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New Zealand Healthcare
  A comparison between the 1970’s
             and Now
• Qualifications and Training
• Health and Safety
• Changes in Technology
• Leave Entitlements
• Patient Demographic
• Pat...
Qualifications and Training
Studying 30 years ago
Nurse
• 3 years
• Hospital based
• Heavy workload and stress
Dental Nurse
• 2 years
• Training schoo...
Studying now
Nurse
• 3 year course
• Train in polytechnics
Dental Therapist
• Changes occurring
• Otago and Auckland Unive...
Restrictions 30 years ago
Nurses
• Able to do most things under supervision
• Not involved in childbirth
• Only watch thea...
Restrictions Now
Nurse
• Supervised with medications, ecg
• Not allowed to give meds to minors
• Can’t carry out any proce...
Effect on Patient Care
Nurses
• Polytechnic training – consistency in training
• More emphasis now on patient rights
• 197...
Effect on Patient Care
Dental Therapists
• Very pt care orientated
• “Need to like and care for people”
• Their role
  hea...
Effect on Patient Care
Radiographer
• Tertiary education
• Big emphasis on patient care
     -classes
     -tests e.g. CBA...
HEALTH AND SAFETY
Questions
• What health and safety
  issues were considered
  important when you entered
  your career?
• What changes hav...
Health and Safety issues

          • Changing of uniforms

          • Wearing of glove/ masks

          • Transferring ...
Uniforms
• Radiographers wore a uniform
  which they could only change
  into while they were in the
  hospital

• Now eve...
Wearing gloves/ masks
• Dental nurses didn’t wear
masks or gloves when they
worked on patients in the 1980’s


• Now they ...
Transferring Patients
• Staff often lifted using their back like a crane
  instead of using there legs. So a lot of health...
Benefit to Patients

• Health and safety has not only benefited the staff but
  the patient also……

• Hoist = moving patie...
Changes in Technology
1970’s Radiography
• Film used
• Processed film manually
  in theatre
• Automatic Processors
• 3 minutes to develop film
•...
1970’s Radiography
• No other
  modalities in
  Radiology
  Department
• Specialised rooms
• Air
  Encepholograms
Nuclear Medicine

     • 1950’s – first used
     • 1970s – visualisation of
       organs beside the thyroid i
     • 198...
General X-ray
• High frequency and constant
  potential generators
• 1973 – phosphor imaging plates
• 1983 – First CR unit...
Development of CT
• 1972 – Hounsfield and
  Cormack invented CT
• 1974 – first medical
  equipment
  manufacture of CT
  e...
MRI
• 1946 – Magnetic resonance
  phenomenon discovered.
• 1973 – MRI of test tube
• 1977 – first MRI of entire
  human bo...
Other Changes...
• Computers now used to quickly access and share
  patient information and radiological images.
• Local a...
Impact of changes on staff


• Still require the same background
  knowledge
• New knowledge is required to
  operate mach...
Impact of changes on staff

• Changes in exposure factors
  are not as evident in CR
  systems
• Pre-set exposures also
  ...
Benefits of technology to patients
         • Technology should ensure patients
           receive better care
         • ...
Disadvantages to patients
• Less understanding,
  procedures more foreign and
  confusing to the public
• Dehumanization
•...
“They strapped me into
  this machine, I didn’t like
  it. It was really close to
  my face. I was alone, I
  did not know...
Technology and Patient Care
           • With support and
             education technology can
             be beneficial...
Future of Technology
• Advances being made
  in making medical
  imaging more patient
  friendly.
• “Ambient Experience”
 ...
LEAVE
Leave Entitlements 30 years ago
• 2 weeks of sick days
• Maternity leave available:
    -not well promoted
    -smaller ho...
Leave Entitlements Now

• Long service leave introduced in private practices

• Parental Leave (1987)

• Paid parental lea...
Leaves’ effect on Patient Care
         • Annual Leave
           “maintain health and well
           being and to achiev...
PATIENT PERCEPTION/ ILLNESS
Reasons for hospital admissions have not changed
              dramatically, however……

The public’s perception of certain...
Hospital Admissions
•                           Late 1980’s:
•                           Accidents e.g. MVA,
•            ...
DEMOGRAPHIC OF PATIENTS
          TREATED
Late 1980’s
• Patients predominantly white
• Trauma = young adults
• Strokes = o...
PUBLIC PERCEPTION TO DENTISTS
Dental clinics were commonly
called the murder house



•                  Now parents now s...
WHAT STAFF CAN/CAN’T DO
20years ago
MRTs were allowed to:
•smoke in the staff rooms
•read books or knit while they
were on...
PATIENT CARE
• Has changed for the better over the last few
  years.

