maintaining active transplant waiting list status. 36,37,38,39,40,41 Aboriginal Australians and Torres Strait Islanders living in remote regions are disadvantaged by distance in terms of completing regular tests to maintain active transplant status and extended cold ischaemic times as a result of available travel options. 42,43,44 Undetected miscommunication between health professionals and Aboriginal Australians and Torres Strait Islanders occurs frequently. Poor understanding is linked to reduced uptake of services and sub-optimal disease management and therefore poor outcomes. 36,45,46,47,48,49,50,51,52 Culturally appropriate education improves understanding, uptake of services and outcomes. 46,52,53,55 Under serviced and vulnerable populations such as Aboriginal Australians and Torres Strait Islanders living in remote areas, are at greater risk of adverse health outcomes. Effective information and communication technology can improve outcomes through increased access to specialist and linguistic services, educational opportunities, enhanced social support and cost-effective client management. 55,56,57,58 12
19 Guideline 3 Regional Dialysis Units Markers of Good Practice Clinical Processes Units provide high quality maintenance haemodialysis services including regular reporting against CARI guidelines clinical indicators (adequacy, access evaluation, clinical parameters). Units promote and encourage the commencement of treatment for new stable clients from the local area. Staff facilitate regular client reviews by the multidisciplinary renal team either onsite or via telemedicine. Staff maintain information systems to monitor the primary health care needs of dialysis clients and link with the local primary care area to support the management and review of clients. Staff are aware of individuals on the active transplant list who are either clients of the regional dialysis unit or who undertake home based therapies and live locally and through liaison and consultation with renal services particularly the transplant RN and nephrologist: Assist clients to complete periodic tests and procedures necessary to maintain active status. Identify and notify tertiary services of any medical or surgical issues that could jeopardise the active status of clients under their care. Have prepared procedures for urgently locating and evacuating clients and their pre-identified escorts in the event of notification of an available kidney. Regional dialysis unit staff are aware of clients receiving home based therapies in the community and have access to protocols after hours in order to assist with trouble shooting. Regional dialysis unit staff provide a link between nephrologists and primary care staff in CKD management of clients and implementation of multidisciplinary care plans. Aboriginal Liaison Officer (ALO) and Aboriginal Health Worker (AHW) positions are in place to educate, support and facilitate the transfer of pending clients to and from a renal service. Renal staff provide education to local primary care staff on CKD management and treatment modalities. Where it is not available locally, regular visits by the multidisciplinary team occur and include nephrologist, dietitian, pharmacist and CKD nurse to review pending clients and educate community, clients and health staff. The management of pending clients should include the development of plans addressing housing needs, support services, schooling and finances in the area where RRT will be commenced. For larger units, high quality peritoneal dialysis care is provided and monitored through regular reporting against CARI guidelines clinical indicators (adequacy, infection rates, membrane function). Client Education and Support Qualified interpreters with medical terminology, facilitate education and development of educational material. Culturally and age appropriate, locally designed educational material is developed to cover pre-dialysis management, dialysis modalities and treatment preparation including education on pre-emptive transplant therapy. 13
20 Guideline 3 Regional Dialysis Units Markers of Good Practice Client Education and Support (cont.) Interpreter services are used to assist with education and preparation for treatment through telemedicine. Vacation and respite dialysis for home and community based dialysis clients are offered by unit, where possible. Respite is offered and planned for PD clients and their carers (particularly carers of children on dialysis) in conjunction with local services and where appropriate other accommodation services or hospitals. Training and support is offered to facilities undertaking respite care for PD clients. Larger regional units may have access to staff, client training and development programs that include: Home and self-care training programs designed to meet the needs of local people in terms of numeracy, literacy, cultural and age appropriateness. Training programs for children that are designed in conjunction with tertiary services. Dedicated self-care trainers with appropriate qualifications and experience in training and cultural awareness. Provision of multidisciplinary PD and HHD education, training, co-ordination and clinical support for clients, family and the community. The provision of a minimum of six monthly home visits for clients on renal replacement therapies to evaluate treatment technique and the environment and provide client, family and Primary Care staff education. Workforce Education and Training All staff participate in cultural safety and cultural respect training. All staff delivering or managing renal replacement therapy clients will have completed at least one unit of theory in an accredited renal course as well as an appropriate practical placement in a regional or urban renal unit. All staff will have access to and receive ongoing renal education at least three monthly (journal club, industry developed educational packages, inservices and demonstrations). Staff competencies in renal replacement therapy will be assessed yearly by a qualified renal nurse. Local Aboriginal Australians and Torres Strait Islanders are employed in the Regional Dialysis unit in a variety of positions. Local Aboriginal Australians and Torres Strait Islanders are offered and supported to complete specialised renal training through VET or higher education courses. Renal staff offer education to local hospitals and health centres on treatment modalities, trouble-shooting likely Accident and Emergency presentations and acute care management. Nurse practitioners and medical officers are provided with professional development to achieve the competencies required to provide onsite medical support. 14
21 Guideline 3 Regional Dialysis Units Markers of Good Practice Systems and Infrastructure Client transport to and from treatment is supported either by Regional Dialysis unit or through collaboration with local services. Staff and clients have access to appropriate electronic and internet facilities to maintain purposeful communication links (telephone, , and video conferencing) with renal services and the multidisciplinary renal team for the monitoring, support and management of all clients. Space is available for staff teaching sessions, inservices and practical demonstrations. Adequate and appropriate space is allocated for client training away from main treatment area. Access to travel and accommodation for the dialysis partner to undertake training is available. Community consultation and onsite visits are carried out in preparation for home and/or community-based dialysis. Liaison with primary care area to ensure appropriate environmental assessment of home and treatment environments are carried out. Local guidelines for space, essential services, infrastructure and operational issues for home and community-based haemodialysis are available for communities, service planners and service providers. Dialysis technicians and service planners experienced in remote area service development are available. Memorandum of Understanding developed with community councils, clinics, landowners and other key stakeholders to provide an agreement about treatment sites, support and services provided to clients returning to community. Ability to provide urgent blood results within one hour (Hb, K +, Ca ++ ) and routine pathology tests within 24 hours. Onsite support is provided for clients requiring surgical intervention to create an acccess site for dialysis treatment. 15
