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Kourouche S, Curtis K, Considine J, Fry M, Mitchell R, Shaban RZ, Sivabalan P, Bedford D. Does improved patient care lead to higher treatment costs? A multicentre cost evaluation of a blunt chest injury care bundle. Injury 2024; 55:111393. [PMID: 38326215 DOI: 10.1016/j.injury.2024.111393] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 01/08/2024] [Accepted: 01/27/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Blunt chest injury is associated with significant adverse health outcomes. A chest injury care bundle (ChIP) was developed for patients with blunt chest injury presenting to the emergency department. ChIP implementation resulted in increased health service use, decreased unplanned Intensive Care Unit admissions and non-invasive ventilation use. In this paper, we report on the financial implications of implementing ChIP and quantify costs/savings. METHODS This was a controlled pre-and post-test study with two intervention and two non-intervention sites. The primary outcome measure was the treatment cost of hospital admission. Costs are reported in Australian dollars (AUD). A generalised linear model (GLM) estimated patient episode treatment costs at ChIP intervention and non-intervention sites. Because healthcare cost data were positive-skewed, a gamma distribution and log-link function were applied. RESULTS A total of 1705 patients were included in the cost analysis. The interaction (Phase x Treatment) was positive but insignificant (p = 0.45). The incremental cost per patient episode at ChIP intervention sites was estimated at $964 (95 % CI, -966 - 2895). The very wide confidence intervals reflect substantial differences in cost changes between individual sites Conclusions: The point estimate of the cost of the ChIP care bundle indicated an appreciable increase compared to standard care, but there is considerable variability between sites, rendering the finding statistically non-significant. The impact on short- and longer-term costs requires further quantification.
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Affiliation(s)
- Sarah Kourouche
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia.
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong NSW, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, VIC, Australia
| | - Margaret Fry
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; University of Technology Sydney, NSW, Australia; Northern Sydney Local Health District, NSW, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Sydney Infectious Diseases Institute, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; Centre for Population Health, Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia
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Albutti A, Mahdi HA, Alwashmi AS, Alfelali M, Barasheed O, Barnes EH, Shaban RZ, Booy R, Rashid H. The relationship between hand hygiene and rates of acute respiratory infections among Umrah pilgrims: A pilot randomised controlled trial. J Infect Public Health 2024; 17 Suppl 1:34-41. [PMID: 37055268 DOI: 10.1016/j.jiph.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/04/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. METHODS A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. RESULTS A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had 'possible ILI' and two (0.4 %) had 'possible COVID-19'. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3-4.0] for intervention relative to control). CONCLUSION This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. TRIAL REGISTRATION This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.
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Affiliation(s)
- Aqel Albutti
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Hashim A Mahdi
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia.
| | - Ameen S Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia.
| | - Mohammad Alfelali
- Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi Arabia.
| | - Osamah Barasheed
- The Executive Administration of Research and Innovation, King Abdullah Medical City in Holy Capital (KAMC-HC), Makkah 24246, Saudi Arabia.
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Ramon Z Shaban
- New South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, NSW 2151, Australia; Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, NSW 2006, Australia; Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia; Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia; Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia.
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Considine J, Shaban RZ, Fry M, Curtis K. Education interventions and emergency nurses' clinical practice behaviours: A scoping review. Australas Emerg Care 2023:S2588-994X(23)00086-6. [PMID: 37980249 DOI: 10.1016/j.auec.2023.10.004] [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: 08/03/2023] [Revised: 09/19/2023] [Accepted: 10/29/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Many education interventions in emergency nursing are aimed at changing nurse behaviours. This scoping review describes and synthesises the published research education interventions and emergency nurses' clinical practice behaviours. METHODS Arksey and O'Malley's methodological framework guided this review, which is reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). CINAHL, MEDLINE complete, ERIC, and Psycinfo were searched on 3 August 2023. Two pairs of researchers independently conducted all screening. Synthesis was guided by the Behaviour Change Wheel and Bloom's Taxonomy of Educational Objectives. RESULTS Twenty-five studies were included. Educational interventions had largely positive effects on emergency nurses' clinical practice behaviours. Ten different interventions were identified, the most common was education sessions (n = 24). Seven studies reported underpinning theoretical frameworks. Of the essential elements of behaviour change, seven interventions addressed capability, four addressed motivation and one addressed opportunity. Mapping against Bloom's taxonomy, thirteen studies addressed analysis, eleven studies addressed synthesis and two studies addressed evaluation. CONCLUSION Few studies addressed elements of behaviour change theory or targeted cognitive domains. Future studies should focus on controlled designs, and more rigorous reporting of the education intervention(s) tested, and theoretical underpinning for intervention(s) selected.
