Australian Health Review最新文献

{"title":"Translating aspects of <i>The National Rural and Remote Nursing Generalist Framework 2023-2027</i> into practice: opportunities and considerations.","authors":"H Beks,&nbsp;S Clayden,&nbsp;V L Versace","doi":"10.1071/AH23098","DOIUrl":"10.1071/AH23098","url":null,"abstract":"<p><p>Reforms that grow the capabilities of the health workforce are critical to improving outcomes for populations residing in rural and remote areas of Australia. Nurses are central to improving the accessibility of health care for populations in these areas. The Australian Government's recent release of The National Rural and Remote Nursing Generalist Framework 2023-2027 is timely for identifying opportunities to strengthen the rural and remote nursing workforce. Further consideration of how the nursing workforce can be supported to translate aspects of the framework into practice is required. To achieve this, it is necessary to identify strategies to support registered nurses to develop capabilities stipulated within the framework. A logical vehicle for this translation is through the continued support of the Australian Government's Rural Health Multidisciplinary Training program, which includes an established network of 19 University Departments of Rural Health. Leveraging from this national network that is geographically expansive and has a long-term strategic impetus for growing the rural and remote nursing workforce, provides an opportunity for translating aspects of the framework at a national scale.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10343168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outlier or handover: outcomes for General Medicine inpatients.","authors":"S Thompkins,&nbsp;S Schaefer,&nbsp;D Toh,&nbsp;C Horwood,&nbsp;C H Thompson","doi":"10.1071/AH22242","DOIUrl":"10.1071/AH22242","url":null,"abstract":"<p><p>Objective Patients admitted from the emergency department may be co-located on the treating team's 'home ward'. If no bed is available, patients may be sent to another ward, where they may remain under the admitting team as an 'outlier'. Conversely, care may be handed over to the team on whose home ward they are located. We conducted a retrospective analysis to understand the impact of outlier status and handovers of care on outcomes for General Medicine inpatients. Methods General Medicine admissions at the Royal Adelaide Hospital between September 2020 and November 2021 were analysed. We examined the rate of hospital-acquired complications, inpatient mortality rate, mortality within 48 h of admission, Relative Stay Index, time of discharge from hospital and rate of adverse events within 28 days of discharge. Results A total of 3109 admissions were analysed. Handovers within 24 h of admission were associated with a longer length of stay. There was a trend towards higher rates of adverse events within 28 days of discharge with handovers of care. Outlier status did not affect any outcome measures. Conclusions Handovers within the first 24 h of admission are associated with longer than expected length of stay.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10111662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of primary caregivers in utilising an mHealth application for remote dental screening in preschool children.","authors":"Somayyeh Azimi,&nbsp;Chrishan Fernando,&nbsp;Mohamed Estai,&nbsp;Jilen Patel,&nbsp;Desiree Silva,&nbsp;Marc Tennant","doi":"10.1071/AH23110","DOIUrl":"10.1071/AH23110","url":null,"abstract":"<p><p>Objectives This study aimed to address the acceptance of mHealth applications for a dental screening app that facilitates patient information entry and captures dental photos remotely to assist in caries diagnosis in preschool children in Australia. Methods All participants were recruited through the ORIGINS Project, a community-based interventional birth cohort study in Western Australia. Forty-two primary caregivers, who were the users of a teledental screening app, were given a questionnaire with 17 questions; these were constructed based on the theme of the Technology Acceptance Model: perceived ease of use (PE), perceived usefulness (PU), behavioural intention to adopt (BI), anxiety (ANX), attitude toward a behaviour (ATB), and self-efficacy (SE). Cronbach's alpha was estimated to determine internal consistency. Path analysis was employed to quantify the relationship between each theme. Results The mean values for most themes indicated high satisfaction with the intervention among caregivers (scores out of 5): PE (4.54 ± 0.55), PU (4.65 ± 0.49), BI (4.40 ± 0.65), ATB (4.23 ± 0.70), SE (4.36 ± 0.64). Results indicated high consistency in response in the PE, PU, ATB, and SE (α  = 0.74-0.84) and moderate consistency was observed in ANX and BI (α = 0.50-0.62). The overall intention of using the dental screening app was significantly related to both PU and ATB (P  Conclusion The perceived usefulness and attitude toward behaviours influenced the overall behavioural intention of the participants to use the telehealth model in dental screening. Recognising these relationships indicates community readiness for implementing the telehealth application in the dental program and enables identification of areas for improving its diffusion.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9999811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a novel and more holistic approach for assessing impact in health and medical research: the Research Impact Assessment Framework.","authors":"Robyn L Ward,&nbsp;Don Nutbeam,&nbsp;Wilfred Mijnhardt,&nbsp;Philip Nelson,&nbsp;Angela Todd,&nbsp;Mark I Rees,&nbsp;Janine Richards,&nbsp;Nadia N Khan,&nbsp;Isaac Ho,&nbsp;Sean Chung","doi":"10.1071/AH23152","DOIUrl":"10.1071/AH23152","url":null,"abstract":"<p><p>Considered investment in health and medical research (HMR) is critical for fostering a healthcare system that is sustainable, effective, responsive, and innovative. While several tools exist to measure the impact of research, few assess the research environment that nurtures and supports impactful research and the strategic alignment of research with societal needs. This perspective article discusses the limitations of existing assessment tools and presents a novel Research Impact Assessment Framework designed to enable more strategic and targeted investment towards HMR, having the potential for significant public benefit.