Journal articles: 'Emergency nursing Victoria Melbourne'

1

Considine, Julie, Tony Walker, and Debra Berry. "Development, implementation and evaluation of an interprofessional graduate program for nursing–paramedicine double-degree graduates." Australian Health Review 39, no. 5 (2015): 595. http://dx.doi.org/10.1071/ah14258.

Full text

Abstract:

Over the past decade, several Australian universities have offered a double degree in nursing and paramedicine. Mainstream employment models that facilitate integrated graduate practice in both nursing and paramedicine are currently lacking. The aim of the present study was to detail the development of the Interprofessional Graduate Program (IPG), the industrial and professional issues that required solutions, outcomes from the first pilot IPG group and future directions. The IPG was an 18-month program during which participants rotated between graduate nursing experience in emergency nursing at Northern Health, Melbourne, Australia and graduate paramedic experience with Ambulance Victoria. The first IPG with 10 participants ran from January 2011 to August 2012. A survey completed by nine of the 10 participants in March 2014 showed that all nine participants nominated Ambulance Victoria as their main employer and five participants were working casual shifts in nursing. Alternative graduate programs that span two health disciplines are feasible but hampered by rigid industrial relations structures and professional ideologies. Despite a ‘purpose built’ graduate program that spanned two disciplines, traditional organisational structures still hamper double-degree graduates using all of skills to full capacity, and force the selection of one dominant profession. What is known about the topic? There are no employment models that facilitate integrated graduate practice in both nursing and paramedicine. The lack of innovative employment models for double-degree graduates means that current graduate program structures force double-degree graduates to practice in one discipline, negating the intent of a double degree. What does this paper add? This is the first time that a graduate program specifically designed for double-degree graduates with qualifications as Registered Nurses and Paramedics has been developed, delivered and evaluated. This paper confirms that graduate programs spanning two health disciplines are feasible. What are the implications for practitioners? Even with a graduate program specifically designed to span nursing and paramedicine, traditional organisational structures still hamper double-degree graduates using all their skills to full capacity, and force the selection of one dominant profession.

APA, Harvard, Vancouver, ISO, and other styles

2

Berridge, Bonita J., Terence V. McCann, Ali Cheetham, and Dan I. Lubman. "Perceived Barriers and Enablers of Help-Seeking for Substance Use Problems During Adolescence." Health Promotion Practice 19, no. 1 (February 1, 2017): 86–93. http://dx.doi.org/10.1177/1524839917691944.

Full text

Abstract:

Aim. Receiving professional help early can reduce long-term harms associated with substance use. However, little is known about the factors that influence help-seeking for substance use problems during early-mid adolescence, prior to the emergence of disorder. Given that beliefs regarding help-seeking are likely to develop early, understanding adolescent views of help-seeking during this period is likely to provide important information for prevention and intervention efforts. The current study identifies perceptions that would facilitate or prevent adolescents from seeking support for substance use problems from formal and informal help sources. Method. Thirty-four 12- to 16-year-olds from two schools in Melbourne, Victoria, Australia, were recruited. A qualitative interpretative design was used, incorporating semistructured, audio-recorded interviews. Results. Three overlapping themes that reflected barriers or enablers to help-seeking were identified: approachability, confidentiality and trustworthiness, and expertise. Help-seeking was facilitated when adolescents believed that the help source would be supportive and understanding, would keep information confidential, and had expertise in the alcohol and drug field. Conversely, adolescents were reluctant to seek help from sources they believed would be judgmental, lacked expertise, or would inform their parents. Conclusions. These findings highlight perceptions that may influence help-seeking for alcohol and drug problems during adolescence. Further research is needed to determine if help-seeking can be facilitated by improving parents’ and peers’ knowledge and promoting health professionals’ expertise in working with young people’s alcohol and drug issues.

APA, Harvard, Vancouver, ISO, and other styles

3

Mitra, Biswadev, Jubair Al Jubair, Peter A. Cameron, and Belinda J. Gabbe. "Tram-related trauma in Melbourne, Victoria." Emergency Medicine Australasia 22, no. 4 (August 2010): 337–42. http://dx.doi.org/10.1111/j.1742-6723.2010.01309.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

WAPOLE, BRYAN. "The first national meeting of emergency medicine doctors JULY 1981 MELBOURNE: VICTORIA." Emergency Medicine 3 (August 26, 2009): 188–89. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00730.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Rahman, Asheq, Catherine Martin, Andis Graudins, and Rose Chapman. "Deliberate Self-Poisoning Presenting to an Emergency Medicine Network in South-East Melbourne: A Descriptive Study." Emergency Medicine International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/461841.

Full text

Abstract:

Background. Deliberate self-poisoning (DSP) comprises a small but significant proportion of presentations to the emergency department (ED). However, the prevalence and patient characteristics of self-poisoning attendances to EDs in Victoria have not been recently characterised.Aim. To identify and compare the characteristics of adult patients presenting to the three EDs of Monash Health following DSP.Methods. Retrospective clinical audit of adult DSP attendances between 1st July 2009 and 30th June 2012.Results. A total of 3558 cases over three years were identified fulfilling the search criteria. The mean age of patients was 36.3 years with the largest numbers aged between 18 and 30 (38%). About 30% of patients were born overseas. Forty-eight percent were discharged home, 15% were admitted to ED short stay units, and 5% required ICU admission. The median ED length of stay was 359 minutes (IQR 231–607). The most frequently reported substances in DSP were benzodiazepines (36.6%), paracetamol (22.2%), and antipsychotics (12.1%). Exposure to more than one substance for the episode of DSP was common (47%).Conclusion. This information may help identify the trends in poisoning substances used for DSP in Victoria, which in turn may provide clinicians with information to provide more focused and targeted interventions.

APA, Harvard, Vancouver, ISO, and other styles

6

King, Meredith A., and Jaclyn Yoong. "Palliative care nursing during the COVID-19 pandemic: reflections from Melbourne, Australia." International Journal of Palliative Nursing 29, no. 1 (January 2, 2023): 43–47. http://dx.doi.org/10.12968/ijpn.2023.29.1.43.

Full text

Abstract:

Background: Nurses played a critical role in providing care for patients throughout the COVID-19 pandemic. Aim: This study aimed to explore perspectives of Australian palliative care nurses regarding the impact of COVID-19 on the provision of care for patients with advanced illness, or at the end of life. Methods: The authors conducted a survey of palliative care nurses in ward- and consultation-based roles at a metropolitan health service in Victoria, Australia. Findings: A total of 24 out of 39 nurses completed the survey. Responses included strong themes of fear of COVID-19 and sadness about separating dying patients from their families. Conclusion: Delivery of palliative care changed at an individual and service level. Importantly, there were strong themes of adapting to change and ‘soldiering on’ with the core business of palliative care.

APA, Harvard, Vancouver, ISO, and other styles

7

Eastwood, Kathryn, Dhanya Nambiar, Rosamond Dwyer, Judy A. Lowthian, Peter Cameron, and Karen Smith. "Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study." BMJ Open 10, no. 11 (November 2020): e042351. http://dx.doi.org/10.1136/bmjopen-2020-042351.

Full text

Abstract:

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

APA, Harvard, Vancouver, ISO, and other styles

8

Cheng, I.-Hao, Jacquie McBride, Miriam Decker, Therese Watson, Hannah Jakubenko, and Alana Russo. "The Asylum Seeker Integrated Healthcare Pathway: a collaborative approach to improving access to primary health care in South Eastern Melbourne, Victoria, Australia." Australian Journal of Primary Health 25, no. 1 (2019): 6. http://dx.doi.org/10.1071/py18028.

Full text

Abstract:

It is important to address the health needs of asylum seekers within the early stages of their arrival in Australia, as this impacts all aspects of their resettlement. However, asylum seekers face a range of barriers to accessing timely and appropriate health care in the community. In 2012, the increasing number of asylum seekers in Australia placed additional demand on health and social services in high-settlement regions. Health providers experienced a substantial increase in Medicare ineligible clients and avoidable presentations to Emergency Departments, and the health needs of new asylum seeker arrivals were not being fully addressed. In response, South Eastern Melbourne Medicare Local, Monash Health, the Australian Red Cross and local settlement support agencies collaborated to develop an integrated healthcare pathway in South Eastern Melbourne to facilitate healthcare access for asylum seekers released from detention. From September 2012 to December 2014, a total of 951 asylum seekers transitioned through the pathway. Seventy-eight percent required primary healthcare assistance, and were provided with a service appointment within 3 weeks of their arrival in Melbourne. This initiative has demonstrated the value of partnership and collaboration when responding to emergent asylum seeker health needs.

