Professor Andrew Bonney and the ISPRN team would like to congratulate Dr Lucie Stanford and Ms Dianna Fornasier on having their abstracts accepted as a poster presentation at the 2013 Primary Health Care and Research Information Service (PHCRIS). PHCRIS is a national primary health care organisation that contributes to improved health care policy and practice by increasing the exchange of information and knowledge about Australian primary health care research, evaluation and development.

Congratulations on all of your hard work!

If you would like to read Lucie and Dianna’s abstract or would like more information about the PHCRIS conference you can click here:

http://www.phcris.org.au/conference/2013/program.php

Dear ISPRN Members,

ISPRN would like to invite expressions of interest to participate in a project which will look at developing a decision aid for the treatment of major depression.

The aid will assist patients and doctors to make a shared decision regarding treatment, based on facts provided in the aid.

A decision aid in the form of a booklet will be developed which will explain all treatment options available to a patient. The aim is to then trial this decision aid in two GP focus groups & two patient focus groups.

We will be using the attached booklet as a basis framework to develop our own aid.

If you are interested in contributing to this project as part of the research team email us isprn-enquiries@uow.edu.au or phone 02 42215958.

http://decisionaid.ohri.ca/docs/develop/develop_da.pdf

Kind Regards,

Professor Andrew Bonney

Project:  Engaging general practitioners to improve health service delivery to older patients: an action-based research project

Researchers: Dr Andrew Dalley¹, Assoc. Prof Karen Charlton², Clinical Professor Jan Potter³, Dr Karen Walton², Professor Andrew Bonney^1,2, Dr George Albert¹, Dr Adam Hodgkins¹, Dr Marianna Milosavljevic³,  Mr Abhijeet Ghosh⁴ and Ms Aliza Haslinda Hamirudin²

¹Illawarra and Southern Practice Research Network, NSW
²University of Wollongong, NSW
³Illawarra Shoalhaven Local Health District, NSW
⁴Illawarra-Shoalhaven Medicare Local, NSW

This participatory research project aims to introduce change in general practice that will improve health service delivery to older adults living in the community, focusing on early identification and management of malnutrition. This project is funded by Illawarra and Health Medical Research Institute (IHMRI) Clinical Grant and consists of three phases:

Phase 1: Situational analysis and action-based research (Ethics number: HE11/232)

I am very pleased to report outcomes of Phase 1 research completed in 2012 at three general practices of the Illawarra and Southern Practice Research Network (ISPRN). The three participating general practices are Shellharbour Medical Centre, Junction Street Family Practice and Culburra Beach General Practice. Barriers to, and opportunities for the introduction of a nutrition screening tool within routine practice were investigated through individual open-ended interviews with practice nurses and general practitioners. Interviews were audio-recorded, transcribed verbatim and analysed thematically using qualitative analysis software. An observational component was also performed to identify opportunities to conduct nutrition screening within the current workflow of participating practices. Lack of time was identified as the major barrier, which was further validated by observational data. Mean consultation time was 13.9 minutes, which would prohibit additional activities within a usual 15 minute consultation. The main opportunity identified was to include a validated nutrition screening tool within the current Medicare funded Health Assessment for  adults aged 75+years (75+ HA).

Phase 1 research outcomes are as below:

1. Peer-reviewed journal publication (Australian Family Physician in May 2013)

HAMIRUDIN, A.H., CHARLTON, K., WALTON, K., BONNEY, A., ALBERT, G., HODGKINS, A., POTTER, J., MILOSAVLJEVIC, M. & DALLEY, A. 2013. ‘We are all time poor’ Is routine nutrition screening of older patients feasible? Australian Family Physician, 42,321-326

1.    Conference presentations

• Oral presentation at 16^th International Congress of Dietetics, in Sydney (5- 8 September 2012)
• Poster presentation at 36^th Nutrition Society of Australia Annual Scientific Meeting, in Wollongong (27- 30 November 2012)
• Oral presentation at the upcoming 20^th IAGG World Congress of Gerontology and Geriatrics in Seoul, South Korea (23- 27 June 2013)

Phase 2: Development of model of care to include nutrition screening and management protocols (Ethics number: HE12/381)

Phase 2 research is currently underway at the same three participating general practices, the purpose of which is:

1. To introduce a resource kit to encourage use of the validated nutrition screening instrument (MNA-SF) within the Health Assessment for older persons aged over 75 years.

