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I created this document in INC5 for a resource for the Primary Survey. It will be helpful for this week's content

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Other resources:
Mental Health Act 2015 : Important to recognise that Act as a nurse because it helps guide the treatment, care/support, rehabilitation and protection of people with a mental health disorder or illness and promoting the recovery of their mental health and wellbeing. This includes their rights, advance consent directions, emergency detention, ECT and forensic psychiatry.
URL: https://www.legislation.act.gov.au/a/2015-38

Workplace Violence Training Programs for Nursing Students: A Literature Review:
WPV can cause physical and psychological harm to nursing students, making them feel unsafe and can hinder their attitudes towards the nursing profession including discontinuing.
WPV Training Programs involving case scenarios and debrief sessions can assist student nursing with learning practical skills to prevent and manage incidents of WPV. This includes understanding types of WPV, prevention strategies, de-escalation techniques and post-event responses.
DOI: 10.1177/1078390321994665

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What? In simulation this week instead of the students presenting to the patient's room, we watched a pre-recorded video of a case scenario presented by the nursing teaching staff. The case scenario was based on a patient who was admitted to ED for asthma exacerbation however was agitated and keen to go home without medical clearance/advice.

So What? This case scenario allowed us to identify a variety of de-escalation techniques when caring for an agitated patient including body language, remaining calm, maintaining a safe distance, empathising, providing reassurances and not blocking the exit. We then reflected on the areas that could be improved; such as preventing stimuli that may trigger the patient including fidgeting or denying their hallucinations. This also included discussing that inappropriateness of trying to get the patient to comply with  interventions (e.g. medication) when they have already stated they do not want it. I know this would make me very frustrated and angry too.
Both patient and staff safety was also considered. This included highlighting key factors for when it is appropriate to escalate for help, e.g, patient becoming physical, yelling or throwing objects, as well as utilising code black. Not blocking the patient's exit and allowing the patient to leave were identified as elements to ensure patient and staff safety too.

Now What? This simulation activity was very helpful in re-enforcing de-escalation techniques and how to implement them in a clinical setting. This will be important for when I begin my clinical placement in the coming weeks and my for my future nursing career when interacting with agitated patients. The activity allowed me to also recognise the importance of engaging in a calm conversation utilising active listening with the patient to understand their current concerns which may be causing the frustration. Lastly, my own safety is important and I feel more confident in my ability to recognise when and who to escalate for help.

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My first placement for INC6 is the Emergency Department at Queanbeyan District Hospital & Health Service. This is my first ED experience as a student nurse. The placement will be conducted over 2 weeks with a mix a PM and AM shifts

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Experience in Caring for a Paediatric patient with a burn injury

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Experience in Caring for a Paediatric patient with a burn injury

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Do you have any experience in caring for a patient with a burn injury? No

Have you or someone close to you experienced a burn injury? No

Reflect on your experience and confidence in caring for a paediatric patient.

My placement at QBN ED was my first experience in caring for a paediatric patient. The patients ranged from 6 - 14 months. Since I lacked experience, I did not have a lot of confidence. I was very nervous and felt a little a little bit incompetent to provide high quality care to infants. Therefore I watched closely to the nurses and doctors in how they interacted with the infants and the parents. Each time, I had a paediatric patient under my care, my confidence to provide therapeutic care did increase however I would say I need more experience.

What are some key concepts that you would utilise when establishing and maintaining a therapeutic relationship with this unique population of patients?

Communicate using appropriate language. This could include positive body languages, soft language and avoid using medical jargon.

Building rapport and gaining trust by talking to them about their likes (e.g., TV programs, toys or pets)

Where possible, use an appropriate environment e.g., dim lights, quiet area or kid-friendly room with fun wallpapers and furniture.

Offer choices, where possible, and use known calming strategies.

Knowledge of childhood development stages to provide appropriate care.

Engaging with the parents, especially if the child is too young to provide their opinion.

