The initiation and administration of drugs for advanced life support by critical care nurses in the absence of a medical practitioner

Current legislation does not permit the administration of first line resuscitation medications by suitably qualified Division 1 registered nurses (RNs) in the absence of a medical officer. This omission by the Drugs,  Poisons and Controlled Substances Act 1981 (Vic) and the Drugs, Poisons and The Controlled Substances Regulations 1995 (Vic) leaves many critical care nurses in a vulnerable legal position.

The primary aim of this study was to gauge the view of critical care nurses with respect to lobbying for change to the current legislation. In addition, the study aimed to explore and describe the educational preparation, practice perceptions and experiences of RNs working in critical care regarding cardiopulmonary resuscitation and the administration of first line advanced life support (ALS) medications in the absence of a medical officer. It was anticipated that data collected would demonstrate some of the dilemmas associated with the initiation and administration of ALS medications for practising critical care nurses and could be used to inform controlling bodies in order for them to gain an appreciation of the issues facing critical care nurses during resuscitation.

A mailout survey was sent to all members of the Victorian Branch of the Australian College of Critical Care Nurses (ACCCN). The results showed that the majority of nurses underwent an annual ALS assessment and had current ALS accreditation. Nurses indicated that they felt educationally prepared and were confident to manage cardiopulmonary resuscitation without a medical officer; indeed, the majority had done so. The differences in practice issues for metropolitan, regional and rural nurses were highlighted. There is therefore clear evidence to suggest that legislative amendments are appropriate and necessary, given the time critical nature of cardiopulmonary arrest. There was overwhelming support for ACCCN Vic. Ltd to lobby the Victorian government for changes to the law.

Best practice in a resource vacuum : responding to the accommodation needs of people with high, complex or changing support needs

This paper aims to identify current practice responses to the housing and support needs of people with high, complex or changing support needs. Case studies of current housing dilemmas and responses were provided by Annecto and Scope (Vic), and included data about the responses of other providers known to these agencies. The paper will first present case study data in three categories of accommodation: living independently (ie. living alone in self-rented or self-owned housing with or without formal support); living without a home (ie. living in non permanent or non secure housing); and living in the parental home and planning for change. The case studies are followed by a discussion of the key response strategies evident in each, and an analysis of significant ‘lessons’ for policy.

Measurement of services and supports (MOSS): project overview and findings

The Measurement of Services and Supports (MOSS) project commenced in 2005, with the initial aim of developing and trialing a tool that would evaluate the outcomes of therapy and psychology services delivered by Scope’s Therapy, Psychology and Related Services teams (previously known as Specialist Services). There are a number of key drivers that have influenced the MOSS project from its inception. These include:
• Scope’s Strategic direction;
• The State Disability Plan 2002-2012 (Victorian Department of Human Services, 2002);
• A desire to provide evidence for funding bodies relating to the effectiveness of the support
delivered by Therapy, Psychology and Related Services; and
• A desire to ensure that Therapy, Psychology and Related Services support is based on evidence.

Open for Inspection? Julstar Pty Ltd v Lynch Morgan Lawyers [2012] QDC 272

In Julstar Pty Ltd v Lynch Morgan Lawyers [2012] QDC 272 Dorney QC DCJ considered whether an applicant for an assessment of all or part of their costs under s 335 of the Legal Profession Act 2007 (Qld) (LPA) must provide grounds on which they dispute the amount of the costs charged or their liability to pay them. His Honour also made an order for inspection of the solicitor’s file, despite a claimed lien for unpaid fees.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

Algal biofuel from urban wastewater in India: Scope and challenges

Rapidly depleting stocks of fossil fuels and increasing greenhouse gas (GHG) emissions have necessitated the exploration of cost effective sustainable energy sources focussing on biofuels through algae. Abundant wastewaters generated in urban localities every day provide the nourishment to nurture algae for biofuel generation. The present communication focuses on the lipid prospects of algae grown in wastewater systems. Euglena sp., Spirogyra sp. and Phormidium sp. were collected from selected locations of sewage fed urban lakes and sewage treatment plants of Bangalore and Mysore. The total lipid content of Euglena sp. was higher (24.6%) compared to Spirogyra sp. (18.4%) followed by Phormidium sp. (8.8%) and their annual lipid yield potential was 6.52, 1.94 and 2.856 t/ha/year, respectively. These species showed higher content of fatty acids (palmitate, stearate followed by oleic and linoleic acids) with the desirable biofuel properties. (C) 2013 Elsevier Ltd. All rights reserved.