The arrival of October brings the start of grass pollen season, generally lasting until 31 December.

Warmer weather, increased amounts of grass pollen in the air and certain types of thunderstorms, when combined, can result in an Epidemic Thunderstorm Asthma (ETSA) event triggering severe asthma.

Thunderstorm Asthma can cause serious health impacts for people with known and unknown conditions of asthma, therefore it is incredibly vital to be aware of the Thunderstorm Asthma procedures and how to be prepared for a potential ETSA event.

Symptoms of ETSA include an itchy and runny nose, sneezing, coughing, wheezing and/or chest tightness. Some of these symptoms can become very severe, very quickly, and may require urgent medical assistance.

Extreme ETSA events, like that experienced on 21 November 2016, can result in large numbers of people with sudden onset asthma in temporal and spatial relation to the storm, and large geographical areas affecting multiple health services, with a resultant strain on health and emergency services.

Sharon Rukavina, Respiratory Clinical Nurse Consultant – Asthma and Allergy, said during the 2016 event, thousands of people suddenly had asthma attacks, therefore, finding it hard to breathe.

“Some had never had asthma symptoms before,” she said.

“In Victoria, from October to December, thunderstorm asthma results from a combination of high grass pollen counts, such as ryegrass, and specific weather conditions. Strong winds carry the pollen, while storms or moisture break open the pollen grains, releasing ultrafine particles into the air.”

“These particles are small enough to penetrate the lower airways, potentially triggering severe asthma symptoms in those that are susceptible.”

“A comprehensive review of the 2016 Melbourne thunderstorm asthma incident revealed that it primarily affected individuals sensitive to grass pollens.”

“Consequently, those with springtime hay fever or poorly controlled asthma – characterised by asthma symptoms on many days of the week or frequent ongoing use of a reliever inhaler – will require additional protection against thunderstorm asthma. If you think your asthma may not be controlled or you have spring hay fever, then please see your GP as soon as you are able.”

Sharon urges everyone in the community to be able to recognise the symptoms of someone having an asthma attack and to know the four steps of asthma first aid.

“It is very important not to ignore any symptoms of asthma such as wheeze, persistent cough or unexplained breathlessness. Everyone should be able to recognise the symptoms of someone having an asthma attack and to know the four steps of asthma first aid,” she said.

Step 1: Sit person suffering the attack upright.

Step 2: Shake the blue/grey reliever puffer and give them four separate puffs using a spacer if available.

Step 3: Wait four minutes and give four more puffs if the person cannot breathe normally.

Step 4: Call an ambulance if they still cannot breathe normally and keep giving reliever puffs as above until an ambulance arrives.

Completely avoiding pollen can be difficult during the pollen season but the following steps may help reduce your exposure if you are sensitive:

• For individuals with known asthma, it is important to use your prescribed preventer inhaler as directed, even in the absence of symptoms.

• Carry a blue/grey reliever inhaler such as Ventolin or Asmol at all times and ensure you are familiar with its proper use

• Avoid going outdoors on days with high pollen counts,  high winds or after thunderstorms. Stay inside with the windows shut and the air conditioner switched to recirculate/recycled.

• Check weather forecasts and pollen levels

• It may be prudent to manage hay fever symptoms with a daily steroid nasal spray during pollen season, although its effectiveness in preventing thunderstorm asthma remains uncertain.

Jason Amos, Director Emergency Management, is encouraging staff to become aware of Northern Health’s emergency plan for such events including ETSA.

“Northern Health has a Code Brown Subplan – Thunderstorm Asthma procedure and the Code Brown – External Emergency procedure. Both are available on Prompt and have been updated to include Kilmore District Hospital following the recent amalgamation,” he said.

The Northern Health Simulation and Safety Team is facilitating a Multiagency Thunderstorm Asthma Simulation on 17 October, 1 pm – 3 pm at NCHER. Representatives from Northern Hospital Epping, Kilmore District Hospital Urgent Care Centre, Epping and Craigieburn Priority Primary Care Centres and Ambulance Victoria will be in attendance.

You can access daily forecasts for ETSA events here.

For more information on asthma first aid, please click here.

Featured image: Jason Amos, Director Emergency Management and Sharon Rukavina, Respiratory Clinical Nurse Consultant.

#WeAreNorthern

Meet Douglas Mponda, Forensic Clinical Specialist/Registered Psychiatric Nurse.