22 Guideline 4 Tertiary Renal Units and Transplantation Units Aim Objective Tertiary renal units develop the services and infrastructure necessary to provide and support a high quality comprehensive renal service for clients and health providers in remote Australia. This includes chronic kidney disease management, education, surgical and psychosocial preparation for renal replacement, home therapies training and transplantation services. To ensure: Support for the effective management and monitoring of people with various stages of kidney disease (including end stage kidney disease clients undertaking therapy in the local community) is provided to the primary health care staff in rural and remote clinics including visiting GPs and DMOs. This can be achieved through establishing sound communication systems and strategies, management plans, educational forums and a multidisciplinary renal outreach service. Staff across the care continuum, from primary care to tertiary services, are assisted to develop appropriate and locally produced educational material around kidney disease management and treatment options. Renal services and health care providers support peritoneal dialysis as a treatment option when clinically and socially appropriate. This will encompass ongoing education, training and assistance to clients, carers and health care providers in rural and remote communities. Tertiary renal services offer dialysis treatments in environments that have been designed around the individuals clinical, social and cultural needs and ensure that the necessary support is in place for people undertaking treatment at home or as close as possible to their home. This includes onsite community consultation, planned respite opportunities and home visits. An increase in access to the kidney transplant waiting list and ultimately transplantation where clinically appropriate for Aboriginal Australians and Torres Strait Islanders. This will provide a high quality support service that extends to the remote areas enabling recipients to achieve the best quality of life. 16
23 Guideline 4 Tertiary Renal Units and Transplantation Units Rationale Earlier identification and management of CKD reduces morbidity and mortality and promotes treatment choice and resource utilisation. Renal outreach programs that support the primary care area in identification and management of renal disease have significant benefit. 11,12,13,14,15,16,17,19 Multidisciplinary management for Aboriginal Australians and Torres Strait Islanders relocating for treatment is necessary to improve outcomes through the promotion and improvement of psychosocial preparedness for treatment. 18,19,20,21,22 Peritoneal dialysis (PD) offers the best opportunity for people to return to their communities with minimal infrastructure, cost and supports. 23,24 PD is often not the treatment of choice for the majority of Aboriginal Australians and Torres Strait Islanders with kidney disease from remote or rural Australia. 40,64 People required to relocate to larger centres for treatment, suffer cultural, social and emotional dislocation. They are financially disadvantaged and lack the family and community supports necessary to engage in disease management and treatment uptake. 18,33,46,60 Providing access to home dialysis or treatments closer to home has been shown to improve health and quality of life outcomes for individuals, families and the community. Clients are more likely to return to work and engage in social and community activities, utilising the flexibility to attend treatments at a day and time of their choosing. 26,29,34,61,62 Home based therapies, regardless of location, are less expensive than satellite or in-centre dialysis however clients, families and community members require appropriate education and ongoing support. 25,26,27,28,29 Community consultation, negotiation and education with (for example clinic, council, store and ambulance and traditional owners) prior to establishing home and/or community based therapies, engenders appropriate levels of support for the clients. 30,31,32,33,34,35 Regular onsite visits to clients undertaking home based therapies to assess technique, review procedures and provide education to family, community and health staff are necessary to provide adequate and appropriate support for isolated clients. 23,24,27 In general, transplantation offers better outcomes in terms of clinical indicators, client quality of life and cost benefits. 41,65 Aboriginal Australians and Torres Strait Islanders have the lowest rate of kidney transplants in the ESKD population and have greater difficulty in attaining and maintaining active transplant waiting list status. 36,37,38,39,40,41 Prolonged cold ischaemic time is associated with delayed initial graft function and may also have a negative impact on long-term graft outcome. Aboriginal Australians and Torres Strait Islanders living in remote regions are disadvantaged by difficulties in completing regular tests to maintain active transplant status and extended cold ischaemic times as a result of available travel options. 42,43,44 Suitability for transplantation requires individualised client assessment, following established criteria. 66,67 Undetected mis-communication between health professionals and Aboriginal Australians and Torres Strait Islanders occurs frequently. Poor understanding is linked to reduced uptake of services, sub-optimal disease management and therefore poor outcomes. 36,45,46,47,48,49,50,51,52 Culturally appropriate education improves understanding, uptake of services and outcomes. 53,54,46,52 Under serviced and vulnerable populations such as Aboriginal Australians and Torres Strait Islanders living in remote areas, are at greater risk of adverse health outcomes. Effective information and communication technology can improve outcomes through increased access to specialist health and linguistic services, educational opportunities, enhanced social support and cost-effective client management. 55,56,57,58 17
24 Guideline 4 Tertiary Renal Units and Transplantation Units Markers of Good Practice Clinical Processes Units provide high quality maintenance haemodialysis services including regular reporting against CARI guidelines clinical indicators (adequacy, access evaluation, clinical parameters). High quality peritoneal dialysis care is provided and monitored through regular reporting against CARI guidelines clinical indicators (adequacy, infection rates, membrane function). Unit provides high quality education, monitoring and management of transplant recipients, through regular reporting against acceptable guidelines for clinical indicators as part of quality improvement processes. Established multidisciplinary renal outreach team including nephrologist, CKD nurse, pharmacist, dietitian, social worker, AHW and/or ALO. Access to further allied health services as needed eg psychologist, occupational therapist and physiotherapists. 