By Kath McDermott, Acting Director Disaster Preparedness and Response. Merrilyn Diverall, BHlth Sc(Nurs), Grad. Cert Periop, Grad. Cert Anaes/PACU, Grad Cert. Emerg, Cert.1V TAA, Ma.Edn (Research), AUSMAT Surgical Cache Review Project Nurse. Wendy Rogers, BNUR (Hons), MNUR (Leadership & Management), FACORN, AUSMAT Surgical Cache Review Project Nurse and Carla Yeung, Communications and Engagement Officer
In a field hospital setting, the surgical cache is an essential component of an EMT Type 2 Emergency and Surgical Field Hospital, providing crucial supplies and equipment necessary for operations and medical procedures. The Australian Medical Assistance Team (AUSMAT) is undertaking a vital project to enhance its surgical cache within the EMT Type 2 Emergency and Surgical Field Hospital. The endeavour is pivotal in strengthening the team’s preparedness, ensuring it is always deployment-ready for sudden onset disasters and other health emergencies. Spearheading the initiative are AUSMAT Surgical Cache Review Project Nurses Merrilyn Diverall and Wendy Rogers, whose collective experience forms the backbone of this project.
Drawing from their extensive backgrounds in perioperative nursing and disaster response, Merrilyn and Wendy bring a unique blend of expertise and experience to the project. A significant part of Wendy's experience was her deployment to Tacloban, Philippines, in response to Typhoon Haiyan in 2013, where the EMT Type 2 hospital was put to the test in an austere environment. Reflecting on this deployment, Wendy recalls,
The Tacloban deployment was not just a career highlight, but a profound lesson in the critical need for adaptability and meticulous preparation in disaster settings.
Having worked in the National Critical Care and Trauma Response Centre’s (NCCTRC) Education Team and deployed with AUSMAT during the COVID-19 pandemic, Merrilyn understands the nuances of disaster response. She adds,
By integrating educational technologies and clinical readiness, we ensure that our team is not just prepared, but ahead of the curve in our response capabilities.
Together, their combined knowledge and strategic vision guide this project to enhance AUSMAT’s surgical cache, ensuring it meets the evolving demands of medical emergencies and upholds AUSMAT’s commitment to excellence in global health emergencies.
Background: Why this project is essential
Over the past eight years, the surgical cache has evolved with valuable contributions from Royal Darwin Hospital (RDH) perioperative nurses and AUSMAT surgical and anaesthesia specialists. However, it has lacked a dedicated perioperative champion. Following the AUSMAT surgical course in September 2023, key AUSMAT faculty members recommended the appointment of dedicated perioperative champions to review and audit the cache. This ensures that the cache is always equipped with the appropriate equipment, instrumentation, and consumables, maintaining the cache in a constant state of readiness for deployment during disasters.
Project objectives and priorities
The primary goal of this project is multifaceted, focusing on both immediate and long-term improvements to the AUSMAT surgical cache, including:
1. Comprehensive audit and review:
The project aims to conduct a thorough audit of the 72-hour and bulk pallet caches. This audit will verify the presence and expiration dates of all consumables, equipment, and instrumentation. Ensuring that everything is in place and within its usability period is crucial for maintaining operational readiness.
2. Surgical Working Group:
Continuing the work with key AUSMAT surgical stakeholders from across Australia is a priority. This group will provide ongoing oversight, ensuring that the surgical cache meets the highest standards and is continuously improved.
3. Procurement:
Acquiring new equipment that is suitable for austere environments is another critical goal. This involves sourcing tools and instruments that can withstand the challenging conditions often encountered during AUSMAT deployments.
4. Workforce review:
Assessing and expanding the AUSMAT perioperative nursing workforce database is essential for building a sustainable future workforce. This review will help identify current capabilities and future needs, ensuring that AUSMAT can deploy skilled professionals whenever required.
5. Standards compliance:
Ensuring that Standard Operating Procedures (SOPs) within the AUSMAT Clinical Compendium reflect updates in AS/NZ 4187:2014 and new AS5369:2023 standards is crucial. This compliance ensures that all procedures are up-to-date and meet the latest industry standards. This includes updating all AUSMAT perioperative surgical nursing and medical deployment paperwork and documentation to benchmark against current AS/NZ perioperative standards is vital. This ensures that all processes and procedures are aligned with the best practices and standards.
