AQUA abstracts

This year's AQUA (Annual Queenstown Update in Anaesthesia, 18-20 August) offered the usual high quality, diverse range of clinically focused updates. The international guest speaker was Associate Professor Bernhard Riedel from the Peter MacCallum Cancer Centre in Melbourne. He spoke about understanding the impact of anaesthesia on long-term outcomes following cancer surgery, preoperative risk stratification and preoperative optimisation through prehabilitation. Other speaker topics included intensive care, updates in advance life support, orthopaedic surgery and services, and procedual pain management. The abstracts from AQUA are on the AQUA Home Page of the website and can be found under the Resources tab.

President's blog

The future role, leadership and value potential of our specialty were brilliantly showcased by speakers at this year's AQUA, writes NZSA President Dr David Kibblewhite. In his latest blog he says that the focus needs to be on both immediate and long-term perioperative outcomes. "In essence, what we do is probably more important long-term than we currently recognise...This is great news in terms of enhancing our value proposition." He expands on the talk presented on cancer surgery by Associate Professor Bernard Riedel of the Peter McCaw Cancer Centre in Melbourne. Read more here

NZSA medico-legal forum at AQUA

The NZSA hosted a medico-legal focused forum at AQUA, following on from the successful Auckland forum. Barrister Hanne Janes spoke about the Commerce Act and how it may affect the structure and functioning of private practices. She provided excellent advice on how to ensure compliance with the Act. NZSA Executive member Kaye Ottaway presented on Health and Safety legislation which she said applied to all anaesthetists, whether working in public or private. She encouraged members to access the NZSA's Health and Safety manual which had been developed to provide members with all the resources needed to comply with the legislation, including tutorials, a risk register specifically for anaesthetists, and forms. 

You can download your copy today by using your member login for the NZSA website. The resource is under the Resources tab on the Home page or can be found on the revolving banner, also on our Home page.

WFSA Innovation Awards

Congratulations to New Zealand's Dr John Hyndman and Dr Ivan Batistich who received the WFSA Innovation Award for their HYVAN Compact Anaesthesia machine.

The HYVAN is designed for use in developing countries where there is reliable electricity and access to volatile agents and soda lime. It is affordable, reliable, simple and able to be maintained by internal hospital workshops.

"Our  intention  is  not  to  make  money  but  rather  to  provide  a  cheap,  ultra-reliable  anaesthetic machine,” Hyndman said. “The WFSA award has given us the confidence to commission the manufacture of 50 HYVAN's in New Zealand. We are grateful to the WFSA. This award will make all the difference to the project’s success.”

The award, one of six innovation awards given, was presented at the World Federation of Anaesthesiologist's annual World Congress in Hong Kong. The HYVAN is being displayed at the NZSA's booth at the Congress. See our Twitter page here.

NZSA Immediate Past President and NZSA CEO Renu Borst are attending the Congress and we will provide members with an update of Congress meetings and events in the next E-zine.

Burnout rife among senior doctors

Burnout is rife among senior doctors in New Zealand’s public hospitals and higher than that found in comparable international studies, said the Association of Salaried Medical Specialists (ASMS), with half of all senior doctors and dentists surveyed reporting symptoms of burnout.

Key survey findings include:

- Half of hospital specialists reported symptoms of burnout, i.e, high levels of fatigue and exhaustion.
- 42.1% said this was due to their work, and they cited frustrations with management, intense and unrelenting workloads, under-staffing, and onerous on-call duties.
- 15.7% attributed their burnout to their interactions with patients.
- Three out of five female specialists (59.4%) were likely to be experiencing burnout, compared with 43.9% of male specialists.
- Burnout was even more prevalent among female doctors aged between 30 and 39, with 7 out of 10 (70.5%) experiencing burnout. More than half (51.1%) attributed this to their work.
- Some medical specialties reported higher levels of burnout than others – in particular, emergency medicine and psychiatry.

The full report can be read here.

ASMS has written to DHBs to alert them to the survey and remind them of their obligations under the Health and Safety at Work Act 2015. They have also asked to meet DHBs to  urgently address the causes of burnout including staffing levels, hours of work and poor resourcing. ASMS says further research is needed to look at the extent to which burnout affects patient care and influences other workforce trends, such as retirement intentions.