100% of all known CKD clients have dialysis access created prior to commencement of dialysis. Client information systems are maintained for pending clients (including data on stage of disease, management plan and actions). The management of pending clients should include the development of plans addressing housing needs, support services, schooling and finances in the area where RRT will be commenced. CKD management plans include surgical reviews, access planning, assessing and establishing social supports and access to interpreters. The decentralisation of simple access creation to regional centres is facilitated through the development of good working relationships between surgical, nephrology and primary care teams. PD treatment is offered to all clients deemed physically suitable or who have appropriate family and community support. Home and community-based haemodialysis is promoted and supported for all individuals able to either independently or with dialysis partner assistance, undertake their dialysis treatment without clinical supervision. Multidisciplinary PD and HD education, training, co-ordination and clinical support is provided to clients, family and the community. Home and self-care training programs are designed to meet the needs of local people in terms of numeracy, literacy, cultural and age appropriateness. Training programs for children are designed in conjunction with tertiary services. Dedicated self-care trainers have appropriate qualifications and experience in training and cultural awareness. Transplant workup and tests are commenced and completed prior to clients transferring to home-based therapies or rural/remote satellite facilities in order to minimise the logistical difficulties of completing these tests at a later stage. Unit develops and disseminates robust policies and procedures for the maintenance of individuals on the active transplant waiting list. This will include timely retrieval from remote areas that addresses travel arrangements for both client and escort to hospital and airport. For units that do not provide transplantation services, the unit will provide a dedicated Tx nurse who will in conjunction with the local nephrologist assess all new clients for appropriateness for transplantation in order to prevent delay in commencing workup. 18
25 Guideline 4 Tertiary Renal Units and Transplantation Units Markers of Good Practice Client Education and Support Culturally and age appropriate, designed educational material is developed to cover pre-dialysis management, treatment modalities and preparation including education on pre-emptive transplant therapy. Qualified interpreters with medical terminology facilitate education and development of educational material. Interpreter services are used to assist with education and preparation for treatment through telemedicine. Aboriginal Liaison Officer (ALO) and AHW positions are in place to educate, support and facilitate the transfer of pending clients to and from a renal service. Cultural assistance is provided for clients travelling to urban areas meeting at airport, escorting to hospital and ward and ensuring escort accommodation is in close proximity to hospital. The provision of a minimum of six monthly home visits for clients on home based therapies to evaluate treatment technique and environment and provide client, family and Primary Care staff education. Respite is offered and planned for PD clients and their carers (particularly those of children) in conjunction with local services and where appropriate other accommodation services or hospitals. Training and support is offered to facilities undertaking respite care for PD clients. Vacation and respite dialysis for home and community based dialysis clients are offered by unit, where possible. Dialysis clients are interviewed, educated and assessed yearly to provide ongoing opportunities to commence work-up for the active transplant waiting list. Transplantation education has been designed to meet the needs of the local people in terms of literacy and cultural acceptability and is provided in a culturally appropriate media format. Pre-emptive transplantation is offered, investigated and encouraged for eligible individuals. Maximise efforts to increase organ donations from all Australians including Aboriginal Australians and Torres Strait Islanders through culturally appropriate education campaigns. This includes seeking local advice and incorporating Aboriginal Australians and Torres Strait Islander faces in campaigns. Workforce Education and Training All staff participate in cultural safety and cultural respect training. All staff delivering renal replacement therapy or managing clients, will have completed at least one unit of theory in an accredited renal course as well as an appropriate practical placement in a regional or urban renal unit. All staff will have access to and receive ongoing renal education at least three monthly (journal club, industry developed educational packages, inservices and demonstrations). Staff competencies in renal replacement therapy will be assessed yearly by a qualified renal nurse. Local Aboriginal Australians and Torres Strait Islanders are employed in the unit in a variety of positions. 19
26 Guideline 4 Tertiary Renal Units and Transplantation Units Markers of Good Practice Workforce Education and Training (cont.) Local Aboriginal Australians and Torres Strait Islanders are offered and supported to complete specialised renal training through VET or higher education courses. Nurse practitioners and medical officers in remote and rural areas are provided with professional development to achieve the competencies required to provide onsite medical support. Renal staff provide education to local primary care staff on CKD management and treatment modalities. Cultural appropriate and sensitive protocols that cover the care continuum are available to assist client, family and their community understand the issues and make appropriate decisions regarding continuation or withdrawal from treatment. Systems and Infrastructure Service is adequately resourced in order to support rural/remote dialysis and regional dialysis units and Primary Care services. Communication protocols are established with Primary Care staff to regularly discuss client assessment, medication and management issues including discharge summaries and primary care needs. Telemedicine is utilised extensively to communicate with remote and regional units for client consultations and staff education. Appropriate imaging is available for assessment and planning of access. Travel costs for client and escort and hostel accommodation is organised to cover investigations, access creation and preparation for relocation to urban area if required. Client transport to and from treatment is supported either by unit or through collaboration with local services. Space is available for staff teaching sessions, inservices and practical demonstrations. Adequate and appropriate space is allocated for client training away from main treatment area. Access to travel and accommodation for the dialysis partner to undertake training is available. Community consultation and onsite visits are carried out in preparation for home and/or community-based dialysis. Liaison with Primary Care area to ensure appropriate environmental assessment of home and treatment environments are carried out. Memoranda of Understanding are developed with community councils, clinics, landowners and other key stakeholders to cover treatment site, support and services provided to clients undertaking home therapies returning to community. Local guidelines for space, essential services, infrastructure and operational issues for home and community-based haemodialysis are available for communities, service planners and service providers. Dialysis technicians and service planners experienced in remote area service development are available. Access to services to complete transplant work-up and periodic tests necessary to stay active are available. 20
