News in brief: New name, new direction for HBPRC; Single troponin value can exclude acute MI in Indigenous patients; Healthcare staff bullied and stressed over PPE provision

16 Jun 2022

New name, new direction for HBPRC

The High Blood Pressure Research Council of Australia (HBPRCA) is to rename itself as Hypertension Australia as part of a move to expand its role beyond research into advocacy.

The group, originally formed in 1979 by members of the Australian hypertension research community, has recently adopted a new growth strategy with the aim of becoming the ‘go to’ organisation for all things to do with hypertension and high blood pressure in Australia.

President Professor Markus Schlaich of the University of WA says the group wants to increase engagement with clinicians, patients and healthcare systems to promote greater awareness of hypertension and the importance of its measurement and appropriate management.

The Executive Council is proposing a constitutional change to put the body on a more professional footing with a skills-based leadership team. The changes will be voted on and come into effect after the group’s ASM to be held in Melbourne from 7–9 December 2022.

Single troponin value can exclude AMI in Indigenous patients

A single low-level high sensitivity cardiac troponin I (hs-cTnI) value can be used for early rule-out of acute myocardial infarction (AMI) in Aboriginal and Torres Strait Islander patients, researchers from Queensland have shown.

A study conducted at Cairns Hospital evaluated data for 110 Aboriginal and Torres Strait Islander people who presented at the ED with suspected acute coronary syndrome.

According to results published in the MJA, 14% of patients had hs-cTnI values of 2 ng/L or less, none of whom reached the primary endpoints of type 1 MI, or cardiac death prior to discharge. Likewise, none reached the secondary outcomes of index AMI (types 1 and 2 MI), and 30-day major adverse cardiac events (MACE).

Test sensitivity was 100% (95% CI: 93–100%) as was the negative predictive value  (95% CI: 78–100%).

Sensitivity and NPV were also 100% with a 4 ng/L cTnI cut‐off, which excluded AMI for 30 people (27%), none of whom reached the primary or secondary endpoints.

Diagnostic accuracy was similar for patients who presented to the emergency department and those who had been transferred from other facilities, the researchers said.

“A low hs-cTnI value may safely exclude AMI, but Aboriginal and Torres Strait Islander people may benefit from referral to culturally appropriate medical services for cardiac risk factor management,” they concluded.

Healthcare staff bullied and stressed over PPE provision

One in five frontline healthcare workers received no training on the use of personal protective equipment (PPE) for COVID-19 when the pandemic was at its height in 2021, and only half received formal training in the workplace, according to a survey of Victorian healthcare staff.

Responses from 2,258 healthcare workers (80% women, 49% doctors and 40% nurses) revealed a wide range of problems with PPE provision in 2021, including a lack of PPE training (20%), lack of fit testing, insufficient PPE (25%) and reuse or extended use of PPE (47%).

More than three quarters (77%) of staff reported workplace bullying by management for being ‘troublemakers’ when they raised issues over PPE, and more than one fifth (22%) reported moderate to severe anxiety related to the lack of training and provision of PPE.

Similarly, about half of staff (48%) reported confusion and concern  about inconsistent and frequently changing PPE guidelines that failed to recognise the airborne transmission of SARS-CoV-2.

“The lack of bargaining power for many respondents limited their agency to resolve matters further exacerbating physical, psychological and financial impacts,” said the authors of the study published in PLOS One.

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