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Issue

Vol 128 No 1424: 30 October 2015

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Issue Summary

SUMMARY

The case for a systematic policy approach to free primary health care for vulnerable groups in New Zealand

Lik Loh, Siobhan Trevallyan, Steve Main, Leo Revell, Vivienne Patton, Akindele Ojo

Unmet health care needs and health inequities are prevalent in New Zealand. Throughout New Zealands history, the power dynamic between general practitioners, as a professional group, and the government has contributed to policies directed at primary-care access barriers not being fully realised. This has given third sector (non-government, non-profit) clinics a continuing role in delivering primary care services to vulnerable populations. The viability of free clinics, 18 of which were identified in our survey, is threatened by their funding and staffing structures. We contend that general practitioners have a stake in reducing health inequities and that there is a strong case for a more systematic policy approach to primary health care provision for vulnerable populations in New Zealand.

SUMMARY

Care versus convenience: Examining paracetamol overdose in New Zealand and harm reduction strategies through sale and supply

Nadia Freeman, Paul Quigley

Statistics on overdoses at Wellington Hospital Emergency Department from 2007-12, found that paracetamol is the most common form of drug poisoning. Examination for potential harm to the liver, is required if a minimum of 10 g of paracetamol is taken within eight hours. For this reason the United Kingdom has limited the sale of paracetamol to 8 g per sale (approximately 16 tablets). In New Zealand, some stores have a limit of 10 g per packet (approximately 20 tablets). But, pharmacies do not have to limit the amount sold in each packet, and there is also no limit on the amount of packets that can be purchased. This is of particular concern when considering online pharmacies, where there are few procedures in place to ensure customer safety.

SUMMARY

Reducing perioperative harm in New Zealand: the WHO Surgical Safety Checklist, briefings and debriefings, and venous thrombembolism prophylaxis

Will Perry, Ian Civil, Simon Mitchell, Carl Shuker, Alan F Merry

New Zealand appears to have a relatively high rate of perioperative adverse events. The Health Quality & Safety Commissions Safe Surgery NZ programme was introduced to address the rates of perioperative harm in New Zealand by promoting proper and effective use of the World Health Organization (WHO) Surgical Safety Checklist, and by encouraging use of operating room (OR) team briefings and debriefings. Venous thromboembolism prophylaxis is a key part of the checklist as deployed in New Zealand ORs, but it remains underused or variably used as well. Communication and teamwork are critical to improving patient safety and efficiency in the OR, and these interventions have demonstrated effectiveness in building and melding effective teams.

ALL ARTICLES
SUMMARY

The case for a systematic policy approach to free primary health care for vulnerable groups in New Zealand

Lik Loh, Siobhan Trevallyan, Steve Main, Leo Revell, Vivienne Patton, Akindele Ojo

Bullying in surgery

Catherine Ferguson

Bullying in health care settings: time for a whole-of-system response

Peter Crampton, Tim Wilkinson, Lynley Anderson, Sue Walthert, Hamish Wilson

Bilateral vertebral artery dissection in a patient with Turner Syndrome following manipulation of the cervical spine

Jonathan S Stevenson, Steven Soule, Philip Parkin, David ONeill-Kerr

Risk management and clinical practice

Graham Mellsop, Peter M Ellis, Paul Glue, Chris Gale, Roger Mulder, David B Menkes

Contract practice with friendly societies

Workplace bullying in hospitals: an unresolved problem

Steven Kelly

Screening for occult cancer in unprovoked venous thromboembolism

Care versus convenience: Examining paracetamol overdose in New Zealand and harm reduction strategies through sale and supply

Nadia Freeman, Paul Quigley

Reducing perioperative harm in New Zealand: the WHO Surgical Safety Checklist, briefings and debriefings, and venous thrombembolism prophylaxis

Will Perry, Ian Civil, Simon Mitchell, Carl Shuker, Alan F Merry

Protrusion of nasal floor

Masayuki Motohashi, Makoto Adachi, Kei Ijichi, Yasunori Muramatsu

Massive localised lymphoedema: a new benign entity in the morbidly obese patient

Jeffrey Tan, Jamish Gandhi, Sanjay Sinha, Mohammad Rafique

Bullying culture: Valuing the teacher-student relationship

Elizabeth Berryman

SUMMARY

The case for a systematic policy approach to free primary health care for vulnerable groups in New Zealand

Lik Loh, Siobhan Trevallyan, Steve Main, Leo Revell, Vivienne Patton, Akindele Ojo

Unmet health care needs and health inequities are prevalent in New Zealand. Throughout New Zealands history, the power dynamic between general practitioners, as a professional group, and the government has contributed to policies directed at primary-care access barriers not being fully realised. This has given third sector (non-government, non-profit) clinics a continuing role in delivering primary care services to vulnerable populations. The viability of free clinics, 18 of which were identified in our survey, is threatened by their funding and staffing structures. We contend that general practitioners have a stake in reducing health inequities and that there is a strong case for a more systematic policy approach to primary health care provision for vulnerable populations in New Zealand.

SUMMARY

Care versus convenience: Examining paracetamol overdose in New Zealand and harm reduction strategies through sale and supply

Nadia Freeman, Paul Quigley

Statistics on overdoses at Wellington Hospital Emergency Department from 2007-12, found that paracetamol is the most common form of drug poisoning. Examination for potential harm to the liver, is required if a minimum of 10 g of paracetamol is taken within eight hours. For this reason the United Kingdom has limited the sale of paracetamol to 8 g per sale (approximately 16 tablets). In New Zealand, some stores have a limit of 10 g per packet (approximately 20 tablets). But, pharmacies do not have to limit the amount sold in each packet, and there is also no limit on the amount of packets that can be purchased. This is of particular concern when considering online pharmacies, where there are few procedures in place to ensure customer safety.

SUMMARY

Reducing perioperative harm in New Zealand: the WHO Surgical Safety Checklist, briefings and debriefings, and venous thrombembolism prophylaxis

Will Perry, Ian Civil, Simon Mitchell, Carl Shuker, Alan F Merry

New Zealand appears to have a relatively high rate of perioperative adverse events. The Health Quality & Safety Commissions Safe Surgery NZ programme was introduced to address the rates of perioperative harm in New Zealand by promoting proper and effective use of the World Health Organization (WHO) Surgical Safety Checklist, and by encouraging use of operating room (OR) team briefings and debriefings. Venous thromboembolism prophylaxis is a key part of the checklist as deployed in New Zealand ORs, but it remains underused or variably used as well. Communication and teamwork are critical to improving patient safety and efficiency in the OR, and these interventions have demonstrated effectiveness in building and melding effective teams.

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