Zero tolerance to violence in health care
The statistics say it all: one Australian health worker is murdered each year and many are verbally abused, assaulted or bullied. In one ED, a nurse was threatened with a knife and a registrar kicked in the throat, in separate incidents recounted in one of several articles on violence in health care. Its author describes violence in the ED as reaching epidemic levels, and examines the reasons for this, with the strategies emerging to curb it (Kennedy, “Violence in emergency departments: under-reported, unconstrained, and unconscionable”).
GPs are no strangers to occupational violence either, say Magin and colleagues : nearly two out of three GPs in their survey had experienced violence in the past year (→ Experiences of occupational violence in Australian urban general practice: a cross-sectional study of GPs).
To increase our understanding of the factors contributing to violence in health care, Benveniste and colleagues present data on violent incidents gathered by the Australian Incident Monitoring System (→ Violence in health care: the contribution of the Australian Patient Safety Foundation to incident monitoring and analysis).
How do we deal with the conflicting tensions of a duty of care to patients and the right to a safe workplace? Staff at one Melbourne hospital show the way, illustrating with case vignettes the strategies they devised (Forster et al, “kNOw workplace violence: developing programs for managing the risk of aggression in the health care setting”).
Mayhew and Chappell’s editorial points out that all strategies to curb workplace violence should be multifaceted and organisation-wide. They also encourage health workers to consider the full range of strategies including those that have been evaluated in other industries (→ Violence in the workplace).
Rattling bones and governments
New therapies such as autologous stem cell transplantation and targeted therapies (including thalidomide) have improved the outlook for myeloma, as described in Joshua’s editorial (→ Multiple myeloma: the present and the future).
Mandatory fortification of flour with folate has been of clear benefit overseas. So why aren’t we doing it here, ask Maberly and Stanley (→ Mandatory fortification of flour with folic acid: an overdue public health opportunity).
Getting down and dirty with the NHMRC
The NHMRC gets an extreme makeover in this issue. Its critics have described it as “arthritically conservative” and bloated by bureaucracy, a 21st century anachronism. Van Der Weyden casts his eye over these accusations in an editorial. His verdict? This body needs to shed weight. Meet the new (imaginary) national health and medical research dynamo, svelte and toned, in “Modernising the National Health and Medical Research Council”.
Hospital tasks go hi-tech
Patients who forget their hospital outpatient appointments are one reason for long clinic waiting lists. Downer and colleagues decided to capitalise on our enthusiastic adoption of the mobile phone to see if sending patients SMS text message reminders would improve outpatient attendance (→ Use of SMS text messaging to improve outpatient attendance).
A letter in this issue describes another innovative use of SMS, with automated notification of the Eye Bank of South Australia of potential corneal donors (Herriot, “Automated SMS notification to facilitate the retrieval of donated corneas”).
Something else that could often function better is the handover between junior doctors going off-duty and staff relieving them. A Victorian hospital developed an electronic handover system for its junior surgical staff, described by Cheah and colleagues in "Electronic medical handover: towards safer medical care".
Medical abortion
Worldwide, millions of women each year seek to terminate unwanted pregnancies through unsafe means. Thousands die in the attempt. This recently prompted the WHO to add mifepristone and misoprostol (known in combination as the abortion pill, RU-486) to its list of essential medicines for developing countries. Although surgical abortion is readily available in Australia, De Costa argues that there are good reasons to make this safe and effective means of abortion available here (→ Medical abortion for Australian women: it’s time).
MJA takes up national obsession
A new MJA Practice Essentials series on Sports Medicine blasts off the blocks in this issue. In “Sport and exercise medicine in Australia”, Series Editors-cum-coaches Orchard and Brukner give us the rationale for the series we had to have, with a focus on the new, the controversial, and the practical.
Paoloni and Orchard kick off the main events with an evidence-based review of what works and what doesn’t among the medications used to treat sports injuries. NSAIDS take a seat in the reserves, while some new drugs (or innovatively used old ones) may shoulder their way into the team (→ 1. The use of therapeutic medications for soft-tissue injuries in sports medicine).
Sweet statement
The Australasian Diabetes in Pregnancy Society has released consensus guidelines for managing diabetes in pregnancy. Its summary appears in “The Australasian Diabetes in Pregnancy Society consensus guidelines for the management of type 1 and type 2 diabetes in relation to pregnancy” and covers type 1 and type 2 diabetes, as well as the gamut of management from preconception through to post-partum stages.
Another time ... another place
Rapid and simple abortion referral must be readily available through state and local public health departments, medical societies, or other non-profit organizations.
American Public Health Association, 1970