2. To improve the skills of general practice staff in identification and management of nutritional risk in older patients

3. To assess the feasibility of widespread uptake of the resource kit and MNA-SF within general practice settings.

Phase 3: Implementation and pilot-testing of a novel model of nutritional care

The third and final part of this project will be to investigate patient-related outcomes associated with routine screening for malnutrition and early identification of a need for referral to services. Results of Phase 2 research will inform study design and development of Phase 3. Phase 3 research is anticipated to be completed by end of 2013.

I would like to express my deepest gratitude to Illawarra and Health Medical Research Institute (IHMRI) for the funding; Illawarra and Southern Practice Research Network (ISPRN) and general practices staff as well as our research partners; Illawarra Shoalhaven Local Health District (ISLHD) and Illawarra-Shoalhaven Medicare Local (ISML) for your valuable contribution to this project. I look forward to great outcomes for Phases 2 and 3 of this project.

– Aliza Haslinda Hamirudin

Invitation
Illawarra and Southern Practice Research Network
Research Development Conference
4 May 2013
Time: 8:45am-4.30pm
Venue: The Sebel Harbourside Kiama,
31 Shoalhaven Street, Kiama

What is the ISPRN Research Development Conference?
The ISPRN Research Development Conference is an annual event where staff of ISPRN practices have an opportunity to meet other members, present research ideas and decide as a group which projects we will support in the coming year. It also provides an opportunity to build research capacity by developing your knowledge of how to develop a research protocol as well as providing opportunities for you to network with others interested in primary care research.

Who?
Members of ISPRN including: GPs, practice nurses and practice managers, Graduate School of Medicine Clinical Academics, members of the Illawarra Shoalhaven Medicare Local (ISML) and GP Registrars/GP supervisors of the Coast City Country General Practice Training (CCCGPT).

Cost?
The Network will pay for the forum registration costs for all delegates (including meals), for two staff members from each practice.

Where?

Directions
For detailed instructions visit www.whereis.com.au and select get directions to The Sebel Harbourside (31 Shoalhaven Street, Kiama).

Parking
The Sebel Harbouside Kiama has 2 complimentary undercover car parks situated at 31 Shoalhaven Street and 2 Minnamurra Street (boom gates will remain up). There is also additional street parking located on Minnamurra and Shoalhaven Street.

If you require accommodation please contact Bridget Dijkmans-Hadley by the 24^th of April (bdh@uow.edu.au) or 42215958 and she will be able to help arrange it for you.

Hosted By
The Illawarra and Southern Practice Research Network working in partnership with the Graduate School of Medicine and the Illawarra Health and Medical Research Institute.

Call for Research Ideas
You are invited to do a brief presentation (a maximum of 5 minutes) on a research idea that you think might be a suitable ISPRN project.  The presentations will then be used for delegates to select research ideas to workshop.

Presentation Template
Here are some things for you to think about when preparing your research idea presentation:

What is the research topic of interest?
Who do you think will be involved?
How or why is it relevant to general practice?

If you have a research idea that may be suitable please email a brief summary (maximum of 300 words) to: isprn-enquiries@uow.edu.au.
The closing date for submission is 29th April 2013.

Note: CPD points will be applied for but are yet to be confirmed.

Hello everyone,

I am delighted to let you know that our Phase 2 research titled “Model of nutritional care in older adults: Assessing the feasibility of using the Mini Nutritional Assessment-Short Form (MNA-SF) in General Practice” is currently underway. Phase 2 research was developed based on results and feedback sessions of Phase 1 research (Nutrition screening of older adults in general practice settings: knowledge, attitude and practice of health professionals) which was conducted last year.

Discussion and training sessions about pathways for malnutrition screening and management in older adults have been performed in each participating general practice: Shellharbour Medical Centre, Culburra Beach General Practice and Junction Street Family Practice. Guidance on how to conduct a validated nutrition screening tool for older adults, the Mini Nutritional Assessment-Short Form (MNA-SF) and resource kit to assist general practitioners and practice nurses in identifying and managing malnutrition were provided to each participant during the sessions.

Below are photos from the sessions:

Associate Professor Karen Charlton (third from left) with Shellharbour Medical Centre staff during a discussion session. The resource kits for staff can be seen on the table in document wallets.

First session at Culburra Beach General Practice. Participants were answering multiple choice questionnaires pre discussion session.

Second session at Culburra Beach General Practice.

