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Gibson C, Goeman D, Pond D, Yates M, Hutchinson A. General practice nurse perceptions of barriers and facilitators to implementation of best-practice dementia care recommendations-a qualitative interview study. BMC Prim Care 2024; 25:147. [PMID: 38698316 PMCID: PMC11064280 DOI: 10.1186/s12875-024-02401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION With an aging population and a growing prevalence of people living with dementia, the demand for best-practice dementia care in general practice increases. There is an opportunity to better utilise the nurse role within the primary care team to meet this increasing demand in the provision of care for people living with dementia. However, general practice nurses have limited knowledge in the provision of best-practice care for people living with dementia and their carer(s). A number of best-practice dementia care recommendations contained in the Australian Clinical Practice Guidelines and Principles of Care for People with Dementia have been identified as highly relevant to the role of the general practice nurse. AIMS To explore general practice nurses' perspectives on published best-practice dementia care recommendations relevant to their role and identify barriers and facilitators to their implementation into clinical practice. METHODS Thirteen Australian general practice nurses took part in this qualitative interview study. The research questions for this study were addressed within a paradigmatic framework of social constructionism. Data were transcribed verbatim and thematically analysed. RESULTS There was a high level of agreement between general practice nurses that the recommendations were important, reflected best-practice dementia care and were relevant to their role. However the recommendations were perceived as limited in their usefulness to nurses' clinical practice due to being too vague and lacking direction. Four main themes were identified describing barriers and facilitators to operationalising best-practice dementia care.: creating a comfortable environment; changing approach to care; optimising the general practice nurse role and working collaboratively. Nine sub-themes were described: physical environment; social environment; complexity of care; care planning for the family; professional role and identity, funding better dementia care, education, networking and resources; different roles, one team; and interagency communication. CONCLUSION This study identified several factors that need addressing to support general practice nurses to integrate best-practice dementia care recommendations into daily clinical practice. The development of interventions needs to include strategies to mitigate potential barriers and enhance facilitators that they perceive impact on their delivery of best-practice care for people living with dementia and their carer(s). The knowledge gained in this study could be used to develop multi-faceted interventions informed by theoretical implementation change models to enable the general practice nurse to operationalise best-practice dementia care recommendations.
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Affiliation(s)
- Caroline Gibson
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, 2308, Australia.
- Grampians Health, Ballarat, Australia.
| | - Dianne Goeman
- University of Newcastle, School of Medicine and Public Health, Callaghan, NSW, 2308, Australia
- Faculty of Medicine, Nursing and Health Sciences, The Alfred Centre, Melbourne, Monash University, Clayton, Australia
| | - Dimity Pond
- University of Tasmania, Wicking Dementia and Teaching Centre, Hobart, Australia
| | - Mark Yates
- Deakin University, School of Medicine, Geelong, Australia
- Grampians Health, Ballarat, Australia
| | - Alison Hutchinson
- Deakin University, School of Nursing and Midwifery, Burwood, Australia
- Faculty of Medicine, Nursing and Health Sciences, The Alfred Centre, Melbourne, Monash University, Clayton, Australia
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Yuen E, Wilson C, Adams J, Kangutkar T, Livingston PM, White VM, Ockerby C, Hutchinson A. Health literacy interventions for informal caregivers: systematic review. BMJ Support Palliat Care 2024:spcare-2023-004513. [PMID: 38326015 DOI: 10.1136/spcare-2023-004513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024]
Abstract
AIM The aim of the systematic review was to identify conceptual models and interventions designed to improve health literacy in caregivers of adults with a chronic disease/disability. METHODS MEDLINE, CINAHL, PsycINFO and Embase were searched for relevant literature. Articles were included if they focused on adults who provided informal care to someone aged 18+ with a chronic disease/disability. Quantitative studies were included if they reported an intervention designed to improve caregiver health literacy (CHL) and assessed outcomes using a validated measure of health literacy. Qualitative and mixed method studies were included if they described a conceptual model or framework of CHL or developed/assessed the feasibility of an intervention. Study quality was appraised using the Mixed Methods Assessment Tool. RESULTS Eleven studies were included. Five studies used pre-post design to assess outcomes of an intervention; four described intervention development and/or pilot testing; two described conceptual models. Two of five studies reported pre-post intervention improvements in CHL; one reported an improvement in one of nine health literacy domains; two reported no improvements following intervention. Interventions predominantly aimed to improve: caregiver understanding of the disease, treatment and potential outcomes, day-to-day care, self-care and health provider engagement. Few interventions targeted broader interpersonal and health service factors identified as influencing CHL. DISCUSSION Evidence on the development and assessment of comprehensive CHL interventions is scarce. Recommendations include the development of interventions that are guided by a CHL framework to ensure they address individual, interpersonal and health service/provider factors that influence CHL.
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Affiliation(s)
- Eva Yuen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton-John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Joanne Adams
- Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Bendigo, Victoria, Australia
| | - Tejashree Kangutkar
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | | | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Barwon Health, Geelong, Victoria, Australia
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Medway P, Hutchinson A, Sweet L. In what ways does maternity care in Australia align with the values and principles of the national maternity strategy? A scoping review. Sex Reprod Healthc 2023; 37:100900. [PMID: 37634300 DOI: 10.1016/j.srhc.2023.100900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/13/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
Australia's national maternity strategy Woman-centred care: strategic directions for Australian maternity services (the Strategy) was released by the federal government in November 2019. It was developed to provide national guidance on the effective provision of woman-centred maternity care. The Strategy is structured around four values of safety, respect, choice, and access, and underpinned by twelve principles of woman-centred care. By examining previous research, this review aims to provide a baseline understanding of how maternity care provision is being met in relation to these core values. A systematic search of Australian literature was undertaken via four databases using the Strategy's values and 41 articles met the selection criteria. Include articles were predominantly published pre-2019, providing a baseline understanding of Australian maternity care provision prior to the Strategy's publication. Findings suggest that the four values align with those of women; however, women were not always receiving care in accordance with the values, particularly among women from priority populations. Women prioritised safety for themselves and their babies, articulated the need for respectful relationships with maternity care providers, wanted autonomy to make their own decisions, and desired access to appropriate, local, maternity services. Additionally, while pockets of appropriate care do exist, these are more likely to occur at a single-service level than more broadly at a population level. This implies the Strategy is needed, and its operationalisation must be prioritised through a coordinated national response to better meet the maternity care needs of Australian women. Further research is warranted to determine the Strategy's effectiveness.
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Affiliation(s)
- Paula Medway
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia. https://twitter.com/@PaulaMedway
| | - Alison Hutchinson
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Australia
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Taylor LC, Hutchinson A, Law K, Shah V, Usher-Smith JA, Dennison RA. Acceptability of risk stratification within population-based cancer screening from the perspective of the general public: A mixed-methods systematic review. Health Expect 2023; 26:989-1008. [PMID: 36852880 PMCID: PMC10154794 DOI: 10.1111/hex.13739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION Risk-stratified cancer screening has the potential to improve resource allocation and the balance of harms and benefits by targeting those most likely to benefit. Public acceptability has implications for engagement, uptake and the success of such a programme. Therefore, this review seeks to understand whether risk stratification of population-based cancer screening programmes is acceptable to the general public and in what context. METHODS Four electronic databases were searched from January 2010 to November 2021. Qualitative, quantitative and mixed-methods papers were eligible for inclusion. The Joanna Briggs Institute convergent integrated approach was used to synthesize the findings and the quality of included literature was assessed using the Mixed Methods Appraisal Tool. The Theoretical Framework of Acceptability was used as a coding frame for thematic analysis. PROSPERO record 2021 CRD42021286667. RESULTS The search returned 12,039 citations, 22 of which were eligible for inclusion. The majority of studies related to breast cancer screening; other cancer types included ovarian, kidney, colorectal and prostate cancer. Risk stratification was generally acceptable to the public, who considered it to be logical and of wider benefit than existing screening practices. We identified 10 priorities for implementation across four key areas: addressing public information needs; understanding communication preferences for risk estimates; mitigating barriers to accessibility to avoid exacerbating inequalities; and the role of healthcare professionals in relation to supporting reduced screening for low-risk individuals. CONCLUSION The public generally find risk stratification of population-based cancer screening programmes to be acceptable; however, we have identified areas that would improve implementation and require further consideration. PATIENT OR PUBLIC CONTRIBUTION This paper is a systematic review and did not formally involve patients or the public; however, three patient and public involvement members were consulted on the topic and scope before the review commenced.
