Issue 286 - 12 October 2023

Welcome to the fortnightly Health Improvement and Innovation Digest. The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Article Access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Health Equity (New Zealand)

Systematic review of Indigenous cultural safety training interventions for healthcare professionals in Australia, Canada, New Zealand and the United States
The objective of this study, published in BMJ Open, was to synthesise and appraise the design and impact of peer-reviewed evaluations of Indigenous cultural safety training programmes and workshops for healthcare workers in Australia, Canada, New Zealand and/or the United States.

Quality Improvement (New Zealand)

Nurse prescriber's understanding of their antimicrobial stewardship role: a qualitative study
Antimicrobial resistance is an infectious disease threat to public health globally, and antimicrobial stewardship among healthcare professionals is one key way to address this potential problem. Registered nurse designated prescribers are the newest group of health professionals to gain prescribing authority in Aotearoa New Zealand, yet little is known about their understanding of their antimicrobial stewardship role. The aim of this study, published in the Journal of Primary Health Care, was to explore registered nurse designated prescribers' understanding of their antimicrobial stewardship role through their prescribing practices and approaches to clinical reasoning.

Closing the equity gap as we move to the elimination of seclusion: Early results from a national quality improvement project
Use of seclusion within mental health inpatient facilities is harmful for consumers and staff, but it is still used in many Aotearoa New Zealand and Australian facilities, at higher, inequitable rates for the indigenous populations of both countries. This study, published in Australasian Psychiatry, reports early results from a national programme to eliminate seclusion in mental health services in Aotearoa New Zealand, using a bicultural approach to reduce inequity for Māori.

Hospital Productivity (New Zealand)

Cascade of care and rapid treatment pathway at Auckland City Hospital for patients with a new diagnosis of HIV infection, 2015–2019
Legislative changes in 2017 enabled subsidised HIV care for all people living with HIV in New Zealand. This enabled a rapid treatment pathway (RTP) to be developed at Auckland City Hospital (ACH). The aims of this study, published in the New Zealand Medical Journal, were to document the cascade of care for people referred with newly diagnosed HIV infection and evaluate the effect of the RTP.

Cancer Services (New Zealand)

Exploring health professionals’ viewpoint of provision of nutrition advice for women with endometrial cancer
The aim of this study, published in the New Zealand Medical Journal, was to explore barriers and facilitators to delivery and uptake of nutrition advice to women diagnosed with endometrial cancer from a health professionals’ viewpoint.

Nutrition screening, assessment, and intervention practices for children with cancer in Aotearoa, New Zealand
The purpose of this study, published in Nutrition, was to investigate dietetic resources and current nutrition screening, assessment, and intervention practices in pediatric oncology centers in Aotearoa, New Zealand.

Emergency Department Services (New Zealand)

Goals of care in the Wellington Emergency Department: a clinical audit
The aim of this study, published in the New Zealand Medical Journal, was to determine how often goals of care are being discussed with older patients in the emergency department (ED).

Cardiovascular Disease and Diabetes (New Zealand)

"Prescribing for the whole person": A qualitative study exploring prescribing pharmacist views on type 2 diabetes management in New Zealand
Pharmacist prescribers have comprehensive pharmacotherapy knowledge that can be useful for management of complex health conditions such as type 2 diabetes, yet the number of pharmacist prescribers working in New Zealand primary care is low. The aim of this study, published in BMC Health Services Research, was to explore the experiences of pharmacist prescribers in supporting type 2 diabetes management in New Zealand primary care.

Cardiovascular Disease and Diabetes (International)

The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review
Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review, published in Adolescent Health, Medicine and Therapeutics, was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada.

Primary Health Care (New Zealand)

Barriers Faced by Australian and New Zealand Women When Sharing Experiences of Family Violence with Primary Healthcare Providers: A Scoping Review
Despite the Australian Government's attempts to reduce domestic violence (DV) incidences, impediments within the social and health systems and current interventions designed to identify DV victims may be contributing to female victims' reluctance to disclose DV experiences to their primary healthcare providers. This scoping review, published in Healthcare, aimed to provide the state of evidence regarding reluctance to disclose DV incidents, symptoms and comorbidities that patients present to healthcare providers, current detection systems and interventions in clinical settings, and recommendations to generate more effective responses to DV.