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Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Victoria, Australia.
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia; Sydney Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Centre for Population Health and New South Wales Biocontainment Centre, Western Sydney Local Health District, Westmead, New South Wales, Australia
| | - Margaret Fry
- Faculty of Health, University of Technology Sydney, New South Wales, Australia; Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia; Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
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Curtis K, Fry M, Shaban RZ, Wolf L, Delao A, Kolbuk ME, Kennedy B, Considine J. Emergency nurses' perceptions of the utility, adaptability and feasibility of the emergency nursing framework HIRAID TM for practice change in US: An exploratory study. Int Emerg Nurs 2023; 71:101377. [PMID: 37972519 DOI: 10.1016/j.ienj.2023.101377] [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: 06/12/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Patient assessment is a core component of nursing practice and underpins safe, high-quality patient care. HIRAIDTM, an evidence-informed emergency nursing framework, provides nurses with a structured approach to patient assessment and management post triage. In Australia, HIRAIDTM resulted in significant improvements to nurse-led communication and reduced adverse patient events. OBJECTIVES First, to explore United States (US) emergency nurses' perceptions of the evidence-informed emergency nursing framework, HIRAIDTM; second, to determine factors that would influence the feasibility and adaptability of HIRAIDTM into nursing clinical practice in EDs within the US. METHODS A cross-sectional cohort study using a survey method with a convenience sample was conducted. A 4-hour workshop introduced the HIRAIDTM framework and supporting evidence at the Emergency Nurses Association's (ENA) conference, Emergency Nursing 2022. Surveys were tested for face validity and collected information on nurse-nurse communication, self-efficacy, the practice environment and feedback on the HIRAIDTM framework. RESULTS The workshop was attended by 48 emergency nurses from 17 US States and four countries. Most respondents reported that all emergency nurses should use the same standardised approach in the assessment of patients. However, the greatest barriers to change were a lack of staff and support from management. The most likely interventions reported to enable change were face-to-face education, the opportunity to ask questions and support in the clinical environment. CONCLUSION HIRAIDTM is an acceptable and suitable emergency nursing framework for consideration in the US. Successful uptake will depend on training methods and organizational support. HIRAIDTM training should incorporate face-to-face interactive workshops.
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Affiliation(s)
- Kate Curtis
- Emergency and Trauma Nursing RC Mills Building, Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia.
| | - Margaret Fry
- Emergency and Critical Care, Conjoint Clinical Chair, Northern Sydney Local Health District, Australia; University of Technology Sydney Faculty of Health School of Nursing and Midwifery, PO Box 123 Broadway, NSW 2007, Australia.
| | - Ramon Z Shaban
- Communicable Diseases Control and Infection Prevention, Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Communicable Diseases Control, Public Health Unit, Centre for Population Health. Director and Chief Infection Control Practitioner Western Sydney LHD, Building 68, 5 Fleet Street, North Parramatta, NSW 2151, Australia; New South Wales Biocontainment Centre, Australia.
| | - Lisa Wolf
- Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL, USA; Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA, USA.
| | - Altair Delao
- Research, Emergency Nurses Association, 930 Woodfield Rd., Schaumburg, IL 60173, USA.
| | - Monica Escalante Kolbuk
- Novice Nurse Education Programs, Emergency Nurses Association, 930 E. Woodfield Road, Schaumburg, IL 60173, USA.
| | - Belinda Kennedy
- The University of Sydney, Rm 169, RC Mills, Camperdown, NSW 2006, Australia.
| | - Julie Considine
- Chair in Nursing (Eastern Health), Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Australia.