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Affiliation(s)
- Lily C Taylor
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Katie Law
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Veeraj Shah
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Juliet A Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Rebecca A Dennison
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Taylor LC, Law K, Hutchinson A, Dennison RA, Usher-Smith JA. Acceptability of risk stratification within population-based cancer screening from the perspective of healthcare professionals: A mixed methods systematic review and recommendations to support implementation. PLoS One 2023; 18:e0279201. [PMID: 36827432 PMCID: PMC9956883 DOI: 10.1371/journal.pone.0279201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/01/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Introduction of risk stratification within population-based cancer screening programmes has the potential to optimise resource allocation by targeting screening towards members of the population who will benefit from it most. Endorsement from healthcare professionals is necessary to facilitate successful development and implementation of risk-stratified interventions. Therefore, this review aims to explore whether using risk stratification within population-based cancer screening programmes is acceptable to healthcare professionals and to identify any requirements for successful implementation. METHODS We searched four electronic databases from January 2010 to October 2021 for quantitative, qualitative, or primary mixed methods studies reporting healthcare professional and/or other stakeholder opinions on acceptability of risk-stratified population-based cancer screening. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Data were analysed using the Joanna Briggs Institute convergent integrated approach to mixed methods analysis and mapped onto the Consolidated Framework for Implementation Research using a 'best fit' approach. PROSPERO record CRD42021286667. RESULTS A total of 12,039 papers were identified through the literature search and seven papers were included in the review, six in the context of breast cancer screening and one considering screening for ovarian cancer. Risk stratification was broadly considered acceptable, with the findings covering all five domains of the framework: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process. Across these five domains, key areas that were identified as needing further consideration to support implementation were: a need for greater evidence, particularly for de-intensifying screening; resource limitations; need for staff training and clear communication; and the importance of public involvement. CONCLUSIONS Risk stratification of population-based cancer screening programmes is largely acceptable to healthcare professionals, but support and training will be required to successfully facilitate implementation. Future research should focus on strengthening the evidence base for risk stratification, particularly in relation to reducing screening frequency among low-risk cohorts and the acceptability of this approach across different cancer types.
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Affiliation(s)
- Lily C. Taylor
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Katie Law
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Alison Hutchinson
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Rebecca A. Dennison
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Juliet A. Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Grinspun D, Wallace K, Li SA, McNeill S, Squires JE, Bujalance J, D'Arpino M, De Souza G, Farshait N, Gabbay J, Graham ID, Hutchinson A, Kinder K, Laur C, Mah T, Moore JE, Plant J, Ploquin J, Ruiter PJA, St-Germain D, Sills-Maerov M, Tao M, Titler M, Zhao J. Corrigendum to “Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis” [Int J Nurs Sci 9/4 (2022) 411–421]. Int J Nurs Sci 2023; 10:e1. [PMID: 37128483 PMCID: PMC10148247 DOI: 10.1016/j.ijnss.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
[This corrects the article DOI: 10.1016/j.ijnss.2022.08.003.].
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Alhariri S, Gutierrez J, Hutchinson A, Sairam S. Trend of gabapentin use in non-diabetic patients who are referred to a rheumatology clinic. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00536-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Bucknall TK, Considine J, Harvey G, Graham ID, Rycroft-Malone J, Mitchell I, Saultry B, Watts JJ, Mohebbi M, Bohingamu Mudiyanselage S, Lotfaliany M, Hutchinson A. Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO): a pragmatic cluster randomised controlled trial evaluating the effectiveness of a facilitation intervention on recognition and response to clinical deterioration. BMJ Qual Saf 2022; 31:818-830. [PMID: 35450936 PMCID: PMC9606509 DOI: 10.1136/bmjqs-2021-013785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 03/01/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most hospitals use physiological signs to trigger an urgent clinical review. We investigated whether facilitation could improve nurses' vital sign measurement, interpretation, treatment and escalation of care for deteriorating patients. METHODS In a pragmatic cluster randomised controlled trial, we randomised 36 inpatient wards at four acute hospitals to receive standard clinical practice guideline (CPG) dissemination to ward staff (n=18) or facilitated implementation for 6 months following standard dissemination (n=18). Expert, hospital and ward facilitators tailored facilitation techniques to promote nurses' CPG adherence. Patient records were audited pre-intervention, 6 and 12 months post-intervention on randomly selected days. Escalation of care as per hospital policy was the primary outcome at 6 and 12 months after implementation. Patients, nurses and assessors were blinded to group assignment. Analysis was by intention-to-treat. RESULTS From 10 383 audits, improved escalation as per hospital policy was evident in the intervention group at 6 months (OR 1.47, 95% CI (1.06 to 2.04)) with a complete set of vital sign measurements sustained at 12 months (OR 1.22, 95% CI (1.02 to 1.47)). There were no significant differences in escalation of care as per hospital policy between study groups at 6 or 12 months post-intervention. After adjusting for patient and hospital characteristics, a significant change from T0 in mean length of stay between groups at 12 months favoured the intervention group (-2.18 days, 95% CI (-3.53 to -0.82)). CONCLUSION Multi-level facilitation significantly improved escalation as per hospital policy at 6 months in the intervention group that was not sustained at 12 months. The intervention group had increased vital sign measurement by nurses, as well as shorter lengths of stay for patients at 12 months. Further research is required to understand the dose of facilitation required to impact clinical practice behaviours and patient outcomes. TRIAL REGISTRATION NUMBER ACTRN12616000544471p.
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Affiliation(s)
- Tracey K Bucknall
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Alfred Health, Melbourne, Victoria, Australia
| | - Julie Considine
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research - Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Gillian Harvey
- Caring Futures Institute, Flinders University College of Nursing and Health Sciences, Bedford Park, South Australia, Australia
| | - Ian D Graham
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- School of Epidemiology and Public Health and School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Imogen Mitchell
- Australian National University Medical School, Canberra, Australian Capital Territory, Australia
| | - Bridey Saultry
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Alfred Health, Melbourne, Victoria, Australia
| | - Jennifer J Watts
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Shalika Bohingamu Mudiyanselage
- School of Health and Social Development, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Mojtaba Lotfaliany
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
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Grinspun D, Wallace K, Li SA, McNeill S, Squires JE, Bujalance J, D’Arpino M, De Souza G, Farshait N, Gabbay J, Graham ID, Hutchinson A, Kinder K, Laur C, Mah T, Moore JE, Plant J, Ploquin J, Ruiter PJA, St-Germain D, Sills-Maerov M, Tao M, Titler M, Zhao J. Exploring social movement concepts and actions in a knowledge uptake and sustainability context: A concept analysis. Int J Nurs Sci 2022; 9:411-421. [PMID: 36285080 PMCID: PMC9587399 DOI: 10.1016/j.ijnss.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/21/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives To share a concept analysis of social movement aimed at advancing its application to evidence uptake and sustainability in health-care. Methods We applied Walker and Avant method to clarify the concept of social movement in the context of knowledge uptake and sustainability. Peer-reviewed and grey literature databases were systematically searched for relevant reports that described how social movement action led to evidence-based practice changes in health and community settings. Titles, abstracts and full texts were reviewed independently and in duplicate, resulting in 38 included articles. Results Social movement action for knowledge uptake and sustainability can be defined as individuals, groups, or organizations that, as voluntary and intrinsically motivated change agents, mobilize around a common cause to improve outcomes through knowledge uptake and sustainability. The 10 defining attributes, three antecedents and three consequences that we identified are dynamic and interrelated, often mutually reinforcing each other to fortify various aspects of the social movement. Examples of defining attributes include an urgent need for action, collective action and collective identity. The concept analysis resulted in the development of the Social Movement Action Framework. Conclusions Social movement action can provide a lens through which we view implementation science. Collective action and collective identity – concepts less frequently canvassed in implementation science literature – can lend insight into grassroots approaches to uptake and sustainability. Findings can also inform providers and change leaders on the practicalities of harnessing social movement action for real-world change initiatives. By mobilizing individuals, groups, or organizations through social movement approaches, they can engage as powered change agents and teams that impact the individual, organizational and health systems levels to facilitate knowledge uptake and sustainability.
