FOCUS Indigenous health

NURSE PRACTITIONERS
COULD SIGNIFICANTLY
IMPROVE INDIGENOUS
HEALTH OUTCOMES
Discover your Personal
and Professional Potential
in Canberra with Mental
Health, Justice Health, and
Alcohol & Drug Services
(MHJHADS)
Are you a Registered Nurse, Social
Worker, Occupational Therapist,
Psychologist or Medical Officer? Do you
have a specialist range of skills in the
areas of Mental Health, Justice Health or
Alcohol or Drug Services?
If you have answered yes to the questions
above then we want to hear from you as
we are recruiting now.
Do you know that Canberra is not rated
as the Number 1 City in the world to live?
The Canberra community has diverse
culture and a population of 379,000
people with all the amenities of a city but
without the stress.
Now for a little about us; the ACT Health
Division of Mental Health, Justice Health
and Alcohol & Drug Services (MHJHADS)
delivers a broad range of acute and
community services delivered through
partnerships with community and other
government organisations. There is
a major focus on Consumer & Carer
participation in all aspects of service
planning and delivery. Our innovative
Models of Care have been developed
utilising a population health framework
and are informed through extensive
consultation, and designed to embrace
best evidence practice to meet National
Standards and the principles of Person
Centred Care.
The range of specialises services includes
programs in the following areas;
Child & Adolescent Mental Health
Services (CAMHS)
ACT Wide Services
Adult Mental Health Services
Justice Health Services
Alcohol & Drug Services
For more information, please go to
www.health.act.gov.au and click on:
Employment Current vacancies Contact
Officer: Maret Rebane
PH: (02) 6207 6279
E: maret.rebane@act.gov.au
www.health.act.gov.au
For more information visit
http://www.canberrayourfuture.com.au

38March 2016 Volume 23, No. 8

By Rosemary Harbridge
A nurse practitioner role could significantly improve outcomes
in the prevention and management of acute rheumatic
fever (ARF) and rheumatic heart disease (RHD), according
to RHDAustralias Framework for a nurse practitioner role in
acute rheumatic fever and rheumatic heart disease (2015).
The framework recommends a scope of practice for a nurse practitioner
(NP) within the current model of service, and presents a case for a NP in
building the capacity of the health service to provide a more systematic,
timely and coordinated approach to addressing service gaps
(www.rhdaustralia.org.au/professional-development/nursepractitioner-framework).
RHD is a significant health issue in Australia, affecting predominantly
Aboriginal and Torres Strait Islander people living in remote and rural areas.
For Indigenous people living in these areas, remoteness, transient population,
poor living and education standards, high health practitioner turnover, and
limited knowledge of the disease all contribute to delays and deficiencies in
health service delivery and, ultimately, to the burden of disease.
ARF is a generalised inflammatory illness caused by a group A
streptococcus (GAS) bacterial infection of the throat or possibly the skin. It
affects specific parts of the body including the heart, joints, brain and skin.
If the heart is involved, there can be persisting heart valve damage, leading
to RHD. Recurrent ARF may cause further valve damage, and worsening
of RHD. Primary and secondary prevention of ARF episodes is therefore
a priority. Recurrences can be prevented by providing regular and timely
antibiotics usually in the form of benzathine penicillin G (BPG) injections
every 28 days. Adherence rates, however, are commonly poor, leaving many
patients vulnerable to repeat episodes of ARF, and potential development
of RHD. RHD typically requires complex long-term care including regular
medical specialist review, echocardiograms and blood tests, and heart
failure medication. The highest rate of ARF is found in children aged 5-14
years, and the highest rate of RHD is found in adults aged 35-39.
The areas where the service system falls down along the RHD care pathway
are well known. Delays and gaps in service are commonly experienced
in initial identification, assessment and initiation of treatment, diagnostic
investigations and review of results, initiation, review, titration and
cessation of medication, and follow up of patients.
Many practitioners are not experienced in working in Aboriginal and Torres
Strait Islander communities and may never have seen a case of ARF. It is
not taught in some medical and nursing courses - perhaps because it is
commonly (and wrongly) thought to have disappeared in the Australian
healthcare setting. This can lead to misdiagnosis and/or missed diagnosis.
A NP would play a role in education and support for the RHD team, as
well as providing an autonomous, advanced and extended clinical nursing
role. A NP could identify and respond to healthcare needs more flexibly
than the existing nursing workforce, thus addressing the issues and gaps
in services outlined above, streamlining the patient journey between acute
and primary healthcare services, and enhancing health outcomes.
A NP could also contribute to cost savings in terms of reduction in medical
practitioner workload, the need for hospitalisation, and specialist and
surgical input. To learn more about ARF and RHD, and to access a copy of
the NP Framework and The Australian guideline for prevention, diagnosis
and management of acute rheumatic fever and rheumatic heart disease.
(RHDAustralia, 2012) visit the RHDAustralia website: www.rhdaustralia.
org.au/ For further information contact: Rosemary Harbridge (Project
Officer) RHDAustralia rosemary.harbridge@menzies.edu.au

Rosemary
Harbridge is
Project Officer
at RHDAustralia
anmf.org.au

Copyright of Australian Nursing & Midwifery Journal is the property of Australian Nursing
& Midwifery Federation and its content may not be copied or emailed to multiple sites or
posted to a listserv without the copyright holder's express written permission. However, users
may print, download, or email articles for individual use.