Papa’s Brand New Bag

Luke Escombe

Award-winning songwriter and comedian Luke Escombe reflects on his twenty five years with IBD, his decision to have an ostomy, and the surprising new direction his life has taken since. Filled with music, humour and brutal honesty about the less than glamorous aspects of ostomy life, Luke’s story is ultimately a reminder that ostomies don’t just save lives, they can also transform them.


Biography:

Luke Escombe is an award-winning songwriter, musician and comedian who has turned his 25 years of living with Crohn’s disease into inspiration for his art.

Luke’s breakthrough as a writer/performer came in 2011 with his one-man show “Chronic”, which combined multiple music styles with candid stand-up comedy about his many hospital stays. It was Luke’s ticket to festivals all over Australia, and led to him becoming an ambassador for Crohn’s and Colitis Australia.

The follow-up to “Chronic” was a show called “The Vegetable Plot”, which premiered at the 2014 Sydney Fringe. After years of speaking about illness, The Vegetable Plot was Luke’s way of making a fresh start – a roots music show for kids, families, and foodies with an emphasis on having fun and being healthy. It won the award for the Best Kid’s show at the festival and has since played at major events all around the country, including at the Sydney Opera House and Splendour in the Grass.

Luke has spoken for three years in a row at Parliament House in Canberra, as well as at the New Zealand National Museum in Wellington, the 2012 and 2014 National Medicines Symposiums, the 2013 Pharmacy Australia Congress, and at conferences, workshops, support groups, Medicare Locals and training seminars across the country. 2017 saw him crossing the Pacific for the first time, speaking at events in Chicago and Miami and receiving standing ovations at both. His work was recognised at the end of the year by WEGO Health, who named him as the winner of their 2017 “Hilarious Patient Leader” award.

He was once described by John Shand in the Sydney Morning Herald as a “rock-soul singer, raconteur, blistering blues guitarist, comedian and songwriter…and very good at them all”, and is most often described by himself as the Mick Jagger of inflammatory bowel disease.

Luke Escombe lives on Sydney’s northern beaches with his wife and son.

Nutrition for ostomates

Dr Philippe Fauqué1

1Head of department of the Clinical Nutrition Unit at the Cannes Polyclinic Institute

The digestive tract is the organ of digestion. It transforms the food into nutrients that are absorbed with water through the wall of the intestine into blood stream. Ostomies modify absorption by increasing the mobility of the digested food, damaging certain enzymes and reducing the absorption area. The consequences are an increased risk of undernutrition and dehydration, which can delay healing processes and reduce immunity.
The nutritional management of ostomate patients therefore requires a few simple rules. First of all, an assessment of the nutritional status and an estimate of energy needs.
Then, the introduction of a diet adapted to the patient’s metabolism and the type of stoma will provide the nutrients necessary for optimal energy production and will cover protein requirements as building blocks. For stomas with high output it may be necessary to introduce parenteral nutrition, systemic hydration, and vitamin and mineral supplementation.


Biography:

Dr Philippe Fauqué is a nutritionist doctor specialized in artificial nutrition. He leads the largest french clinical nutrition unit at the Institute Polyclinique of Cannes that welcomes patients with various digestive pathologies, hepatitis, pancreatitis, digestive cancers, hepatic transplant and digestive surgery.
With his team of 25 nurses, caretakers and dieticians they take care of patients during more or less long hospitalization in order to educate them to adapt food intake according to their pathologies and to manage enteral and parenteral nutrition. For ostomates a therapeutic educational program is also provided.
Dr Fauqué have been working for many years to optimize diet in pre and post surgical procedure and specifically for patients with wounded digestive tract to prevent risk of malnutrition and to improve the recovery and the quality of life throughout their pathologies.

Are you hearing or listening to the patient’s story?