• Now treat a lot more Maori people

• This has lead...
References
FujiFilm Corporation. (2009). Innovation History. Retrieved June 01, 2009, from http://www.fujifilm.com/about/h...
NZ Healthcare - 1970's and Now
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NZ Healthcare - 1970's and Now

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NZ Healthcare - 1970's and Now

  1. 1. New Zealand Healthcare A comparison between the 1970’s and Now
  2. 2. • Qualifications and Training • Health and Safety • Changes in Technology • Leave Entitlements • Patient Demographic • Patient Perception of Healthcare
  3. 3. Qualifications and Training
  4. 4. Studying 30 years ago Nurse • 3 years • Hospital based • Heavy workload and stress Dental Nurse • 2 years • Training schools Wellington, Christchurch and Auckland • Principal (dentist) dental tutor sisters (dental nurses) Radiographer • Hospital based • Theory and practical study
  5. 5. Studying now Nurse • 3 year course • Train in polytechnics Dental Therapist • Changes occurring • Otago and Auckland University now offer dual qualification • “phantom heads” , treat pt’s under supervision Radiographer • 3 year course • Train in polytechnics
  6. 6. Restrictions 30 years ago Nurses • Able to do most things under supervision • Not involved in childbirth • Only watch theatre cases Dental Nurses • Complete supervision • Everything checked off Radiographers • Watched in theatre until almost fully qualified • Given a lot of dirty jobs e.g barium enemas
  7. 7. Restrictions Now Nurse • Supervised with medications, ecg • Not allowed to give meds to minors • Can’t carry out any procedures that requires further study Dental Therapist • 1st year :work solely on phantom heads, • 2nd and 3rd year :pt’s under supervision Radiographer • Supervised by Qualified • Films must be checked off • Not able to do morgue, NAI cases.
  8. 8. Effect on Patient Care Nurses • Polytechnic training – consistency in training • More emphasis now on patient rights • 1970’s - pt’s communal showering • “Right to be Treated with Respect” • “Right to Dignity and Independence” (“HDC”, 2009)
  9. 9. Effect on Patient Care Dental Therapists • Very pt care orientated • “Need to like and care for people” • Their role health promotion in education, community development
  10. 10. Effect on Patient Care Radiographer • Tertiary education • Big emphasis on patient care -classes -tests e.g. CBA • Restrictions -supervision ensures positive/safe patient experience
  11. 11. HEALTH AND SAFETY
  12. 12. Questions • What health and safety issues were considered important when you entered your career? • What changes have there been in the way infectious patients are handled? • Have there been changes to do with health and safety?
  13. 13. Health and Safety issues • Changing of uniforms • Wearing of glove/ masks • Transferring patients
  14. 14. Uniforms • Radiographers wore a uniform which they could only change into while they were in the hospital • Now everyone is able to change into their uniforms at home and wear them into the hospital
  15. 15. Wearing gloves/ masks • Dental nurses didn’t wear masks or gloves when they worked on patients in the 1980’s • Now they always wear gloves, masks and protective glasses. Very infectious patients are now treated at the end of the day and Electrical safety is also very important
  16. 16. Transferring Patients • Staff often lifted using their back like a crane instead of using there legs. So a lot of health care workers often got chronic back problems. • Now new lifting techniques are enforced • Use slippery sams and Pat slides
  17. 17. Benefit to Patients • Health and safety has not only benefited the staff but the patient also…… • Hoist = moving patients safely onto examination tables • Wearing gloves/gowns with infectious patients=helps minimise the risk to the next patient of becoming infectious
  18. 18. Changes in Technology
  19. 19. 1970’s Radiography • Film used • Processed film manually in theatre • Automatic Processors • 3 minutes to develop film • Single phase generators with line voltage compensators that had to be adjusted manually.
  20. 20. 1970’s Radiography • No other modalities in Radiology Department • Specialised rooms • Air Encepholograms
  21. 21. Nuclear Medicine • 1950’s – first used • 1970s – visualisation of organs beside the thyroid i • 1980s – nuclear medicine used to diagnose heart disease • Now – over 100 types of different examinations can be performed.
  22. 22. General X-ray • High frequency and constant potential generators • 1973 – phosphor imaging plates • 1983 – First CR units were commercialised • Late 1980’s CR accepted by medical community • Latest CR readers take 5 seconds to read a 35 X 43 imaging plate. • Equipment generally smaller and lighter • DR virtually instant
  23. 23. Development of CT • 1972 – Hounsfield and Cormack invented CT • 1974 – first medical equipment manufacture of CT equipment • 1989 – first spiral CT machine in routine operation
  24. 24. MRI • 1946 – Magnetic resonance phenomenon discovered. • 1973 – MRI of test tube • 1977 – first MRI of entire human body • 1980 - First commercial scanner developed • 1993 – functional MRI developed
  25. 25. Other Changes... • Computers now used to quickly access and share patient information and radiological images. • Local anesthesia and high speed drills introduced into dental nursing since 1970’s • Electronic monitoring of blood pressure, pulse, oxygen levels adopted.
  26. 26. Impact of changes on staff • Still require the same background knowledge • New knowledge is required to operate machinery • Loss of some skills as some processes become automated.