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Affiliation(s)
- Doris Grinspun
- Registered Nurses’ Association of Ontario, Toronto, Canada
| | - Katherine Wallace
- Registered Nurses’ Association of Ontario, Toronto, Canada
- Corresponding author.
| | - Shelly-Anne Li
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Susan McNeill
- Registered Nurses’ Association of Ontario, Toronto, Canada
| | - Janet Elaine Squires
- School of Nursing, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | | | | | | | | | - John Gabbay
- University of Southampton, Southampton, England, UK
| | - Ian D. Graham
- Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | - Alison Hutchinson
- School of Nursing and Midwifery, Deakin University Australia, Victoria, Australia
| | - Kim Kinder
- Healthcare Excellence Canada, Ottawa, Canada
| | - Celia Laur
- Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV), Toronto, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Tina Mah
- Schlegel-UW Research Institute for Aging, Waterloo, Canada
| | | | | | | | | | | | | | - May Tao
- Toronto Public Health, Toronto, Canada
| | - Marita Titler
- School of Nursing, University of Michigan, Ann Arbor, United States
| | - Junqiang Zhao
- School of Nursing, University of Ottawa, Ottawa, Canada
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Meyer C, Ogrin R, Golenko X, Cyarto E, Paine K, Walsh W, Hutchinson A, Lowthian J. A codesigned fit-for-purpose implementation framework for aged care. J Eval Clin Pract 2022; 28:421-435. [PMID: 35129259 PMCID: PMC9303944 DOI: 10.1111/jep.13660] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES The field of implementation science is critical for embedding research evidence into healthcare practice, benefiting individuals, organizations, governments, and the broader community. Implementation science is messy and complex, underpinned by many theories and frameworks. Efficacious interventions for older people with multiple comorbidities exist, yet many lack effectiveness evaluation relevant to pragmatic implementation within aged care practice. This article outlines the conceptualization and development of an Implementation Framework for Aged Care (IFAC), fit-for-purpose for an aged care organization, Bolton Clarke, intent on embedding evidence into practice. METHOD A four-stage process was adopted to (1) explore context and relevant literature to conceptualize the IFAC; (2) identify key elements for a draft IFAC; (3) expand elements and refine the draft in consultation with experts and (4) apply the IFAC to three existing projects, identifying key learnings. A checklist to operationalize the IFAC was then developed. RESULTS The IFAC is grounded in codesign principles and encapsulated by the implementation context, from a social, cultural and political perspective. The IFAC addresses the questions of (1) why do we need to change?; (2) what do we know?; (3) who will benefit?; (4) who will make the change?; (5) what strategies will be used?; and (6) what difference are we making? Three pilot projects: early adoption of a Wellness and Reablement approach; a care worker and virtual physiotherapist-led program to prevent falls; and a therapeutic horticulture program for residential communities, highlight learnings of applying the IFAC in practice. CONCLUSION This fit-for-purpose IFAC was developed for a proactive and responsive aged care provider. The simplicity of the six-question IFAC is underpinned by substantial theoretical perspectives for its elements and their connections. This complexity is then consolidated into an 18-question checklist to operationalize the IFAC, necessary to advance the translation of evidence into clinical practice.
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Affiliation(s)
- Claudia Meyer
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia.,Department is School of Psychology and Public Health, Centre for Health Communication and Participation, La Trobe University, Bundoora, Victoria, Australia.,Department is School of Primary and Allied Health Care, Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, Victoria, Australia
| | - Rajna Ogrin
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia.,Department of Business Strategy and Innovation, Griffith University, Southport, Queensland, Australia
| | - Xanthe Golenko
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia.,Department of Business Innovation and Strategy, Griffith Business School, Griffith University, Southport, Queensland, Australia
| | - Elizabeth Cyarto
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Kath Paine
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia
| | - Willeke Walsh
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia
| | - Alison Hutchinson
- Department is School of Psychology and Public Health, Centre for Health Communication and Participation, La Trobe University, Bundoora, Victoria, Australia.,School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia
| | - Judy Lowthian
- Department of Bolton Clarke, Bolton Clarke Research Institute, Victoria, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Queensland, Australia.,Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Redley B, Douglas T, Hoon L, White K, Hutchinson A. Nursing guidelines for comprehensive harm prevention strategies for adult patients in acute hospitals: An integrative review and synthesis. Int J Nurs Stud 2022; 127:104178. [DOI: 10.1016/j.ijnurstu.2022.104178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/05/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022]
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12
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Haines TP, Botti M, Brusco N, O’Brien L, Redley B, Bowles KA, Hutchinson A, Mitchell D, Jellett J, Steen K, Boyd L, Webb-St Mart M, Raymond M, Hunter P, Russo P, Bonnici R, Pu D, Sevenhuysen S, Davies V, Shorr R. Disinvestment in the presence of uncertainty: Description of a novel, multi-group, disinvestment trial design and protocol for an application to reduce or cease use of mobilisation alarms for preventing falls in hospitals. PLoS One 2021; 16:e0261793. [PMID: 34969050 PMCID: PMC8717976 DOI: 10.1371/journal.pone.0261793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022] Open
Abstract
Disinvestment is the removal or reduction of previously provided practices or services, and has typically been undertaken where a practice or service has been clearly shown to be ineffective, inefficient and/or harmful. However, practices and services that have uncertain evidence of effectiveness, efficiency and safety can also be considered as candidates for disinvestment. Disinvestment from these practices and services is risky as they may yet prove to be beneficial if further evidence becomes available. A novel research approach has previously been described for this situation, allowing disinvestment to take place while simultaneously generating evidence previously missing from consideration. In this paper, we describe how this approach can be expanded to situations where three or more conditions are of relevance, and describe the protocol for a trial examining the reduction and elimination of use of mobilisation alarms on hospital wards to prevent patient falls. Our approach utilises a 3-group, concurrent, non-inferiority, stepped wedge, randomised design with an embedded parallel, cluster randomised design. Eighteen hospital wards with high rates of alarm use (≥3%) will be paired within their health service and randomly allocated to a calendar month when they will transition to a “Reduced” (<3%) or “Eliminated” (0%) mobilisation alarm condition. Dynamic randomisation will be used to determine which ward in each pair will be allocated to either the reduced or eliminated condition to promote equivalence between wards for the embedded parallel, cluster randomised component of the design. A project governance committee will set non-inferiority margins. The primary outcome will be rates of falls. Secondary clinical, process, safety, and economic outcomes will be collected and a concurrent economic evaluation undertaken.