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the end-of-life actions in the National Safety and Quality Health Service Standards (2nd edn): a national survey.","authors":"Elise Button,&nbsp;Sara Baniahmadi,&nbsp;Shirley Chambers,&nbsp;Patsy Yates","doi":"10.1071/AH22136","DOIUrl":"10.1071/AH22136","url":null,"abstract":"<p><p>Objectives To describe current and planned processes and outcome measures to address implementation of the six end-of-life actions in the National Safety and Quality Health Service (NSQHS) Standards (2nd edn) and explore associated barriers and enablers. Methods This study used an exploratory mixed methods national survey of acute healthcare facilities between September 2018 and March 2019. This study involved public and private facilities (N  = 765) that provided end-of-life care, which are required to be accredited to the NSQHS Standards. Participants include those responsible for reporting implementation of end-of-life care actions at a facility providing end-of-life care. Participants were asked what processes and outcome measures were implemented or being planned to address the end-of-life care actions, and the associated barriers and enablers. Results Fifty respondents (6.5% response rate) from across Australia contributed data, reporting greater confidence in addressing Actions 5.16: Clinicians have access to Specialist Palliative Care Services; 5.17: Advance care plans can be received from patients and stored in medical records; and 5.18: Supervision and support is available for workforce providing end-of-life care. Barriers associated with the actions that were the most challenging to address included: competing clinical priorities, and insufficient resources to provide best practice end-of-life care; and the burdensome nature of conducting audits. Enablers included: (1) local, jurisdictional, and national strategic plans and policies; (2) support from Specialist Palliative Care Services; (3) access to resources and data; (4) standardised approaches to implementation and measuring outcomes; and (5) clinician, consumer and community engagement and education on end-of-life care. Conclusion Enablers and barriers in implementing the six end-of-life care actions were identified. Respondents reported that high-level support and direction, system-wide approaches, practical clinical support, and widespread community and clinician engagement would enable their facility to better address the end-of-life actions.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10230961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging health and social policy considerations for safe and quality end-of-life care in Australia - the evidence, gaps and challenges.","authors":"Deb Rawlings,&nbsp;Raechel Damarell,&nbsp;Paul Tait,&nbsp;Amal Chakraborty,&nbsp;Angie Dalli,&nbsp;Kim Devery,&nbsp;Jennifer Tieman","doi":"10.1071/AH23166","DOIUrl":"10.1071/AH23166","url":null,"abstract":"<p><p>Recognition of the importance of end-of-life care will enable improvements in the quality of care delivered to patients and their families. Australia is experiencing an increasing number of deaths, (many expected), with an aging population who are living longer, often with multimorbidity. This makes end of life care a priority. The last year of someone's life takes place in a complex healthcare system, with increasing pressures on care delivery, placing the spotlight on health service providers to ensure that teams and individuals are supported and enabled to provide such care. Two rapid literature reviews identified best practice principles and processes for delivering safe and high-quality end-of-life care in acute care, aged care and community settings. The reviews identified that end-of-life care is experienced within the whole health and social care system, including hospital admissions interspersed with care in the community, outpatient and emergency department visits and potentially admission to a hospice. Much of this last year of life is spent at home, which may be a personal residence, an aged care facility, prison, supported accommodation or even on the streets. Transitions across settings requires seamless care, as well as organisational readiness to deliver safe and culturally appropriate care. This is more important now with end-of-life care subject to quality assurance mechanisms within the National Safety and Quality Health Service Standards (2nd edn): Comprehensive care. This requires all sectors to work collaboratively when caring for someone at the end of their life in order to see positive changes in care outcomes.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of the first Australian public and health-professional palliative care advice service: exploring caller needs and gaps in care.","authors":"David J T Marco,&nbsp;Esther McMillan-Drendel,&nbsp;Jennifer A M Philip,&nbsp;Theresa Williamson,&nbsp;Brian Le","doi":"10.1071/AH23108","DOIUrl":"10.1071/AH23108","url":null,"abstract":"<p><p>This study explores and describes the state-wide needs of the first 1000 calls to the newly established Victorian Palliative Care Advice Service (PCAS). A retrospective analysis investigated calls from the Victorian general public (n  = 618 calls) and healthcare professionals (n  = 382 calls) to PCAS between 26 May 2020 and 24 October 2022. Caller demographics, disease type, reason for call, and perceived utility of service were described. Most calls were from members of the public (62%) and related to malignant conditions (41%). Regional/rural clients comprised 45% of all calls to the service, of which half (50%) were health professionals seeking advice on symptom management and medication. One-third (29.3%) of all calls from health professionals were escalated to a palliative care medical consultant. PCAS prevented calls to emergency services in 10% of cases, and 82% of callers reported their issue was 'very much' or 'completely' addressed by PCAS. PCAS was shown to be frequently used by the public and healthcare professionals supporting patients with advanced, life-limiting illnesses. The service provided a solution without requiring complex technology, delivering a rapid connection for consumers with specialist palliative care expertise that might otherwise be unavailable, particularly in regional areas.