Getting consent by someone of legal age (parent/guardian) or considered a mature minor (Gillick competence)

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An annotated bibliography of three research articles related to INC6 modules or PEP preparation

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Advanced Life Support (ALS) & C.O.A.C.H.E.D acronym

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What? For our skills activity, we watched and then debriefed on a video of a nurse provide a handover for her patient in a mental health hospital. The video showed the patient visibly fidgeting and appeared to be trying to swat an object that was not visible to the viewer.
So What? The video allowed us to identify and discuss elements that we thought needed improvements or were inappropriate towards the patient. One point we focused on was language, e.g., saying "the schizophrenic patient" instead of "the person experiencing schizophrenia". The later is important as it does not define the person with their condition.
Now What? To ensure throughout my nursing career I reflecting on conversation and understand words matter and can have a great impact on a person. This includes not defining a patient as their condition/illness and to acknowledge language regarding factors such as gender, culture, religion, disability etc.

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First Nations People exploratory response

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First Nations People exploratory response

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This is the resuscitation table which is located in one of the Resus Bays.

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For this seminar, we focused on linking the assessments (below) to the laboratory data (above) they present. This crucial for the diagnosis of DKA and is important for identifying the severity of DKA and the best treatment pathway.

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Forensic Drug & Alcohol Sampling in Emergency Departments

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Forensic Drug & Alcohol Sampling in Emergency Departments

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Forensic Drug and Alcohol Sampling

Policy Directive: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2021_010.pdf

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In the clinical lab, we practice administering fluid therapy of normal saline and IV insulin therapy for a 17 y/o Avery Black.

They had moderate dehydration and were 54kg therefore the of IVF was 160ml/hr. We also administered 5.4 units of insulin as the calculation for children and adolescents: 0.1 unit/kg/hr IV.

Use titration to aim to maintain the BGL between 6-12mmol/L.

We used the Canberra Hospital and Health Services Clinical Guideline: Paediatric and Adolescent Diabetes – Management (not neonates) as our evidence-based resource.

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ED Documentation - HIRAID

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Practice drug calculation questions I completed. The Clinical Nurse Educator marked it. 

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Practice drug calculations for Paediatric patients.

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In the skills lab, we practised utilising the Lund & Browder chart & Modified Parkland Formula to administer fluid rehydration appropriate to the burn injury. Additionally, we practiced administering intranasal fentanyl with the MAD device. This skills lab was beneficial as I was able to use tools and medication administering devices I am fairly unfamiliar with.

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Implicit Bias: In this week's seminar we explored 'implicit bias'. Implicit bias involves associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics. This includes race, gender, age, disability or socio status. Factors that we discussed can influence implicit bias include social norms, individual experiences, social media, surrounding environment (e.g., friends and family).

We highlighted that implicit bias is harmful to the therapeutic relationship that is crucial between patient and healthcare professional to provide high quality care. Implicit bias goes against the bioethical principles of beneficent and non-maleficence.

The activity we completed in the seminar was looking at 6 different photos of a person without any context and listing the words that come to our head when looking at each picture individually. At the end, we were given their story. We then compared our opinions/thoughts written on the whiteboard to the individuals stories. This activity allowed us as a group and as an individual myself to realise that we typically do hold bias against someone's appearance. It is important as nurses, to recognise we do this and incorporate self-reflection to examine our reasoning for decision making and wider environment. It is important to have personal accountability and ask the single question: ‘If this person were different in terms of race, age, gender, etc, would we treat them the same?’

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A resource which can assist the nurse in the triaging process

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Triage Process in the Emergency Department

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Throughout the semester I will use Borton's Model of Reflection to help guide my self-reflection once I have completed module learning activities and/or placement CPD.

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The link is to Clinical Practice Guidelines for DKA by The Royal Children's Hospital. I used this guideline to explore DKA in children including assessment and management.