APA, Harvard, Vancouver, ISO, and other styles

9

Jennings, Natasha, Gerard O'Reilly, Geraldine Lee, Peter Cameron, Belinda Free, and Michael Bailey. "Evaluating outcomes of the emergency nurse practitioner role in a major urban emergency department, Melbourne, Australia." Journal of Clinical Nursing 17, no. 8 (April 2008): 1044–50. http://dx.doi.org/10.1111/j.1365-2702.2007.02038.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Zhao, Henry, Lauren Pesavento, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, et al. "009 The ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithmic pre-hospital triage tool for endovascular thrombectomy: ongoing paramedic validation." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A5.1—A5. http://dx.doi.org/10.1136/jnnp-2018-anzan.9.

Full text

Abstract:

IntroductionThe ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithm is a severity based 3-step paramedic triage tool for pre-hospital recognition of large vessel occlusion (LVO), designed to improve specificity and paramedic assessment reliability compared to existing triage scales. ACT-FAST sequentially assesses 1. Unilateral arm fall to stretcher <10 s; 2a. Severe language disturbance (right arm weak), or 2b. Severe gaze deviation/hemi-neglect assessed by shoulder tap (left arm weak); 3. Clinical eligibility questions. We present the results of the ongoing Ambulance Victoria paramedic validation study.MethodsAmbulance Victoria paramedics assessed ACT-FAST in all suspected stroke patients pre-hospital in metropolitan Melbourne, Australia, and in the Royal Melbourne Hospital Emergency Department since July 2017. Algorithm results were validated against a comparator of ICA/M1 occlusion on CT-angiography with NIHSS ≥6 (Class 1 indications for endovascular thrombectomy).ResultsData were available from n=119 assessments (ED n=68, pre-hospital n=51). Patient diagnoses were LVO n=20 (15.6%), non-LVO infarcts n=45 (38.5%), ICH n=10 (8.3%) and no stroke on imaging n=44 (37.6%). ACT-FAST showed 85% sensitivity, 88.9% specificity, 60.7% (72% excluding ICH) positive predictive value and 96.7% negative predictive value for LVO. Of 10 false-positives, 4 received thrombectomy for non-Class 1 indications (basilar/M2 occlusions/cervical dissection), 3 were ICH, and 1 was tumour. Three false-negatives were LVO with milder syndromes.DiscussionThe ongoing ACT-FAST algorithm validation study shows high accuracy for clinical recognition of LVO. The streamlined algorithmic approach with just two examination items provides a more practical option for implementation in large emergency service networks. Accurate pre-hospital recognition of LVO will allow bypass to endovascular centres and early activation of neuro-intervention services to expedite endovascular thrombectomy.

APA, Harvard, Vancouver, ISO, and other styles

11

McMillan, Alison. "Epidemic Thunderstorm Asthma." Prehospital and Disaster Medicine 34, s1 (May 2019): s7. http://dx.doi.org/10.1017/s1049023x19000335.

Full text

Abstract:

Introduction:On November 21 and 22 of 2016, Victoria witnessed an unprecedented epidemic thunderstorm asthma emergency event in size acuity and impact. This scenario was never exercised nor contemplated. The event resulted in a 73% increase in calls to the Emergency Services Telecommunications Authority and 814 ambulance cases in the six hours from 6 pm on November 21, 2016. A 58% increase in people presented to public hospital emergency departments in Melbourne and Geelong on November 21 and 22, 2016 (based on the three-year average). 313 calls were made to the nurse on call from people with breathing, respiratory, and allergy problems (compared to an average of 63 calls for the previous month). Tragically, ten deaths are linked to this event.Methods:A substantial amount of work has been completed, much of which goes towards addressing the Inspector-General for Emergency Management recommendations following a review of the event, including: Release of an epidemic thunderstorm asthma campaign and education programs which were rolled out across Victoria for the community and health professionals from September through November 2017;Development of a new epidemic thunderstorm asthma forecasting system on 1 October 2017 and updated warning protocols during the 2017 grass pollen season;Implementation of a Real-time Health Emergency Monitoring System to alert the department of demands on public hospital emergency departments on the system; andIntroduction of a new State Health Emergency Response Plan in October 2017 to improve coordination and communications before and during a health emergency.Discussion:The presentation will concentrate on the lessons learned more than two years down the track from the event in November 2016.

APA, Harvard, Vancouver, ISO, and other styles

12

Cox, Shelley, Rohan Martin, Piyali Somaia, and Karen Smith. "The development of a data-matching algorithm to define the ‘case patient’." Australian Health Review 37, no. 1 (2013): 54. http://dx.doi.org/10.1071/ah11161.

Full text

Abstract:

Objectives. To describe a model that matches electronic patient care records within a given case to one or more patients within that case. Method. This retrospective study included data from all metropolitan Ambulance Victoria electronic patient care records (n = 445 576) for the time period 1 January 2009–31 May 2010. Data were captured via VACIS (Ambulance Victoria, Melbourne, Vic., Australia), an in-field electronic data capture system linked to an integrated data warehouse database. The case patient algorithm included ‘Jaro–Winkler’, ‘Soundex’ and ‘weight matching’ conditions. Results. The case patient matching algorithm has a sensitivity of 99.98%, a specificity of 99.91% and an overall accuracy of 99.98%. Conclusions. The case patient algorithm provides Ambulance Victoria with a sophisticated, efficient and highly accurate method of matching patient records within a given case. This method has applicability to other emergency services where unique identifiers are case based rather than patient based. What is known about the topic? Accurate pre-hospital data that can be linked to patient outcomes is widely accepted as critical to support pre-hospital patient care and system performance. What does this paper add? There is a paucity of literature describing electronic matching of patient care records at the patient level rather than the case level. Ambulance Victoria has developed a complex yet efficient and highly accurate method for electronically matching patient records, in the absence of a patient-specific unique identifier. Linkage of patient information from multiple patient care records to determine if the records are for the same individual defines the ‘case patient’. What are the implications for practitioners? This paper describes a model of record linkage where patients are matched within a given case at the patient level as opposed to the case level. This methodology is applicable to other emergency services where unique identifiers are case based.

APA, Harvard, Vancouver, ISO, and other styles

13

Grundstein, Andrew, Marshall Shepherd, Paul Miller, and Stefanie Ebelt Sarnat. "The Role of Mesoscale-Convective Processes in Explaining the 21 November 2016 Epidemic Thunderstorm Asthma Event in Melbourne, Australia." Journal of Applied Meteorology and Climatology 56, no. 5 (May 2017): 1337–43. http://dx.doi.org/10.1175/jamc-d-17-0027.1.

Full text

Abstract:

AbstractA major thunderstorm asthma epidemic struck Melbourne and surrounding Victoria, Australia, on 21 November 2016, which led to multiple deaths, a flood of residents seeking medical attention for respiratory problems, and an overwhelmed emergency management system. This case day had all the classic ingredients for an epidemic, including high rye grass pollen concentrations, a strong multicellular thunderstorm system moving across the region, and a large population of several million people in the vicinity of Melbourne. A particular characteristic of this event was the strong, gusty winds that likely spread the pollen grains and/or allergenic contents widely across the region to increase population exposure. This exploratory case study is the first to examine the usefulness of low-to-middle-atmospheric thermodynamic information for anticipating epidemic thunderstorm asthma outbreaks by allowing the forecast of strong downdraft winds. The authors investigated the utility of several mesoscale products derived from atmospheric soundings such as downdraft convective available potential energy (DCAPE) and indices for predicting surface wind gusts such as microburst wind speed potential index (MWPI) and a wind gust index (GUSTEX). These results indicate that DCAPE levels reached “high” to “very high” thresholds for strong downdraft winds in the lead-up to the thunderstorm, and the MWPI and GUSTEX indices accurately predicted the high maximum surface wind observations. This information may be useful for diagnostic and prognostic assessment of epidemic thunderstorm asthma and in providing an early warning to health practitioners, emergency management officials, and residents in affected areas.

APA, Harvard, Vancouver, ISO, and other styles

14

Curtis, Kate, Margaret Fry, Sarah Kourouche, Belinda Kennedy, Julie Considine, Hatem Alkhouri, Mary Lam, et al. "Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): study protocol for a step-wedge randomised control trial." BMJ Open 13, no. 1 (January 2023): e067022. http://dx.doi.org/10.1136/bmjopen-2022-067022.