Participants at Junction Street Family Practice were watching a video regarding guidance on how to perform MNA-S

Each general practice was also provided with a stadiometer, tape measures and digital weighing scales for their participation in this research. The outcomes of the Phase 2 research will be evaluated at each General Practice in 3 months.

Thank you to all of those who are involved in this important research. We look forward to discussing and sharing the findings.

Regards,
Aliza Hamirudin

Dear ISPRNers,

Happy New Year to you all and wishing you all the best for 2013. Along with our usual research development activities this year, I am looking to you for your ideas about an ISPRN ‘Big Idea’. We are having great success in developing a diverse range of practice based research projects, and I don’t want this to stop. However, in looking to the future, if we are going to chase some larger grants we will also need to develop a track record or stream of research in a single topic area. Basically, for larger long term grants, funders want to see that you have ‘produced’ in a given area and developed expertise and novel ideas. ISPRN has been successful because we all know that the kind of research GPs get enthused about is research that helps us solve the important day-to-day problems we face. So, I’d really appreciate your thoughts on a Big Idea. What do you think we could start small with and build on? What enthuses us as a group? What are problems that we all face that we would like to tackle as a group? This won’t stop our individual researcher driven projects but would tick away in the background over time. I’d be most appreciative of your thoughts – please post a blog and lets us all know!

Best wishes

Andrew Bonney

Phase 1 of this research which aimed to identify perceived barriers and opportunities to implementing nutrition screening of older adults in general practice has been completed. Feedback sessions regarding results of the research are ongoing at the moment in the participating general practices. A summary will be shared via the blog soon. Here are some photos from one of the feedback sessions.

Dr. Karen Walton, Professor Andrew Bonney and I

Dr. Karen Walton and I in front of one of the participating general practices

Phase 2 of the research is currently being discussed with the collaborators and will aim to assess the feasibility of conducting nutrition screening in general practice settings.

Regards,

Aliza Hamirudin

Nutrition screening of older adults in general practice settings: knowledge, attitude and practice of health professionals Aliza Hamirudin (PhD Candidate) has now completed the data collection for Phase one of this IHMRI funded study. She conducted in-depth interviews with a total of 27 staff at three general practices – Shellharbour Medical Centre, Culburra Beach General Practice and Junction Street Family Practice. Thank you to all who were involved in the planning and conduct of this important study.

Analysis of the typed interview transcripts is in progress. While time has been identified as a major barrier by both doctors and practice nurses, there appears to be widespread support for the incorporation of nutrition screening instruments into the annual Medicare-funded 75+ health assessment. More than half of the participants said they would like to receive training on how to conduct nutrition screening in a systematic way. An ethics application is currently being developed for Phase two, which aims to assess the impact of a short training session and a resource kit in these general practice settings.

Regards,

Karen Walton

I am happy to report that this study is now well underway. Aliza began interviews at the Shellharbour Medical Centre in mid March and she visited Culburra Beach General Practice last week; where she also conducted interviews with practice staff. I have attached some smiling faces from Culburra Beach.

Aliza with Professor Andrew Bonney

After Easter Aliza will be visiting the Junction Street Family Practice to complete her interviews with the General Practice staff there. Much of her time will then be spent analysing the interviews and discussing the results with the co-researchers, before sharing the findings with each Practice.

Best wishes to all for the Easter break,

Karen Walton

Hello,
My name is Dr Karen Walton.
Today I write to introduce a new research study that involves collaboration between the Illawarra Health and Medical Research Institute (IHMRI), the Illawarra Shoalhaven Medicare Local and the University of Wollongong. The study is titled, ‘Engaging General Practitioners to improve health service delivery to older patients: an action-based research project’.

This study is funded by IHMRI and has three phases. The first phase involves a qualitative, exploratory study to better understand the context that general practice staff work within and to identify barriers and opportunities to nutrition screening in older patients. Recruitment of General Practice staff members is currently underway at the three General Practice settings involved in this first phase of the study.

The research team includes: Dr Andrew Dalley, Associate Professor Karen Charlton, Professor Jan Potter, Dr Karen Walton, Mariana Milosavljevic, Dr George Albert, Dr Adam Hodgkins, Dr Andrew Bonney and Aliza Hamirudin.

Regular updates will be provided once the exploratory interviews have started.

Three members of the research team –Dr Karen Walton, Aliza Hamirudin (Dietitian & PhD student) and A/Prof. Karen Charlton