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Silberberg B, Young C, Bag S, Moreira C, Norton S, Wells J, Shaban RZ. Socioeconomic disadvantage and engagement with digital contact tracing for COVID-19 in Western Sydney: A secondary analysis of surveillance data. Aust N Z J Public Health 2023; 47:100087. [PMID: 37738808 DOI: 10.1016/j.anzjph.2023.100087] [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: 05/19/2023] [Revised: 07/30/2023] [Accepted: 08/21/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE COVID-19 outcomes were highly inequitably distributed in Australia and worldwide. The digitalisation of public health interventions offers resource-efficiency and increased capacity for pandemic responses, but risks excluding the elderly and disadvantaged, reinforcing existing inequalities. Despite this, there has been little evaluation of the determinants of uptake of digital contact tracing. This paper describes the use of digital contact tracing for COVID-19 in a population in metropolitan Sydney and the determinants of engagement in this population. METHODS Routinely collected surveillance data for residents of Western Sydney Local Health District, returning a positive SARS-CoV-2 result between 1st August 2021 and 12th February 2022, were extracted including responses to a digital contact tracing questionnaire. Individual records were linked to area-level socioeconomic indices of disadvantage. Descriptive analyses explored characteristics of non-responders and geospatial variation. Logistic regression was undertaken to evaluate the effect of age, sex and socioeconomic disadvantage on the odds of response. RESULTS Of the 133 055 individuals included, 130 645 (98%) were issued a digital contact tracing questionnaire, and 106 432 (81%) responded. Odds of responding were lower in males (odds ratio: 0.79), individuals aged 80+ (odds ratio: 0.17) and the most disadvantaged communities (odds ratio: 0.32). CONCLUSIONS Digital data collection for contact tracing was a scalable and efficient tool in the context of the Western Sydney Local Health District COVID-19 response. However, older people and individuals in disadvantaged communities were less likely to engage. IMPLICATIONS FOR PUBLIC HEALTH Responses to future pandemics should leverage the resource-efficiency of digital interventions but should avoid compounding existing health inequalities.
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Affiliation(s)
- Benjamin Silberberg
- Centre for Population Health, Western Sydney Local Health District, Australia.
| | - Christian Young
- NSW Biostatistics Training Program, NSW Ministry of Health, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Conrad Moreira
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Sophie Norton
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Jessica Wells
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Ramon Z Shaban
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia
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Mahdi HA, Alluhidan M, Almohammed AB, Alfelali M, Shaban RZ, Booy R, Rashid H. Epidemiological Differences in Hajj-Acquired Airborne Infections in Pilgrims Arriving from Low and Middle-Income versus High-Income Countries: A Systematised Review. Trop Med Infect Dis 2023; 8:418. [PMID: 37624356 PMCID: PMC10459586 DOI: 10.3390/tropicalmed8080418] [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: 07/04/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023] Open
Abstract
This systematised review aims to compare the epidemiological patterns of Hajj-acquired airborne infections among pilgrims from low and middle-income countries (LMIC) versus those from high-income countries (HIC). A PubMed search was carried out for all published articles before February 2023, using a combination of MeSH terms and text words. The Newcastle-Ottawa Scale (NOS) was used to assess data quality. From a total of 453 titles identified, 58 studies were included in the review (LMIC = 32, and HIC = 26). In the pooled sample, there were 27,799 pilgrims aged 2 days to 105 years (male: female = 1.3:1) from LMIC and 70,865 pilgrims aged 2 months to 95 years (male: female = 1:1) from HIC. Pilgrims from both HIC and LMIC had viral and bacterial infections, but pilgrims from HIC tended to have higher attack rates of viral infections than their LMIC counterparts. However, the attack rates of bacterial infections were variable: for instance, pilgrims from LMIC seemed to have higher rates of meningococcal infections (0.015-82% in LMIC vs. 0.002-40% in HIC) based on the study population, but not Mycobacterium tuberculosis (0.7-20.3% in LMIC vs. 38% in HIC). Targeted measures are needed to prevent the spread of airborne infections at Hajj.