27 Guideline 4 Tertiary Renal Units and Transplantation Units Markers of Good Practice Systems and Infrastructure (cont.) Agreements are established with cardiology departments to undertake timely investigations and corrective procedures necessary for admission to pretransplant list. Procedures are developed between primary care staff, dialysis units and dental services to ensure individuals living in remote/rural areas are reviewed regularly. Procedures are established with primary care staff, dialysis units and radiology department to plan for the transport, booking and completion of periodic tests. Multidisciplinary assessment by transplant team (transplant surgeon, nephrologist and transplant physician) is facilitated through telemedicine. Agreements are developed with the transplant team and regional and tertiary renal units to enable local on-site client assessment and approval for admission to the active transplant list. Procedures are established for deceased donor transplants (addressing client location, available transport and flight schedules) to reduce cold ischaemic time for individuals living in remote or rural areas. There is access to videoconferencing for remote clients undertaking transplantation in urban areas to facilitate communication with family and community and lessen the impact of isolation and loneliness. Post transplantation care is formally instituted and shared between the local primary care service and the tertiary renal service or transplantation hospital and mediated through mechanisms such as videoconferencing. Transplant nurse outreach service is available to provide additional monitoring and ongoing support for transplanted clients and Primary Care staff in remote areas. Facility has the ability to perform and interpret kidney biopsies and immunosuppressive levels. 21
The National Health Plan for Young Australians An action plan to protect and promote the health of children and young people
The National Health Plan for Young Australians An action plan to protect and promote the health of children and young people Copyright 1997 ISBN 0 642 27200 X This work is copyright. It may be reproduced
More informationThe Impact of Increased Power Costs on Home Haemodialysis Northern Territory
Victoria 125 Cecil Street South Melbourne VIC 3205 GPO Box 9993 Melbourne VIC 3001 www.kidney.org.au vic@kidney.org.au Telephone 03 9674 4300 Facsimile 03 9686 7289 The Impact of Increased Power Costs
More informationSTATEMENT ON THE DELINEATION OF EMERGENCY DEPARTMENTS
STATEMENT Document No: S12 Approved: Jul-97 Last Revised: Nov-12 Version No: 05 STATEMENT ON THE DELINEATION OF EMERGENCY DEPARTMENTS 1. PURPOSE This document defines the minimum requirement for a health
More informationConnect with us: Freecall 1800 454 363 www.kidney.org.au
Connect with us: Freecall 1800 454 363 www.kidney.org.au 12 December 2015 Private Health Insurance Section PHCAG Taskforce Department of Health PHIconsultations2015-16@health.gov.au To whom it may concern
More informationCancer services children s CSCF v3.2
Cancer services children s CSCF v3.2 Module overview Please note: This module should be read in conjunction with the Fundamentals of the Framework (including glossary and acronym list), Children s Services
More informationPalliative Care Role Delineation Framework
Director-General Palliative Care Role Delineation Framework Document Number GL2007_022 Publication date 26-Nov-2007 Functional Sub group Clinical/ Patient Services - Medical Treatment Clinical/ Patient
More informationRecommendations. 2004 National SARRAH Conference. Alice Springs, 26-28 August 2004
Recommendations 2004 National SARRAH Conference Alice Springs, 26-28 August 2004 At the end of each concurrent session during the conference there was time allocated for documenting issues raised in each
More informationForeword. Closing the Gap in Indigenous Health Outcomes. Indigenous Early Childhood Development. Indigenous Economic Participation.
National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2011 2015 Prepared for The Australian Health Ministers Advisory Council by the Aboriginal and Torres Strait Islander
More informationAboriginal and Torres Strait Islander Health Workers / Practitioners in focus
Aboriginal and Torres Strait Islander Health Workers / Practitioners in focus i Contents Introduction... 1 What is an Aboriginal and Torres Strait Islander Health Worker?... 2 How are Aboriginal and Torres
More informationINDIGENOUS CHRONIC DISEASE PACKAGE CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM GUIDELINES
CLOSING THE GAP tackling disease INDIGENOUS CHRONIC DISEASE PACKAGE CARE COORDINATION AND SUPPLEMENTARY SERVICES PROGRAM GUIDELINES November 2012 CONTENTS 1. Introduction... 3 Program Context... 3 Service
More informationChief Executive s foreword
1 Minister s foreword When a senior elder from Umbakumba was diagnosed with renal failure four years ago, the only option for him was to relocate to Darwin for treatment. Today he is living back in his
More informationNATIONAL PARTNERSHIP AGREEMENT ON CLOSING THE GAP IN INDIGENOUS HEALTH OUTCOMES
NATIONAL PARTNERSHIP AGREEMENT ON CLOSING THE GAP IN INDIGENOUS HEALTH OUTCOMES Council of Australian Governments An agreement between the Commonwealth of Australia and the State of New South Wales; the
More informationAge-friendly principles and practices
Age-friendly principles and practices Managing older people in the health service environment Developed on behalf of the Australian Health Ministers Advisory Council (AHMAC) by the AHMAC Care of Older
More informationNATIONAL PARTNERSHIP AGREEMENT ON TRANSITIONING RESPONSIBILITIES FOR AGED CARE AND DISABILITY SERVICES
National Partnership Agreement on Transitioning Responsibilities for Aged Care and Disability Services NATIONAL PARTNERSHIP AGREEMENT ON TRANSITIONING RESPONSIBILITIES FOR AGED CARE AND DISABILITY SERVICES
More informationRehabilitation Stroke Services Framework Summary 2013
Rehabilitation Stroke Services Framework Summary 2013 The Rehabilitation Stroke Services Framework is designed to enable the delivery and monitoring of best practice stroke care across Australia. Rehabilitation
More informationNuffield Joint Travel Scholarship to Remote and Rural Australia. October/November 2007
REMOTE AND RURAL STEERING GROUP Nuffield Joint Travel Scholarship to Remote and Rural Australia October/November 2007 Introduction A successful application was made by Mrs Fiona Grant, Remote and Rural
More informationSubmission by the Australian College of Midwives (Inc.) in relation to The Australian Safety and Quality Goals for Health Care
Submission by the Australian College of Midwives (Inc.) in relation to The Australian Safety and Quality Goals for Health Care The Consultation Paper titled Australian Safety and Quality Goals for Health
More informationFuture Service Directions
Alcohol, Tobacco and Other Drug Services Tasmania Future Service Directions A five year plan 2008/09 2012/13 Department of Health and Human Services Contents Foreword... 5 Introduction... 6 Australian
More informationKey Priority Area 1: Key Direction for Change
Key Priority Areas Key Priority Area 1: Improving access and reducing inequity Key Direction for Change Primary health care is delivered through an integrated service system which provides more uniform
More informationaustralian nursing and midwifery federation
australian nursing and midwifery federation Submission to the Australian Nursing and Midwifery Council for Consultation Paper 1: Accreditation Standards required for Eligible Midwife Programs February
More informationCHC40308 Certificate IV in Disability
CHC40308 Certificate IV in Disability Course information and vocational outcomes This is nationally accredited course addresses work in residential group homes, training resource centres, day respite centres
More informationMBS items (10994, 10995) for Pap smears and Preventive Checks taken by a Practice Nurse on behalf of a GP
MBS items (10994, 10995) for Pap smears and Preventive Checks taken by a Practice Nurse on behalf of a GP Medicare item numbers 10994 and 10995 apply to Pap smears and preventive checks provided by a practice
More informationNATIONAL FRAMEWORK FOR RURAL AND REMOTE EDUCATION
NATIONAL FRAMEWORK FOR RURAL AND REMOTE EDUCATION DEVELOPED BY THE MCEETYA TASK FORCE ON RURAL AND REMOTE EDUCATION, TRAINING, EMPLOYMENT AND CHILDREN S SERVICES 1 CONTENTS Introduction... 3 Purpose...