Professor Kerry Reid-Searl1, Professor Keryln Carville

1 CQUniversity Australia
2 Curtin University WA

 

Background

Stomal therapy nurses play an integral part in facilitating a person to manage their lives whilst experiencing a stoma. Understanding the person as a unique individual is important step that the nurse needs to make and part of that involves not just hearing the persons’ story but truly listening.

Aim

The aim of this presentation is to present to the audience a simulation experience using Mask Ed (KRS Simulation) and Pup Ed (KRS Simulation) which will showcase the role of the stomal therapy nurse as they prepare two clients Mr Eddie Reid and Simon Richie-Seal on their journeys in living with a stoma. The presentation will highlight not only effective communication through listening to the persons story but also consideration for the learning needs of clients and how best to address these as a nurse. The final part of the presentation will highlight to the audience the key elements and underlying pedagogy of Mask Ed (KRS Simulation) and Pup Ed (KRS Simulation).

Discussion

Stomal therapy nurses play and essential role in facilitating a positive journey for the person experiencing a stoma. Understanding the individual and their learning needs begins with listening to the persons’ story. As nurses we need to consider innovations in the way we meet the needs of clients especially in the area of education. Both Mask Ed (KRS Simulation) and Pup Ed (KRS Simulation) are examples of nurses thinking outside the box in terms of engaging with persons such as those experiencing a stoma.

Conclusion

Stomal therapy nurses can facilitate a positive journey for the person experiencing a stoma through listening to their story and hearing what their needs are.


Biographies:

Professor Kerry Reid Searl is the Assistant Dean Simulation at CQUniversity Rockhampton Campus. Kerry has been involved in undergraduate nursing education for the past 25 years and has been the recipient of numerous teaching awards. Some of these include the CQUniversity Vice Chancellors Teaching Award in 2008 and 2010, two Australian Learning and Teaching Citations for her outstanding contribution to student learning in 2008 and 2012, was named Pearson/Australian Nurse Teacher Society- Nurse Teacher of the Year in 2009 and in 2012 was awarded and Australian University Teaching Excellence Award. In 2013 Kerry was awarded the Simulation Australia Achievement award.For the past 4 years Kerry has been the recipient of certificates of commendation for Student Voice Awards for CQU Educator of the Year and CQU Distance Educator of the Year.

Kerry has become known nationally and internationally for her pioneering work in creating, designing and researching an innovative simulation strategy which suspends learners in disbelief. The technique is called Mask-Ed (KRS Simulation). Additionally Kerry also works with puppets and has designed a technique called Pup-Ed (KRS Simulation).

 

Keryln has extensive clinical experience and is committed to research and education within the domains of wound and ostomy care. She is Chair of the Wounds Australia Pressure Injury Advisory Panel and Australia Wound Standards Committee and Chairs the Pan Pacific Pressure Injury Alliance. She was appointed a Fellow of the Australian Wound Management Association now Wounds Australia) in 2006 and Life Membership of the Australian Association of Stomal Therapy Nurses in 2015. She is a lead researcher in the Silver Chain and Curtin University Wound Management Innovation Cooperative Research Centre (CRC) projects.

Australian narrative medicine – what our stoma patients are really saying

Dr. Maria Giulia Marini1

1 Executive Director of ISTUD Milan. Italy

Narrative medicine is what occurs between the health provider and the patient: from the collection of information of events before the occurrence of the disease, how the disease showed up, with attention to physical, psychological, social and ontological features.
Narrative Medicine fortifies clinical practice with the narrative competence to recognize, absorb, metabolize, interpret, and be moved by the stories of illness: helps doctors, nurses, social workers, and therapists to improve the effectiveness of care by developing the capacity for attention, reflection, representation, and affiliation with patients and colleagues.

This session will compare and contrast the ostomy patient narratives from two different countries – Italy and Australia and examine how we might approach our stoma patients differently.