Full text

Abstract:

IntroductionPoor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) was developed and piloted. This paper presents the rationale and protocol for a multicentre clinical trial of HIRAID.Methods and analysisUsing an effectiveness-implementation hybrid design, the study incorporates a stepped-wedge cluster randomised controlled trial of HIRAID at 31 emergency departments (EDs) in New South Wales, Victoria and Queensland. The primary outcomes are incidence of inpatient deterioration related to ED care, time to analgesia, patient satisfaction and medical satisfaction with nursing clinical handover (effectiveness). Strategies that optimise HIRAID uptake (implementation) and implementation fidelity will be determined to assess if HIRAID was implemented as intended at all sites.Ethics and disseminationEthics has been approved for NSW sites through Greater Western Human Research Ethics Committee (2020/ETH02164), and for Victoria and Queensland sites through Royal Brisbane & Woman’s Hospital Human Research Ethics Committee (2021/QRBW/80026). The final phase of the study will integrate the findings in a toolkit for national rollout. A dissemination, communications (variety of platforms) and upscaling strategy will be designed and actioned with the organisations that influence state and national level health policy and emergency nurse education, including the Australian Commission for Quality and Safety in Health Care. Scaling up of findings could be achieved by embedding HIRAID into national transition to nursing programmes, ‘business as usual’ ED training schedules and university curricula.Trial registration numberACTRN12621001456842.

APA, Harvard, Vancouver, ISO, and other styles

15

Crock, Elizabeth, and Judy-Ann Butwilowsky. "The HIV Resource Nurse Role at the Royal District Nursing Service (Melbourne): Making A Difference for People Living with HIV/AIDS in the Community." Australian Journal of Primary Health 12, no. 2 (2006): 83. http://dx.doi.org/10.1071/py06026.

Full text

Abstract:

The care of people living with HIV/AIDS in the home and community can be complex and challenging, requiring high levels of knowledge, skill, preparedness and, importantly, the ability to engage with people belonging to marginalised groups. In 2003, the Royal District Nursing Service (RDNS) HIV/AIDS Team in Victoria, Australia, developed the new role of HIV Resource Nurse at two RDNS centres in Melbourne serving high numbers of people living with HIV/AIDS. Drawing from two case studies and interviews with two HIV Resource Nurses from one of the centres, this paper describes this practice innovation. Benefits (including a positive impact on client engagement with services, client care, relationships with other health care workers and job satisfaction) are outlined, along with challenges in the implementation and evolution of the role. Strategies to sustain and develop the HIV Resource Nurse role are proposed.

APA, Harvard, Vancouver, ISO, and other styles

16

Cooley, S. Regan, Henry Zhao, Bruce C. V. Campbell, Leonid Churilov, Skye Coote, Damien Easton, Francesca Langenberg, et al. "Mobile Stroke Units Facilitate Prehospital Management of Intracerebral Hemorrhage." Stroke 52, no. 10 (October 2021): 3163–66. http://dx.doi.org/10.1161/strokeaha.121.034592.

Full text

Abstract:

Background and Purpose: Mobile stroke units (MSUs) improve reperfusion therapy times in acute ischemic stroke (AIS). However, prehospital management options for intracerebral hemorrhage (ICH) are less established. We describe the initial Melbourne MSU experience in ICH. Methods: Consecutive patients with ICH and AIS treated by the Melbourne MSU were included. We describe demographics, proportions of patients receiving specific therapies, and bypass to comprehensive/neurosurgical centers. We also compare operational time metrics between patients with MSU-ICH and MSU-AIS. Results: During a 2-year period, the Melbourne MSU managed 49 patients with ICH, mean (SD) age 74 (12) years, median (interquartile range) National Institutes of Health Stroke Scale 17 (12–20). Intravenous antihypertensives were the commonest treatment provided (46.9%). Bypass of a primary center to a comprehensive center with neurosurgical expertise occurred in 32.7% of patients with MSU-ICH compared with 20.5% of patients with MSU-AIS. Compared with patients with MSU-AIS, patients with MSU-ICH had faster onset-to-emergency-call, and onset-to-scene-arrival times at the median and 75th percentiles. Conclusions: MSUs can facilitate ultra-early ICH diagnosis, management, and triage.

APA, Harvard, Vancouver, ISO, and other styles

17

Ryan, Norbert. "Reopening a hospital laboratory in Banda Aceh." Microbiology Australia 26, no. 4 (2005): 169. http://dx.doi.org/10.1071/ma05169.

Full text

Abstract:

Medical team GOLF departed Melbourne on Australia Day bound for Banda Aceh. This was an AusAID initiative coordinated by Emergency Management Australia (EMA). The group of 24 was the seventh Australian government team sent to tsunami devastated areas. The team consisted of surgeons, anaesthetists, nursing staff, paramedics, environmental and public health experts and a laboratory team, comprising Dr Geoff Hogg (pathologist), Kay Withnall and myself. Our brief was to provide public health and medical support to communities affected by the tsunami, to coordinate with other agencies and to support local health authorities.

APA, Harvard, Vancouver, ISO, and other styles

18

Ranse, J., and S. Lenson. "(A111) Role, Resources, and Clinical and Educational Backgrounds of Nurses Who Participated in the Prehospital Response to the 2009 Bushfires in Victoria, Australia." Prehospital and Disaster Medicine 26, S1 (May 2011): s31. http://dx.doi.org/10.1017/s1049023x11001130.

Full text

Abstract:

The bushfires of February 2009 in Victoria, Australia resulted in the deaths of 173 people and caused injuries to 414. Furthermore, > 2,030 houses and 3,500 structures were destroyed. The role and experience of nurses in this environment are not well understood, and little is known about the clinical and education background of nurses in this setting. This presentation will provide an overview of the bushfires and report on two research projects. The aims of these projects were to explore participant demographics and various aspects of nursing activities in the prehospital environment. These projects used volunteer nursing members of St John Ambulance Australia who responded to the Victorian fires. The first project used a retrospective, descriptive postal survey, and the second was descriptive and exploratory, using semi-structured interviews as a means of data collection. The survey highlighted that nurses had varying clinical and educational backgrounds. Males were overrepresented when compared to the national average of nurses. Most participants had taken disaster-related education, however, this varied in type and duration. Similarly, most had participated in training or mock disasters; however this usually was not related to bushfire emergencies. The qualitative findings identified two main themes having expansive roles and being prepared. These highlighted that nurses maintained a variety of roles, such as clinicians, emotional supporters, coordinators and problem solvers, and they were well prepared for these roles. This research provided insight into the characteristics and level of preparedness of nurses who responded to the 2009 Victorian bushfires in the prehospital environment. Additionally, it highlights the need for more structured education and training for nurse that is aligned with their role and deployment environment.

APA, Harvard, Vancouver, ISO, and other styles

19

Rose, Louise, Sioban Nelson, Linda Johnston, and Jeffrey J. Presneill. "Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit." American Journal of Critical Care 16, no. 5 (September 1, 2007): 434–43. http://dx.doi.org/10.4037/ajcc2007.16.5.434.

Full text

Abstract:

Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

APA, Harvard, Vancouver, ISO, and other styles

20

Smith, Erin, Lisa Holmes, Brigid Larkin, Brennen Mills, and Mark Dobson. "Supporting Volunteer Firefighter Well-Being: Lessons from the Australian “Black Summer” Bushfires." Prehospital and Disaster Medicine 37, no. 2 (March 2, 2022): 273–76. http://dx.doi.org/10.1017/s1049023x22000322.

Full text

Abstract:

AbstractIntroduction:The 2019-2020 “Black Summer” bushfires in Australia focused the attention of the nation on the critical role that volunteer firefighters play in the response to such a disaster, spurring a national conversation about how to best support those on the frontline. The objective of this research was to explore the impact of the Black Summer bushfires on volunteer firefighter well-being and to investigate how to deliver effective well-being support.Methods:An explorative qualitative design underpinned by a phenomenological approach was applied. Participant recruitment followed a multi-modal sampling strategy and data were collected through semi-structured, in-depth interviews.Results:Qualitative data were collected from 58 participants aged from 23 to 61-years-of-age (average age of 46 years). All self-reported as volunteer firefighters who had responded to the Black Summer bushfires in Australia. Just over 80% of participants were male and the majority lived in the Australian states of New South Wales (65%) and Victoria (32%). All participants reported impact on their well-being, resulting from cumulative trauma exposure, responding to fires in local communities, intense work demands, minimal intervals between deployments, and disruption to primary employment. In regard to supporting well-being, four key themes emerged from data analysis: (1) Well-being support needs to be both proactive and reactive and empower local leaders to “reach in” while encouraging responders to “reach out;” (2) Employee Assistance Programs (EAPs) should not be the only well-being support option available; (3) The sharing of lived experience is important; and (4) Support programs need to address self-stigmatization.Conclusion:Participants in this research identified that effective well-being support needs to be both proactive and reactive and holistic in approach.