More informationRelease: 1. HLTCR401C Work effectively in community rehabilitation
Release: 1 HLTCR401C Work effectively in community rehabilitation HLTCR401C Work effectively in community rehabilitation Modification History Version 4 Version 5 Comments HLTCR401B Work effectively in
More informationMedical Outreach - Indigenous Chronic Disease Program. Service Delivery Standards
Medical Outreach - Indigenous Chronic Disease Program Service Delivery Standards Rural and Regional Health Australia Medical Outreach - Indigenous Chronic Disease Program Service Delivery Standards November
More informationPRACTICE FRAMEWORK AND COMPETENCY STANDARDS FOR THE PROSTATE CANCER SPECIALIST NURSE
PRACTICE FRAMEWORK AND COMPETENCY STANDARDS FOR THE PROSTATE CANCER SPECIALIST NURSE MARCH 2013 MONOGRAPHS IN PROSTATE CANCER OUR VISION, MISSION AND VALUES Prostate Cancer Foundation of Australia (PCFA)
More informationBarwon Medicare Local Annual Plan 2014-2015
Barwon Medicare Local Annual Plan 2014-2015 Strategic Directions All Barwon Medicare Local activities are underpinned by our organisational vision of well connected health systems in our community. Barwon
More informationOPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES
DRAFT OPERATIONAL GUIDELINES FOR ACCESS TO ALLIED PSYCHOLOGICAL SERVICES (ATAPS) TIER 2 ABORIGINAL AND TORRES STRAIT ISLANDERS MENTAL HEALTH SERVICES APRIL 2012 Mental Health Services Branch Mental Health
More informationImproving access to quality care at the end of life for Aboriginal and Torres Strait Islander Australians
Improving access to quality care at the end of life for Aboriginal and Torres Strait Islander Australians Position Statement Palliative Care Australia is the national peak body established by the collective
More informationHow To Model Health Care In Rural Australia
Chapter 7 Health service models Peter Jones, Jenny May and Amy Creighton Learning objectives Describe the relationships and respective roles of the Australian, state and territory governments in the funding
More informationhealthcare associated infection 1.2
healthcare associated infection A C T I O N G U I D E 1.2 AUSTRALIAN SAFETY AND QUALITY GOALS FOR HEALTH CARE What are the goals? The Australian Safety and Quality Goals for Health Care set out some important
More informationPrimary Health Networks Life After Medicare Locals
Health Industry Group Primary Health Networks Life After Medicare Locals BULLETIN 2 25 MARCH 2015 HEALTH INDUSTRY GROUP BULLETIN a Federal health policy is changing with 30 Primary Health Networks (PHNs)
More informationInquiry into educational opportunities for Aboriginal and Torres Strait Islander students Submission 18
Introduction The National Catholic Education Commission (NCEC) welcomes the opportunity to provide a submission as part of the House of Representatives Standing Committee on Indigenous Affairs inquiry
More informationHuman Services Certificate III in Aged Care (CHC30212)
Human Services Certificate III in Aged Care (CHC30212) Effective from 2013 Date published January 2013 Date updated February 2014 Training Package CHC08 version 4.2 Original published version updated:
More informationScope of Social Work Practice in Health
in Health Section 1 The unique contribution of social work practice in the health context The social work profession operates at the interface between people and their social, cultural, physical and natural
More informationWhat are the current rates of Dialysis Modalities? 2. What are the findings of the Consumer Perspectives Survey? 3
Contents A decision aid for the treatment of kidney disease A Guide for Health Professionals about this tool My Kidneys Contents Background 2 What are the current rates of Dialysis Modalities? 2 What are
More informationBase Salary: $113,000 Total Salary: $142,734. Indirect Supervision: 21. Policy coordination Medical treatment
Position Title and Position Number Supervisor Community Services (P118 076) CEO Classification and Salary: Base Salary: $113,000 Total Salary: $142,734 Staff Direct Supervision: 8 Location (Note: Total
More informationPrimary Health Care Demonstration Site Project. Memorandum of Understanding between the Shire of Cunderdin, WA Country Health Service
Primary Health Care Demonstration Site Project Memorandum of Understanding between the Shire of Cunderdin, WA Country Health Service Page 1 of 6 1. BACKGROUND a) The West Australian Government has committed
More informationNATIONAL PARTNERSHIP AGREEMENT ON IMPROVING TEACHER QUALITY
NATIONAL PARTNERSHIP AGREEMENT ON IMPROVING TEACHER QUALITY Council of Australian Governments An agreement between the Commonwealth of Australia and the States and Territories, being: t t t t t t t t the
More informationQUESTIONS AND ANSWERS HEALTHCARE IDENTIFIERS BILL 2010
About Healthcare Identifiers QUESTIONS AND ANSWERS HEALTHCARE IDENTIFIERS BILL 2010 Q1. What is the Healthcare Identifiers Service? The Healthcare Identifiers (HI) Service will implement and maintain a
More informationMental Health Nurse Incentive Program Program Guidelines
Mental Health Nurse Incentive Program Program Guidelines 1 Introduction On 5 April 2006, the Prime Minister announced the Australian Government would provide funding of $1.9 billion over five years for
More informationSTRATEGIC PLAN 2014-2017 PROMOTING AFFORDABLE HOUSING AND WORKING TOWARDS THE ELIMINATION OF HOMELESSNESS IN WESTERN AUSTRALIA
STRATEGIC PLAN 2014-2017 PROMOTING AFFORDABLE HOUSING AND WORKING TOWARDS THE ELIMINATION OF HOMELESSNESS IN WESTERN AUSTRALIA Contents Foreword... 1 Shelter WA... 2 Strategic Priorities... 5 Policy Advice...