Biography:

Executive Director of ISTUD Milan. Italy. Epidemiologist, Author of over 100 clinical papers, Member of Narrative Medicine reference panel at World Health Organisation, Adjunct Professor of Medical Humanities of HUNIMED faculty of Medicine and Nursing.

Translating evidence into intensive care nursing practice to reduce pressure injuries: the SUSTAIN study

Coyer FM1,2, Campbell J3, Vann A2, McNamara G, Cook J-L1

Affiliations:

  1. School of Nursing, Queensland University of Technology
  2. Intensive Care Services, Royal Brisbane and Women’s Hospital
  3. Skin Integrity, Royal Brisbane and Women’s Hospital.

Background

Intensive care units (ICUs) have the highest rates of pressure injuries (PIs) in Australian hospitals with PI rates reported from 18-50%.1,2 These figures demonstrate a lack of sustained translation of best available evidence into practice and indicate an imperative for change to skin management practice in this vulnerable patient population and unique practice environment

Aim

This study aimed to systematically assess the barriers and facilitators to PI prevention practice in the ICU and to develop research translation strategies to overcome barriers. This presentation will address the translation strategies employed in the study.

Project description

We created an expert clinical liaison group to identify and prioritise targeted ICU PI prevention strategies.3 Strategies included weekly multidisciplinary skin integrity rounds with emailed feedback, turn round audits, inclusion of skin integrity updates in mandatory in-service, development of a skin integrity work unit guideline imbedded in the ICU clinical information system, series of targeted in-services, and weekly PI prevalence audit with feedback emailed to all staff.

Project outcomes

We evaluated the project by weekly skin integrity audits over 52 weeks. A total of 928 patients were audited; mean age 55.5 years, 55% were male with a mean ICU length of stay of 8 days. Pressure injury prevalence trended from 16% at the commencement of the audit to 9% at completion; a decrease of 0.14% per week over 52 weeks. Further, RNs noted increased diligence in routine patient skin assessment and reporting of skin injuries and a raised awareness of resources available within the hospital e.g. skin integrity team, medical photography services, and the contribution of occupational therapy and physiotherapy to PI prevention.

Conclusion

This initiative demonstrates a novel approach, to assist RNs to refocus their attention to the need for prioritising skin care in the challenging ICU environment. Raising awareness of evidence-based best practice in PI prevention was shown to be a positive vehicle for education and professional development, enhancing a collaborative multidisciplinary team approach to patient care.

References

  1. Coyer F, Gardner A, Doubrovsky A et al. Reducing pressure injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE). Am J of Crit Care. 2015;24(3):199-209.
  2. National Pressure Ulcer Advisory Panel (NPUAP), European Pressure Ulcer Advisory Panel (EUAP) and Pan Pacific Pressure Injury Alliance (PPPIA). Prevention and treatment of Pressure Ulcers: Clinical Practice Guideline. Emily Haesler (Ed.). 2014; Cambridge Media: Perth, Australia.

Biography:

Dr Fiona Coyer holds a joint appointment as Professor of Nursing with the School of Nursing, Queensland University of Technology and Metro-North Hospital Health Services. She is based at the Department of Intensive Care, Royal Brisbane and Women’s Hospital. Fiona has extensive experience as a leader in academic and research programs in intensive care nursing, with research interests including patients and families perspectives of intensive care, nursing care of the critically ill patient and skin integrity in critically ill patients.

Orthotopic bladder

 


Biography

Dr Dunglison underwent 2 years of sub-specialist training in ‘Reconstructive and Prosthetic’ urological surgery at the Institute of Urology, University College London Hospitals under the mentorship of the internationally renowned reconstructive urologist Professor A R Mundy.

In 2002, Dr Dunglison returned to Brisbane, having been appointed Director of Urology at the Royal Brisbane Womens’ Hospital. He has developed the Urology Department to incorporate Robotic, Laparoscopic, Laser, Prosthetic, Reconstructive and Flexible endoscopic surgeries along with Prostate MRI and Brachytherapy. Concurrently Dr Dunglison has continued to develop his own comprehensive Reconstructive + Prosthetic private urological surgery incorporating regular international mentorships and training.