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Affiliation(s)
- Terry P. Haines
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, Australia
- * E-mail:
| | - Mari Botti
- School of Nursing & Midwifery, Deakin University, Geelong, Australia
| | - Natasha Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Lisa O’Brien
- Department of Occupational Therapy, Monash University, Melbourne, Australia
| | - Bernice Redley
- Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Kelly-Ann Bowles
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Alison Hutchinson
- Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Debra Mitchell
- Allied Health Workforce, Innovation, Strategy, Education and Research (WISER) Unit, Monash Health, Clayton, Australia
| | - Joanna Jellett
- Falls Prevention Service, The Mornington Centre, Peninsula Health, Victoria, Australia
| | | | - Leanne Boyd
- Chief Nursing and Midwifery Officer, Executive Director Learning and Teaching, Eastern Health, Richmond, Australia
| | | | - Melissa Raymond
- Physiotherapy Department, Alfred Health, Melbourne, Australia
- College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Peter Hunter
- Geriatric Medicine, Alfred Health, Melbourne, Australia
| | - Phillip Russo
- School of Nursing & Midwifery, Monash University, Melbourne, Australia
- Department of Nursing Research, Cabrini Institute, Malvern, Australia
| | - Rachel Bonnici
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, Australia
| | - Dai Pu
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, Australia
| | | | - Vicki Davies
- Subacute Ambulatory Care Manager Peninsula Health, Frankston, Australia
| | - Ronald Shorr
- Geriatric Research Education and Clinical Center, Malcolm Randall Veterans Affairs Medical Center, Gainesville, Florida
- Department of Epidemiology, University of Florida, Gainesville, Florida
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13
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Osajiuba SA, Jedwab R, Calvo R, Dobroff N, Glozier N, Hutchinson A, Leiter M, Nankervis K, Rawson H, Redley B, Manias E. Facilitators and Barriers to the Adoption of an Electronic Medical Record System by Intensive Care Nurses. Stud Health Technol Inform 2021; 284:510-515. [PMID: 34920583 DOI: 10.3233/shti210785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introducing new technology, such as an electronic medical record (EMR) into an Intensive Care Unit (ICU), can contribute to nurses' stress and negative consequences for patient safety. The aim of this study was to explore ICU nurses' perceptions of factors expected to influence their adoption of an EMR in their workplace. The objectives were to: 1) measure psychological factors expected to influence ICU nurses' adoption of EMR, and 2) explore perceptions of facilitators and barriers to the implementation of an EMR in their workplace. Using an explanatory sequential mixed method approach, data were collected using surveys and focus groups. ICU nurses reported high scores for motivation, work engagement and wellbeing. Focus group analyses revealed two themes: Hope the EMR will bring a new world and Fear of unintended consequences. Recommendations relate to strategies for education and training, environmental restructuring and enablement. Overall, ICU nurses were optimistic about EMR implementation.
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Affiliation(s)
| | - Rebecca Jedwab
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Rafael Calvo
- Dyson School of Design Engineering, Imperial College London, London South Kensington, United Kingdom
| | - Naomi Dobroff
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | | | - Alison Hutchinson
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
| | | | - Katrina Nankervis
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Helen Rawson
- Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
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14
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Njane A, Jedwab R, Calvo R, Dobroff N, Glozier N, Hutchinson A, Leiter M, Manias E, Nankervis K, Rawson H, Redley B. Perioperative Nurses' Perceptions Pre-Implementation of an Electronic Medical Record System. Stud Health Technol Inform 2021; 284:522-527. [PMID: 34920585 DOI: 10.3233/shti210787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of electronic medical record (EMR) systems is transforming health care delivery in hospitals. Perioperative nurses work in a unique high-risk health setting, hence require specific considerations for EMR implementation. This research explored perioperative nurses' perceptions of facilitators and barriers to the implementation of an EMR in their workplace to make context-specific recommendations about strategies to optimise EMR adoption. Using a qualitative exploratory descriptive design, focus group data were collected from 27 perioperative nurses across three hospital sites. Thematic analyses revealed three themes: 1) The world is going to change; 2) What does it mean for me? and 3) We can do it, but we have some reservations. Mapping coded data to the Theoretical Domains Framework identified prominent facilitators and barriers, and informed recommended implementation strategies for EMR adoption by perioperative nurses.
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Affiliation(s)
- Agnes Njane
- Deakin University, Melbourne, Victoria, Australia
| | - Rebecca Jedwab
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Rafael Calvo
- Dyson School of Design Engineering, Iimperial College London, London South Kensington, United Kingdom
| | - Naomi Dobroff
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | | | - Alison Hutchinson
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
| | | | | | - Katrina Nankervis
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Helen Rawson
- Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
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15
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Tissera S, Jedwab R, Calvo R, Dobroff N, Glozier N, Hutchinson A, Leiter M, Manias E, Nankervis K, Rawson H, Redley B. Older Nurses' Perceptions of an Electronic Medical Record Implementation. Stud Health Technol Inform 2021; 284:516-521. [PMID: 34920584 DOI: 10.3233/shti210786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In Australia, almost 40% of nurses are aged 50 years and older. These nurses may be vulnerable to leaving the workforce due to challenges experienced during electronic medical record (EMR) implementations. This research explored older nurses' perceptions of factors expected to influence their adoption of an EMR, to inform recommendations to support implementation. The objectives were to: 1) measure psychological factors expected to influence older nurses' adoption of the EMR; and 2) explore older nurses' perceptions of facilitators and barriers to EMR adoption. An explanatory sequential mixed methods design was used to collect survey and focus group data from older nurses, prior to introducing an EMR system. These nurses were highly engaged with their work; 79.3% reported high wellbeing scores. However, their motivation appeared to be predominantly governed by external rather than internal influences. Themes reflecting barriers to EMR and resistance to adoption emerged in the qualitative data.
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Affiliation(s)
| | - Rebecca Jedwab
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Rafael Calvo
- Dyson School of Design Engineering, Imperial College London, London South, Kensington, United Kingdom
| | - Naomi Dobroff
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | | | - Alison Hutchinson
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
| | | | | | - Katrina Nankervis
- Deakin University, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Helen Rawson
- Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Melbourne, Victoria, Australia
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16
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Rasmussen B, Hutchinson A, Lowe G, Wynter K, Redley B, Holton S, Manias E, Phillips N, McDonall J, McTier L, Kerr D. The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey. Nurse Educ Pract 2021; 58:103275. [PMID: 34922092 PMCID: PMC8662551 DOI: 10.1016/j.nepr.2021.103275] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/20/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023]
Abstract
Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university. Background The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic. Design Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020. Methods A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed. Results Of 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study. Conclusions Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.
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Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia; Faculty of Health and Medical Sciences, University of Copenhagen Blegdamsvej 3B, 2200 Copenhagen, Denmark; Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Campusvej 55, Odense M, DK-5230, Denmark.
| | - Alison Hutchinson
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Monash Health Partnership, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Grainne Lowe
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Karen Wynter
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia.
| | - Bernice Redley
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Monash Health Partnership, Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia.
| | - Sara Holton
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Furlong Road, St Albans VIC 3021 Australia.
| | - Elizabeth Manias
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Nikki Phillips
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Jo McDonall
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Lauren McTier
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
| | - Debra Kerr
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.
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17
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Davis KM, Eckert MC, Hutchinson A, Harmon J, Sharplin G, Shakib S, Caughey GE. Effectiveness of nurse-led services for people with chronic disease in achieving an outcome of continuity of care at the primary-secondary healthcare interface: A quantitative systematic review. Int J Nurs Stud 2021; 121:103986. [PMID: 34242979 DOI: 10.1016/j.ijnurstu.2021.103986] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Globally, chronic disease is a leading cause of illness, disability and death and an important driver of health system utilization and spending. Continuity of care is a significant component of quality healthcare. However, an association between nurse-led services, interventions, patient outcomes and continuity of care at the primary and secondary interface as an outcome, has not been established for people with chronic disease. OBJECTIVE To identify the effectiveness of nurse-led services for people with chronic disease in achieving an outcome of continuity of care at the primary-secondary healthcare interface. DESIGN Quantitative systematic review. DATA SOURCES Systematic searches of Medline, Cochrane, Embase, Emcare, JBI and Scopus databases were conducted of studies published between 1946 and May 2019 using the search terms "nurse", "continuity of care" and "chronic disease". REVIEW METHODS Quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials and Joanna Briggs Institute quality appraisal checklists. A second reviewer screened 10% of full text articles and all articles in critical appraisal. Studies were excluded from the review if they were of poor methodological quality or the description of the effect of the nurse-led service was inadequately reported. RESULTS Fourteen studies were included in the review (n=4,090 participants). All studies incorporated recognized continuity of care interventions. The nurse-led services were associated with fewer hospitalizations, reduced by 2-8.9% and re-admissions reduced by 14.8-51% (n=886). Reporting of positive patient experiences and improvement in symptoms and lifestyle was also evident. An association of nurse-led services with improved continuity of care between primary and secondary health services as an outcome per se could not be concluded. CONCLUSION Nurse-led services for adults provide coordinated interventions that support continuity of care for people with chronic disease in both the primary and secondary healthcare settings that are associated with reduced hospitalizations or readmissions and patient satisfaction. However, the limited use of validated continuity of care outcome measurement tools precluded establishing correlations between interventions, patient outcomes and continuity of care as a specific outcome.