APA, Harvard, Vancouver, ISO, and other styles

21

Lowthian, Judy A., Lahn D. Straney, Caroline A. Brand, Anna Barker, P. de Villiers Smit, Harvey Newnham, Peter Hunter, Cathie Smith, and Peter A. Cameron. "Predicting functional decline in older emergency patients—the Safe Elderly Emergency Discharge (SEED) project." Age and Ageing 46, no. 2 (December 8, 2016): 219–25. http://dx.doi.org/10.1093/ageing/afw210.

Full text

Abstract:

AbstractObjectiveto profile the trajectory of, and risk factors for, functional decline in older patients in the 30 days following Emergency Department (ED) discharge.Methodsprospective cohort study of community-dwelling patients aged ≥65 years, discharged home from a metropolitan Melbourne ED, 31 July 2012 to 30 November 2013. The primary outcome was functional decline, comprising either increased dependency in personal activities of daily living (ADL) or in skills required for living independently instrumental ADL (IADL), deterioration in cognitive function, nursing home admission or death. Univariate analyses were used to select risk factors and logistic regression models constructed to predict functional decline.Resultsat 30 days, 34.4% experienced functional decline; with 16.7% becoming more dependent in personal ADL, 17.5% more dependant in IADL and 18.4% suffering deterioration in cognitive function. Factors independently associated with decline were functional impairment prior to the visit in personal ADL (Odds Ratio [OR] 3.21, 95% confidence interval [CI] 2.26–4.53) or in IADL (OR 6.69, 95% CI 4.31–10.38). The relative odds were less for patients with moderately impaired cognition relative to those with normal cognition (OR 0.38, 95% CI 0.19–0.75). There was a 68% decline in the relative odds of functional decline for those with any impairment in IADL who used an aid for mobility (OR 0.32, 95% CI 0.14–0.7).Conclusionolder people with pre-existing ADL impairment were at high risk of functional decline in the 30 days following ED presentation. This effect was largely mitigated for those who used a mobility aid. Early intervention with functional assessments and appropriate implementation of support services and mobility aids could reduce functional decline after discharge.

APA, Harvard, Vancouver, ISO, and other styles

22

Smith, Erin, Michella Hill, Cameron Anderson, Moira Sim, Alecka Miles, David Reid, and Brennen Mills. "Lived Experience of Emergency Health Care Utilization during the COVID-19 Pandemic: A Qualitative Study." Prehospital and Disaster Medicine 36, no. 6 (October 8, 2021): 691–96. http://dx.doi.org/10.1017/s1049023x21001126.

Full text

Abstract:

AbstractIntroduction:As the understanding of health care worker lived experience during coronavirus disease 2019 (COVID-19) grows, the experiences of those utilizing emergency health care services (EHS) during the pandemic are yet to be fully appreciated.Study Objective:The objective of this research was to explore lived experience of EHS utilization in Victoria, Australia during the COVID-19 pandemic from March 2020 through March 2021.Methods:An explorative qualitative design underpinned by a phenomenological approach was applied. Data were collected through semi-structured, in-depth interviews, which were transcribed verbatim and analyzed using Colaizzi’s approach.Results:Qualitative data were collected from 67 participants aged from 32 to 78-years-of-age (average age of 52). Just over one-half of the research participants were male (54%) and three-quarters lived in metropolitan regions (75%). Four key themes emerged from data analysis: (1) Concerns regarding exposure and infection delayed EHS utilization among participants with chronic health conditions; (2) Participants with acute health conditions expressed concern regarding the impact of COVID-19 on their care, but continued to access services as required; (3) Participants caring for people with sensory and developmental disabilities identified unique communication needs during interactions with EHS during the COVID-19 pandemic; communicating with emergency health care workers wearing personal protective equipment (PPE) was identified as a key challenge, with face masks reported as especially problematic for people who are deaf or hard-of-hearing; and (4) Children and older people also experienced communication challenges associated with PPE, and the need for connection with emergency health care workers was important for positive lived experience during interactions with EHS throughout the pandemic.Conclusion:This research provides an important insight into the lived experience of EHS utilization during the COVID-19 pandemic, a perspective currently lacking in the published peer-reviewed literature.

APA, Harvard, Vancouver, ISO, and other styles

23

Campbell, Sharon, Paul Fox-Hughes, Penelope Jones, Tomas Remenyi, Kate Chappell, Christopher White, and Fay Johnston. "Evaluating the Risk of Epidemic Thunderstorm Asthma: Lessons from Australia." International Journal of Environmental Research and Public Health 16, no. 5 (March 7, 2019): 837. http://dx.doi.org/10.3390/ijerph16050837.

Full text

Abstract:

Epidemic thunderstorm asthma (ETA) is an emerging public health threat in Australia, highlighted by the 2016 event in Melbourne, Victoria, that overwhelmed health services and caused loss of life. However, there is limited understanding of the regional variations in risk. We evaluated the public health risk of ETA in the nearby state of Tasmania by quantifying the frequency of potential ETA episodes and applying a standardized natural disaster risk assessment framework. Using a case–control approach, we analyzed emergency presentations in Tasmania’s public hospitals from 2002 to 2017. Cases were defined as days when asthma presentations exceeded four standard deviations from the mean, and controls as days when asthma presentations were less than one standard deviation from the mean. Four controls were randomly selected for each case. Independently, a meteorologist identified the dates of potential high-risk thunderstorm events. No case days coincided with thunderstorms during the study period. ETA was assessed as a very low risk to the Tasmanian population, with these findings informing risk prioritization and resource allocation. This approach may be scaled and applied in other settings to determine local ETA risk. Furthermore, the identification of hazards using this method allows for critical analysis of existing public health systems.

APA, Harvard, Vancouver, ISO, and other styles

24

Cullinane, Meabh, Stefanie A. Zugna, Helen L. McLachlan, Michelle S. Newton, and Della A. Forster. "Evaluating the impact of a maternity and neonatal emergencies education programme in Australian regional and rural health services on clinician knowledge and confidence: a pre-test post-test study." BMJ Open 12, no. 5 (May 2022): e059921. http://dx.doi.org/10.1136/bmjopen-2021-059921.

Full text

Abstract:

IntroductionAlmost 78 000 women gave birth in the state of Victoria, Australia, in 2019. While most births occurred in metropolitan Melbourne and large regional centres, a significant proportion of women birthed in rural services. In late 2016, to support clinicians to recognise and respond to clinical deterioration, the Victorian government mandated provision of an emergency training programme, called Maternity and Newborn Emergencies (MANE), to rural and regional maternity services across the state. This paper describes the evaluation of MANE.Design and settingA quasi-experimental study design was used; the Kirkpatrick Evaluation Model provided the framework.ParticipantsParticipants came from the 17 rural and regional Victorian maternity services who received MANE in 2018 and/or 2019.Outcome measuresBaseline data were collected from MANE attendees before MANE delivery, and at four time points up to 12 months post-delivery. Clinicians’ knowledge of the MANE learning objectives, and confidence ratings regarding the emergencies covered in MANE were evaluated. The Safety Attitudes Questionnaire (SAQ) assessed safety climate pre-MANE and 6 months post-MANE among all maternity providers at the sites.ResultsImmediately post-MANE, most attendees reported increased confidence to escalate clinical concerns (n=251/259). Knowledge in the non-technical and practical aspects of the programme increased. Management of perinatal emergencies was viewed as equally stressful pre-MANE and post-MANE, but confidence to manage these emergencies increased post-delivery. Pre-MANE SAQ scores showed consistently strong and poor performing services. Six months post-MANE, some services showed improvements in SAQ scores indicative of improved safety climate.ConclusionMANE delivery resulted in both short-term and sustained improvements in knowledge of, and confidence in, maternity emergencies. Further investigation of the SAQ across Victoria may facilitate identification of services with a poor safety climate who could benefit from frequent targeted interventions (such as the MANE programme) at these sites.