Dr Dunglison completed his medical degree at the University of QLD in 1989 and received his Fellowship from the Royal Australasian College of Surgeons in 2000.

Using the taTME approach for rectal cancer surgery

A/Prof Andrew Stevenson

Head of the Colorectal Surgery department, Royal Brisbane Hospital


Biography

Andrew completed his post-fellowship training in Colorectal surgery at Royal Brisbane and Royal Prince Alfred hospitals in the mid 1990’s. It was during this training, particularly under the guidance of Prof. Russell Stitz, that he began routinely using minimally invasive techniques including laparoscopy and TEMS for treatment of a variety of colorectal pathologies. Andrew is now Head of the Colorectal Surgery department at Royal Brisbane, as well as Associate Professor of Colorectal surgery at University of Queensland.

Along with the team in Brisbane, Andrew has conducted over 100 workshops on minimally invasive techniques, and is Chairman-Elect for the CSSANZ Training Board of Colorectal Surgery. Prof. Stevenson began using robotics and assessing its utility in colorectal surgery in 2009. He performed the first reported robotic male pelvic exenteration in the Southern Hemisphere and in combination with colleagues in Korea, published as the first case series. He more recently began using transanal TME late 2013 for benign and malignant rectal resections, and visited Prof. Antonio Lacy in 2014 to further his knowledge of the technique. Andrew recently participated in a select international consensus forum into the development of new minimally invasive techniques for the treatment of rectal prolapse (laparoscopic ventral rectopexy), as well as participated in the recent international consensus on transanal TME for rectal cancer.

Member of both the Australian and American Societies of Colon and Rectal Surgeons, as well as European Society Coloproctoloogy and Executive Member of the Queensland Clinical Oncology Group for the Queensland Cancer Foundation.

Incontinence-associated dermatitis; state of the evidence

Dr Jill Campbell RN, PhD., NsgCert(Intensive Care), BApp Sc (Nursing), GradCert (Sexual Reproductive Heath), GradDip(Wound Care), MACN1

1 Skin Integrity Clinical Nurse, Royal Brisbane & Women’s Hospital

 

Incontinence-associated dermatitis (IAD) represents a significant threat to skin integrity in vulnerable individuals. It is now also recognised as a risk factor for the development of pressure injury. Furthermore, the condition is often misdiagnosed due to the complexity of skin assessment of the pelvic region.

There is a growing body of evidence in this field, although some gaps remain. This presentation will explore the state of current evidence concerning IAD, including definitions, classification, prevalence, prevention and management.


Biography:

Jill Campbell; RN, NsgCert(Intensive Care), BApp Sc(Nursing), GradCert (Sexual Reproductive Heath), GradDip(Wound Care), PhD

Jill has been a registered nurse for over 30 years. She has had a diverse career with experience in intensive care, cardiology, women’s health, aged care and wound care.

Currently, she is a Skin Integrity Clinical Nurse at Royal Brisbane & Women’s Hospital. Her special skin integrity interests are in the area of incontinence- associated dermatitis and skin integrity models of care for older patients.

Jill has recently completed a PhD at Queensland University of Technology. Her doctoral studies investigated the relationship between IAD and Candida infection, as well as conducting the only Australian study exploring the prevalence of incontinence-associated dermatitis in the acute care setting. Her research has resulted in several international publications. In addition, Jill is a co-author on the global IAD consensus document, Incontinence-associated dermatitis: Moving prevention forward.

Taking care of the carer: A practical approach to patient care as well as personal self-care

The life-long question of why helping others is so challenging will be addressed. We will look at what effects of helping others has on health professionals and discuss both positive/negative Coping Mechanisms we utilise in our lives. We will also look at how we can assist patients better in their recovery and lastly, we will focus on the 7 steps to emotional & physical wellbeing that has proven to be helpful in patient and personal self-care.