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Affiliation(s)
- K M Davis
- Rosemary Bryant AO Research Centre, UniSA, Clinical and Health Sciences, University of South Australia.
| | - M C Eckert
- Rosemary Bryant AO Research Centre, UniSA, Clinical and Health Sciences, University of South Australia. https://twitter.com/@DrJoanneHarmon
| | - A Hutchinson
- UniSA, Clinical and Health Sciences, University of South Australia
| | - J Harmon
- UniSA, Clinical and Health Sciences, University of South Australia. https://twitter.com/marioneckert5
| | - G Sharplin
- Rosemary Bryant AO Research Centre, UniSA, Clinical and Health Sciences, University of South Australia
| | - S Shakib
- Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, Australia; Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - G E Caughey
- Clinical Pharmacology, Royal Adelaide Hospital, North Terrace, Adelaide, Australia; Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, Australia
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18
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Wyatt T, Friedman K, Hutchinson A. Are Fish Wild? Liverp Law Rev 2021; 42:485-492. [PMID: 34276110 PMCID: PMC8274253 DOI: 10.1007/s10991-021-09285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
As the global biodiversity crisis continues, it is important to examine the legislative protection that is in place for species around the world. Such legislation not only includes environmental or wildlife law, but also trade law, such as the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), which gets transposed into national legislation. This commentary analyses legislative definitions of wildlife, whether or not that includes fish, which has implications for fish welfare, use of fish for food security, and biodiversity conservation when fish, or other wildlife, are excluded. Through a legislative content analysis of the 183 parties' legislation of CITES, we explore whether fish are afforded the same protections as other species by being included in legal definitions of wildlife. We found that while a majority of CITES parties' legislation appear to define fish as wildlife, there are a number of instances where this is unclear or not the case, and this could have significant ramifications for the welfare of non-human animals, their use, and conservation.
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Affiliation(s)
| | - Kim Friedman
- The United Nations Food and Agriculture Organization, Fisheries Division, Rome, Italy
- The University of Western Australia, Oceans Institute, Crawley, Western Australia Australia
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19
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Manias E, Bucknall T, Hutchinson A, Dow B, Borrott N. Resident and family engagement in medication management in aged care facilities: a systematic review. Expert Opin Drug Saf 2021; 20:1391-1409. [PMID: 34058923 DOI: 10.1080/14740338.2021.1935862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Medication-related harms may occur if residents and families are not involved when important medication decisions are made. We examined how residents and families engage in the management of residents' medications in aged care facilities.Areas covered: A systematic review was undertaken, which was registered with PROSPERO (CRD42020152700). Electronic databases were searched from inception until 27 August 2020 using MEDLINE/PubMed, CINAHL, PsycINFO and EMBASE. Data synthesis was undertaken using thematic analysis.Expert opinion: Forty studies were included. Communication tended to be unidirectional comprising consultations where residents and families provided medication information to health care providers or where health care providers provided medication information to residents and families. Many challenges prevailed that prevented effective engagement, including families' hesitation about making decisions, and the lack of adequately-trained health care providers. Testing of interventions often did not include residents or families in developing these interventions or in examining how they participated in medication decisions following implementation of interventions. Areas for improvement comprise actively involving residents and families in planning interventions for resident-centered care. Health care providers need to have greater appreciation of families' ability to detect dynamic changes in residents' behavior, which can be used to enable optimal alterations in medication therapy.
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Affiliation(s)
- Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Foundational Chair in Nursing and Director of Nursing Research, Alfred Health, Prahran, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Victoria, Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, Victoria, Australia.,School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Narelle Borrott
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
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20
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Gibson C, Goeman D, Hutchinson A, Yates M, Pond D. The provision of dementia care in general practice: practice nurse perceptions of their role. BMC Fam Pract 2021; 22:110. [PMID: 34107867 PMCID: PMC8191039 DOI: 10.1186/s12875-021-01467-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022]
Abstract
Background Primary care nurses can assist General Practitioner’s to identify cognition concerns and support patient health self-management for those experiencing cognitive impairment or dementia. This support may lead to more appropriate care and better health outcomes for this group. Consequently, there is a need to identify the role of the primary care nurse in dementia care provision, nurse perceptions of this role and to also understand the barriers and enablers that may influence any current or potential primary care nurse role in dementia care provision. Methods Eight focus groups were conducted with a total of 36 primary care nurses. Data was transcribed verbatim and thematically analysed. Results There was a high level of agreement between primary care nurses that they had a role in provision of dementia care. This role was largely attributed to the strong therapeutic relationship between nurses and patients. However, dementia care provision was not without its challenges, including a perceived lack of knowledge, limited resources and the hierarchical nature of general practice. Three main themes were identified: personal attributes of the primary care nurse; professional attributes of the primary care nurse role and the context of practice. Six sub-themes were identified: knowing the person; overcoming stigma; providing holistic care; knowing what to do; team culture and working in the system. Conclusions The findings of this study suggest primary care nurses have a role in dementia care provision and, there is a need to provide support for the nurse to deliver person-centred health care in the context of cognitive impairment. As the demand for good quality primary care for people living with dementia increases, the role of the primary care nurse should be considered in primary care policy discussions. The knowledge gained from this study could be useful in informing dementia training content, to provide better prompts in the health assessment and care planning templates used by primary care nurses to better identify the care needs of people with a cognitive impairment and to develop dementia care guidelines for primary care nurses.
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Affiliation(s)
- Caroline Gibson
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Melbourne, Australia.
| | - Dianne Goeman
- Faculty of Health and Medicine, School of Medicine and Public Health, Central Clinical School, University of Newcastle, Monash University, Melbourne, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Monash HealthCentre for Quality and Patient Safety ResearchInstitute for Health Transformation, Deakin University, Melbourne, Australia
| | - Mark Yates
- Deakin University School of Medicine, Ballarat Health Services, Melbourne, Australia
| | - Dimity Pond
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Melbourne, Australia
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21
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Williams R, Ockerby C, Rawson H, Redley B, Hutchinson A. Residential aged care staff awareness of and engagement with dementia-specific support services and education. Australas J Ageing 2021; 40:e223-e233. [PMID: 33522078 PMCID: PMC8519096 DOI: 10.1111/ajag.12904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/04/2022]
Abstract
Objective To examine residential aged care (RAC) staff awareness of and engagement with dementia‐specific support services and education. Methods A cross‐sectional survey of staff (n = 179) from 36 Victorian RAC facilities. Results 60% (n = 107) of respondents were aware of dementia‐specific support services, but only 27% (n = 48) accessed services in the previous 2 years. Approximately 77% (n = 137) were aware of dementia‐specific education, with 66% (n = 115) completing education in the previous 2 years. A significantly higher proportion of registered nurses had accessed dementia‐specific support services in the past 2 years compared with enrolled nurses and personal care assistants (P < 0.001). Conclusion A relatively large proportion of RAC staff were unaware of available dementia‐specific support services and education. While approximately two thirds accessed such education, only one in four accessed dementia‐specific support services. To optimise the quality of care for people with dementia, strategies to increase awareness of and access to these resources are warranted.
