News in brief: People missing out on CVD risk assessment; Usual post-op care misses POAF; Mandatory vaccination for all healthcare staff in NSW

People missing out on CVD risk assessment

Nationally, less than half (48.5%) of people aged 45 to 74 years have CVD risk factors recorded in their GP record in the 12 months before July 2021.

While this is a slight improvement compared to a rate of 44.9% in October 2020, the findings suggest GPs do not have the necessary data to calculate CVD risk assessment for primary prevention.

The report from the Australian Institute of Health and Welfare on the Practice Incentives Program Quality Improvement Measures found the rate varied across the primary health networks from as low as 36.0% to 67.5%.

Recording of the necessary CVD risk factors was higher in older adults 65-74 years (55%) compared to 45-54 years (42%) and slightly higher in males compared to females.

Nationally, 58.7% of regular clients with diabetes had blood pressure recorded in their GP record within the previous 6 months.

Usual post-op care misses POAF

Continuous 30-day ECG monitoring after cardiac surgery has revealed almost one in five patients (19.6%) experience postoperative atrial fibrillation (POAF) or atrial flutter after they are discharged from hospital.

Most episodes (73.3%) were detected during the first week of monitoring, 20.0% during the second week, and 6.7% during the third week.

The randomised SEARCH-AF trial of 336 patients found POAF was detected in only 1.7% of the usual care group.

“Most patients in this study had no POAF detected during hospitalisation after cardiac surgery. These findings demonstrate that POAF after cardiac surgery is not confined to the hospitalisation period. A high rate of AF can be detected in the first month after surgery.”

“Future research is needed to assess whether early anticoagulation may mitigate adverse short-term and long-term cardiovascular outcomes,” the study said.

Read more in JAMA Network Open

Mandatory COVID-19 vaccination for all healthcare staff: AMA

The AMA has called for a national mandatory vaccination regulation against COVID-19 for all healthcare staff after NSW led the way for staff in public and private hospitals.

Under a new Public Health Order, NSW health staff must have a first dose of vaccine by 30 September 2021 and be fully vaccinated by 30 November 2021, or at least have their second appointment booked or they will be excluded from the workplace.

Health Minister Brad Hazzard said 80% of staff were already vaccinated and the new requirement was similar to existing mandatory vaccination requirements for frontline health staff for influenza, chicken pox, measles and pertussis.

“National Cabinet agreed in June to mandate COVID-19 vaccination for aged care workers, and NSW will now ensure the same protections exist for all our health workers,” he said.

“It will also ease pressure on our health system during this challenging time. More than 1,200 healthcare workers have been in isolation each day over the past seven days and we cannot afford that right now. Vaccinations will help ensure our fantastic staff can continue to care for patients.”

The AMA said mandatory vaccination rules should be put in place nationally for the workforce of the entire health care system including support staff.

With worrying numbers of COVID-19-infected frontline workers furloughed and unable to work, as well as several clusters being linked to hospitals,  AMA President Dr Omar Khorshid said mandatory vaccines for health care workers are needed to sustain the health system into the future as Australia learns to live with COVID-19.

“We’ve said plans to reopen Australia will be a disaster unless our health sector is ready, and that will mean having a fully protected medical workforce,” he said.

“There is widespread uncertainty as to whether other occupations and workplaces can also mandate vaccinations. The law needs clarity to give employers and employees certainty.

“AMA proposes nationally consistent public health orders be issued by state and territory governments to provide legal protection to any employer who can also reasonably establish worker safety would benefit from a workplace vaccine mandate. Longer term, statutory coverage may be required.”

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