 


Biography

Nic Marcon is a Business Owner, Director, Principal Psychologist, Speaker, Trainer and Supervisor. He has worked in a maximum security prison, a drug rehab for adults, a detox unit for Teenagers, and nearly 10 years ago founded Emotional Balance Pty Ltd a private practice and with 2 Centres around Brisbane he and his team provide counselling to children, adolescents, adults and couples.
He has a strong passion in helping people achieve their goals and dreams and believes that with the right support, anyone can achieve and overcome anything. Nic has always done things differently. His personal experiences both positive and negative, his down-to-earth approach, his humour and his passion for making a difference has always pushed him to find a way to enhance his life, and those around him. He’s designed many unique programs to help individuals, parents, teenagers to make a difference in what they want in life.
He has been featured in Newspapers and has appeared on Television a number of times due to his experience and passion. He has been sought after as a speaker, and speaks on a range of topics. He also provides professional development to various professions like Teachers, Nurses, Psychologists, Psychiatrists and Doctors,
Areas of expertise: Addictions, Trauma and Abuse, Illness, Depression, Anxiety, PTSD, Stress and Anger Management, Teenage, Parenting and relationship issues.ta

Outcomes of the A La CaRT trial

Dr John Lumley MCCS, FRACS1

1 The Wesley Hospital

 

Laparoscopic surgery as the standard?

There is growing use of laparoscopic surgery for rectal cancer in Australia over recent years, but without reliable evidence of its safety, efficacy and long-term effectiveness when compared with open surgery

Advantages

While there are potential advantages of laparoscopic surgery in terms of less time in hospital, smaller scars and less post-operative morbidity, these advantages are less established for the treatment of rectal cancer

Evidence

Before laparoscopic procedures become recommended as standard, it is essential that reliable evidence is obtained that shows laparoscopic surgery is at least equivalent to open surgery in terms of pathological results, patient-rated and long-term clinical outcomes

The A La CaRT study was performed by 26 colorectal surgeons in Australia and New Zealand. It compares open to laparoscopic pelvic dissections for rectal cancer. The main basis of comparison is based on pathological examination of the resected specimen. Long term survival and tumour recurrences will also be monitored. This study parallels a study from the United States- Z6051. Results from both will be presented.


Biography:

Dr John Lumley MCCS, FRACS is a Colorectal Surgeon with a special interest in laparoscopic surgery and pelvic floor dysfunction. He has been practicing at The Wesley Hospital since 1992.

After gaining his surgical qualifications, Dr Lumley undertook additional training in the Australian Post Fellowship Colorectal Training Scheme. Dr Lumley is experienced in all aspects of laparoscopic colorectal surgery, sacral nerve stimulation for faecal incontinence and pelvic floor disorders with access to colorectal diagnostics.

Dr Lumley has been involved with teaching laparoscopic colorectal surgery since its inception 20 years ago. He continues to be involved with research on aspects of colorectal cancer. He is a member of the Australian Medical Association, the Royal Australasian College of Surgeons, and a member of the Colorectal Surgical Society of Australia and New Zealand.

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AASTN

This conference is proudly hosted by the Australian Association of Stomal Therapy Nurses: www.stomaltherapy.com

One of the Association's major objectives is the promotion of quality care for a wide range of people with specific needs. These needs may be related to ostomy construction, urinary or faecal incontinence, wounds with or without tube insertion and breast surgery.

Patients/clients across the life span are provided with preventative, acute, rehabilitative and continuing care as required. Another objective is the maintenance and improvement of professional standards in relation to Stomal Therapy Nursing Practice to the highest degree possible. Recognition of the need for and encouragement of the development of specialist expertise in the field of Stomal Therapy Nursing underpins the Standards for Stomal Therapy Nursing Practice.

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