APA, Harvard, Vancouver, ISO, and other styles

25

Sullivan, Elise, Karen Francis, and Desley Hegney. "Review of small rural health services in Victoria: how does the nursing-medical division of labour affect access to emergency care?" Journal of Clinical Nursing 17, no. 12 (June 2008): 1543–52. http://dx.doi.org/10.1111/j.1365-2702.2007.02087.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Ireland, Sharyn, Rachel Cross, Kelly Decker, and Biswadev Mitra. "Perceptions of an educational programme for registered nurses who work at non-major trauma services in Victoria, Australia: The Nursing Emergency eXternal Trauma Programme." Australasian Emergency Nursing Journal 20, no. 3 (August 2017): 131–38. http://dx.doi.org/10.1016/j.aenj.2017.05.002.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

McDougall, Rosalind, Barbara Hayes, Marcus Sellars, Bridget Pratt, Anastasia Hutchinson, Mark Tacey, Karen Detering, Cade Shadbolt, and Danielle Ko. "'This is uncharted water for all of us': challenges anticipated by hospital clinicians when voluntary assisted dying becomes legal in Victoria." Australian Health Review 44, no. 3 (2020): 399. http://dx.doi.org/10.1071/ah19108.

Full text

Abstract:

ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia. MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians’ views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description. ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital’s overall work were also raised. ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels. What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation. What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals’ overall work. What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.

APA, Harvard, Vancouver, ISO, and other styles

28

Withiel, T. D., S. Sheridan, N. Rudd, and C. A. Fisher. "Preparedness to Respond to Family Violence: A Cross-Sectional Study Across Clinical Areas." SAGE Open Nursing 8 (January 2022): 237796082211263. http://dx.doi.org/10.1177/23779608221126355.

Full text

Abstract:

Introduction Family violence (FV) is one of the most urgent health issues of our generation. While nurses play a vital role in identifying and supporting victim/survivors of violence, little is known about nursing readiness to respond across clinical areas. Objective This study aimed to compare and contrast the knowledge, confidence, clinical skills, and perceived barriers of nurses across three clinical areas of a tertiary trauma hospital in Melbourne, Australia, in responding to FV. Method A prospective, mixed methods design was used. The nursing staff at a large trauma hospital were approached to participate. Participants completed a brief online survey to quantify clinician-reported knowledge, clinical skills, and barriers to managing FV. Results Two hundred and forty-two nursing staff electronically completed a brief survey to capture self-reported confidence, knowledge, clinical skills, and barriers to working effectively in the area. The descriptive analysis reflected service-wide deficits in knowledge, confidence, and self-reported clinical skills, irrespective of the work area. Deficits were identified on a background of limited structured training for FV among this cohort. Significantly higher rates of FV confidence and knowledge were identified among emergency department nurses relative to acute and subacute clinical counterparts. Conclusion Nurse respondents overall reported low rates of confidence, knowledge, and clinical skills in responding to disclosures of FV. Findings reinforce the need for imbedded training programs to support frontline responses.

APA, Harvard, Vancouver, ISO, and other styles

29

Hallinan, Christine M., and Kelsey L. Hegarty. "Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education." Australian Journal of Primary Health 22, no. 2 (2016): 113. http://dx.doi.org/10.1071/py14072.

Full text

Abstract:

The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the educational level of PCNs, PCN role expansion and the extent of interprofessional collaboration that is evident from research undertaken to date. Nurses with postgraduate education have the potential to increase their scope of practice, take on a greater teaching role and provide more preventive and chronic disease services in primary care. Policies aimed at increasing access to education for nurses working in primary care would strengthen the primary care nursing profession, and enhance the delivery of primary health care services in Australia.

APA, Harvard, Vancouver, ISO, and other styles

30

Dennett, Amy M., Katherine E. Harding, Casey L. Peiris, Nora Shields, Christian Barton, Lauren Lynch, Phillip Parente, David Lim, and Nicholas F. Taylor. "Efficacy of Group Exercise–Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial." JMIR Research Protocols 11, no. 7 (July 18, 2022): e38553. http://dx.doi.org/10.2196/38553.

Full text

Abstract:

Background Access to rehabilitation to support cancer survivors to exercise is poor. Group exercise–based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy. Objective We aimed to evaluate the efficacy of a group exercise–based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors. Methods A parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed. Results The trial commenced in April 2022. As of June 2022, we enrolled 14 participants. Conclusions This trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtr International Registered Report Identifier (IRRID) PRR1-10.2196/38553

APA, Harvard, Vancouver, ISO, and other styles

31

Cullinane, Meabh, Helen L. McLachlan, Michelle S. Newton, Stefanie A. Zugna, and Della A. Forster. "Using the Kirkpatrick Model to evaluate the Maternity and Neonatal Emergencies (MANE) programme: Background and study protocol." BMJ Open 10, no. 1 (January 2020): e032873. http://dx.doi.org/10.1136/bmjopen-2019-032873.

Full text

Abstract:

IntroductionOver 310 000 women gave birth in Australia in 2016, with approximately 80 000 births in the state of Victoria. While most of these births occur in metropolitan Melbourne and other large regional centres, a significant proportion of Victorian women birth in local rural health services. The Victorian state government recently mandated the provision of a maternal and neonatal emergency training programme, called Maternal and Newborn Emergencies (MANE), to rural and regional maternity service providers across the state. MANE aims to educate maternity and newborn care clinicians about recognising and responding to clinical deterioration in an effort to improve clinical outcomes. This paper describes the protocol for an evaluation of the MANE programme.Methods and analysisThis study will evaluate the effectiveness of MANE in relation to: clinician confidence, skills and knowledge; changes in teamwork and collaboration; and consumer experience and satisfaction, and will explore and describe any governance changes within the organisations after MANE implementation. The Kirkpatrick Evaluation Model will provide a framework for the evaluation. The participants of MANE, 27 rural and regional Victorian health services ranging in size from approximately 20 to 1000 births per year, will be invited to participate. Baseline data will be collected from maternity service staff and consumers at each health service before MANE delivery, and at four time-points post-MANE delivery. There will be four components to data collection: a survey of maternity services staff; follow-up interviews with Maternity Managers at health services 4 months after MANE delivery; consumer feedback from all health services collected through the Victorian Healthcare Experience Survey; case studies with five regional or rural health service providers.Ethics and disseminationThis evaluation has been approved by the La Trobe University Science, Health and Engineering College Human Ethics Sub-Committee. Findings will be presented to project stakeholders in a deidentified report, and disseminated through peer-reviewed publications and conference presentations.

APA, Harvard, Vancouver, ISO, and other styles

32

Tracy, Jane M. "People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group?" Australian Health Review 33, no. 3 (2009): 478. http://dx.doi.org/10.1071/ah090478.

Full text

Abstract:

TO THE EDITOR: Goddard et al, authors of ?People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group??1 are to be congratulated for raising discussion about one of the most vulnerable groups in Australia with respect to their receipt of optimal health care. The authors conclude that ?developing interventions and strategies to increase the knowledge of health care workers . . . caring for people with intellectual disabilities will likely improve the health care needs of this population and their families?. In relation to this identified need for health professional education and training in the care of people with intellectual disabilities, we would like to draw the attention of your readers to some work undertaken by the Centre for Developmental Disability Health Victoria (CDDHV) to address this issue. The CDDHV works to improve the health and health care of people with developmental disabilities through a range of educational, research and clinical activities. In recent years there has been an increasing awareness of the need for health professional education in this area. Moreover, as people with disabilities often have chronic and complex health and social issues, focusing on their health care provides a platform for interprofessional education and a springboard for understanding the essential importance and value of interprofessional practice. Recently, the CDDHV has taken a lead role in developing a teaching and learning resource that focuses both on the health care of people with disabilities and on the importance and value of interprofessional practice. This resource promotes and facilitates interprofessional learning, and develops understanding of the health and health care issues experienced by people with disabilities and those who support them. ?Health and disability: partnerships in action? is a new video-based teaching and learning package, produced through an interprofessional collaboration between health professionals from medicine, nursing, occupational therapy, physiotherapy, paramedic practice, health science, social work, speech pathology, dietetics and dentistry. Those living with a disability are the experts on their own experience and so their direct involvement in and contribution to the education of health care professionals is essential. The collaboration between those featured in the video stories and health professionals has led to the development of a powerful resource that facilitates students and practitioners developing insights into the health and health care issues encountered by people with developmental disabilities. We also believe that through improving their understanding of, and health provision to, people with disabilities and those who support them, health professionals will acquire valuable attitudes, knowledge and skills applicable to many other patients in their practice population. Jane M Tracy Education Director Centre for Developmental Disability Health Victoria Melbourne, VIC

APA, Harvard, Vancouver, ISO, and other styles

33

Santamaria, N., M. Gerdtz, W. Liu, S. Rakis, S. Sage, A. W. Ng, H. Tudor, et al. "Clinical effectiveness of a silicone foam dressing for the prevention of heel pressure ulcers in critically ill patients: Border II Trial." Journal of Wound Care 29, Sup9a (September 1, 2020): S26—S31. http://dx.doi.org/10.12968/jowc.2020.29.sup9a.s26.