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Affiliation(s)
- Ruth Williams
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Cherene Ockerby
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Helen Rawson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia.,Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia.,Centre for Quality and Patient Safety Research-Monash Health Partnership, Melbourne, Victoria, Australia.,Monash Health, Melbourne, Victoria, Australia
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Bloom J, Andrew E, Nehme Z, Dinh D, Shi W, Vriesendorp P, Nanayakarra S, Fernando H, Dawson L, Brennan A, Noaman S, Layland J, William J, Al-Fiadh A, Brookes M, Freeman M, Hutchinson A, McGaw D, Van GW, Wilson W, White A, Prakash R, Reid C, Lefkovits J, Duffy S, Chan W, Kaye D, Stephenson M, Bernard S, Smith K, Stub D. Pre-Hospital Heparin Use for ST-Elevation Myocardial Infarction is Safe and Improves Angiographic Outcomes. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ostaszkiewicz J, Dickson-Swift V, Hutchinson A, Wagg A. A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC Geriatr 2020; 20:266. [PMID: 32727481 PMCID: PMC7392826 DOI: 10.1186/s12877-020-01673-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/23/2020] [Indexed: 12/25/2022] Open
Abstract
Background Although codes of conduct, guidelines and standards call for healthcare practitioners to protect patients’ dignity, there are widespread concerns about a lack of attention to the dignity of older people who need assistance with toileting, incontinence or bladder or bowel care in health or social care settings that provide long-term care. Incontinence and care dependence threatens patient dignity. The aim of this research was to explore, describe and explain the concept of dignity as it relates to continence care for older people requiring long-term care. Methods The first four steps of Rodgers evolutionary method of concept analysis were followed. First, a comprehensive and systematic search of databases and key guidelines about continence care was undertaken to identify empirical research about dignity and continence care in older people in facilities that provide permanent residential or inpatient care of older people for day-to-day living. Data were extracted on the authors, date, sample, country of origin, and key definitions, attributes, contexts and consequences from each included record. Findings were inductively analysed and grouped according to whether they were the key attributes and antecedents of dignity in relation to continence care or the consequences of undignified continence care. Results Of 625 articles identified, 18 were included in the final analysis. Fifty individual attributes were identified that were categorised in 6 domains (respect, empathy, trust, privacy, autonomy and communication). A further 15 were identified that related to the environment (6 physical and 9 social). Key consequences of undignified continence care were also identified and categorised into 3 levels of impact (resident/family member, staff or organisation). Conclusions This research resulted in a conceptual understanding of dignity that can be used as a value or guiding principle in an ethic of care for older people who need assistance with toileting, incontinence or bladder or bowel care in long-term care settings.
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Affiliation(s)
- Joan Ostaszkiewicz
- Centre for Quality and Patient Safety Research - Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, VIC, 3220, Australia. .,School of Nursing and Midwifery, Deakin University, Gheringhap St, Geelong, VIC, 3220, Australia. .,National Ageing Research Institute, P.O Box 2127, Royal Melbourne Hospital, 21, Melbourne, VIC, 3530, Australia.
| | - Virginia Dickson-Swift
- Centre for Quality and Patient Safety Research - Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, VIC, 3220, Australia.,School of Nursing and Midwifery, Deakin University, Gheringhap St, Geelong, VIC, 3220, Australia
| | - Alison Hutchinson
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Institute for Healthcare Transformation, Deakin University, Burwood, VIC, 3125, Australia
| | - Adrian Wagg
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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24
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Ostaszkiewicz J, Dunning T, Hutchinson A, Wagg A, Gwini S, Dickson-Swift V. The development and validation of instruments to measure dignity-protective continence care for care-dependent older people in residential aged care facilities: A study protocol. Neurourol Urodyn 2020; 39:1363-1370. [PMID: 32227651 DOI: 10.1002/nau.24343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/10/2020] [Accepted: 03/18/2020] [Indexed: 12/29/2022]
Abstract
AIMS To develop and validate two instruments to measure dignity-protective continence care for care-dependent older people in residential aged care facilities: one instrument to be completed by care recipients and another for healthcare professionals. METHODS The first phase of the project will involve a review of literature to identify the attributes of "dignity-protective continence care" for older people, which will be used to design the initial drafts of the instruments. Thereafter the Delphi survey technique will be used to establish the face and content validity of the draft instruments with three purposive samples; (a) care recipients (care-dependent older people with decisional capacity), (b) formal carers (nurses and personal care workers from residential aged care facilities, and (c) healthcare professionals with gerontological expertize in the management of incontinence. After instrument development, a large cross-sectional survey of care recipients and formal carers will be conducted to establish the internal consistency and construct validity of the instruments. This will be followed by a series of tests to establish their test-retest reliability. CONCLUSION The completed research will result in two reliable and valid instruments that will support broader efforts to ensure that care practices in residential aged care facilities do not violate the dignity of care-dependent older people with continence care needs, and allow care partners and providers to act upon the results.
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Affiliation(s)
- Joan Ostaszkiewicz
- Centre for Quality and Patient Safety Research-Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Trisha Dunning
- Centre for Quality and Patient Safety Research-Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety Research-Monash Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
| | - Adrian Wagg
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - StellaMay Gwini
- Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
- iMPACT Institute, Deakin University, Geelong, Victoria, Australia
| | - Virginia Dickson-Swift
- Centre for Quality and Patient Safety Research-Barwon Health Partnership, Institute for Healthcare Transformation, Deakin University, Geelong, Victoria, Australia
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
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25
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Oldland E, Botti M, Redley B, Hutchinson A. Do nurses describe development of broad safety and quality related competencies as motivations for commencing postgraduate critical care studies? Aust Crit Care 2020. [DOI: 10.1016/j.aucc.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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26
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Oldland E, Botti M, Hutchinson A, Mohebbi M, Redley B. Measuring nurses’ perceptions of their responsibility for healthcare quality - instrument validity and reliability. Aust Crit Care 2020. [DOI: 10.1016/j.aucc.2020.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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27
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Friedman J, Hutchinson A, Milad MP. 1181 Laparoscopic Management of Hernia Uterus Inguinale with Associated Unicornuate Uterus: A Case Report. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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28
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Chapman A, Nagle C, Bick D, Lindberg R, Kent B, Calace J, Hutchinson A. Organisational interventions to reduce caesarean section: A systematic review and meta-analyses. Women Birth 2019. [DOI: 10.1016/j.wombi.2019.07.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Warren J, Nanayakkara S, Andrianopoulos N, Brennan A, Dinh D, Yudi M, Clark D, Ajani AE, Reid CM, Selkrig L, Shaw J, Hiew C, Freeman M, Kaye D, Kingwell BA, Dart AM, Duffy SJ, Reid C, Andrianopoulos N, Brennan A, Dinh D, Reid C, Ajani A, Duffy S, Clark D, Freeman M, Hiew C, Andrianopoulos N, Oqueli E, Brennan A, Duffy S, Shaw J, Walton A, Dart A, Broughton A, Federman J, Keighley C, Hengel C, Peter K, Stub D, Chan W, Warren J, O’Brien J, Selkrig L, Huntington R, Clark D, Farouque O, Horrigan M, Johns J, Oliver L, Brennan J, Chan R, Proimos G, Dortimer T, Chan B, Nadurata V, Huq R, Fernando D, Al-Fiadh A, Yudi M, Sugumar H, Ramchand J, Han H, Picardo S, Brown L, Oqueli E, Hengel C, Sharma A, Zhu B, Ryan N, Harrison T, New G, Roberts L, Freeman M, Rowe M, Proimos G, Cheong Y, Goods C, Fernando D, Teh A, Parfrey S, Ramzy J, Koshy A, Venkataraman P, Flannery D, Hiew C, Sebastian M, Yip T, Mok M, Jaworski C, Hutchinson A, Cimenkaya C, Ngu P, Khialani B, Salehi H, Turner M, Dyson J, McDonald B, Van Den Nouwelant D, Halliburton K, Reid C, Andrianopoulos N, Brennan A, Dinh D, Yan B, Ajani A, Warren R, Eccleston D, Lefkovits J, Iyer R, Gurvitch R, Wilson W, Brooks M, Biswas S, Yeoh J. Impact of Pre-Procedural Blood Pressure on Long-Term Outcomes Following Percutaneous Coronary Intervention. J Am Coll Cardiol 2019; 73:2846-2855. [DOI: 10.1016/j.jacc.2019.03.493] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 11/28/2022]