Q: What is your coffee order?

A: I prefer a simple latte as I am not much of a coffee drinker.

Q: Tell me about your work as a Forensic Clinical Specialist (FCS) – what does it entail?

A: My work as an FCS is centered around what we refer to as the four pillars:

1. Clinical consultancy, which can be primary (seeing the consumer face to face) or secondary consultancy where I meet with the clinician(s) and explore options with them. This way, we offer first line consultancy, offender specific risk assessment and intervention support to the mental health workforce for the following behaviours of concern – violence, threateners, stalking, sexual offending, general offending, querulous (vexatious) complainants, fire-setting and psychopathy. I also undertake joint assessments of consumers with a forensic history or potentially high risk of offending.
2. Organisational service development and quality improvement which involves contributing to the development, review and evaluation of risk assessment and management frameworks in relation to target population. I also contribute to operational review of incidents involving consumers with an offending history.
3. Workforce education and training through providing training on forensic mental health topics like principles of forensic mental health; risk assessment and management; role of mental health in offending; navigating the forensic system.
4. Partnerships and networking via working with local mental health and justice sector in order to lead and support the development of strong collaborative relationships between Northern Area Mental Health Service (NAMHS) and local justice services to reduce gaps in service delivery, particularly during discharge, transfer to or release from prison. I also contribute to the development and review of protocols and processes between mental health services, justice system and local support agencies, including clear referral pathways, collaborative practice principles, information flow and timely communication mechanisms. External services I liaise with include: police; courts; prison based mental health services; Forensicare and non-government support providers. Within the NAMHS, together with my fellow FCS, we coordinate the monthly high risk review panel and I have been a standing member of the NAMHS Safety Committee.

Q: What do you enjoy most about your work?

A: I really enjoy the capacity building aspect of the role in that we try to make a difference in the clinicians’ way of thinking and how we offer them a different perspective of approaching risk, its assessment and subsequent management.

Q: How do you like to unwind after work?

A: Depending on how busy I would have been at work, I listen to a lot of podcasts, watch movies (to escape reality) or documentaries (to add onto my general knowledge base).

Q: What is one place you would like to travel to and why?

A: This is a difficult one to answer as there are many places I would like to visit. Included in my bucket list has to be trips to China and Japan. As an avid martial artist, I would love to visit some of the areas where certain styles of Karate and Kung Fu originated from so that I can pay my homage.

Every worker deserves a safe and healthy workplace.  The Occupational Health and Safety (OHS) fundamentals is focused on keeping staff safe and healthy at work. Every worker has a right to a safe and healthy working environment, no matter what.

National Safe Work Month, held annually in October, encourages all individuals and organisations to prioritise work health and safety and take preventative action to reduce the number of work-related injuries, illnesses and fatalities. National Safe Work Month is a time for employers and workers across Australia commit to creating safe and healthy workplaces. The theme for National Safe Work Month 2024 is “Safety is everyone’s business.”

OHS is essential for any business or organisation. It is a system of practices, procedures, and strategies that help employers protect workers from workplace hazards. At Northern Health, OHS fundamentals helps us to consider health and safety in everything we do and every decision we make. Our OHS systems includes, proactively managing OHS risks, genuinely consulting with workers and providing education and training on safety procedures to understand the importance of workplace safety.

The OHS & Wellbeing team got back to basics by unpacking the fundamentals of good OHS practice in our Mental Health Inpatient Unit on Ward 8.

The Northern Health OHS team and Ward 8 Senior Management team acted on concerns from staff, HSR’s and managers about stress, anxiety and burnout. Staff retention was down and sick days had gone up. The organisation has good processes for managing physical OHS risks, including worker consultation. However, the consultative forums and risk management practices could be improved to better manage psychosocial and physical hazards on the ward.

A local workplace consultative group forum consisting of Ward 8 senior management team, staff, HSR and OHS was established to unpack the fundamentals of OHS.

These are the responses from Ward 8 staff about the consultation sessions:

• “It was great to feel heard and someone was in our corner focussing on staff safety.”
• “They were helpful – moving forward being able to identify similar patterns and putting strategies in earlier works.”
• “Developing safety huddles, management plans, debriefs happening in good time since early this year.”
• “Provided a safe space to vent.”
• “Acknowledged how we felt.”

“From a management perspective it provided me with a framework to build upon,” said Alexia Sheldon, Acting Clinical Nurse Leader, Ward 8.