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Affiliation(s)
- Hashim A. Mahdi
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia
| | - Mohammed Alluhidan
- General Directorate for National Health Economics and Policy, Saudi Health Council, Riyadh 13315, Saudi Arabia
| | | | - Mohammad Alfelali
- Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi Arabia
| | - Ramon Z. Shaban
- New South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, NSW 2151, Australia
- Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, NSW 2006, Australia
- Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
| | - Robert Booy
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, NSW 2145, Australia
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Curtis K, Dinh MM, Shetty A, Kourouche S, Fry M, Considine J, Li L, Lung T, Shaw T, Lam MK, Murphy M, Alkhouri H, Aggar C, Russell SB, Seimon RV, Hughes JA, Varndell W, Shaban RZ. The Emergency nurse Protocols Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) trial: protocol for a stepped wedge implementation trial. Implement Sci Commun 2023; 4:70. [PMID: 37340486 DOI: 10.1186/s43058-023-00452-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/04/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care-Sydney Triage to Admission Risk Tool (EPIC-START) was developed. EPIC-START is a model of care incorporating EPIC protocols, the START patient admission prediction tool, and a clinical deterioration tool to support ED flow, timely care, and patient safety. The aim of this study is to evaluate the impact of EPIC-START implementation across 30 EDs on patient, implementation, and health service outcomes. METHODS AND ANALYSIS This study protocol adopts an effectiveness-implementation hybrid design (Med Care 50: 217-226, 2012) and uses a stepped-wedge cluster randomised control trial of EPIC-START, including uptake and sustainability, within 30 EDs across four NSW local health districts spanning rural, regional, and metropolitan settings. Each cluster will be randomised independently of the research team to 1 of 4 dates until all EDs have been exposed to the intervention. Quantitative and qualitative evaluations will be conducted on data from medical records and routinely collected data, and patient, nursing, and medical staff pre- and post-surveys. ETHICS AND DISSEMINATION Ethical approval for the research was received from the Sydney Local Health District Research Ethics Committee (Reference Number 2022/ETH01940) on 14 December 2022. TRIAL REGISTRATION Australian and New Zealand Clinical trial, ACTRN12622001480774p. Registered on 27 October 2022.
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Affiliation(s)
- Kate Curtis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia.
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia.
| | - Michael M Dinh
- New South Wales Institute of Trauma and Injury Management, Chatswood, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
- RPA Green Light Institute for Emergency Care, Sydney Local Health District, Camperdown, Australia
| | - Amith Shetty
- System Sustainability and Performance, NSW Ministry of Health, St Leonards, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Sarah Kourouche
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia
| | - Margaret Fry
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia
- Sydney Faculty of Health, University of Technology, Ultimo, NSW, Australia
- Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Experience in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, VIC, Australia
| | - Ling Li
- Macquarie University, Sydney, Australia
| | - Thomas Lung
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Timothy Shaw
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Mary K Lam
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Margaret Murphy
- Western Sydney Local Health District, North Parramatta, NSW, 2145, Australia
| | - Hatem Alkhouri
- Agency for Clinical Innovation, NSW Emergency Care Institute, St Leonards, NSW, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Christina Aggar
- Nothern NSW Local Health District, Southern Cross University, Lismore, Australia
| | | | - Radhika V Seimon
- RPA Green Light Institute for Emergency Care, Sydney Local Health District, Camperdown, Australia
| | - James A Hughes
- School of Nursing, Centre for Healthcare Transformation, Brisbane, QUT, Australia
| | - Wayne Varndell
- Prince of Wales Hospital Emergency Department, Randwick, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
- College of Emergency Nursing Australasia (CENA), Hobart, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia
- Faculty of Medicine and Health, Sydney Institute for Infectious Diseases, The University of Sydney, Camperdown, NSW, 2006, Australia