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30
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Redley B, Richardson B, Peel C, Ockerby C, Rawson H, Tomlinson E, Hutchinson A. Co-development of "BRAIN-TRK": Qualitative examination of acceptability, usability and feasibility of an App to support nurses' care for patients with behavioural and psychological symptoms of neurocognitive disorders in hospital. J Clin Nurs 2019; 28:2868-2879. [PMID: 30938865 DOI: 10.1111/jocn.14874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/13/2019] [Accepted: 03/23/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES (a) Describe the co-development of a point-of-care App to promote uptake of best practice recommendations and consolidate nurses' knowledge for managing symptoms of neurocognitive disorders. (b) Report acceptability, usability and feasibility of the App to nurses for patient care in hospital. BACKGROUND Strategies used in hospitals to reduce symptoms, risk of harm, or complications of behavioural and psychological symptoms associated with neurocognitive disorders are frequently inconsistent with best practice recommendations. DESIGN Three-stage, mixed-methods, process and outcome evaluation. METHODS The App was co-developed with experts, nurse end-users and a consumer. Evaluation data were collected from a convenience sample of nurses observed during delivery of 80.5 hr of care to 38 patients; the App (n = 32 patients); and individual and focus group interviews with nurses (n = 25). Reporting adhered to an adapted STROBE checklist. RESULTS The App included three components: cognition and risk assessment; tailored evidence-based strategies; and monitoring and evaluation of effectiveness. Observation data captured nurses using the App with 44.7% (n = 17) of eligible inpatients. Cognitive screening was completed at least once for each patient, with 146 risk assessments recorded. Interview data indicated the App's acceptability was enhanced by familiarity and perceived benefits, but hindered by perceived increases in workload, inconsistent use, pressure to use the App and resistance to change. Feasibility and usability were enhanced by easy navigation, and clear and useful content, but hindered by unclear expectations, unfamiliarity and device-related factors. CONCLUSIONS The App provided an evidence-based tool that was, overall, considered feasible and acceptable to support best practice. Findings provide guidance to enhance usability for future implementation. RELEVANCE TO CLINICAL PRACTICE Co-development using best evidence and key stakeholders enabled creation of a novel, feasible and acceptable technology. Real-time access to assessment tools and tailored knowledge supported nurses' clinical decision-making; workload and unfamiliarity were barriers to use.
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Affiliation(s)
- Bernice Redley
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
| | - Ben Richardson
- Cairnmillar Institute, Hawthorn East, Victoria, Australia
| | - Charlotte Peel
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
| | - Cherene Ockerby
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
| | - Helen Rawson
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
| | - Emily Tomlinson
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
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31
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Omair M, Dinh D, Brennan A, Farouque O, Duffy S, Ajani A, Reid C, Oqueli E, Hutchinson A, Andrianopoulos N, Koshy A, Yudi M, Clark D. Impact of Single-Vessel vs Multi-vessel CAD on Long-Term Mortality in Patients with Diabetes Mellitus Undergoing PCI. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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32
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Bouchoucha S, Bucknall T, Hutchinson A, Russo P. Patient participation in infection prevention and control: A systematic review. Infect Dis Health 2018. [DOI: 10.1016/j.idh.2018.09.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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33
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Bloomer M, Botti M, Hutchinson A. ISQUA18-1667An Investigation of the Quality of End-Of-Life Care Provision for Older People in a Subacute Care. Int J Qual Health Care 2018. [DOI: 10.1093/intqhc/mzy167.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Bloomer
- School of Nursing and Midwifery
- Centre for Quality and Patient Safety Research, Deakin University, Geelong
- Epworth Deakin Centre for Clinical Nursing Research, Epworth Healthcare, Richmond
- Centre for Nursing Research, Deakin University and Monash Health, Monash Health, Clayton, Australia
| | - M Botti
- School of Nursing and Midwifery
- Centre for Quality and Patient Safety Research, Deakin University, Geelong
- Epworth Deakin Centre for Clinical Nursing Research, Epworth Healthcare, Richmond
| | - A Hutchinson
- School of Nursing and Midwifery
- Centre for Quality and Patient Safety Research, Deakin University, Geelong
- Centre for Nursing Research, Deakin University and Monash Health, Monash Health, Clayton, Australia
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34
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Hutchinson A, Rees S, Young A, Maraveyas A, Date K, Johnson M. Patient and carer experience of oral and injected anticoagulation for cancer-associated thrombosis: select-d trial qualitative sub-study. Thromb Res 2018. [DOI: 10.1016/j.thromres.2018.02.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
In a paper communicated to this Society in March, 1903, it was shown that antimonite is fairly transparent to radiations of long wave-length and that its behaviour between crossed nicols is consistent with orthorhombic symmetry. At the same time it was pointed out that it would be of interest to determine the wave-lengths of the radiations transmitted and the principal indices of refraction of antimonlte for these radiations. On undertaking this investigation it was soon found that antimonite was quite sufficiently transparent to the rays at the extreme red end of the visible spectrum to enable visual observations to, be made, and in a verbal communication to the Society on March 22, 1904, it was stated that the indices of refraction for red light were 4.129 for rays vibrating parallel to the axis Z and 3.873 for rays vibrating parallel to the axis X.
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36
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Jedwab R, Redley B, Hutchinson A. Magnesium sulphate replacement therapy in cardiac surgery patients: A systematic review. Aust Crit Care 2018. [DOI: 10.1016/j.aucc.2017.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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37
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Ciampoli N, Bouchoucha S, Currey J, Hutchinson A. Evaluation of current practice for the prevention of ventilator associated pneumonia in four Australian intensive care units. Aust Crit Care 2018. [DOI: 10.1016/j.aucc.2017.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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38
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Redley B, McTier L, Botti M, Hutchinson A, Newnham H, Campbell D, Bucknall T. Patient participation in inpatient ward rounds on acute inpatient medical wards: a descriptive study. BMJ Qual Saf 2018; 28:15-23. [PMID: 29475980 PMCID: PMC6860730 DOI: 10.1136/bmjqs-2017-007292] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/26/2017] [Accepted: 01/28/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Meaningful partnering with patients is advocated to enhance care delivery. Little is known about how this is operationalised at the point of care during hospital ward rounds, where decision-making concerning patient care frequently occurs. OBJECTIVE Describe participation of patients, with differing preferences for participation, during ward rounds in acute medical inpatient services. METHODS Naturalistic, multimethod design. Data were collected using surveys and observations of ward rounds at two hospitals in Melbourne, Australia. Using convenience sampling, a stratified sample of acute general medical patients were recruited. Prior to observation and interview, patient responses to the Control Preference Scale were used to stratify them into three groups representing diverse participation preferences: active control where the patient makes decisions; shared control where the patient prefers to make decisions jointly with clinicians; and passive control where the patient prefers clinicians make decisions. RESULTS Of the 52 patients observed over 133 ward rounds, 30.8% (n=16) reported an active control preference for participation in decision-making during ward rounds, 25% (n=13) expressed shared control preference and 44.2% (n=23) expressed low control preference. Patients' participation was observed in 75% (n=85) of ward rounds, but few rounds (18%, n=20) involved patient contribution to decisions about their care. Clinicians prompted patient participation in 54% of rounds; and in 15% patients initiated their own participation. Thematic analysis of qualitative observation and patient interview data revealed two themes, supporting patient capability and clinician-led opportunity, that contributed to patient participation or non-participation in ward rounds. CONCLUSIONS Participation in ward rounds was similar for patients irrespective of control preference. This study demonstrates the need to better understand clinician roles in supporting strategies that promote patient participation in day-to-day hospital care.
