Judith A. McInnes

Minimising harm from heatwaves: a survey of awareness, knowledge, and practices of health professionals and care providers in Victoria, Australia

ObjectivesHeatwaves cause illness and death, and are likely to become more severe and frequent in the future. This study has investigated the awareness, knowledge and practices of health professionals and care providers regarding heatwaves and health of older clients, in order to inform harm minimisation strategies for Victoria, Australia.MethodsAn electronic survey of personnel of six health profession and care provider groups that support the health of older people living in the community was conducted in Victoria, Australia, in 2008. Descriptive statistics were derived through quantitative analysis.ResultsSurvey respondents showed a high level of awareness that heatwaves can be harmful for older people. Gaps in knowledge were identified regarding thermoregulation, risk factors, heat-related illness, and the use of fans. Few organisations had existing heatwave response plans, and responses to heatwaves were mostly reactive and opportunistic.ConclusionsDespite a broad level of understanding of the dangers of heatwaves, an opportunistic, reactive approach by health profession and carer personnel, in conjunction with gaps in knowledge, leaves older people in Victoria at risk of preventable harm from extreme hot weather.

The Effect of Printed Educational Material from the Coroner in Victoria, Australia, on Changing Aged Care Health Professional Practice: A Subscriber Survey

There are substantial knowledge and research gaps about the effects of printed educational material on professional practice. This study has examined whether the Residential Aged Care Coronial (RACC) Communiqué, an electronic newsletter of narrative case reports about lessons learned from deaths in residential aged care settings reported to the coroner in Victoria, Australia, prompted subscribers to initiate change in professional practice to improve care. An anonymous electronic survey was distributed to all registered subscribers of the RACC Communiqué to collect information about self‐reported changes in professional practice, respondent characteristics, reading behavior, and an assessment of effect and content of the publication. Researchers from the Victoria Institute of Forensic Medicine, Victoria, Australia, conducted the study in 2008. Of 778 subscribers invited to participate in the study, 426 (54.8%) provided valid responses. The majority of respondents were aged 45 and older, female, and working at a residential aged care facility in a management role. Half of the survey respondents reported making a change to their professional practice as a result of reading the RACC Communiqué, with one‐fifth of these respondents agreeing that they would not have made the self‐reported change if they had not read this publication. These findings are greater than the previously reported small effects of education through printed education material and make an important contribution to understanding the use of printed education material for initiating professional practice change.

Minimising harm to older Victorians from heatwaves: A qualitative study of the role of community‐based health profession and carer organisations

Aim:  To investigate the role of community‐based health profession and carer organisations in Victoria in minimising harm to older people from heatwaves.

Comparison of data sets for surveillance of work-related injury in Victoria, Australia

Objective To investigate differences and similarities between three sources of work-related injury information: workers compensation claims, emergency department (ED) presentation data and hospital admissions data. Methods This population-based, retrospective descriptive analysis of non-fatal, work-related injuries of workforce participants in Victoria, Australia, has compared data from workers compensation claims and ED presentation and hospital admission data sets for the period 2004–2011. Work-related injury case frequency and rate were compared across study years according to gender, age, geographical location and injury type. Injury rates were expressed as cases per million hours worked. Results Rates of hospital admissions for treatment of work-related injury increased over the study period, compared with decreasing rates of injury in compensation claims and ED data. The highest rate of injuries to younger workers was captured in ED data. There was greater capture of musculoskeletal injuries by workers’ compensation data, and of open wound and burn injury by the ED data. Broad similarities were noted for temporal trends according to gender, for the distribution of cases across older age groups and for rates of fracture injuries. Conclusions These study findings inform use of workers’ compensation, ED presentation and hospital admission data sets as sources of information for surveillance of work-related injuries in countries where these types of data are routinely collected. Choice of data source for investigation of work-related injury should take into consideration the population and injury types of interest.

Can a spatial index of heat-related vulnerability predict emergency service demand in Australian capital cities?