- Communicable Diseases Branch, Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, 2141, Australia
- New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, Westmead, NSW, 2145, Australia
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McKay KJ, Shaban RZ. Video based monitoring systems for hand hygiene compliance auditing: What do patients think? PLoS One 2023; 18:e0281895. [PMID: 36893120 PMCID: PMC9997901 DOI: 10.1371/journal.pone.0281895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 02/02/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Compliance with hand hygiene by healthcare workers is a vital aspect of the quality and safety in healthcare. The current method of monitoring compliance, known as direct observation, has been questioned as have the various electronic measures proposed as alternatives. In our earlier work we established the capacity of video-based monitoring systems (VMS) to collect data with increased efficacy, efficiency and accuracy. However, the spectre of the approach being seen as an unacceptable invasion of patient privacy, was raised as a barrier to implementation by healthcare workers. METHODS In depth, semi structured interviews were conducted with 8 patients in order to explore their beliefs and options regarding the proposed approach. Interviews were transcribed and then thematic and content analysis was conducted in order to uncover themes from the data. RESULTS Despite healthcare worker predictions, patients were generally accepting of the use of video-based monitoring systems for the auditing of hand hygiene compliance. However, this acceptance was conditional. Four interconnected themes emerged from the interview data; quality and safety of care versus privacy, consumer Involvement-knowledge, understanding and consent, technical features of the system, and rules of operation. CONCLUSION The use of within zone VMS approaches to hand hygiene auditing has the potential to improve the efficacy, efficiency and accuracy of hand hygiene auditing and hence the safety and quality of healthcare. By combining a suite of technical and operational specifications with high level consumer engagement and information the acceptability of the approach for patients may be significantly enhanced.
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Affiliation(s)
- Katherine J. McKay
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- * E-mail:
| | - Ramon Z. Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, Camperdown, NSW, Australia
- Communicable Disease Branch, Public Health Unit, Centre for Population Health, Western Sydney Local Health District, Westmead, North Parramatta, NSW, Australia
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Albutti A, Mahdi HA, Alwashmi AS, Shaban RZ, Rashid H. Hand hygiene knowledge and practices, and rates of respiratory tract infections between Hajj and Umrah pilgrims: a comparative study. Int Marit Health 2023; 74:92-97. [PMID: 37417842 DOI: 10.5603/imh.2023.0014] [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: 01/24/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Hajj and Umrah mass gatherings (MGs) in the Kingdom of Saudi Arabia amplify the risk of viral respiratory tract infections (RTIs), but there is a lack of comparative data from these two MGs. This study aims to compare pilgrims' hand hygiene knowledge, practices, and rates of RTIs during the peak periods of Umrah and Hajj in 2021. MATERIALS AND METHODS The datasets of this comparative study were obtained from two previously conducted studies that used similar study tools and identical syndromic definitions. The binary logistic regression was applied to compare the categorical variables and, a t-test was used to compare the continuous variables. RESULTS A total of 510 Hajj pilgrims and 507 Umrah pilgrims were recruited. The majority of Hajj pilgrims (68%) were ≥ 40 years old, while most Umrah pilgrims (63%) were < 40 years old. The mean total knowledge scores of hand hygiene between the Hajj and Umrah pilgrims differed significantly (4.1 vs. 3.7, respectively, p < 0.001) so did their compliance with frequent use of alcohol-based hand rubs (53.0% vs. 36.3%, respectively, p < 0.001) and the rates of RTIs (4.7% vs. 2.2%, respectively, p = 0.05). CONCLUSIONS These differences could be attributable to the distinctive characteristics of Hajj and Umrah pilgrimages, and the unique differences in risks posed by those MGs.
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Affiliation(s)
- Aqel Albutti
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Hashim A Mahdi
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia.
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia.