Full text

Abstract:

• Objective: Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and critically ill patients in the intensive care unit (ICU). • Method: A cohort of critically ill patients were enrolled at the Royal Melbourne Hospital. Each patient had the multi-layer soft silicone foam dressing applied to each heel on admission to the emergency department. The dressings were retained with a tubular bandage for the duration of the patients' stay in the ICU. The skin under the dressings was examined daily and the dressings were replaced every three days. The comparator for our cohort study was the control group from the recently completed Border Trial. • Results: Of the 191 patients in the initial cohort, excluding deaths, loss to follow-up and transfers to another ward, 150 patients were included in the final analysis. There was no difference in key demographic or physiological variables between the cohorts, apart from a longer ICU length of stay for our current cohort. No PUs developed in any of our intervention cohort patients compared with 14 patients in the control cohort (n=152; p<0.001) who developed a total of 19 heel PUs. • Conclusion: We conclude, based on our results, that the multi-layer soft silicone foam dressing under investigation was clinically effective in reducing ICU-acquired heel PUs. The findings also support previous research on the clinical effectiveness of multi-layer soft silicone foam dressings for PU prevention in the ICU.

APA, Harvard, Vancouver, ISO, and other styles

34

Rezania, Fatemeh, Christopher J. A. Neil, and Tissa Wijeratne. "Disparities in Care and Outcome of Stroke Patients from Culturally and Linguistically Diverse Communities in Metropolitan Australia." Journal of Clinical Medicine 10, no. 24 (December 14, 2021): 5870. http://dx.doi.org/10.3390/jcm10245870.

Full text

Abstract:

Background: Acute stroke is a time-critical emergency where diagnosis and acute management are highly dependent upon the accuracy of the patient’s history. We hypothesised that the language barrier is associated with delayed onset time to thrombolysis and poor clinical outcomes. This study aims to evaluate the effect of language barriers on time to thrombolysis and clinical outcomes in acute ischemic stroke. Concerning the method, this is a retrospective study of all patients admitted to a metropolitan stroke unit (Melbourne, Victoria, Australia) with an acute ischemic stroke treated with tissue plasminogen activator between 1/2013 and 9/2017. Baseline characteristics, thrombolysis time intervals, length of stay, discharge destination, and in-hospital mortality were compared among patients with and without a language barrier using multivariate analysis after adjustment for age, sex, stroke severity, premorbid modified Rankin Scale (mRS), and Charlson Comorbidity Index (CCI). Language barriers were defined as a primary language other than English. A total of 374 patients were included. Our findings show that 76 patients (20.3%) had a language barrier. Mean age was five years older for patients with language barriers (76.7 vs. 71.8 years, p = 0.004). Less non-English speaking patients had premorbid mRS score of zero (p = 0.002), and more had premorbid mRS score of one or two (p = 0.04). There was no statistically significant difference between the two groups in terms of stroke severity on presentation (p = 0.06). The onset to needle time was significantly longer in patients with a language barrier (188 min vs. 173 min, p = 0.04). Onset to arrival and door to imaging times were reassuringly similar between the two groups. However, imaging to needle time was 9 min delayed in non-English speaking patients with a marginal p value (65 vs. 56 min, p = 0.06). Patients with language barriers stayed longer in the stroke unit (six vs. four days, p = 0.02) and had higher discharge rates than residential aged care facilities in those admitted from home (9.2% vs. 2.3%, p = 0.02). In-hospital mortality was not different between the two groups (p = 0.8). In conclusion, language barriers were associated with almost 14 min delay in thrombolysis. The delay was primarily attributable to imaging to needle time. Language barriers were also associated with poorer clinical outcomes.

APA, Harvard, Vancouver, ISO, and other styles

35

Islam, Tasneem, Beverly O'Connell, and Mary Hawkins. "Factors associated with transfers from healthcare facilities among readmitted older adults with chronic illness." Australian Health Review 38, no. 3 (2014): 354. http://dx.doi.org/10.1071/ah13133.

Full text

Abstract:

Objective Because chronic illness accounts for a considerable proportion of Australian healthcare expenditure, there is a need to identify factors that may reduce hospital readmissions for patients with chronic illness. The aim of the present study was to examine a range of factors potentially associated with transfer from healthcare facilities among older adults readmitted to hospital within a large public health service in Melbourne, Australia. Methods Data on readmitted patients between June 2006 and June 2011 were extracted from hospital databases and medical records. Adopting a retrospective case-control study design, a sample of 51 patients transferred from private residences was matched by age and gender with 55 patients transferred from healthcare facilities (including nursing homes and acute care facilities). Univariate and multivariate logistic regression analyses were used to compare the two groups, and to determine associations between 46 variables and transfer from a healthcare facility. Results Univariate analysis indicated that patients readmitted from healthcare facilities were significantly more likely to experience relative socioeconomic advantage, disorientation on admission, dementia diagnosis, incontinence and poor skin integrity than those readmitted from a private residence. Three of these variables remained significantly associated with admission from healthcare facilities after multivariate analysis: relative socioeconomic advantage (odds ratio (OR) 11.30; 95% confidence interval (CI) 2.62–48.77), incontinence (OR 7.18; 95% CI 1.19–43.30) and poor skin integrity (OR 18.05; 95% CI 1.85–176.16). Conclusions Older adults with chronic illness readmitted to hospital from healthcare facilities are significantly more likely to differ from those readmitted from private residences in terms of relative socioeconomic advantage, incontinence and skin integrity. The findings direct efforts towards addressing the apparent disparity in management of patients admitted from a facility as opposed to a private residence. What is known about the topic? Older adults with chronic disease require ongoing medical care in both community and healthcare settings. They may frequently require emergency admission to hospital for management of exacerbations of their chronic disease. Previous Australian research has found that transfer from a healthcare facility may be associated with likelihood of readmission among older adults. What does this paper add? This research addresses the shortage of research on the link between transfer from a healthcare facility and likelihood of readmission within Australia. Older adults with chronic illness readmitted to hospital from healthcare facilities were found to be significantly more likely to differ from those readmitted from private residences in terms of relative socioeconomic advantage, incontinence and skin integrity. What are the implications for practitioners? The findings may be used to identify older readmitted patients with chronic diagnoses at greater risk of presenting with poor skin integrity or incontinence, and direct efforts towards addressing the apparent disparity in management of patients admitted from facilities as opposed to private residences. Sound discharge planning and clear channels of communication between healthcare facilities are particularly important for patients transferred between facilities.

APA, Harvard, Vancouver, ISO, and other styles

36

Montalto, Michael, Simon Shay, and Andy Le. "Evaluation of a mobile X-ray service for elderly residents of residential aged care facilities." Australian Health Review 39, no. 5 (2015): 517. http://dx.doi.org/10.1071/ah15059.

