emergency departments

A fresh plea for a helping hand for primary care, to ease the pressure on hospital emergency departments. 

An opinion piece in today's New Zealand Medical Journal suggests ED overcrowding may not be caused by unnecessary visits, but an increase in more urgent cases. 

But Northcare Accident and Medical's Peter Boot says primary care is more efficient at dealing with small issues filing EDs, and it needs investment. 

He told Tim Dower that 30% of General Practices are technically insolvent. 

Boot says doctors are leaving, and about half of the workforce are older or planning to retire in the short term so there's a crisis in primary care. 

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A nurses union says having more staff will reduce violence in emergency departments.

There have been more than 7,000 assaults of public health employees in the two years to April.

The Australasian College for Emergency Medicine is calling for around-the-clock security guards in all EDs.

NZNO's Kerri Nuku says reducing wait times will lower the tension.

"If we had more nurses, more doctors on the floor to be able to deal with the crisis- ED departments across the whole workforce are short."

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In this episode, Latesha Elopre, MD, MSPH, and Jason Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRN, answer questions about HIV PrEP including:

• How long someone can receive PrEP and the monitoring that is needed over time
• Recommendations for monitoring bone health while receiving oral PrEP
• Treatment as prevention and PrEP efficacy data and options for people who inject drugs
• The role of circumcision in HIV prevention
• The use of PrEP in pregnancy
• Concern for ART resistance if someone seroconverts while receiving PrEP, especially when using nondaily PrEP options
• The possibility of using FTC/TAF on demand
• Inequities in adherence and persistence
• Cost considerations with different PrEP modalities
• Recommendations for hospitalized patients receiving PrEP
• PrEP considerations for patients with renal dysfunction and higher BMIs
• PrEP efficacy based on site of exposure

Presenters:

Latesha Elopre, MD, MSPH
Associate Professor
Division of Infectious Diseases
Assistant Dean of Diversity and Inclusion
General Medical Education
University of Alabama at Birmingham
Birmingham, Alabama

Jason Farley, PhD, MPH, ANP-BC, FAAN, FAANP, AACRN
Professor
School of Nursing
Johns Hopkins University
Nurse Practitioner
Department of Infectious Diseases
John G. Bartlett Specialty Practice
Baltimore, Maryland

Link to full program:
https://bit.ly/3Fqdgs9

In this episode, Carolyn Chu, MD, MSc, FAAFP, AAHIVS, and Samantha Strong, PharmD, BCACP, AAHIVP, CDCES, answer questions including:

• Strategies to improve disparities in pre-exposure prophylaxis (PrEP) access in difficult-to-reach populations 
• Key remaining questions related to PrEP options for cisgender women and people who inject drugs
• Concerns about resistance at seroconversion in patients with suboptimal PrEP compliance
• Implementation of molecular screening for patients receiving PrEP
• Expectations for weight gain and patient counseling points

Presenters:

Carolyn Chu, MD, MSc, FAAFP, AAHIVS
Chief Medical Officer
American Academy of HIV Medicine
Chief Clinical Officer
National Clinician Consultation Center

Samantha Strong, PharmD, BCACP, AAHIVP, CDCES 
Clinical Director of Pharmacy
Nevada Health Centers
Las Vegas, Nevada

Link to full program: 
https://bit.ly/3Fqdgs9

In this episode, Carolyn Chu, MD, MSc, FAAFP, AAHIVS, discusses improving HIV pre-exposure prophylaxis accessibility and availability for PWID, including by:

• Integrating PrEP with services that PWID are already aware of and/or connected to (eg, harm reduction/syringe services and substance use disorder treatment programs, peer-based training/education initiatives, healthcare for the homeless programs, and emergency departments) 
• Staffing PrEP programs with people who are trusted by PWID and delivering PrEP in settings where patients feel respected, comfortable, and safe 
• Tailoring prescribing practices and interventions (eg, same-day medication initiation, on-site pharmacies and/or medication storage, and intensive outreach and navigation) to support the care needs of PWID

Carolyn Chu, MD, MSc, FAAFP, AAHIVS
Chief Medical Office
American Academy of HIV Medicine

See the full program at: 
https://bit.ly/3WhbBvZ

A push to get overseas nurses moved onto the green list for immigration.

Te Whatu Ora has decided against moving nurses around the country to help alleviate continued stress on emergency departments.

But Board Chair Rob Campbell says an immigration fast track for overseas nurses would be helpful. 

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Ryan McCormack discusses a Viewpoint about better treatment in hospital emergency departments for people with severe alcohol problems.

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