Pradeep Chandravathy, Clinical Nurse Educator Ward 8, said, “During the consultation sessions on Ward 8, staff had the opportunity to discuss their concerns and felt well-supported by the team. This feedback is based on input from various staff members who attended the sessions.”

Michael Sadkiewicz, HSR Ward 8, said, “Regarding the OHS consultation, there have been many changes on the ward following the meetings, including the reimplementation of safe wards and the designation of the safe ward, ‘champions,’ to head a different domain each month and fortnightly meetings of the safer for all work group.”

Casey O’Brien, Senior Psychologist People & Culture, OHS & Wellbeing, said, “In addition to the workplace factors impacting the team, we spent time empowering them to also support their individual wellbeing, especially when there were circumstances they did not have influence or control over.”

“We did this through promoting a holistic discussion about all aspects of their wellbeing, including  emotional, physical, social, spiritual and occupational. We also encouraged them to support each other by sharing strategies they use to cope with the demands of the work, and to seek professional support when needed,” Casey continued.

Let’s keep workers safe and healthy by ensuring OHS is core to how we do business at Northern Health. Safety is my business, your business, our business.

Featured image: Ward 8 staff.

October is Breast Cancer Awareness Month. The campaign aims to raise awareness of the disease, educate about its symptoms and prevention, and fund research into causes, treatment, and cure. This year’s focus is on metastatic breast cancer, where the cancer has spread beyond the initial tumour site of the breast and into other parts of the body.

Melanie Bullock, McGrath Metastatic Breast Care Nurse Consultant (MBCN), who is based at Northern Hospital Epping, said, “Diagnosis rates continue to rise, but so has the survival rate. It’s all about early detection.”

Australia has one of the best breast cancer survival rates in the world, with 87.4 percent of people diagnosed surviving at least 10 years.

“Our team has grown to match the needs in the community,” Cheryl Murray, Breast Cancer Nurse Consultant added.

“As patients live longer, the duration of the specialised care they require to navigate their path to recovery naturally increases too. Northern Health now has three breast care nurses, allowing for a wider support service, including metastatic patients.”

Understanding the need for a multi-disciplinary approach for effective care, the team has organised an ‘Introduction to Breast Cancer’ study day for all Northern Health staff to be held on Thursday 17 October, 8 am – 2 pm in person at NCHER Lecture Theatre 2. Staff can Register Here.

The study will include topics on:

• Patient journey from diagnosis to treatment
• Treatment options
• Supportive care of the patient, and much more.

To facilitate early detection, BreastScreen Victoria provides free mammograms to women and trans and gender-diverse people with no breast symptoms.

• Women and trans and gender-diverse people aged 50 to 74 should be screened every two years.
• Women and trans and gender-diverse people aged 40 to 49 and over 75 are also eligible to receive a mammogram with BreastScreen Victoria every two years, however, it is encouraged to speak to a doctor to see if breast screening is the right option for you.

To schedule your free breast screening appointment, please visit Breast Screen Victoria or call 13 20 50 for more information.

Pictured in featured image: Breast Care Nurse Consultants, (L-R) Sarah Young, Cheryl Murray and Melanie Bullock.

October is Mental Health Month, and we are ‘Celebrating Diversity, Healing Together’.

It is a commitment to fostering an inclusive society where every individual, regardless of their cultural background, can access the mental health resources they need.

Within our Community Care Units (CCU), which provide recovery-focused rehabilitation in a community residential setting, 24 per cent of participants were born outside of Australia, and six per cent are First Nations People. This in turn is reflected in our workforce, with 53.1 per cent born in a country outside Australia and 0.6 per cent First Nations People.

The CCU team support individuals to increase their independence through a variety of person-centred programs, focussed on developing daily living skills. One such consumer was Raj (name changed), an Indian consumer who was experiencing depression and spent most of his time, alone in his room, not engaging in activities within the CCU. He had limited experience cooking his own meals but needed to build this skill to manage independent living on exit from CCU.

That was until one of our Associate Nurse Unit Managers, Sumeet, with an Indian background, provided Raj with some recipes for familiar, traditional and vegetarian dishes, and encouraged him to start cooking.

With one-on-one support, Raj began cooking. He then joined a group led by the CCU Senior Occupational Therapist (OT) Louisa, and Peer Worker, Graeme, where a spinach and paneer curry was prepared. Raj was encouraged to take on a leadership role within the group. Raj was then further supported by CCU OT Ira, who also shared his ethnic background, to cook a few other traditional dishes.