More informationIntern training National standards for programs
Intern training National standards for programs Introduction These national standards outline requirements for processes, systems and resources that contribute to good quality intern training. Health services
More informationNATIONAL HEALTHCARE AGREEMENT 2012
NATIONAL HEALTHCARE AGREEMENT 2012 Council of Australian Governments An agreement between the Commonwealth of Australia and the States and Territories, being: t t t t t t t t the State of New South Wales;
More informationBetter Outcomes for People Living with Chronic and Complex Health Conditions through Primary Health Care
Submission: Primary Health Care Advisory Group Discussion Paper (August 2015) Better Outcomes for People Living with Chronic and Complex Health Conditions through Primary Health Care August 2015 Contact
More informationAn outline of National Standards for Out of home Care
Department of Families, Housing, Community Services and Indigenous Affairs together with the National Framework Implementation Working Group An outline of National Standards for Out of home Care A Priority
More informationReview of the Health Training Package and impact on Allied Health Professions in Australia Di Lawson SARRAH Conference September 2006
Review of the Health Training Package and impact on Allied Health Professions in Australia Di Lawson SARRAH Conference September 2006 Our Mission: Australia will have a community services and health workforce
More informationAccreditation Workbook for Mental Health Services. March 2014
Accreditation Workbook for Mental Health Services March 2014 Accreditation Workbook for Mental Health Services, 2014 ISBN Print: 978-1-921983-66-5 ISBN Online: 978-1-921983-60-3 Commonwealth of Australia
More informationSummary of new Medicare Benefits Schedule (MBS) item numbers: general practice and allied health. Updated April 2013
Summary of new Medicare Benefits Schedule (MBS) item numbers: general practice and allied health Updated April 2013 If you would like to receive this publication in an accessible format please phone (03)
More informationFOREWORD... 4 CHAPTER 2: INTRODUCTION... 5 2.1 Transition care in brief... 5 2.2 Roles and responsibilities within the transition care programme...
Transition Care Programme Guidelines [June 2015] 1 FOREWORD... 4 CHAPTER 2: INTRODUCTION... 5 2.1 Transition care in brief... 5 2.2 Roles and responsibilities within the transition care programme... 6
More informationThe Role and Scope of Occupational Therapy and Physiotherapy Services in State Schools Revised edition
The Role and Scope of Occupational Therapy and Physiotherapy Services in State Schools Revised edition 2 Contents Purpose 3 1. Definitions 3 Occupational Therapy 3 Physiotherapy 3 Relationship between
More information4040 McEwen Rd. Suite 350. Dallas. TX 75244 972-503-3215 * fax 972-503-3219 * info@nw 14.esrd.net * www.esrdnetwork.org
4040 McEwen Rd. Suite 350. Dallas. TX 75244 972-503-3215 * fax 972-503-3219 * info@nw 14.esrd.net * www.esrdnetwork.org STANDARD 1 ESRD NETWORK #14 MEDICAL REVIEW BOARD STANDARDS FOR THE REGISTERED NURSE
More informationHealth Consumers Queensland...your voice in health. Consumer and Community Engagement Framework
Health Consumers Queensland...your voice in health Consumer and Community Engagement Framework February 2012 Definitions In this Framework, Health Consumers Queensland utilises the following definitions
More informationAUSTRALIAN PROFESSIONAL STANDARDS FOR TEACHERS I L C O U N C
AUSTRALIAN PROFESSIONAL STANDARDS FOR TEACHERS QUALITY TEACHING I L C O U N C Contents Introduction 2 Organisation of the Australian Professional Standards for Teachers 4 Professional Knowledge 8 Professional
More informationA Regional Approach to the Planning and Delivery of the RHOF and MOICDP in Queensland
CheckUP & QAIHC Working in Partnership A Regional Approach to the Planning and Delivery of the RHOF and MOICDP in Queensland Background CheckUP, in partnership with the Queensland Aboriginal and Islander
More informationThe Robert Darbishire Practice JOB DESCRIPTION. Nursing Team Leader
The Robert Darbishire Practice JOB DESCRIPTION Nursing Team Leader JOB SUMMARY To provide a practice nursing service to patients, including in chronic disease management and other specialist areas. To
More informationRelease: 1. HLTEN511B Provide nursing care for clients requiring palliative care
Release: 1 HLTEN511B Provide nursing care for clients requiring palliative care HLTEN511B Provide nursing care for clients requiring palliative care Modification History Not Applicable Unit Descriptor
More informationSCAN Program (Supporting Children with Additional Needs)
NOVEMBER 2013 SCAN Program (Supporting Children with Additional Needs) Grant program guidelines The aim of the SCAN Program (Supporting Children with Additional Needs) is to improve access to funded preschools
More informationNational Standards for Mental Health Services
National Standards for Mental Health Services 2010 Contents Foreword 2 Standard 1. Rights and responsibilities 7 Standard 2. Safety 9 Standard 3. Consumer and carer participation 11 Standard 4. Diversity
More informationaustralian nursing federation
australian nursing federation Submission to Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 and two related Bills: Midwife Professional Indemnity (Commonwealth Contribution) Scheme
More informationGuidelines on the provision of Sustainable eye care for Aboriginal and Torres Strait Islander Australians
Guidelines on the provision of Sustainable eye care for Aboriginal and Torres Strait Islander Australians (Note: These Guidelines should not be used as a substitute for statutory responsibilities. Optometrists
More informationELEMENTS OF AUSTRALIAN INFECTION CONTROL AND PREVENTION PROGRAMS
ELEMENTS OF AUSTRALIAN INFECTION CONTROL AND PREVENTION PROGRAMS SUMMARY In 2007 the Australian Commission for Safety and Quality in Healthcare initiated a series of interventions designed to improve patient
More informationRACGP General Practice Patient Charter Australian Primary Health Care Nurses Association (APNA) September 2014
RACGP General Practice Patient Charter Australian Primary Health Care Nurses Association (APNA) September 2014 For further information and comment please contact Kathy Bell, Chief Executive Officer, Australian
More informationProfessional Competencies of the Newly Qualified Dental Prosthetist
Professional Competencies of the Newly Qualified Dental Prosthetist February 2016 Australian Dental Council Level 2, 99 King Street Melbourne Victoria Australia Copyright 2016 This work is copyright 2016.