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Diabetes mellitus
Diabetes phone calls

Diabetes mellitus and surgery

Key points

1. Cerebral oedema is the key life-threatening complication of DKA

2. When managing DKA, hypoglycaemia and hypo/hyperkalaemia are the other main complications which must be monitored for and treated

3. Children with DKA are deplete in total body potassium regardless of the initial serum potassium level

4. Measured serum sodium may be low due to osmotic dilution with glucose. Corrected sodium levels should be calculated and monitored

Background

The biochemical criteria for diagnosis of DKA are:

Children with hyperglycaemia (Blood glucose level (BGL) >11 mmol/L) +/- ketosis who are not acidotic can be managed with subcutaneous insulin (see Diabetes mellitus, new presentation, mildly ill).

Hyperglycaemic children with altered conscious state who are not acidotic (pH of ≥7.3) and have little to no ketonaemia may have hyperglycaemic-hyperosmolar non-ketotic coma. If this is a possibility, insulin should ONLY be given after discussion with local paediatric team and/or paediatric endocrinologist.

Precipitants for DKA

Assessment

History and examination are directed towards potential precipitants, assessment of severity, and detecting complications of DKA.

Assessment of Dehydration

Weigh child - compare to recent weight if available.

Caution

The degree of dehydration is often over-estimated in DKA, this may be compounded by peripheral shutdown due to acidosis.

Excessive fluid replacement may increase the risk of cerebral oedema.

Children and adolescents with DKA should be managed in a unit that has:

Investigations

Bloods - Insert an IV when taking bloods

Serum glucose

Urea, creatinine and electrolytes (sodium, potassium, calcium, magnesium, phosphate)

Venous gas (including bicarbonate)

FBE (haematocrit may be elevated as a marker of dehydration, WCC may be elevated as a stress response)

Blood ketones (bedside test, normal <0.6 mmol/L)

Consider investigations for precipitating cause: if clinical signs of infection consider septic work up

The following bloods are part of a diagnostic work up for first presentation T1DM: Insulin antibodies, GAD antibodies, ZnT8 antibodies, celiac screen (total IgA, anti-gliadin Ab, tissue transglutaminase Ab) TSH and fT4. Collect these bloods with initial blood sampling if practical. Please handover to admitting team if not done

Urine

Dipstick for ketones, glucose and FWT

Culture if clinical suspicion of UTI

Consider ECG if potassium results will be delayed

Once DKA is confirmed, the following biochemical monitoring should be put in place to guide ongoing management. These will continue until resolution of DKA:

Hourly - BGL, bedside ketone testing

At 2 hours and 2-4 hourly thereafter - VBG, UEC, Ca, Mg, PO4

Severity of DKA

Assessed based on the more severe of these parameters:

Venous pH

Bicarbonate (mmol/L)

Treatment

Goals of Treatment:

Sections below include:

1. Correct dehydration

2. Reverse ketosis, correct acidosis and glucose

3. Monitor for complications of DKA and its treatment: Cerebral oedema, hypo/hyperkalaemia, hypoglycaemia

4. Identify and treat any precipitating cause

Airway/Breathing/Circulation

Supportive measures and monitoring

Nurse head up

In children with reduced conscious state monitor airway safety. Consider inserting an NGT to prevent aspiration

Keep nil by mouth until child is alert and preferably until acidosis resolves. Children can be given ice to suck on for comfort

Insert second IVC to use as a blood sampling line, take initial diagnostic bloods if not drawn with initial IVC insertion

Supplemental oxygen for children with severe circulatory impairment or shock

Cardiac monitoring - for assessment of ECG changes related to potassium levels (hyperkalaemia: peaked T waves, widened QRS, hypokalaemia: flattened or inverted T waves, ST depression, PR prolongation). See ECG Interpretation

Consider antibiotics for febrile children after obtaining appropriate cultures

Consider urinary catheter for children who are unconscious to allow strict monitoring of fluid balance. Weighing nappies can be used for strict fluid balance for children who can't urinate on demand

Timeline of monitoring and management

Presentation

Assessment and ABC

IV access and initial bloods including VBG

Weigh child

Start rehydration fluids

Nurse head up

Document passage of urine (ask child to void)