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah, Saudi Arabia.
| | - Ameen S Alwashmi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Ramon Z Shaban
- New South Wales Biocontainment Centre, New South Wales Ministry of Health, Westmead, Australia
- Faculty of Medicine and Health Susan Wakil School of Nursing, The University of Sydney, Sydney, Australia
- Public Health Unit, Centre for Population Health, Western Sydney Local Health District, North Parramatta, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, Australia
| | - Harunor Rashid
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, Australia
- Sydney Infectious Diseases Institute, The University of Sydney, Westmead, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
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10
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McKay KJ, Li C, Sotomayor-Castillo C, Ferguson PE, Wyer M, Shaban RZ. Health care workers' experiences of video-based monitoring of hand hygiene behaviors: a qualitative study. Am J Infect Control 2023; 51:83-88. [PMID: 35339623 DOI: 10.1016/j.ajic.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/27/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hand hygiene is key to preventing health care-associated infections. Human observation is the gold standard for measuring compliance, but its utility is increasingly being questioned with calls for the use of video monitoring approaches. The utility of video-based systems to measure compliance according to the WHO 5 moments is largely unexamined, as is its acceptability amongst health care workers (HCW) and patients. This study examined HCW acceptability of video monitoring for hand hygiene auditing. METHODS Following trial of a video monitoring system (reported elsewhere), 5 participating HCW attended 2 in-depth group interviews where they reviewed the footage and explored responses to the approach. Transcripts were analyzed using thematic analysis. RESULTS Four themes were identified: 1) Fears; 2) Concerns for patients; 3) Changes to feedback; and 4) Behavioral responses to the cameras. HCWs expressed fears of punitive consequences, data security, and confidentiality. For patients, HCWs raised issues regarding invasion of privacy, ethics, and consent. HCWs suggested that video systems may result in less immediate feedback but also identified potential to use the footage for feedback. They also suggested that the Hawthorne Effect was less potent with video systems than human observation. CONCLUSIONS The acceptability of video monitoring systems for hand hygiene compliance is complex and has the potential to complicate practical implementation. Additionally, exploration of the acceptability to patients is warranted. CHECKLIST COREQ.
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Affiliation(s)
- Katherine J McKay
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia
| | - Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia
| | - Patricia E Ferguson
- Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia
| | - Mary Wyer
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia
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11
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Curtis K, Kourouche S, Asha S, Buckley T, Considine J, Middleton S, Mitchell R, Munroe B, Shaban RZ, Lam M, Fry M. Effect of an intervention for patients 65 years and older with blunt chest injury: Patient and health service outcomes. Injury 2022; 53:2939-2946. [PMID: 35644642 DOI: 10.1016/j.injury.2022.04.024] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/05/2022] [Accepted: 04/29/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Blunt chest injury in older adults, aged 65 years and older, leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes in older adults with blunt chest injury. METHODS ChIP comprised multidimensional implementation guidance in three key pillars of care for blunt chest injury: respiratory support, analgesia, and complication prevention. Implementation was guided using the Behaviour Change Wheel. This proof-of-concept controlled pre- and post-test study with two intervention and two control sites in Australia was conducted from July 2015 to June 2019. The primary outcomes were non-invasive ventilation (NIV) use, unplanned Intensive Care Unit (ICU) admissions, and in-hospital mortality. Secondary outcomes were health service and costing outcomes. RESULTS There were 1122 patients included in the analysis, with 673 at intervention sites (331 pre-test and 342 post-test) and 449 at control sites (256 pre-test and 193 post-test). ChIP was associated with unplanned ICU admissions and in NIV use with a reduction of the odds in the post vs the pre periods in the intervention sites when compared to the controls (ratio of OR=0.13, 95%CI=0.03-0.55) and (ratio of OR=0.14, 95%CI=0.02-0.98) respectively. There was no significant change in mortality. Implementing ChIP was also associated with health service team reviews with an increased odds in the post vs pre periods in the intervention sites in comparison to the controls for surgical review (ratio of OR =6.93, 95%CI=4.70-10.28), ICU doctor (ratio of OR =5.06, 95%CI=2.26-9.25), ICU liaison (ratio of OR =14.14, 95%CI=3.15-63.31), and pain (ratio of OR =5.59, 95%CI=3.25-9.29). ChIP was also related to incentive spirometry (ratio of OR=6.35, 95%CI= 3.15-12.82) and overall costs (ratio of mean ratio=1.34, 95%CI=1.09-1.66) with a higher ratio for intervention sites. CONCLUSION Implementation of ChIP using the Behaviour Change Wheel was associated with reduced unplanned ICU admissions and NIV use and improved health care delivery. TRIAL REGISTRATION ANZCTR: ACTRN12618001548224, approved 17/09/2018.