More informationSubmission on the National Registration and Accreditation Scheme Partially Regulated Occupations
Submission on the National Registration and Accreditation Scheme Partially Regulated Occupations The Australian Medical Council Limited (AMC) welcomes the opportunity to make a submission to the Practitioner
More informationHOME CARE PACKAGES PROGRAMME GUIDELINES
HOME CARE PACKAGES PROGRAMME GUIDELINES JULY 2014 TABLE OF CONTENTS FOREWORD... 3 PART A INTRODUCTION... 5 1. Home Care Packages Programme... 5 2. Consumer Directed Care (CDC)... 7 3. Use of innovative
More informationCustomers first Ideas into action Unleash potential Be courageous Empower people
Role Description Job ad reference: RK6B204896 Hospital and Health Service: Role title: Allied Health Senior (Clinical Intake Officer) Status: Permanent Part Time (38 hrs p.f.) Unit: Child Development Services
More informationStrategic Plan for Nurse Practitioners in the Northern Territory
Strategic Plan for Nurse Practitioners in the Northern Territory 2014-2016 www.nt.gov.au/health PAGE 1 NT Department of Health Office of the Chief Nursing and Midwifery Officer NT Department of Health
More informationProposed overarching principles for National Standards for Out of Home Care
Working document Development of National Standards for out of home care Over the last ten years, all Australian governments in strong partnership with the non-government sector have increasingly recognised
More informationAccreditation Standards for Entry-Level. Occupational Therapy Education Programs PRELIMINARY CONSULTATION
Accreditation Standards for Entry-Level Occupational Therapy Education Programs PRELIMINARY CONSULTATION NOVEMBER 2012 Occupational Therapy Council (Australia & New Zealand) Ltd PO Box 959 South Perth
More informationCommunity Services Sector
Community Services Sector Q ueensland s community services sector provides effective, inclusive human services by supporting communities in building skills, finding solutions and promoting social justice.
More informationGuideline for social work assistant training. Allied Health Professions Office of Queensland
Guideline for social work assistant training Allied Health Professions Office of Queensland August 2014 Guideline for social work assistant training Published by the State of Queensland (Queensland Health),
More informationSouth Australian Women s Health Policy
South Australian Women s Health Policy 1 2 South Australian Women s Health Policy To order copies of this publication, please contact: Department of Health PO Box 287 Rundle Mall Adelaide SA 5000 Telephone:
More informationSUBMISSION TO THE MEDICARE BENEFITS SCHEDULE REVIEW TASKFORCE
SUBMISSION November 2015 SUBMISSION TO THE MEDICARE BENEFITS SCHEDULE REVIEW TASKFORCE Submission by the Chiropractors Association of Australia Page 1 of 10 About the Chiropractors Association of Australia
More informationnursing, midwifery, allied health, & psychology NURSING, MIDWIFERY, ALLIED HEALTH & PSYCHOLOGY
NURSING, MIDWIFERY, ALLIED HEALTH & PSYCHOLOGY www.scu.edu.au/healthscience CRICOS Provider Nos: NSW 01241G, WA 02621K, QLD 03135E nursing, midwifery, allied health, & psychology Psychological Science
More informationGuide to the National Safety and Quality Health Service Standards for health service organisation boards
Guide to the National Safety and Quality Health Service Standards for health service organisation boards April 2015 ISBN Print: 978-1-925224-10-8 Electronic: 978-1-925224-11-5 Suggested citation: Australian
More informationMr Bruce Cooper General Manager Intelligence, Infocentre and Policy Liaison Branch phireport@accc.gov.au. Dear Mr Cooper
Mr Bruce Cooper General Manager Intelligence, Infocentre and Policy Liaison Branch phireport@accc.gov.au Dear Mr Cooper The Australian College of Mental Health Nurses (ACMHN) would like to provide feedback
More informationSUPERSEDED BY OD0290/10
Aged Care Policy Directorate Enquiries to: Jeanette Plenty Tel: 9222 2162 Number: OD 0279/10 : 23/04/2010 Supersedes: OD0043/07 (29/03/2007) OP2067/06 (11/05/2006) OP1882/04 (02/12/2004) OP1576/02 (01/05/2002)
More informationPalliative Care Link Nurse Program
Palliative Care Link Nurse Program Mallee Division 2009-2010 DRAFT V2 MDGP acknowledges the funding support from the Australian Government Department of Health and Ageing for this program. Table of Contents
More informationGuidelines on continuing professional development
Guidelines on continuing professional development 7982 Introduction These guidelines on continuing professional development (CPD) have been developed by the Occupational Therapy Board of Australia (the
More informationIf you have any questions after you have read this document, please refer them to Jessica Bennetts, Human Resource Manager on 02 6333 2800.