0.9% sodium chloride +/- potassium

1 hour

Fluid balance

Vital signs

Neurological observations

BGL and bedside ketones

Start insulin infusion

2 hours

Fluid balance

Vital signs

Neurological observations, VBG,

VBG and bedside ketones

UEC (must check serum potassium within 1 hour of starting insulin infusion)

Serum calcium, magnesium, phosphate

Adjust fluids if required based on glucose and electrolytes

3 hours

Fluid balance

Vital signs

Neurological observations

BGL and bedside ketones

Adjust fluids if required based on glucose

4 hours

Fluid balance

Vital signs

Neurological observations

VBG and bedside ketones

UEC

Serum calcium, magnesium, phosphate

Adjust fluids if required based on glucose and electrolytes

5 hours

Fluid balance

Vital signs

Neurological observations

BGL and bedside ketones

Adjust fluids if required based on glucose

6 hours

Continue the following hourly:

Fluid balance

Vital signs

Neurological observations

BGL and bedside ketones

Continue the following 1-2 hourly:

BGL

Continue the following 2-4 hourly:

UEC

VBG

Serum calcium, magnesium, phosphate

1) Correct Dehydration

Children with DKA will be dehydrated. Clinical estimates of fluid deficits are subjective and often inaccurate thus most children can initially be commenced on the "mild" or "moderate" fluid rate (see below).

A 10 mL/kg 0.9% sodium chloride bolus can be given to children who are tachycardic with delayed central capillary refill.

This should be followed by a reassessment

Acidosis results in poor peripheral perfusion so use central capillary refill with vital signs to assess response to fluids

Initial Fluid Replacement

Commence rehydration with isotonic fluid eg 0.9% sodium chloride.

Keep nil by mouth until child is alert and acidosis has resolved.

Children can be given ice to suck on for comfort.

Intravenous or oral fluids that have been given at another facility may need to be factored into the assessment and calculation of fluid deficit and replacement.

If the child has received more than 20 mL/kg, discuss the adjustment of fluids with the consultant.

Initial fluid rates (mL/hr) based on degree of dehydration

Fluid Adjustments

Frequent monitoring of electrolytes, glucose, and osmolality will guide fluid composition and infusion rates. Fluids containing 0.9% sodium chloride should be continued for at least the first 6 hours.

The three key parameters to monitor and manage are:

Osmolality can be calculated using the following formula:

Osmolality = 2 x (serum sodium + serum potassium) + glucose + urea

Glucose

BGL will decrease rapidly during initial rehydration / volume expansion and continue to decrease once the insulin infusion is started

Once BGL is ≤ 15 mmol/L change fluids to 0.9% sodium chloride with 5% glucose and potassium chloride (maximum 60 mmol/L) as required

Aim to keep the BGL between 5-10 mmol/L

If BGL falls below 5mmol/L or is falling rapidly (>5 mmol/L/hour) in the range between 5-15 mmol/L and the child remains acidotic, increase the glucose content to 10%

Insulin infusion rate should only be decreased if BGL continues to fall despite glucose concentration of 10%

Potassium

Children with DKA have a deficit of total body potassium however serum potassium levels may be normal, high, or low

Treatment with insulin will shift potassium to the intracellular space rapidly resulting in hypokalaemia if potassium is not replaced

Start potassium chloride at a concentration of 40 mmol/L, increase to a maximum 60 mmol/L if required to maintain serum potassium in the normal range

Once insulin is commenced, a repeat serum potassium should be measured within one hour and two to four hourly thereafter

Sodium

Measured sodium is depressed by the dilutional effect of hyperglycaemia

Corrected sodium can be calculated with this formula:
Corrected sodium = measured sodium + 0.3 x (glucose - 5.5) mmol/L
ie 3 mmol/L sodium to be added for every 10 mmol/L of glucose above 5.5 mmol/L.