BWT Ritchie Scholarship

The BWT Ritchie Scholarship provides financial assistance to New Zealand-based anaesthesia trainees who have passed the final examination for fellowship of ANZCA and are eligible to proceed to training year 5, to gain overseas experience and bring it back to New Zealand. It is also open to those who wish to undertake a further year of study outside New Zealand in the year following completion of their ANZCA fellowship (FANZCA); and to anaesthetists with FANZCA who are also training in pain medicine or intensive care medicine and who have reached a similar stage for those fellowships. Applicants must be nominated and supported by their training departments. The scholarship fund available for disbursement is up to $15,000 per year.

Applications close 31 October 2016. To find out more about the scholarship and how to apply, please go to the BWT Ritchie page of the NZAEC website.

Getting smart with smartphones

When—and when not—to use a phone camera during a patient’s treatment is at the heart of a new publication Clinical images and the use of personal mobile devices. It outlines the primary ethical and legal issues clinicians need to be aware of when using mobile devices to take or transmit clinical images to help with clinical care. This resource has been developed by the New Zealand Medical Association (NZMA) and the New Zealand Private Surgical Hospitals Association (NZPSHA). NZPSHA says that it recognises the value of using mobile devices in clinical settings but that clinical images must be treated with the same privacy and confidentiality as any other health record. NZMA Chair Dr Stephen Child says that it's a great bonus for patient care, and a natural evolution of the doctor/patient relationship, "but care must always be taken to ensure appropriate use. This guide can help ensure responsible use and we look forward to sharing it, particularly with students and young doctors, who have grown up using this technology every day and are keen to use it to help them in their work life.”

NZSA Forum presentations

A reminder to members that some of the presentations delivered at the NZSA's Auckland forum on 30 July to update members on issues relevant to their practice are on our website. (You will find presentations under the Education and Events tab on the Home Page; please log in first as these are only viewable to NZSA members). This includes the medico-legal presentation by Barrister Hanne Janes who spoke about the Commerce Act and how it may affect the structure and functioning of your practice. This presentation was also delivered at the NZSA's medico-legal session held at this year's AQUA.

Widened prescribing rights for nurses

New regulations will take effect from 20 September enabling qualified and approved designated registered nurses to prescribe from a specified list of medicines used to treat certain common and long-term conditions. Nurses who prescribe must be qualified, approved by the Nursing Council, working in collaborative primary or specialty teams, and able to consult a medical practitioner or nurse practitioner when they need advice on diagnosis or treatment.

Health Minister Dr Jonathan Coleman says:"This has the potential to deliver faster care, reduce double handling and improve access to medicines."

Nurse prescribing will take place within an organisation with well-established clinical governance structures such as a District Health Board or a Primary Health Organisation. These organisations are responsible for providing support through nominating a senior clinician who co-ordinates the introduction of registered nurse prescribing and provides links to committees that oversee quality and risk and medicines review.

The New Zealand Nursing Council will be responsible for ensuring nurses meet the required education and competence standards before they can become designated prescribers. Guidance material for registered nurses and their employers has been developed by the Nursing Council. Read here: Preparing to prescribe in primary health and specialty teams: Guidance for registered nurses and employers

Vacancies

The NZSA regularly posts vacancies on its website, for positions in New Zealand and overseas. 

In the Media

Vexing question on patient surveys - United States
As the United States struggles to control the epidemic of overdoses and deaths from prescription opioids, many medical professionals are challenging the wisdom of asking patients to rate how hospital employees manage pain. They argue that this creates a dangerous incentive for doctors to prescribe powerful and potentially addictive painkillers to avoid poor satisfaction scores from patients. In a culture increasingly influenced by consumer ratings, doctors say that these questions pressure them to substitute what a patient wants rather than their judgment about what the patient needs. Scores on inpatient surveys are also tied to the hospitals' medicare reimbursement. Read more in the New York Times. 

Attention: Supervisors of training and advanced trainees

Please be aware that the Part 3 registrations are open with limited capacity. The Part 3 one-day course on 19 November is designed for advanced trainees and will feature workshops, small group discussions and interactive presentations.

