Thread by @WePublicHealth

We are back after lunch - hope you all had a nice break and stretch #GiantSteps22

I'm joining into breakout session 4. The first presenter in this session is Dr Sasha Bennett talking about optimising sleep in hospitals - 'Your sleep, your say - Implementing shared decision making to treat insomnia' - #GiantSteps22

Typical scenarios for someone in hospital are either planned or unplanned. Regardless of why they are there, they have come into an environment that is not very conducive to sleep - Bennett #GiantSteps22

Very poor sleep in hospitals is not surprisingly very common. Can have significant consequences - lower pain threshold, delay recovery & discharge, daytime drowsiness & follow-on effects after discharge such as chronic insomnia - Bennett #GiantSteps22

If a patient has poor sleep in hospital, they either say nothing or they don't. If they do, they may be given medication - very rarely are other strategies discussed - Bennett #GiantSteps22

Type of night sedation medicines used = benzodiazepines and Z-drugs most common and incidentally, the most commonly inappropriately used medicines in Australia.
Other medicines used = antihistamines, melatonin antidepressants - Bennett #GiantSteps22

Impacts from sedatives = independence, respiratory depressants, impaired cognitive function etc etc - Bennett #GiantSteps22

Far better to target the causes for poor sleep in hospitals. - Bennett #GiantSteps22

Assigned the task to reduce unsafe, largely ineffective night sedation medicine use in hospitalised patients - Bennett #GiantSteps22

Quickly realised it was not going to be addressed by a simple drug guidance. System-wide transformational change required - Bennett #GiantSteps22

"It will not surprise you that the hospital environment is actually in-hospitable for sleep" - Bennett #GiantSteps22

1) Targeting prevention of sleep disturbance as part of a hospital's duty of care and safety culture -
Developed a patient information booklet with information 👇 - Bennett #GiantSteps22
nswtag.org.au/wp-content/upl…

2) Select wise management options - e.g. support shared decision making, medication review
3) If night medication the right way to go, choose appropriate night sedation medicine - Bennett #GiantSteps22

4) Ensure safe and effective use of medicine - shared decision making, monitor, daily enquiry about effectiveness and adverse events - Bennett #GiantSteps22

For frameworks developed by NSW Therapeutic Advisory Group for both treatment naive and treatment non naive patients 👇- Bennett #GiantSteps22 nswtag.org.au/optimising-sle…

For successful implementation = vision, strong leadership, clear communication, identify barriers and enablers, resourcing - Bennett #GiantSteps22

Dr @SandroDemaio CEO & Zahra Sufeeya @VicHealth is next up, to discuss presentation titled 'Creating a healthy future for young people' #GiantSteps22

@SandroDemaio begins by saying "Health promotion is not about doing things 'to' people, but 'with' people" - #GiantSteps22

Zahra Sufeeya, a Melbourne student, working with @VicHealth past 12 months on future healthy program, joins @SandroDemaio for discussion about experiences of young Victorians over past couple of years #GiantSteps22
futurehealthy.vichealth.vic.gov.au/for-organisati…

On surface, past 2 years has been a string of events - bushfires, pandemic, racially fueled violence - all impacted Zahra's mental health - Zahra #GiantSteps22

Zahra realised that sharing experiences with other young people helped, and they wanted to be part of the solution #GiantSteps22

Three critical tracks of work identified during early on in pandemic:
1) business as usual - staff & programs stable as much as possibly could
2) supporting government as part of the public sector - @SandroDemaio #GiantSteps22

3) organisational reform and change - challenges facing Victorians evolving quickly & that people's needs and demands for healthcare would not be the same. VicHealth needed to become ready and efficient to address that - @SandroDemaio #GiantSteps22

Gap identified in the health of young people, Future Healthy borne from that - @SandroDemaio #GiantSteps22

1) Young people want flexible, non-competitive options to be active
2) Improved access to fresh and healthy food
3) Improve mental health by driving social connection (Big Connect programs) - @SandroDemaio #GiantSteps22
vichealth.vic.gov.au/funding/the-bi…

Zahra describes how pausing and enjoying the little moments has helped her get through the past two years - #GiantSteps22

Co-design concept enables empowerment, inclusion, involved in community & awareness of society - Zahra says #GiantSteps22 - "There are people who want to listen to what I have experienced".

Zahra add that it is great to have support of organisations like @VicHealth enabling co-design - "The issues facing young people can be overwhelming" and sometimes they don't know where and how to get help to make change. #GiantSteps22

A person in the audience asks how co-design, engagement with young people in rural areas would work. Zahra responds "Social media" - having people reach out to us is easier than us having to reach out for support - #GiantSteps22

@SandroDemaio adds 'Build on those already doing great work in those communities,' often working with very little resources - @SandroDemaio adds #GiantSteps22

@VicHealth tries to find those people in local communities, give them skills, resources, visibility & connect them to others. Work with people who are on the journey, build on what's already there, and co-design with young people in the communities - @SandroDemaio #GiantSteps22