0.9% sodium chloride with glucose and potassium chloride (maximum 60 mmol/L) as required should generally be used for the duration of IV rehydration

If a hypotonic solution is later thought to be required, discuss this with the paediatric endocrinologist on call. The sodium chloride content should be at least 0.45% or greater

If measured sodium does not rise as the glucose falls during treatment or if hyponatraemia develops, this usually indicates excessive fluid correction which may increase the risk of cerebral oedema

Extremes of corrected sodium should be discussed with a senior doctor early

IV fluids can be ceased once pH and bicarbonate have normalised and the child is able to tolerate oral intake (this usually coincides with insulin being changed to subcutaneous injections).

Phosphate

2) Reverse ketosis and correct acidosis

IV rehydration should be commenced prior to starting an insulin infusion.

Insulin

To make up the insulin infusion:

Add 50 units of clear/rapid acting insulin (Actrapid HM or Humulin R) to 49.5 mL of 0.9% sodium chloride to form a 1 unit/mL solution.

Initial insulin infusion rates

Children with DKA should generally be commenced at 0.1 units/kg/hour

A reduced infusion rate of 0.05 units/kg/hour should be used for:

Children undergoing inter-hospital transfer (limited access to biochemical monitoring)

Children less than 5 years old

Children with BGL <15 mmol/L at the time of commencement of the insulin infusion

Practical points

Insulin infusion can be run as a sideline with the rehydration fluids via a three-way tap provided a syringe pump is used. Ensure the insulin is clearly labelled

Adequate insulin must be continued to clear ketones and correct acidosis

Aim to keep the blood glucose between 5-10 mmol/L by increasing the fluid glucose concentration to 10% before adjusting the insulin infusion rate

Changing from an insulin infusion to subcutaneous insulin:

Can be changed when child is alert and metabolically stable (pH>7.3, HCO3 > 15)

Best time to change to subcutaneous insulin is just prior to a meal. Discuss the dose and regimen with the consultant on call

Continue the insulin infusion for 30 minutes after the first subcutaneous injection of rapid-acting insulin, then cease

3) Monitor for complications of DKA and its treatment

The most important complications of DKA and its treatment are:

Cerebral oedema

Hypoglycaemia

Hypo/hyperkalaemia

Hypo/hypernatraemia

Aspiration (if obtunded)

Cerebral Oedema

Background

Some degree of subclinical brain swelling is present during most episodes of DKA

Clinical cerebral oedema occurs suddenly, usually between 6-12 hours after starting therapy (range 2-24 hours)

Mortality and severe morbidity rates are very high without early treatment

If cerebral oedema is suspected, this should be immediately discussed with a consultant

Risk Factors

Signs

Treatment

Nurse head up

Reduce fluid infusion rate by one-third

Contact Paediatric, Infant and Perinatal Emergency Retrievals on 1300 137 650[KH14]

Give mannitol immediately if cerebral oedema suspected - do NOT wait for cerebral imaging.

Mannitol 20% (0.2 g/mL) dose: 0.5 g/kg IV over 20 minutes (dose range: 0.25-1 g/kg), repeat if no improvement within 30-60mins.

Discuss with consultant on call and liaise with intensive care or paediatric retrieval service to discuss transfer.

A BGL of <4.0 mmol/L should be treated with additional glucose as below.

2 mL/kg 10% glucose IV bolus (repeat if required) and change rehydration fluids to include 10% glucose with 0.9% sodium chloride, with potassium chloride (maximum 60 mmol/L) as required

Do NOT discontinue the insulin infusion

If hypoglycaemia occurs despite use of 10% glucose in preceding 2 hours - decrease insulin infusion to 0.05 units/kg/hr (0.03 units/kg/hr if previously on 0.05 units/kg/hr)

Continue with 10% glucose in fluids until BGL is stable between 5-10 mmol/L

Oral treatment for hypoglycaemia can be used if pH≥7.3 and the child is alert and able to tolerate oral intake. Use 4-5 Jelly beans or a serve of juice: 60 mL (5g carbohydrate) for children <25kg, 120 mL (10g carbohydrate) for children ≥25kg

Recheck BGL after 15-20mins and give another serve of juice or jelly beans if BGL still <4.0 mmol/L. If oral treatment has been used discuss timing of transition to sub-cutaneous insulin and oral diet with endocrinology / consultant on call

4) Identify and Treat precipitating cause

Assess for underlying infections and consider antibiotics after obtaining relevant cultures if appropriate.