Raj gradually became less withdrawn. He invited others to taste his curries. Raj was clearly pleased and proud of his curry. It was the first time he had smiled in a while.

Whilst Raj had initially been reluctant to use public transport, his rapport with staff and enhanced self-efficacy helped him start using public transport to get out into the community with his OT. He has built his confidence to use public transport independently.

Belinda Scott, Executive Director, Mental Health Services says, “This year’s theme highlights the importance of ‘coming together to support each other’. Helping consumers like Raj grow their independence with everyday living skills, whilst rebuilding and maintaining their cultural identity, is vital to a recovery-oriented model.”

Click here for the paneer and spinach curry recipe.

Featured image: Sumeet (Associate Nurse Unit Manager) and Ira (Occupational Therapist) from Northern Community Care Unit.

Today, Northern Health proudly celebrates International Translation Day, an opportunity to recognise the invaluable work of language professionals, including our very own team of in-house interpreters and translators at TALS (Transcultural and Language Services).

While the terms ‘translator’ and ‘interpreter’ are often used interchangeably, they represent distinct roles, each with its own set of specialised skills. An interpreter works with spoken or signed language in real time, either face-to-face or via video or phone calls. In contrast, a translator takes written material from one language and conveys it in another, ensuring the meaning remains clear and accurate. Both professions are essential, bringing unique value to the diverse communities we serve.

At Northern Health, we are fortunate to have both services available in-house. In the last financial year alone, TALS received over 70,000 interpreting requests across 122 languages and completed 65 translation projects, translating a remarkable total of 276,097 words.

Our hospital interpreters and translators play a critical role in bridging the communication gap between patients whose first language is not English and their healthcare providers. The team works diligently to adhere to the strict Code of Ethics for interpreters and translators, ensuring that they remain accurate, impartial, and that all conversations remain confidential.

To celebrate International Translation Day, here are some insights and experiences from our incredible TALS team:

Imad Hirmiz, Arabic/Assyrian/Chaldean Interpreter and Translator, reflects:

“The world has become a smaller place, with people from different backgrounds crossing paths daily. Professional interpreters and translators facilitate communication at a professional level, tackling complex cross-cultural issues. Interpreting goes beyond mere word exchange, it is a mental process at both intellectual and cognitive levels where a bilingual person lack experience. In healthcare, this work takes on its highest form, combining mental and physical aspects to provide critical support. Utilising interpreters and translators not only enhances formal consultations but also strengthens this vital profession.”

Federica Stefani-Comi, Italian Interpreter and Translator, shared a poignant quote from Italian writer Italo Calvino:

“Without translation, I would be limited to the borders of my own country. The translator is my most important ally. They introduce me to the world.”

Luyuan Chen, Mandarin Interpreter and Translator, shared feedback he received from one of the patients after interpreting for her over multiple sessions:

“The idea of going to a local hospital used to be intimidating because I assumed that English was the only language spoken there, and I would always need my daughter to take time off work to come with me for support. However, having an interpreter, especially one with a familiar face, changed my mind completely. They know what they are doing and make me feel confident about going there on my own. Thank you!”

George Karagiannis, Greek Interpreter and Translator, shared:

“Last week I was asked to interpret for an elderly patient in the ward. The doctor briefed me and did not think would have much success to convince the patient for the investigations needed to diagnose her condition. The patient wanted to discharge herself as she was feeling better post the two bags of blood given to her. Apparently, she comes often by ambulance with abdominal pain and bleeding and a “dangerously low” blood count.  We were able to talk to her in her language and convinced her of the importance of going ahead with the tests, and she signed the consent form. This was an amazing result for the patient, the hospital and the taxpayer.”

Yan Qin, Mandarin Interpreter and Translator, shared:

“Interpreting and translating are to build bridges between different languages, cultures and values. The practice of interpreting and translating is beyond only words, which adds value to the profession, and differentiates the work done by people, and by machine. As in-house interpreters, we are also the reliable source of support to the non-English speaking patients, yet within our role boundaries.”

These stories reflect the profound impact our interpreters and translators have on our patients and the broader community. By removing language barriers, we ensure that every patient has equal access to healthcare. We are proud to celebrate and honour the essential work of our TALS team today and every day.