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of physiotherapy-led lung ultrasound in the intensive care unit.","authors":"Jane Lockstone,&nbsp;Matt Brain,&nbsp;Nadia Zalucki,&nbsp;George Ntoumenopoulos","doi":"10.1071/AH23045","DOIUrl":"10.1071/AH23045","url":null,"abstract":"<p><p>The use of lung ultrasound (LUS) in clinical settings is emerging as an important tool in the assessment of lung pathology and/or function and has gained considerable acceptance. LUS is being integrated into clinical care by trained respiratory physiotherapists and has been shown to influence physiotherapists' clinical decision-making in the respiratory management of patients. Considering the use of LUS by physiotherapy is in its infancy and still evolving, there is likely variability in the ability and confidence of physiotherapists to use LUS in clinical practice, both in Australia and internationally. While the UK has had a rapid increase in the number of LUS-accredited physiotherapists (n  = 111), the number of LUS-accredited physiotherapists in Australia remains very low (n  = 4). There is a growing body of work in the UK on physiotherapy-led LUS in respiratory care, however, there is currently little work published on the practicalities of training and establishing physiotherapy-led LUS in Australia. This report describes the training and implementation of physiotherapy-led LUS in the intensive care unit from a regional hospital perspective.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9686169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of an in-reach rehabilitation program can increase the rate of discharge home from acute hospital care.","authors":"Jane Wu,&nbsp;Christine T Shiner,&nbsp;Steven G Faux,&nbsp;Yuriko Watanabe","doi":"10.1071/AH23033","DOIUrl":"10.1071/AH23033","url":null,"abstract":"<p><p>Objective This study describes how a model of early rehabilitation ('in-reach rehabilitation') can be integrated into acute care provision for hospitalised patients with high rehabilitation needs. This pragmatic evaluation aimed to assess service impact on home discharge rates from acute care. Methods An integrated early rehabilitation service was implemented at a tertiary teaching hospital in Sydney, Australia. Eligible patients were screened, placed on a waitlist, and treated in order of debility (six to eight patients concurrently). Routine data were collected and compared between those who received an in-reach rehabilitation program, and controls who remained on waitlist. Results From December 2021 to September 2022, 229 patients were identified as suitable for in-reach rehabilitation; of whom 100 received an in-reach program and the remaining 129 were waitlist controls. Patients who received in-reach rehabilitation achieved a significantly higher rate of discharge home from acute care compared to waitlist controls (46.0% vs 24.0%, P  = 0.002) and lower rates of transfer to subacute inpatient rehabilitation (43.0% vs 62.0%). This was despite in-reach patients having high functional care needs (60% needed assistance from ≥two people to mobilise) and complex medical needs (median hospital length of stay 44.5 days, IQR 27.8-66.0). Conclusions It is feasible to deliver in-reach rehabilitation to hospitalised patients with heterogeneous diagnoses who have high rehabilitation needs. The rate of discharge home directly from acute wards is higher among those patients who received early in-reach rehabilitation compared to those on a waitlist.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating an implementation of the Australian National Guidelines for the On-Screen Display of Discharge Summaries.","authors":"Masarrat Mahera,&nbsp;Hamish Rodda,&nbsp;Nick Monypenny,&nbsp;Paul Wembridge","doi":"10.1071/AH22248","DOIUrl":"10.1071/AH22248","url":null,"abstract":"<p><p>Objective The objective of this study was to evaluate changes in the inclusion of pertinent information on electronic discharge summaries (eDS) after implementation of a revised template and electronic medical record (EMR) workflow. Methods A retrospective medical record audit of eDS at three metropolitan hospitals was undertaken for adult inpatient encounters in June 2021 (pre-intervention, n  = 100) and June 2022 (post-intervention, n  = 100). The eDS were evaluated against 16 components listed in the Australian National Guidelines for the On-Screen Display of Discharge Summaries. Nine components were further broken down to between two and 11 sub-components. Sub-analysis compared a hospital with full EMR to pooled results from hospitals with hybrid EMRs. Components and sub-components were evaluated for inclusion only; accuracy or relevance of the information was not assessed. Results Inclusion of three out of 16 components (presentation details: 47% vs 62%, problems and diagnosis: 61% vs 86% and recipient details: 82% vs 93%) and eight out of 36 sub-components (discharge destination, principal diagnosis, history of presenting complaint, infection risk, pressure injury, screening and/or diagnosis of delirium and GP phone number and address) was higher in the post-intervention group (all P  < 0.05). Reduced eDS information inclusion in the post-intervention group was observed for discharge date and falls risk only (both P  < 0.05). Reporting of falls history decreased at the hospital with full EMR (71% vs 20% P  < 0.001) but not at hospitals utilising hybrid EMRs (24% vs 30% P  = 0.5). Conclusion The intervention was associated with improved inclusion of pertinent information as described in the Australian National Guidelines for the On-Screen Display of Discharge Summaries.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}