6. Education:
Working with the NCCTRC Education team to update the AUSMAT perioperative nursing education curriculum is vital. This update aims to enhance engagement and address the specific learning needs of all staff. Ensuring that all perioperative AUSMAT members are well-prepared for their continuous skill improvement. Additionally, creating a repository of educational resources and e-learning activities will support ongoing training for perioperative nursing AUSMAT members. These resources will be invaluable for just-in-time learning and maintaining high standards of care.
7. Inventory system entry:
Ensuring all equipment, instrumentation, and consumables are accurately entered into the warehouse inventory system, UpLift, is essential for effective inventory management and operational readiness.
8. Final report and recommendations:
Preparing a final project report with recommendations for future improvements will provide a roadmap for ongoing enhancements to the surgical cache and overall preparedness.
This comprehensive project aims to ensure that AUSMAT's surgical cache is always ready for rapid deployment, improving disaster preparedness, and enhancing the effectiveness of medical responses in crisis situations. As this enhancement progresses, Merrilyn and Wendy reflect on the project’s developments and their personal experiences. Drawing from her deployment in Tacloban with the EMT Type 2 hospital, Wendy notes, "Each step we've taken to bolster the surgical cache has been informed by real-world challenges, ensuring we're truly prepared for the next disaster."
Each step we've taken to bolster the surgical cache has been informed by real-world challenges, ensuring we're truly prepared for the next disaster.
Their ongoing focus is on turning lessons learnt into actionable improvements that enhance AUSMAT's response capabilities. Together, Merrilyn and Wendy are not only upgrading a critical health resource but enhancing the capabilities of AUSMAT's personnel. Their work ensures that the team remains ahead of the curve in global health emergency responses.
Kathleen McDermott
Acting Director Disaster, Preparedness and Response
Kath played a significant, senior role in Australia’s response to the COVID-19 pandemic, both operationally and in the field. Kath was the Clinical Nurse Lead and then Mission Lead, supporting the establishment and operations of the AUSMAT Howard Springs International Quarantine Program from October 2020 – May 2021. As a registered nurse, with sub specialties that include public health, peri-operative, emergency and infectious diseases, and an established AUSMAT member, Kath has contributed to multiple deployments to incidents of national and international significance. Most recently this includes international AUSMAT deployments to support COVID-19 response in Fiji and Kiribati, as well as domestically. Kath has lived and worked in the Northern Territory for almost 30 years and commenced at the NCCTRC in 2008. Further experience includes roles as Research Coordinator and AUSMAT Health Information System Manager at NCCTRC, and as the AUSMAT representative on the WHO Minimum Data Set Working Group for EMTs which contributes to the AUSMAT field operations and member of various AUSMAT Technical Working Groups.
Merrilyn Diverall
AUSMAT Surgical Cache Review Project Nurse
Merrilyn is a Registered Nurse with extensive experience in perioperative nursing and clinical education. She has been a part of the NCCTRC’s Education Team since 2017 before her recent secondment to the NCCTRC’s Disaster Preparedness Response Team. Merrilyn has developed significant skills in creating clinical and educational programs. Coupled with three deployments in response to the COVID-19 pandemic, she now applies her expertise to enhance operational and educational outcomes in health emergencies.
Wendy Rogers
AUSMAT Surgical Cache Review Project Nurse
Wendy is a seasoned Perioperative Nurse with extensive experience from her tenure at the Royal Darwin Hospital (RDH) Operating Theatre. She first connected with NCCTRC and AUSMAT in 2011 by completing the AUSMAT Disaster Surgical and Anaesthetic Course. Wendy subsequently assisted NCCTRC in procuring of surgical instrumentation and consumables to strengthen AUSMAT’s deployment capabilities. Her notable deployment to Tacloban, Philippines in 2013, showcased her ability to adapt under challenging conditions, providing key improvisational skills in an austere environment. Wendy has continued to be involved with AUSMAT, contributing to the development of Standard Operating Procedures, serving as faculty for training courses and participating in verification exercises.
Carla Yeung
Communications and Digital Engagement Officer