Overall, infective precipitants are uncommon.

In children with known T1DM the most common cause of DKA is omission or significant reduction in recent insulin doses.

Other Things to Consider

Persisting Acidosis

If the acidosis is not correcting, consider the following:

Insufficient insulin to switch off ketosis (check insulin delivery)

Inadequate rehydration

Sepsis

Hyperchloraemic acidosis (secondary to IV fluids)

Salicylates or other substances that cause metabolic acidosis

Rarely required

Bicarbonate

Discuss with consultant endocrinologist prior to administration

ONLY appropriate for children with life threatening hyperkalaemia or requiring inotropic support

May cause paradoxical CNS acidosis

Associated with increased risk of cerebral oedema

Sodium bicarbonate dose (mmol) = 0.15 x body weight (kg) x base deficit (mmol/L)

Administer IV over 30-60 minutes with cardiac monitoring

Reassess acid-base status and beware of hypokalaemia

Consider consultation with local paediatric team for

All children with DKA
All newly diagnosed diabetes mellitus
Hyper/hyponatraemia

Consider transfer when

Intensive care monitoring is recommended for

Children <2 years of age

Coma

Cardiovascular compromise

Seizures

Signs of cerebral oedema

Severe acidosis (pH <7.1 or HCO3<5)

The care required is beyond the level of comfort or resources of the local hospital. Children and adolescents with DKA should be managed in a unit that has:

For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.

Information specific to RCH and Monash Children's Hospital:

Children with DKA should be discussed with the paediatric endocrinologist on-call

Last Updated November 2018

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Diabetes mellitus Diabetes phone calls Diabetes mellitus and surgery Cerebral oedema is the key life-threatening complication of DKA When managing DKA, hypoglycaemia and hypo/hyperkalaemia are the other main complications which must be monitored for and treated Children with DKA are deplete in total body potassium regardless of the initial serum potassium level Measured serum sodium may be low due to osmotic dilution with glucose.

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In the Seminar we listened to a podcast of Bec interviewing a mother whose young child had suffering burn injuries and their experience of receiving healthcare whilst living in rural Victoria.

Parent's Perspective: The child's mother is a nurse, therefore we explored her role as a mum and a healthcare worker. She highlighted that when it did occur her 'mum mode' did activate and she focused on that whilst letting the healthcare professionals do their job. She mentioned her struggles were trying to explain to her child what had occurred and what it meant e.g., not being allowed to shower or go outside to play.

Rural: living rurally did have a burden on the family as they had to travel for hours to attend their specialist appointments in Melbourne. This costs time and money for the family. Also a long car ride for a young child who has suffered burn injuries would not be comfortable. They were however extremely impressed by the expertise the Burns Unit at the Royal Children's Hospital provided. One thing that the mother highlighted was the incredible support they providing including contact numbers and emails, which was important due to living rurally.

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A mind map I created of some of the ideas mentioned by Peta in the podcast about Trauma Informed Care. It was great to hear from a professional's experience in mental health care and forensic mental health. She also provided some great tips on how to interact with patients experiencing mental health as well as de-escalation tips too.

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What?
This week we focused on caring for patients who have experienced workplace injuries. The simulation focused on conducting a primary and secondary assessment on a patient and involved a speedy deterioration of the patient. The seminar involved a podcast with a physiotherapist and occupational therapist and their role as part of the MDT to help the patient get back to normal as much as possible and providing support networks and systems in the hospital and in everyday life e.g., going back to work. The skills session allowed us to practice a primary and secondary assessment and implement interventions to help the patient. Number 3 chilli allowed us to discuss how medications may add/detract concerns we may have for the patient e.g., are they masking symptoms?