Purpose – The purpose of this paper is to demonstrate a spatial model of population vulnerability (VI) capable of identifying areas of high emergency service demand (ESD) during extreme heat events (EHE). Design/methodology/approach – An index of population vulnerability to EHE was developed from a literature review. Threshold temperatures for EHE were defined using local temperatures, and indicators of increased morbidity. Spearman correlations determined the strength of the relationship between the VI and morbidity during EHE. The VI was mapped providing a visual guide of risk during EHE. Future changes in population vulnerability based on future population projections (2020-2030) were mapped. Findings – The VI can be used to explain the spatial distribution of ESD during EHE. Mapping future changes in population density/demography indicated several areas currently showing high risk will continue to show increased risk. Research limitations/implications – The limitations include using outdoor temperatur...

Characteristics of an educational publication sourced from deaths investigated by the coroner that is reported to have promoted practice change.

OBJECTIVE The purpose of this study was to investigate the characteristics of the Residential Aged Care Coronial Communiqué that have promoted previously reported professional practice change, and to explore the circumstances of these changes. METHODS This was an exploratory, qualitative study for which data was collected through semi-structured interview of 15 subscribers to the Residential Aged Care Coronial Communiqué. RESULTS The Residential Aged Care Coronial Communiqué was reported to promote self-reported practice change though the inclusion of case studies, by being associated with the Coroner, and by providing evidence to justify change. The combination of existing concerns about risk and staff awareness, in conjunction with reading the Residential Aged Care Coronial Communiqué was also reported to promote practice change, as was having the support of senior staff and the authority to implement change. CONCLUSIONS The combination of narrative case studies in the context of an educational publication associated with the Coroners Office has been reported to provided evidence and incentive to promote professional practice change in an aged care setting. However the relative influence of the Residential Aged Care Coronial Communiqué, and other background circumstance and facilitating factors on practice change cannot be determined from this study.

Working in hot weather: a review of policies and guidelines to minimise the risk of harm to Australian workers

Australia has experienced a number of lethal heatwaves, and hot summers are normal for most parts of the country.1 ,2 However, while there has been a strong research and policy focus to inform and support strategies to minimise harm from hot weather to vulnerable groups at the community level,3 less attention has been paid to the safety of people while they work. Heat-related workplace fatalities have been reported in Australia,4 ,5 and deaths of people of working age occurred in Victoria during a severe heatwave in 2009.6 A study set in Adelaide found the risk of occupational heat illness during heatwave periods to be approximately seven times higher than during non-heatwave periods, over the years 2001–2010.7 Workers, especially those engaged in heavy physical activity in outdoor or non-temperature-regulated indoor locations, face challenges to their health during hot weather as heat generated by muscle activity adds to their heat burden from the environment.8 Excessive heat stress arising from working in hot weather, in conjunction with inadequate replacement of water and electrolytes lost through sweating, can lead to a spectrum of acute heat-related illnesses ranging from heat rashes, cramps and heat exhaustion, to heat stroke, a severe potentially fatal illness requiring urgent medical attention.9 Working in hot weather has also been associated with an increased risk of work-related injury and renal disease.10 ,11 Sensitivity to hot weather is increased by factors that reduce the effectiveness of thermoregulation including dehydration, older age, obesity, skin conditions that limit sweating, heavy or impermeable clothing, chronic disease, some medications, alcohol and recreational drugs.12 ,13 Conversely, acclimatisation to heat and improved fitness increase thermoregulatory efficiency.14 The capacity of individual workers and the workplace to adapt to hot weather will be influenced by workplace …

Preparation of residential aged care services for extreme hot weather in Victoria, Australia

OBJECTIVES The purpose of this study was to describe preparations for extreme hot weather at Victorian public sector residential aged care services for the 2010-11 summer, and to examine the role of the Residential Aged Care Services Heatwave Ready Resource in this process. METHOD Qualitative data was collected through semi-structured interviews of senior staff of Victorian public sector residential aged care services. Interviews were conducted at monthly intervals from November 2010 to March 2011, and data were analysed thematically. RESULTS All interviewees described pre-summer preparations for hot weather undertaken at the health services they represented. Staff awareness and experience, and having a heatwave plan, were reported to have facilitated heat preparedness, whereas challenges to preparations mainly concerned air conditioning. The Residential Aged Care Services Heatwave Ready Resource was used to inform heatwave plans, for staff and family education, and as an audit tool. CONCLUSIONS An extensive and well-considered approach to minimisation of harm from extreme heat by a sample of residential aged care services is described, and the Residential Aged Care Services Heatwave Ready Resource is reported to have supported the heatwave preparedness process.