Full text

Abstract:

Objective The Royal Melbourne Hospital established a mobile X-ray service (MXS) in 2013. The goal of the MXS is to address the radiology needs of frail, elderly or demented residents of residential aged care facilities (RACFs) who would otherwise require transportation to attend for X-ray. The present study describes the activity of the MXS, and the impact of the MXS on emergency department (ED) attendances by residents of RACFs. Methods The study is a descriptive study and uses a before-and-after cohort approach. Activity for the first year of operation was collected and described. At the end of the first year of operation, the top 30 RACF users of the MXS were identified. The hospital Department of Radiology database was examined to find all plain X-rays performed on any patient presenting from the same 30 RACFs for the 1 year before commencement of the MXS (1 July 2012–30 June 2013) and for the 1 year period after the commencement of the MXS (1 July 2013–30 June 2014). Attendances were compared. Results The MXS delivered 1532 service attendances to 109 different RACFs. The mean age of patients receiving MXS services was 86 years (range 16–107 years). In all, 1124 services (73.4%) were delivered to patients in high-care RACFs. Most patients (n = 634; 41.4%) were bed or wheelchair bound, followed by those who required assistance to ambulate (n = 457; 29.8%). The most common X-ray examinations performed were chest, hip and pelvis, spine and abdomen. There were 919 service attendances to the top 30 RACFs using the MXS (60.0% of all attendances). There was an 11.5% reduction in ED presentations requiring plain X-ray in the year following the commencement of the MXS (95% confidence interval 0.62–3.98; P = 0.019). Conclusion The present study suggests a reduction in hospital ED attendances for high users of the MXS. This has benefits for hospitals, patients and nursing homes. It also allows the extension of other programs designed to treat patients in their RACFs. Special rebates for home-based radiology service provision should be considered. What is already known about this subject? Digital processing has changed the way radiology delivers services. The Australian community is in the middle of a shift towards an aging population, with a greater numbers of residents in RACFs. It has been suggested in previous studies that mobile X-ray reduces the rate of delirium in patients who require X-ray. What does this paper add? There is an unmet demand for MXS to residents of RACFs. MXS may reduce presentations by elderly residents of RACFs to hospital EDs for X-rays. MXS may assist general practitioners, and other innovative programs, such as Hospital in the Home and Inreach, to better manage care for patients in RACFs. What are the implications for practitioners? Providers of radiology services should examine the opportunities and benefits of establishing MXS. Funders of services should examine ways of rebating MXS to encourage further development. Hospitals (Hospital in the Home and Inreach services), RACFs and general practitioners should use mobile X-ray and integrate these services into their management of aged care delivered in RACFs.

APA, Harvard, Vancouver, ISO, and other styles

37

Hoit, G., C. Hinkewich, J. Tiao, V. Porgo, L. Moore, L. Moore, J. Tiao, et al. "Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review." Canadian Journal of Surgery 56, no. 2 Suppl (April 2013): S1—S42. http://dx.doi.org/10.1503/cjs.005813.

Full text

APA, Harvard, Vancouver, ISO, and other styles

38

Kilkenny, Monique F., Helen M. Dewey, Natasha A. Lannin, Vijaya Sundararajan, Joyce Lim, Craig Anderson, Geoffrey A. Donnan, and Dominique A. Cadilhac. "Abstract TP374: Data Linkage is Effective for Improving the Available Data for Stroke: An Example from the Australian Stroke Clinical Registry." Stroke 44, suppl_1 (February 2013). http://dx.doi.org/10.1161/str.44.suppl_1.atp374.

Full text

Abstract:

Introduction: Multiple data collections can be a burden for clinicians. In 2009, the Australian Stroke Clinical Registry (AuSCR) was established by non-government and research organizations to provide quality of care data unavailable for acute stroke admissions. We show here the reliability of linking complimentary registry data with routinely collected hospital discharge data submitted to governmental bodies. Hypothesis: A high quality linkage with a > 90% rate is possible, but requires multiple personal identifiers common to each dataset. Methods: AuSCR identifying variables included date of birth (DoB), Medicare number, first name, surname, postcode, gender, hospital record number, hospital name and admission date. The Victorian Department of Health emergency department (ED) and hospital discharge linked dataset has most of these, with first name truncated to the first 3 digits, but no surname. Common data elements of AuSCR patients registered at a large hospital in Melbourne, Victoria (Australia) between 15 June 2009 and 31 December 2010 were submitted to undergo stepwise deterministic linkage. Results: The Victorian AuSCR sample had 818 records from 788 individuals. Three steps with 1) Medicare number, postcode, gender and DoB (80% matched); 2) hospital number/admit date; and 3) ED number/visit date were required to link AuSCR data with the ED and hospital discharge data. These led to an overall high quality linkage of >99% (782/788) of AuSCR patients, including 731/788 for ED records and 736/788 for hospital records. Conclusion: Multiple personal identifiers from registries are required to achieve reliable linkage to routinely collected hospital data. Benefits of these linked data include the ability to investigate a broader range of research questions than with a single dataset. Characters with spaces= 1941 (limit is 1950)

APA, Harvard, Vancouver, ISO, and other styles

39

Kilkenny, Monique, Helen Dewey, Natasha Lannin, Joyce Lim, Craig Anderson, Geoffrey A. Donnan, and Dominique Cadilhac. "Abstract TP398: Stroke prevention opportunities being missed: the Australian Stroke Clinical Registry experience." Stroke 44, suppl_1 (February 2013). http://dx.doi.org/10.1161/str.44.suppl_1.atp398.

Full text

Abstract:

Introduction: Stroke utilizes a large portion of hospital resources. Little is known about the frequency of contacts with hospitals prior to first-ever stroke and potentially missed opportunities for stroke prevention. In addition, re-admissions may indicate failed secondary prevention. Hypothesis: Many patients have had a presentation or admission to hospital in the year prior to a first-ever stroke event. Methods: Data from the prospective, national Australian Stroke Clinical Registry (AuSCR) obtained between 15 June 2009 and 31 December 2010 from a large hospital in Melbourne, Victoria (Australia) were linked to the Victorian government emergency department (ED) and hospital discharge datasets for a 3 year ‘look-back’ period and any re-presentation up until February 2011 using stepwise deterministic linkage methods. Descriptive statistics are presented. Results: Matched linkage to ED (731/788) and hospital discharge (736/788) datasets was achieved in 93% of AuSCR registrants, of whom 513 were first-ever strokes (51% male, average age 74 [±16] years, 82% ischemic). Prior to the first-ever stroke, 221 (47%) registrants had ED presentations and 283 had a hospital admission on average 2.9 months before stroke. The mean number of ED presentations within 3 years of AuSCR registration for a first-ever event was 2.1 (SD 1.6); and 48/466 (10%) occurred in the month prior to stroke. Among first-ever stroke registrants, 200 were re-admitted on average within 5 months following discharge; 3.5% for recurrent stroke/TIA. Conclusion: Contact with hospitals was common (~50%) before first stroke, raising opportunities to screen and intervene in people at risk of stroke. As one in 5 hospital re-admissions is for recurrent stroke, a closer monitoring of secondary prevention measures in the early post-discharge period may be warranted.

APA, Harvard, Vancouver, ISO, and other styles

40

Mullins, Alexandra, Renee O’Donnell, Heather Morris, Michael Ben-Meir, Kostas Hatzikiriakidis, Lisa Brichko, and Helen Skouteris. "The effect of My Health Record use in the emergency department on clinician-assessed patient care: results from a survey." BMC Medical Informatics and Decision Making 22, no. 1 (July 5, 2022). http://dx.doi.org/10.1186/s12911-022-01920-8.

Full text

Abstract:

Abstract Background The emergency department has been a major focus for the implementation of Australia’s national electronic health record, known as My Health Record. However, the association between use of My Health Record in the emergency department setting and patient care is largely unknown. The aim of this study was to explore the perspectives of emergency department clinicians regarding My Health Record use frequency, the benefits of My Health Record use (with a focus on patient care) and the barriers to use. Methods All 393 nursing, pharmacy, physician and allied health staff employed within the emergency department at a tertiary metropolitan public hospital in Melbourne were invited to participate in a web-based survey, between 1 May 2021 and 1 December 2021, during the height of the Delta and Omicron Covid-19 outbreaks in Victoria, Australia. Results Overall, the survey response rate was 18% (70/393). Approximately half of the sample indicated My Health Record use in the emergency department (n = 39, 56%, confidence interval [CI] 43–68%). The results showed that users typically only engaged with My Health Record less than once per shift (n = 15, 39%, CI 23–55%). Just over half (n = 19/39, 54%, CI 32–65%) of all participants who use My Health Record agreed they could remember a time when My Health Record had been critical to the care of a patient. Overall, clinicians indicated the biggest barrier preventing their use of My Health Record is that they forget to utilise the system. Conclusion The results suggest that My Health Record has not been adopted as routine practice in the emergency department, by the majority of participants. Close to half of self-identified users of My Health Record do not associate use as being critical to patient care. Instead, My Health Record may only be used in scenarios that clinicians perceive will yield the greatest benefit—which clinicians in this paper suggest is patients with chronic and complex conditions. Further research that explores the predictors to use and consumers most likely to benefit from use is recommended—and strategies to socialise this knowledge and educate clinicians is desperately required.