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Affiliation(s)
- Bernice Redley
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research- MonashHealth Partnership, Monash Health, Clayton, Victoria, Australia
| | - Lauren McTier
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research-Epworth Healthcare Partnership, Epworth HealthCare, Richmond, Victoria, Australia
| | - Alison Hutchinson
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research- MonashHealth Partnership, Monash Health, Clayton, Victoria, Australia
| | - Harvey Newnham
- General Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Donald Campbell
- General Medicine, Monash Health, Clayton, Victoria, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research-Alfred Partnership, Alfred Health, Melbourne, Victoria, Australia
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39
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Fossum M, Hughes L, Manias E, Bennett P, Dunning T, Hutchinson A, Considine J, Botti M, Duke MM, Bucknall T. Comparison of medication policies to guide nursing practice across seven Victorian health services. AUST HEALTH REV 2018; 40:526-532. [PMID: 26803689 DOI: 10.1071/ah15202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 11/24/2015] [Indexed: 11/23/2022]
Abstract
Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.
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Affiliation(s)
- Mariann Fossum
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Lee Hughes
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Elizabeth Manias
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Paul Bennett
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Trisha Dunning
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Alison Hutchinson
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Julie Considine
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Mari Botti
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Maxine M Duke
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
| | - Tracey Bucknall
- Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Vic. 3125, Australia. ; ; ; ; ; ;
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Hutchinson A, Tiplady S, Tullo E. THE VALUE OF INTERPROFESSIONAL FEEDBACK AS PART OF A PRE-REGISTRATION MODULE IN GERIATRIC NURSING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - S. Tiplady
- Northumbria University, Newcastle, United Kingdom,
| | - E. Tullo
- University of Newcastle, Newcastle, United Kingdom
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Wilson PM, Sales A, Wensing M, Aarons GA, Flottorp S, Glidewell L, Hutchinson A, Presseau J, Rogers A, Sevdalis N, Squires J, Straus S. Enhancing the reporting of implementation research. Implement Sci 2017; 12:13. [PMID: 28178987 PMCID: PMC5299701 DOI: 10.1186/s13012-017-0546-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 11/10/2022] Open
Abstract
In the 10 years since the inception of Implementation Science, we have witnessed a continued rise in the number of submissions received, reflecting the continued global interest in methods to enhance the uptake of research findings into healthcare practice and policy. We receive over 750 submissions annually, and there is now a large gap between what is submitted and what gets published. In this editorial, we restate the journal scope and current boundaries. We also identify some specific reporting issues that if addressed will help enhance the scientific reporting quality and transparency of the manuscripts we receive. We hope that this editorial acts as a further guide to researchers seeking to publish their work in Implementation Science.
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Affiliation(s)
- Paul M Wilson
- Alliance Manchester Business School, University of Manchester, Booth Street East, Manchester, M15 6PB, UK.
| | - Anne Sales
- Department of Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,University of Michigan, Ann Arbor, MI, USA
| | | | | | - Signe Flottorp
- Norwegian Knowledge Centre for the Health Services, Oslo, Norway
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Cooper E, Sheikh Z, Townend W, Johnson M, Hutchinson A. PALLIATIVE CARE IN THE EMERGENCY DEPARTMENT: A SYSTEMATIC REVIEW. Arch Emerg Med 2016. [DOI: 10.1136/emermed-2016-206402.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hutchinson A, Rawson H, O'Connell B, Walker H, Bucknall T, Forbes H, Ostaszkiewicz J, Ockerby C. Tri-focal Model of Care Implementation: Perspectives of Residents and Family. J Nurs Scholarsh 2016; 49:33-43. [PMID: 27871120 PMCID: PMC5299456 DOI: 10.1111/jnu.12269] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/11/2016] [Accepted: 10/03/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore residents' and family members' perceptions of partnership-centered long-term care (LTC) associated with implementation of the Tri-focal Model of Care. The Model promotes partnership-centered care, evidence-based practice, and a positive environment. Its implementation is supported by a specifically designed education program. METHODS The Model was implemented over approximately 12 months in seven LTC facilities in Victoria, Australia. A qualitative exploratory-descriptive approach was used. Data were collected using individual and focus group interviews with residents and family members prior to and following implementation of the Model. Data were analyzed thematically. FINDINGS Prior to implementation of the Model, residents described experiencing a sense of disempowerment, and emphasized the importance of communication, engagement, and being a partner in the staff-resident care relationship. Following implementation, residents reported experiencing improved partnership approaches to care, although there were factors that impacted on having a good experience. Family members described a desire to remain involved in the resident's life by establishing good communication and rapport with staff. They acknowledged this was important for partnership-centered care. Following implementation, they described experiencing a partnership with staff, giving them confidence to assist staff and be included in decisions about the resident. CONCLUSIONS The Tri-focal Model of Care can enable residents, family members, and staff to be partners in resident care in LTC settings. CLINICAL RELEVANCE With an ageing population, an increasing demand for complex, individualized LTC exists. Delivery of high-quality LTC requires a strategy to implement a partnership-centered approach, involving residents, family members, and staff.
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Affiliation(s)
- Alison Hutchinson
- Lambda Pi-at-Large, Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery; Chair in Nursing, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia
| | - Helen Rawson
- Research Fellow, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia
| | - Beverly O'Connell
- Dean and Professor, College of Nursing, Rady, Faculty of Health Sciences; University of Manitoba, Canada and Honorary Professor, Deakin University, Melbourne, Australia
| | - Helen Walker
- Research Manager, Centre for Research in Assessment and Digital Learning, Portfolio of the Deputy Vice-Chancellor, Deakin University, Melbourne, Australia
| | - Tracey Bucknall
- Xi Omicron, Associate Head of School (Research), Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery; Foundational Chair of Nursing, Alfred Health, Melbourne, Australia
| | - Helen Forbes
- Associate Head of School (Teaching & Learning), Associate Professor of Nursing, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Melbourne, Australia
| | - Joan Ostaszkiewicz
- Research Fellow, Deakin University, Geelong, Australia - Centre for Quality and Patient Safety Research School of Nursing and Midwifery, Melbourne, Australia
| | - Cherene Ockerby
- Research Assistant, Centre for Nursing Research - Deakin University & Monash Health Partnership, Melbourne, Australia
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Oldland E, Mohebbi M, Redley B, Hutchinson A, Botti M. Development of an instrument to assess nurses’ perceptions of their responsibility for healthcare quality. Aust Crit Care 2016. [DOI: 10.1016/j.aucc.2015.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hutchinson A. XXIX. Die chemische Zusammensetzung des Lengenbachits. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1907.43.1.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hutchinson A. XXVIII. Die optischen Eigenschaften des Antiinonits. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1907.43.1.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hutchinson A, Tutton ΑΕH. XV. Über die Temperatur der optischen Einaxigkeit von Gyps. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1913.52.1.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hutchinson A. XX. Ueber Stokesit. ein neues Zinnmineral von Cornwall. Z KRIST-CRYST MATER 2015. [DOI: 10.1524/zkri.1901.34.1.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hutchinson A, O'Qonnell B, Rawson H, Walker H. The Tri-focal Model of Care: building staff capacity for partnership-centred, evidence-based residential aged care. Aust Nurs Midwifery J 2015; 23:43. [PMID: 26454997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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