  27. 27. Impact of changes on staff • Changes in exposure factors are not as evident in CR systems • Pre-set exposures also reduce need to thoroughly understand exposures. • Exposure creep
  28. 28. Benefits of technology to patients • Technology should ensure patients receive better care • Advances in medical imaging provides more accurate diagnoses faster • Better pain relief • Increased accuracy of monitoring equipment • Staff have access to more knowledge, easily and quickly • Simple procedures can be performed faster
  29. 29. Disadvantages to patients • Less understanding, procedures more foreign and confusing to the public • Dehumanization • Monitoring done by interacting with machines, not patient • Equipment can seem intimidating, claustrophobic and isolating. • May have elevated expectations
  30. 30. “They strapped me into this machine, I didn’t like it. It was really close to my face. I was alone, I did not know where they (the radiographers) had gone. It was noisy. I wouldn’t want another one.”
  31. 31. Technology and Patient Care • With support and education technology can be beneficial patients. • Need to remember that they don’t understand what is happening. • Risk of losing basic patient care skills and getting caught up in technology • Technology makes patient care more essential
  32. 32. Future of Technology • Advances being made in making medical imaging more patient friendly. • “Ambient Experience” technology for CT/MRI rooms • Patient controls surroundings
  33. 33. LEAVE
  34. 34. Leave Entitlements 30 years ago • 2 weeks of sick days • Maternity leave available: -not well promoted -smaller hospitals tended to accommodate for this more
  35. 35. Leave Entitlements Now • Long service leave introduced in private practices • Parental Leave (1987) • Paid parental leave (2002) • Minimum Annual Leave Entitlements (2007)
  36. 36. Leaves’ effect on Patient Care • Annual Leave “maintain health and well being and to achieve a work/life balance” (“Staff annual leave”, 2007) • Positive effect patient experience • Motivation • Higher quality performance
  37. 37. PATIENT PERCEPTION/ ILLNESS
  38. 38. Reasons for hospital admissions have not changed dramatically, however…… The public’s perception of certain jobs, The demographic of patients treated and What a staff member can/can not do has changed.
  39. 39. Hospital Admissions • Late 1980’s: • Accidents e.g. MVA, • arthritis, and rheumatism. • Followed by hearing and • eyesight difficulties. In 2002/2003: MVA were still one of the major causes of hospital admissions along with: -alcohol admissions, -strokes and arthritis
  40. 40. DEMOGRAPHIC OF PATIENTS TREATED Late 1980’s • Patients predominantly white • Trauma = young adults • Strokes = older people 2002/2003 • Females = 57.2% of hospital discharges, • 27.8% of patients discharged were 65years + • Maori accounted for 16% of total discharges
  41. 41. PUBLIC PERCEPTION TO DENTISTS Dental clinics were commonly called the murder house • Now parents now see them as being an important part of their child’s school life
  42. 42. WHAT STAFF CAN/CAN’T DO 20years ago MRTs were allowed to: •smoke in the staff rooms •read books or knit while they were on the job Now MRT’s are more focused on their career paths and have responsibilities
  43. 43. PATIENT CARE • Has changed for the better over the last few years. • Now treat a lot more Maori people • This has lead to continuing education on how to deal with different cultures
  44. 44. References FujiFilm Corporation. (2009). Innovation History. Retrieved June 01, 2009, from http://www.fujifilm.com/about/history/innovation_history/#content5c Health and Disability Commissioner. (2009). The HDC Code of Health and DisabilityServices Consumer’s Rights Regulation 1996. Retrieved June 4 2009, from http://www.hdc.org.nz/theact/theact-thecodesummary • History of Nuclear Medicine. (2008, June 10). Retrieved June 01, 2009, from http://www.imaginis.com/nuclear-medicine/nuc_history.asp Kodak. (2005, August). Kodak Continues With It’s Computed Radiography Innovation [PDF]. Available from http://www.shawinspectionsystems.com/products/kodak/datasheets/CR_history.pdf Medical Imaging Technology and Innovative Tools Improve Patient Experience. (2006, September 13). Retrieved June 01, 2009, from http://www.jobwerx.com/news/phg_medical_biz-id=948453_843.html Nagasaki University School of Medicine. (n.d.). Introduction to MRI – History. Retrieved June 01, 2009 from http://www.med.nagasaki- u.ac.jp/radiolgy/MRI%20of%20the%20FOOT/MRI-CDNUH/nf-history.html NDT Resource Centre. (n.d.). Present State of Radiography. Retrieved June 01, 2009 from http://www.ndt- ed.org/EducationResources/CommunityCollege/Radiography/Introduction/presentstate.htm Priority Improvements to Parental Leave (2007). Retrieved June 4, 2009, from http://74.125.155.132/search?q=cache:sXMHpYcCXBcJ:www.nacew.govt.nz/publications/files/parental- leave.doc+leave+entitlements+1980%27s&cd=2&hl=en&ct=clnk&gl=nz Santacroce, L. (2005, October 27). Mammogram. Retrieved June 01, 2009, from http://www.emedicinehealth.com/mammogram/article_em.htm Siemens Medical. (n.d.). Computed Tomography – It’s History and Technology [PDF]. Available from http://www.medical.siemens.com/siemens/zh_CN/gg_ct_FBAs/files/brochures/CT_History_and_Technology.pdf Staff Annual Leave Balances (2007). Retrieved June 6 2009, from services.eng.uts.edu.au/StaffandAlumni/secure/StaffAnnualLeaveBalances.doc

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