Kathryn Hagen (NZSA Incoming President and Vice President) who attended the inaugural Part 3 course held at Ko Awatea in 2011 says: "It was a great opportunity to meet other trainees without the stresses of the exams hanging over us. What I particularly liked about it was the chance to ask questions and get information about what life after training is like- a chance to see the different directions a FANZCA can take you and also some tips on how to acquire that sought after consultant position.  If you are post Part 2 and now have the head space to think and plan for the future, I highly recommend the meeting."

Part 3 will take place at the Waipuna Hotel in Auckland. Places are limited to 24 to ensure participants gain optimal value. To view the programme and to register please visit our Part 3 web page. You can also check out bios of course speakers and facilitators. The NZSA is now hosting the Part 3 course, which was previously run by NZSA and the New Zealand National Committee of ANZCA.

NZ Anaesthesia Visiting Lectureship

Nominations for the 2017 New Zealand Anaesthesia Visiting Lectureship are open. Heads of departments and practices are invited to nominate a member of their staff who has given an outstanding presentation at a CME session. Nominees should be an anaesthetist who will give a stimulating, informative and well delivered presentation to their colleagues and be willing to travel to two other centres in New Zealand during 2017 to give their lectures.

Dr Sabine Pecher, one of this year's recipients of the Lectureship, says that there was a great turnout with anaesthetists attending, as well as many other theatre staff. "I highly recommend to anyone with a great talk to apply to NZAEC - this is a fantastic opportunity to connect to colleagues in rural settings and to spread your knowledge."

Nominations close on 30 September 2016. The Lectureship was established in 2008 by the New Zealand Anaesthesia Education Committee to promote the sharing of knowledge and experience through outstanding presentations amongst anaesthetic departments and practices.

More information about the programme, including a downloadable nomination form or expression of interest form for regional centres interested in hosting a NZA visiting lecturer in 2017, can be found on the NZAEC website.  

ACE News

The Anaesthesia Continuing Education Co-ordinating Committee (ACE) encourages members convening conferences, workshops or meetings which assist ongoing CPD requirements, to add their event to the ACE website.  The parent groups, NZSA, ANZCA and ASA, host the site as part of the tripartite committee. Learn more about the many CPD opportunities available on the website 

Events on NZSA website

The NZSA website lists New Zealand and overseas events. Below is a selection of events:

62nd Annual Update in Anaesthesia
University of Utah, Department of Anesthesiology
February 12-17, 2017
Park City, Utah  @ the Grand Summit – Canyons Village
Website: www.medicine.utah.edu/anesthesiology/postgrad

Contact information:
Course Coordinator – Chris Haber
Chris.haber@hsc.utah.edu

Introduction to Anaesthesia (NOVICE) Course
This course is ideally suited for Resident Medical Officers just starting their training in Anaesthesia. Course content includes Airway Assessment, Anaesthetic Pharmacology, Pre-assessment, Hypotension, Ischemia and Hypoxia and Crisis Management, taught through a combination of didactic sessions with presentations and simulation scenarios.

Course date: 19 - 20 December 2016
Time:  8.30am – 5.00pm.
Location: Capital & Coast DHB, Wellington Hospital, Riddiford Street, Newtown, Wellington, The Simulation & Skills Centre, Level 9, Clinical Services Block

More information: NOVICE Course flyer 2016

MSD (Advertising)

Merck Sharp & Dohme (NZ) Ltd (MSD) was established in New Zealand in 1962 and is a wholly owned subsidiary of Merck & Co. Inc. MSD New Zealand supplies pharmaceuticals and vaccines for New Zealand patients across a wide number of therapeutic areas, including; oncology, cardiovascular, musculoskeletal, women's health, fertility, HIV/AIDS, antibacterials/antifungals and immunisations.

MSD is one of the few companies still conducting clinical trials in New Zealand. Current research programmes include oncology (melanoma, lung, gastric, bladder, breast and haematological cancers) diabetes, atherosclerosis, osteoporosis, HIV, alzheimer’s and hepatitis C. Merck & Co. Inc, invests $USD 7Bn per annum in R&D for new medicines.