APA, Harvard, Vancouver, ISO, and other styles

41

Lee, Chung, Rami Fezai, Rachel Kluck, and Michael Toussaint. "Abstracts of the 2015 Student Paramedics Australasia Conference." Australasian Journal of Paramedicine 12, no. 4 (September 3, 2015). http://dx.doi.org/10.33151/ajp.12.4.490.

Full text

APA, Harvard, Vancouver, ISO, and other styles

42

Boyle, Malcolm, Stephen Burgess, Mark Chilton, Brian Fallows, Bill Lord, David Shugg, Brett Williams, and Andrea Wyatt. "Monash University Centre for Ambulance and Paramedic Studies (MUCAPS) Submission to the Department of Human Services (DHS), in response to the DHS Discussion Paper examining the regulation of the Health Professions in Victoria." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.208.

Full text

Abstract:

This submission will primarily address the regulation of the health professions from the perspective of an education institution, and is made in response to the Discussion paper examining regulation of the health professions in Victoria, dated October 2003 which was issued by the Policy and Strategic Projects Division of the Victorian Department of Human Services, Melbourne, Victoria.

APA, Harvard, Vancouver, ISO, and other styles

43

Hotchin, Les. "Abstracts of the 2014 Australian College of Ambulance Professionals National Conference." Australasian Journal of Paramedicine 6, no. 3 (July 16, 2015). http://dx.doi.org/10.33151/ajp.6.3.465.

Full text

Abstract:

These are the conferences abstracts for oral and poster presentations at the Australian College of Ambulance Professionals National Conference, Melbourne, Victoria, Australia, on 4th to 6th of September 2008.

APA, Harvard, Vancouver, ISO, and other styles

44

Thuma, Ev. "Australian Asthma Conference - 2004 “A fresh breath – looking to the future”." Australasian Journal of Paramedicine 1, no. 3 (October 6, 2003). http://dx.doi.org/10.33151/ajp.1.3.203.

Full text

Abstract:

The Australian Asthma Conference held this year in Melbourne, was hosted by the Asthma Foundation of Victoria. The conference attracted over 300 participants from all states and internationally, and was headed by a range of keynote speakers representing national and international leaders in the various aspects of asthma management from prevention through to clinical care. Participants included the full spectrum of health professionals, with a large number of asthma educators represented.

APA, Harvard, Vancouver, ISO, and other styles

45

Williams, Brett. "Removal of Invasive Devices from Deceased Persons: Forensic implications for Paramedics – a Victorian perspective." Australasian Journal of Paramedicine 3, no. 4 (July 14, 2015). http://dx.doi.org/10.33151/ajp.3.4.339.

Full text

Abstract:

Professor Cordner is Professor of forensic medicine at Monash University Institutes of Health and Director of the Victorian Institute of Forensic Medicine His work in the area of forensic medicine and human rights has seen him take tours of duty in East Timor and Kosovo, as well as a year-long stint consulting to the International Committee of the Red Cross in Geneva. The following interview was conducted to invite Professor Cordner’s professional opinion in relation to practices and implications with respect to the removal of invasive clinical devices from deceased persons, as they currently apply to paramedics of Metropolitan Ambulance Service in Melbourne, and Rural Ambulance Victoria.

APA, Harvard, Vancouver, ISO, and other styles

46

Ranse, Jamie. "Future Directions, Future Challenges …Beyond Tomorrow, 6th International Conference for Emergency Nurses, Melbourne, Victoria, Australia 11-13 October 2007." Australasian Journal of Paramedicine 5, no. 4 (July 16, 2015). http://dx.doi.org/10.33151/ajp.5.4.436.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

O’Brien, Kylie, Amber Moore, Peter Hartley, and David Dawson. "Lessons about work readiness from final year paramedic students in an Australian university." Australasian Journal of Paramedicine 10, no. 4 (November 4, 2013). http://dx.doi.org/10.33151/ajp.10.4.52.

Full text

Abstract:

Introduction Paramedic education is changing in Australia from a post-employment model in which in-house training is provided by state-based service providers to pre-employment Bachelor degree education in universities. Little is known about how well prepared final year paramedic students nearing the end of their university course perceive themselves to be to enter the workforce. The objective of the study was to investigate perceptions of preparedness for the workforce of final year paramedic students at Victoria University, Melbourne, Australia. Methods A survey was conducted with final year paramedic students in their last semester at Victoria University, Melbourne, Australia. The survey focussed on eight dimensions relating to paramedic practice: theoretical skills, clinical skills; practical skills; interpersonal skills; communication with colleagues and other professionals; coping skills; lifelong learning; and ethics and legal responsibilities. Part 1 of the survey required participants to choose from six possible responses on how well they believe their paramedic course has prepared them in relation to 64 statements. Part 2 consisted of 5 open- ended questions. Data from part 1 was analysed to find the mean ‘preparedness scores’ on the 8 dimensions of paramedic practice. Responses from part 2 of survey were transcribed and imported into NVivo8, where each part of the questions were analysed and grouped into themes. Results Response rate was 14% (n=23). Respondents felt ‘somewhat adequately’ to ‘adequately’ prepared for the workforce. Responses to Part 2 indicated a range of perceptions in relation to preparedness to enter the paramedic workforce, ranging from feeling unprepared to put knowledge into practice, prepared in some aspects but not in others, through to feeling prepared but with a realisation that there would be much to learn on the job. Respondents comments provide paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice: whilst respondents valued the clinical practice opportunities they had had, they wanted more clinical placements with more variety, for example placements in different areas of healthcare. Conclusion This small survey provides paramedic educators with some clear ideas about what final year students value in terms of preparing them for practice. As Australian paramedic education moves from a post-employment training model to a pre-employment model, further consideration is needed of how courses will best address the development of clinical and practical skills of students and meet the requirements of ambulance service employers. Collegiate dialogue between employers, educators and students will assist in addressing this.

APA, Harvard, Vancouver, ISO, and other styles

48

Kearney, Jason, Carlyn Muir, and Karen Smith. "Factors associated with lost time injury among paramedics in Victoria, Australia." Prehospital Emergency Care, January 12, 2023, 1–19. http://dx.doi.org/10.1080/10903127.2023.2168095.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Tan, Sing Chee, Hongyung Ma, Graeme K. Hart, and Monica Holdsworth. "Rapid response teams: A review of data collection practice in Victoria, Australia." Australian Critical Care, January 2022. http://dx.doi.org/10.1016/j.aucc.2021.12.001.

Full text

APA, Harvard, Vancouver, ISO, and other styles

50

Bye, Rembrandt, Toby St Clair, Ashleigh Delorenzo, Kelly-Ann Bowles, and Karen Smith. "Needle Cricothyroidotomy by Intensive Care Paramedics." Prehospital and Disaster Medicine, August 12, 2022, 1–5. http://dx.doi.org/10.1017/s1049023x22001157.

Full text

Abstract:

Abstract Objective: Cricothyroidotomy is an advanced airway procedure for critically ill or injured patients. In Victoria, Australia, intensive care paramedics (ICPs) perform needle cricothyroidotomy utilizing the proprietary QuickTrach II (QTII) device. Recently, an Ambulance Victoria (AV) institutional change in workflow included pre-puncture surgical incision to assist in successful placement. This review aims to explore whether a surgical pre-incision prior to the insertion of the device improved overall procedural success rates of needle cricothyroidotomy using the QTII. Methods: This was a retrospective review of all patients who received a needle cricothyroidotomy by ICPs from May 1, 2015 through September 15, 2020. Data and patient care records were sourced from the AV data warehouse. Results: A total of 27 patients underwent a needle cricothyroidotomy with the mean age of patients being 50.2 years. Most cricothyroidotomies were performed using the QuickTrach II kit (92.6%). Prior to modification of the QTII procedure, front-of-neck access (FONA) success was 50.0%; however, this improved to 82.4% after the procedures recent update. The overall success rate of all paramedic-performed needle cricothyroidotomy during the study period was 74.1% (n = 20). Conclusions: This review demonstrates that propriety devices such as the QTII device achieve a low success rate for a FONA intervention. Despite the low frequency of this procedure, ICPs with extensive training and regular maintenance can perform needle cricothyroidotomy using scalpel assistance with a reasonable success rate. But when compared to the broader literature, success rate using a more straightforward technique such as a surgical cricothyroidotomy technique is likely going to be higher.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Emergency nursing Victoria Melbourne'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles