Review of the cultural safety of a national Indigenous point-of-care testing program for diabetes management

2016 ◽  
Vol 22 (4) ◽  
pp. 368 ◽  
Author(s):  
Mark Shephard ◽  
Christopher O'Brien ◽  
Anthony Burgoyne ◽  
Jody Croft ◽  
Trevor Garlett ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Diabetes Management ◽  
Health Workers ◽  
Point Of Care ◽  
Cultural Safety ◽  
Medical Services ◽  
Indigenous Australians ◽  
Point Of Care Testing ◽  
Group Setting ◽  
Torres Strait

In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible ‘one-stop’ pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.

scholarly journals Results From 16 Years of Quality Surveillance of Urine Albumin to Creatinine Ratio Testing for a National Indigenous Point-of-Care Testing Program

2020 ◽  
Vol 144 (10) ◽  
pp. 1199-1203
Author(s):  
Tamika Regnier ◽  
Mark Shephard ◽  
Anne Shephard ◽  
Peter Graham ◽  
Rizzi DeLeon ◽  
...  
Keyword(s):  
Quality Control ◽  
Quality Assurance ◽  
Torres Strait Islander ◽  
Point Of Care ◽  
Medical Services ◽  
Indigenous Australians ◽  
Creatinine Ratio ◽  
Point Of Care Testing ◽  
Testing Program ◽  
Urine Albumin

Context.— The burden of chronic kidney disease in Indigenous Australians is 7.3 times higher than that of non–Indigenous Australians. If chronic kidney disease is detected early and managed, deterioration in kidney function can be reduced. Urine albumin to creatinine ratio is a key marker of early renal damage. Objective.— To report on 16 years of analytic quality of urine albumin to creatinine ratio testing on Siemens DCA devices enrolled in the national Quality Assurance for Aboriginal and Torres Strait Islander Medical Services point-of-care testing program. Design.— Quality Assurance for Aboriginal and Torres Strait Islander Medical Services participants are required to test 2 quality assurance samples each month across two 6-monthly testing cycles per year. Participants also test 2 quality control samples monthly. Results.— The percentage of urine albumin, creatinine, and albumin to creatinine ratio results for quality assurance point-of-care testing that were within assigned allowable limits of performance averaged 96.9%, 95.9%, and 97.5%, respectively. The percentage acceptable quality control results for urine albumin and creatinine averaged 93.5% and 86.8%. The median imprecision for urine albumin, creatinine, and albumin to creatinine ratio quality assurance testing averaged 5.5%, 4.1%, and 3.3%, respectively, and the median within-site imprecision for quality control testing averaged 5.4%, 4.3%, and 5.7%, respectively, for the low sample and 4.0%, 4.1%, and 4.5%, respectively, for the high sample. Conclusions.— For 16 years the DCA system has proven to be reliable and robust and operators at Aboriginal medical services have demonstrated they are able to conduct point-of-care testing for urine albumin to creatinine ratio that consistently meets analytic performance standards.

An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in indigenous medical services and has international application

2005 ◽  
Vol 42 (3) ◽  
pp. 208-215 ◽  
Author(s):  
MDS Shephard ◽  
JP Gill
Keyword(s):  
Quality Assurance ◽  
Indigenous People ◽  
Diabetes Management ◽  
Health Workers ◽  
Point Of Care ◽  
Participation Rate ◽  
Aboriginal Health ◽  
Indigenous Communities ◽  
Medical Services ◽  
Wide Range

Background: Type 2 diabetes is the leading cause of end-stage renal failure in Australia's indigenous people. The measurement of urine albumin:creatinine ratio (ACR) as a marker for early renal disease is an important component of the management of indigenous patients with diabetes. Methods: An innovative national program (Quality Assurance for Aboriginal Medical Services [QAAMS]) for point-of-care (POC) urine ACR testing on the DCA 2000 analyser (Bayer Diagnostics) was established to monitor microalbuminuria in indigenous people with diabetes in 30 Aboriginal and Torres Strait Islander medical services across Australia. Aboriginal health workers perform the ACR test. The QAAMS model provides ongoing education and training, an annual workshop, monthly quality assurance testing and a telephone help hotline. Quality assurance testing is conducted using paired, linearly related samples with a wide range of ACR concentrations (1-25 mg/mmol). Results: The average participation rate across four six-monthly QAAMS ACR testing cycles was 83%. In all, 94% of 1163 quality assurance tests performed were within the preset limits of acceptability. The median precision (coefficient of variation percent for ACR quality assurance testing averaged 5.4%, well within desirable performance specifications. Between-site accuracy was excellent. Conclusion: This unique POC model for supporting diabetes management is the first of its type to be developed for indigenous communities and has considerable potential to be adopted worldwide.

scholarly journals Scaling up sexually transmissible infections point-of-care testing in remote Aboriginal and Torres Strait Islander communities: healthcare workers’ perceptions of the barriers and facilitators

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Lise Lafferty ◽  
Kirsty Smith ◽  
Louise Causer ◽  
Kelly Andrewartha ◽  
David Whiley ◽  
...  
Keyword(s):  
Health Services ◽  
Patient Engagement ◽  
Healthcare Workers ◽  
Torres Strait Islander ◽  
Point Of Care ◽  
Scaling Up ◽  
Point Of Care Testing ◽  
Sti Testing ◽  
Sexually Transmissible Infections ◽  
Torres Strait

Abstract Background Sexually transmissible infections (STIs), such as gonorrhoea and chlamydia, are highly prevalent, particularly in remote Aboriginal and Torres Strait Islander communities in Australia. In these settings, due to distance to centralised laboratories, the return of laboratory test results can take a week or longer, and many young people do not receive treatment, or it is considerably delayed. Point-of-care testing (POCT) provides an opportunity for same day diagnosis and treatment. Molecular POC testing for STIs was available at 31 regional or remote primary health care clinic sites through the Test-Treat-And-GO (TANGO2) program. This qualitative study sought to identify barriers and facilitators to further scaling up STI POCT in remote Aboriginal communities within Australia. Methods A total of 15 healthcare workers (including nurses and Aboriginal health practitioners) and five managers (including clinic coordinators and practice managers) were recruited from remote health services involved in the TTANGO2 program to participate in semi-structured in-depth interviews. Health services’ clinics were purposively selected to include those with high or low STI POCT uptake. Personnel participants were selected via a hybrid approach including nomination by clinic managers and purposive sampling to include those in roles relevant to STI testing and treatment and those who had received TTANGO2 training for POCT technology. Milat’s scaling up guide informed the coding framework and analysis. Results Acceptability of STI POCT technology among healthcare workers and managers was predominantly influenced by self-efficacy and perceived effectiveness of POCT technology as well as perceptions of additional workload burden associated with POCT. Barriers to integration of STI POCT included retention of trained staff to conduct POCT. Patient reach (including strategies for patient engagement) was broadly considered an enabler for STI testing scale up using POCT technology. Conclusions Remote healthcare clinics should be supported by both program and clinic management throughout scaling up efforts to ensure broad acceptability of STI POCT as well as addressing local health systems’ issues and identifying and enhancing opportunities for patient engagement.

scholarly journals Release of the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
James M. Gerrard ◽  
Shirley Godwin ◽  
Vivienne Chuter ◽  
Shannon E. Munteanu ◽  
Matthew West ◽  
...  
Keyword(s):  
Health Outcomes ◽  
First Nations ◽  
Torres Strait Islander ◽  
Collective Responsibility ◽  
Cultural Safety ◽  
Main Body ◽  
Torres Strait ◽  
The Impact ◽  
Torres Strait Islander Health ◽  
Safety Strategy

Abstract Background Developing since colonisation, Australia’s healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting ‘very old’ First Nations Peoples being ‘far more happier than we Europeans’ and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates’ observation of First Nations Peoples living ‘into their eighties’ and having a higher life expectancy than Europeans; our healthcare system’s shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. Main body In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020–2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. Conclusion Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.

scholarly journals A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy

2021 ◽  
Vol 18 (15) ◽  
pp. 8061
Author(s):  
Ariana Kong ◽  
Michelle Dickson ◽  
Lucie Ramjan ◽  
Mariana S. Sousa ◽  
Joanne Goulding ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Care Providers ◽  
Torres Strait Islander ◽  
Health Workers ◽  
Healthcare Providers ◽  
Aboriginal Health ◽  
Health Staff ◽  
Care Providers ◽  
Aboriginal Women ◽  
Torres Strait

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.

scholarly journals Impact of racism and discrimination on the physical and mental health among Aboriginal and Torres Strait Islander peoples living in Australia: a protocol for a scoping review

2020 ◽  
Author(s):  
Camila A Kairuz ◽  
Lisa M Casanelia ◽  
Keziah Bennett-Brook ◽  
Julieann Coombes ◽  
Uday Narayan Yadav
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Torres Strait Islander ◽  
Health Interventions ◽  
Indigenous Australians ◽  
Physical And Mental Health ◽  
Future Health ◽  
Design Data ◽  
Global Trends ◽  
Torres Strait

Abstract Background Racism is increasingly recognised internationally as a key factor contributing to health disparities. A comprehensive body of strong research from international authors has reported negative associations between racism and health outcomes. In Australia, although the literature is more limited, available findings follow global trends. Australia has an identified health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians, and despite efforts to bridge this gap, health inequities continue to exist. This scoping review aims to assess, analyse and synthesise the relationship between racism and discrimination on the physical and mental health of Aboriginal and Torres Strait Islander peoples living in Australia.Method This is the study protocol for a scoping review. A systematic search will be conducted using five electronic databases: PubMed, CINAHL, Embase, Web of Science and the Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research. The database search will include studies published between 2000 and 2020. Reference lists of the included articles will be searched. Outcome measures will include physical and mental health components including chronic conditions, depression and anxiety, psychological distress, social and emotional difficulties, suicide and health-related outcomes such as wellbeing and life satisfaction. Duplications will be removed, and titles and abstracts will be reviewed to select studies. Full-text screening of preselected studies will be performed by four reviewers independently, to select studies according to inclusion criteria. Included studies will be appraised for quality using appropriate tools tailored for each study design. Data will be extracted, and study findings and characteristics synthesised in a narrative summary. Discussion Our scoping review will synthesise the evidence on the impacts of racism and discrimination in relation to the physical and mental health of Aboriginal and Torres Strait Islander peoples living in Australia. These findings could guide future health interventions by addressing the exposure of racism and racial discrimination in order to reduce health disparity. It is anticipated the findings to be of interest to policymakers, researchers, Aboriginal and Torres Strait Islander communities and community health organisations and other stakeholders interested in optimising public health interventions for and in partnership with Aboriginal and Strait Torres Islander communities of Australia. Scoping review registration The protocol for this review has been registered on the International prospective register of systematic reviews (PROSPERO). The registration ID is CRD42020186193.

What's in a Name?: Exploring the Implications of Eurocentric (Re)naming Practices of Aboriginal and Torres Strait Islander Nomenclature in Australian Education Practices

2016 ◽  
Vol 45 (2) ◽  
pp. 181-190 ◽  
Author(s):  
Sara Weuffen ◽  
Fred Cahir ◽  
Margaret Zeegers
Keyword(s):  
Teaching And Learning ◽  
Torres Strait Islander ◽  
Aboriginal Peoples ◽  
Indigenous Australians ◽  
Australian Curriculum ◽  
Curriculum Assessment ◽  
Australian Education ◽  
History Of ◽  
Torres Strait ◽  
Naming Practices

The aim of this article is to provide teachers with knowledge of ways in which Eurocentric (re)naming practices inform contemporary pedagogical approaches, while providing understandings pertinent to the mandatory inclusion of the cross-curriculum priority area: Aboriginal and Torres Strait Islander histories and cultures (Australian Curriculum Assessment and Reporting Authority, 2015). While we have focused on Eurocentric naming practices, we have also been conscious of names used by Aboriginal peoples and Torres Strait Islanders to name themselves and others and as non-Indigenous Australians we acknowledge that it is not our place to explore these in detail, or offer alternatives. In this article, we have explored the history of nomenclature as it relates to original inhabitants, the connotations of contemporary (re)naming practices in Australian education and discussed the importance of drawing on cultural protocols and engaging local communities for teaching and learning of Aboriginal and Torres Strait Islander histories and cultures. It is anticipated that discussions arising from this article may open up spaces where teachers may think about ways in which they approach Aboriginal and Torres Strait Islander histories and cultures.

Sign in / Sign up

Export Citation Format

Share Document