So What?
One of the discussion points I found very beneficial in the simulation activity was considering our scope of practice when a patient is rapidly deteriorating and pushing away the hesitation to press the MET call button. Remaining calm !BREATHE! and collecting your thoughts to present a quick ISBAR handover focussing on the 'now problem' for the MET team was an element I found important as it is one of my concerns knowing I may one day have to press the button. In the seminar, an aspect that stood out was the physiotherapist mentioning that they only see the patient for a short period on a daily basis whilst they are admitted and therefore they rely on the nursing observing the patient's throughout the day to get a bigger picture of the patient's current ability. This is important to know as a new nurse as if I am able to provide further information to the physiotherapist to help better the patient's recovery process, then that would make me feel good.  Listening to the OT, allowed me to recognise the significant impacts a head injury can have in the longer term, such as considering the cognitive impacts (e.g., memory, attention and concentration) and how that make affect the patient's work life or doing everyday things such as driving.

Now What?
- continue to challenge myself, and complete the 3 chilli tasks
- continue to practice primary and secondary survey
- trust my instinct on knowing signs of deterioration. A MET call is not scary, press it. Or call the staff assist.
- Use delegation in my practice when in moments of pressure or high intensity.
- Collaborate with the MDT to help to patient's recovery!!

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WorkSafe ACT is responsible for regulating the workers' compensation legislation.

WorkSafe ACT inspectors are appointment under the Workers Compensation Act 1951 - https://www.legislation.act.gov.au/View/a/1951-2/current/html/1951-2.html
They make sure employers are fulfilling their workers' compensation obligations. Inspectors are also authorised to investigate employee complaints, investigate contraventions, refer breaches for regulatory sanctions and/or prosecutions.

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What is workers' compensation?

Workers' compensation is a type of insurance that can offer injured workers an important safety net if they are injured or become ill because of work.

If a worker is injured at work, they can lodge a claim against their employer's mandatory insurance policy to:

Need more info?

The Workers Compensation Act 1951 makes sure workers' are supported to return to work through injury management and income support. It works together with the ACT's work health and safety legislative framework, which seeks to reduce costs of work-related injury through improving the management of health and safety in the workplace.

If you would like to find out more about workers' compensation indexation of benefits, please read ACT Indexation Benefit Guide (PDF 333KB) or (WORD (128KB).

To assist insurers, employers and workers' operating within the ACT private sector workers' compensation scheme please review the ACT wages and earnings guide - December 2016.

For more information about employer obligations, read our guidance note (PDF 208KB) or (WORD 94KB).

For information about the Labour Hire Licensing Act 2020, visit the ACT Legislation Register. For information about Labour Hire, read our guidance note.

To get qualifications as a 'return to work coordinator', Carfi is offering training sessions at the following times:

Tuesday 27 June & Wednesday 28 June 2023, 9.00am - 12.30pm via Zoom each day

Tuesday 5 September 2023, 8.30am - 4.30pm, face-to-face at Carfi Office: Unit 4, 27-29 Napier Close, DEAKIN, ACT 2600 (lunch provided)

Tuesday 5 December & Wednesday 6 December 2023, 9.00am - 12.30pm via Zoom each day

Please register via Carfi's online form.

Injured Workers' Service Canberra

The Injured Workers Service Canberra provides free and confidential non-legal advice, assistance, and support to injured workers in the ACT. The Injured Workers Service is funded by Employers Mutual Limited (EML) and operated by the Trades and Labour Council of the ACT (UnionsACT).

The purpose of the Injured Workers' Support Service is to provide independent, non-legal advice and support to injured workers to help them navigate the workers' compensation claims process, indicate relevant trade unions and referral pathways for ongoing support and, where possible, help them return to meaningful work.

Workers in the ACT can contact the Service via the website, email and phone line, or through referrals by EML and UnionsACT affiliated unions. The Service's contact information are email: injuredworkerscbr@unionsact.org.au, phone: (02) 8294 5181 or website: https://injuredworkerscbr.org.au/.

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Workers’ compensation is a type of insurance that can offer injured workers an important safety net if they are injured or become ill because of work.