Primary Health Care (International)

Immediate versus delayed versus no antibiotics for respiratory infections
Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This update of a Cochrane Review aims to evaluate the effects on duration and/or severity of clinical outcomes (pain, malaise, fever, cough and rhinorrhoea), antibiotic use, antibiotic resistance and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections.

Increased Immunisation (New Zealand)

Interventions to improve vaccine coverage of pregnant women in Aotearoa New Zealand
Maternal vaccination against influenza and pertussis protects mothers and babies from severe disease and is recommended and funded in Aotearoa New Zealand. Despite this, maternal vaccination uptake is low, varies by region and is inequitable, with Māori and Pacific māmā (mothers) less likely to receive vaccination. The aim of this study, published in the Journal of Primary Health Care, was to determine what interventions currently exist to support and encourage maternal vaccination against influenza and pertussis and what changes and interventions could be implemented to improve coverage, with a focus on Māori and Pacific hapū māmā (pregnant mothers).

Exploring factors that influence vaccination uptake for children with refugee backgrounds: An interpretive description study of primary healthcare providers’ perspectives
Children with refugee backgrounds are at high risk of acquiring vaccine preventable diseases (VPDs) due to a complex set of factors, one being under-immunisation. In Aotearoa New Zealand (NZ), reported age-appropriate vaccination rates are suboptimal among children with refugee backgrounds. This study, published in Vaccine, explored factors associated with access and uptake of immunisations and develop strategies to improve age-appropriate vaccinations among refugee children post-resettlement in NZ.

Smoking Cessation (New Zealand)

Pacific Peoples’ Nicotine-Free Futures: Understanding Pacific Peoples’ perceptions and practices of vaping
Increased rates of smoking (nicotine use through tobacco) among the Pacific population have resulted in an urgent need to explore possible harm reduction techniques. This report, published by the Health Promotion Agency, uses Pacific research methodologies to present Pacific peoples’ attitudes towards vaping, in Aotearoa New Zealand.

Smoking Cessation (International)

Interventions for Preventing E-Cigarette Use Among Children and Youth: A Systematic Review
This systematic review, published in the American Journal of Preventive Medicine, aims to synthesise the evidence on the effectiveness of interventions aimed at preventing e-cigarette initiation among children and youth.

Weight Management (International)

Healthier Together: Implementation and evaluation of a co-designed, culturally tailored childhood obesity community prevention program for Māori and Pacific Islander children and families
Co-designed and culturally tailored preventive initiatives delivered in childhood have high potential to close the cross-cultural gap in health outcomes of priority populations. Māori and Pacific Islander people living in Australia exhibit a higher prevalence of overweight and obesity and higher rates of multimorbidity, including heart disease, cancer and diabetes. This mixed-methods, pilot implementation and evaluation study, published in Health Promotion Journal of Australia, aimed to evaluate the implementation of a community-based, co-designed and culturally tailored childhood obesity prevention program.

Key Ministry of Health Publications

Ngā Wānanga Pae Ora 2023 – Summary Report
This document brings together the voices, reflections and themes raised at Ngā Wānanga Pae Ora 2023, which informed the development of Pae Tū: Hauora Māori Strategy and other Pae Ora health strategies.

Ministry of Health Consultations & Events

Quarterly Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation September 2023
HealthCERT continues to support the implementation of Ngā Paerewa Health and disability services standard NZS 8134:2021 (Ngā Paerewa). As part of the implementation and transition period, HealthCERT is running a regular survey to gather feedback from all stakeholders, including service providers, health professionals, people and whānau who use these services. This survey aims to check in on how the transition is going so we can identify the most useful guidance and training to offer. This survey closes on the 31st October.

Health Sector Initiative

Transition Unit improves patient flow
A new transition unit to improve patient flow between the emergency department and wards at Taranaki Base Hospital has been hailed a resounding success. When the hospital’s new renal unit was opened earlier this year, the former renal unit was repurposed into a transition unit to help with admissions from the ED into wards, and discharges from wards back into the community. The unit has eased pressure on ED beds by creating a five-bed post-ED admission staging area until a ward bed comes free. In turn, to free up ward beds, the unit has five Lay-Z-Boy chairs for patients waiting to be picked up following being discharged from their ward.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.