Northern Health’s Asthma Clinic has officially launched a co-designed Asthma Digital Care Pathway via the My Health @ Northern app, offering essential support for patients living with uncontrolled or severe asthma. The codesign process involved bringing together a group with people with lived experience of severe asthma and a multidisciplinary team of asthma clinicians.

This collaborative approach fostered valuable connections and ensured that patients’ voices were heard throughout the process. Pam, a consumer and member of the co-design working group, shared her experience: “People formed a bond quickly and were respected when they had their say. We could see the progress, from the first meeting and then the second meeting, you had some things in place, we could see that it was being formed and that we had a say on it all”

The Respiratory Medicine Unit received a grant from AstraZeneca to design, develop and implement a severe asthma digital care pathway. This project was a collaboration between the Respiratory Unit and the Clinical Leadership, Effectiveness, and Outcomes (CLEO) team, as part of a broader strategy to roll out Digital Care Pathways at Northern Health.

“It is great to watch the Digital Care Pathways progressively being rolled out. This has been a long journey from before COVID-19 to be able to provide innovative solutions to our patients. The team, Clinical Leadership, Effectiveness and Outcomes (CLEO) who are providing the virtual programs are doing a fantastic job.  In particular the asthma pathway will greatly benefit our patients not only in self-management but improving their quality of life” said Anthony Gust, Executive Director, Digital Health.

The app provides the opportunity for people with asthma to track their asthma symptoms and control, screen for comorbidities, and access trusted health education and self-management advice. Communication between patients and the care team is now improved through features including in app messaging and video calls.

Sharon Rukavina, Respiratory Clinical Nurse Consultant has been on secondment to the CLEO team as project manager for this project.

“I regularly observe the profound impact that uncontrolled and severe asthma symptoms have on our patient’s quality of life and contribute to increased anxiety often resulting in significant feelings of isolation. Patients can view their asthma care plans directly on their phones, supporting better self-management and allowing for easy sharing with healthcare providers,” said Ms Rukavina.

“This transformational program helps us connect with our purpose as clinicians which is to deliver and improve the health outcomes that matter most to our patients and community. We can’t wait to expand to other conditions and specialties,” said Dr Katharine See, Chief Health Outcomes Officer and Director of Respiratory Medicine.

Back pain is the fifth most common reason for visits to the emergency department, often leaving patients both debilitated and uncertain about how to proceed.

“Back pain is a debilitating condition affecting one in six Australians and is the second leading cause of disease burden,” explains Dr Adam Semciw, Associate Professor at La Trobe University and Northern Health.

When a patient with back pain arrives at the emergency department, they undergo a comprehensive assessment to identify the underlying cause and rule out any serious issues. Following discharge, patients are frequently referred to the Northern Health Back Pain Hot Clinic. Here, Senior Physiotherapist Nicole Alousis, evaluates the patient’s situation and provides strategies to manage the pain and prevent future flare-ups.

In alignment with Northern Health’s commitment to effective back pain management, the Back Pain Hot Clinic has collaborated with the Clinical Leadership Effectiveness and Outcomes (CLEO) team and La Trobe University to create the Back Pain Digital Care Pathway. Central to this initiative is the My Health @ Northern app, available on both Apple and Android platforms and developed by Datos Health and CLEO.

This app provides educational resources for managing back pain and delivers important information about the back pain program. The educational resources include specialist-designed videos about managing back pain and whether the use of scans is necessary to diagnose the cause of back pain.

The Back Pain Digital Care Pathway also includes periodic questionnaires sent to patients, called Patient Reported Outcome Measures (PROMS), which gather valuable data to optimise care and for patients to monitor progress.

“There is a large scope for a digital care pathway to optimise the way we manage lower back pain,” notes Nicole Alousis.

Dr Semciw adds, “This Digital Care Pathway will help to inform risk stratification processes for the management of people with back pain.”

Elisha O’Dowd, Effectiveness and Outcomes Manager, CLEO, concludes, “Digital care pathways are a great way to bridge the gap between patient and healthcare, providing essential information right in the palm of the patient’s hand when they need it.”

The Back Pain Digital Care Pathway is a finalist in the 2024 Victorian Public Healthcare Awards, we wish the team the best of luck!

 

 

Pictured in featured image: Nicole Alouisis, Senior Physiotherapist, Northern Health Back Pain Hot Clinic.