INFORMATION PACK Thank you for considering Marathon Health as your next employer. This Information Package is designed to tell you more about Marathon Health and the role, identify the selection criteria
More informationHEALTH POLICY STATEMENT
Page 1 HEALTH POLICY STATEMENT PREAMBLE The American Nephrology Nurses Association (ANNA) is a national organization of registered nurses practicing in nephrology, which includes but is not limited to
More informationAMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number
Criterion AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Criterion Level (1 or 2) Number Criterion BURN CENTER ADMINISTRATION 1. The burn center hospital is currently accredited by The
More informationTransplant Program. Education REPORT
Transplant Program Education REPORT 2007 MESSAGE FROM THE VICE-PRESIDENT OF EDUCATION Dr. Richard Reznick The Transplant Program at UHN is leading the charge in successfully moving forward its educational
More informationStandard 5. Patient Identification and Procedure Matching. Safety and Quality Improvement Guide
Standard 5 Patient Identification and Procedure Matching Safety and Quality Improvement Guide 5 5 5October 5 2012 ISBN: Print: 978-1-921983-35-1 Electronic: 978-1-921983-36-8 Suggested citation: Australian
More informationInterprofessional, student-assisted clinics: a solution for neurological rehab in remote Queensland?
Interprofessional, student-assisted clinics: a solution for neurological rehab in remote Queensland? Katherine Galligan 1, Sabina Knight 1, Ruth Barker 1,2, Peter Wallace 3 1 Mount Isa Centre for Rural
More informationMental Health Workforce Study: Mental Health Workforce Planning Data Inventory
Mental Health Workforce Study: Mental Health Workforce Planning Data Inventory September 2013 1 Health Workforce Australia. This work is copyright. It may be reproduced in whole or part for study or training
More informationFREQUENTLY USED DESKTOP GUIDE TO ITEM NUMBERS for Allied Health Services
FREQUENTLY USED DESKTOP GUIDE TO ITEM NUMBERS for Allied Health Services July 2014 FREQUENTLY USED DESKTOP GUIDE TO ITEM NUMBERS ELIGIBILITY CRITERIA FOR ALLIED HEALTH PROFESSIONALS... 3 ALLIED HEALTH
More informationPathway to Remote Practice - Tying it all together
Fact Sheet 4 Pathway to Remote Practice - Tying it all together Now that you have successfully navigated the other preparatory steps, and have professionally and personally decided to take up the opportunities
More informationFeedback on the Inquiry into Serious Injury. Presented to the Road Safety Committee of the Parliament of Victoria. 08 May 2013
Feedback on the Inquiry into Serious Injury Presented to the Road Safety Committee of the Parliament of Victoria 08 May 2013 About the APA The Australian Physiotherapy Association (APA) is the peak body
More informationBuilding a 21st Century Primary Health Care System. A Draft of Australia s First National Primary Health Care Strategy
Building a 21st Century Primary Health Care System A Draft of Australia s First National Primary Health Care Strategy Building a 21st Century Primary Health Care System A Draft of Australia s First National
More informationRegistered Nurse professional practice in Queensland
Nursing and Midwifery Office, Queensland Strengthening health services through optimising nursing Registered Nurse professional practice in Queensland Guidance for practitioners, employers and consumers.
More informationPosition Statement #37 POLICY ON MENTAL HEALTH SERVICES
THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF PSYCHIATRISTS Position Statement #37 POLICY ON MENTAL HEALTH SERVICES Mental disorder is a major cause of distress in the community. It is one of the remaining
More informationThe State of Queensland (Department of Education and Training) 2009 First published 1996 as Guidelines for Speech language Therapy Services Revised
The State of Queensland (Department of Education and Training) 2009 First published 1996 as Guidelines for Speech language Therapy Services Revised edition 1998 as SM10 - Speech language Therapy Services
More informationSubmission on the draft National Primary Health Care Strategic Framework October 2012
Submission on the draft National Primary Health Care Strategic Framework October 2012 Council of Social Service of NSW (NCOSS) 66 Albion Street, Surry Hills 2010 Ph: 02 9211 2599 Fax: 9281 1968 email:
More informationEnquiries to: Jeanette Plenty OD/IC number: OD0290/10 Phone Number: 9222 2162 Date: 22/6/2010
Enquiries to: Jeanette Plenty OD/IC number: OD0290/10 Phone Number: 9222 2162 Date: 22/6/2010 File No: RSD-03149 Supersedes: OD0279/10 (23/04/2010) OD0043/07 (29/03/2007) OP2067/06 (11/05/2006) OP1882/04
More informationModels of Chronic Kidney Disease Care and Initiation of Dialysis. Dr Paul Stevens Kent Kidney Care Centre East Kent Hospitals, UK
Models of Chronic Kidney Disease Care and Initiation of Dialysis Dr Paul Stevens Kent Kidney Care Centre East Kent Hospitals, UK Early Crash Landings Talk Outline Pathways & Definitions Guideline recommendations
More informationSubmission to the Productivity Commission Childcare and Early Childhood Learning February 2014. Background. The Montessori Australia Foundation (MAF)
Submission to the Productivity Commission Childcare and Early Childhood Learning February 2014 Background The Montessori sector is unique, diverse and significant in Australian education, particularly
More informationNEONATAL NURSE PRACTITIONER MODEL OF CARE WERRIBEE MERCY HOSPITAL
NEONATAL NURSE PRACTITIONER MODEL OF CARE WERRIBEE MERCY HOSPITAL Background Neonatal Nurse practitioners provide an additional model of care for neonates and their families. They have been educated to
More informationCommonwealth of Australia 2008
Commonwealth of Australia 2008 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth.
More information