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Affiliation(s)
- Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong NSW, Australia; Illawarra Health and Medical Research Institute, Building 32 University of Wollongong, Northfields Avenue, Wollongong NSW, Australia.
| | - Sarah Kourouche
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia.
| | - Stephen Asha
- Emergency Department, St George Hospital, Kogarah, NSW, Australia; St George Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia.
| | - Thomas Buckley
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia.
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Experience in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; Centre for Quality and Patient Safety Experience, Eastern Health Partnership, Box Hill, VIC, Australia.
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne; Australian Catholic University, NSW Australia.
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2113, Australia.
| | - Belinda Munroe
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong NSW, Australia.
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Sydney Institute for Infectious Diseases, The University of Sydney, Camperdown, NSW 2006, Australia; Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, 2145, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, 2145, Australia.
| | - Mary Lam
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia.
| | - Margaret Fry
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; University of Technology Sydney, Faculty of Health, NSW, Australia; Northern Sydney Local Health District, NSW, Australia.
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12
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Mahdi HA, Qashqari FS, Hariri SH, Bamerdah S, Altayyar SA, Almalki HM, Alwadani FA, Alabbasi RA, Alqahtani MH, Alfelali M, Shaban RZ, Booy R, Rashid H. Low Prevalence of Syndromic Respiratory Tract Infections among Returning Hajj Pilgrims Amidst the COVID-19 Pandemic: A Post-Hajj Survey. Trop Med Infect Dis 2022; 7:tropicalmed7080182. [PMID: 36006274 PMCID: PMC9413585 DOI: 10.3390/tropicalmed7080182] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
This study estimates the point prevalence of symptomatic respiratory tract infections (RTIs) among returned Hajj pilgrims and their contacts in 2021. Using the computer-assisted telephone interview (CATI) technique, domestic pilgrims were invited to participate in this cross-sectional survey two weeks after their home return from Hajj. Of 600 pilgrims approached, 79.3% agreed to participate and completed the survey. Syndromic definitions were used to clinically diagnose possible influenza-like illnesses (ILI) and COVID-19. Median with range was applied to summarise the continuous data, and frequencies and proportions were used to present the categorical variables. Simple logistic regression was carried out to assess the correlations of potential factors with the prevalence of RTIs. The majority of pilgrims (88.7%) reported receiving at least two doses of the COVID-19 vaccine before Hajj. Eleven (2.3%) pilgrims reported respiratory symptoms with the estimated prevalence of possible ILI being 0.2%, and of possible COVID-19 being 0.4%. Among those who were symptomatic, five (45.5%) reported that one or more of their close contacts had developed similar RTI symptoms after the pilgrims’ home return. The prevalence of RTIs among pilgrims who returned home after attending the Hajj 2021 was lower compared with those reported in the pre-pandemic studies; however, the risk of spread of infection among contacts following Hajj is still a concern.
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Affiliation(s)
- Hashim A. Mahdi
- Public Health Department, College of Health Sciences, Saudi Electronic University, Jeddah 23442, Saudi Arabia
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Correspondence:
| | - Fadi S. Qashqari
- Microbiology Department, Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Sumyya H. Hariri
- Microbiology Department, Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Shahad Bamerdah
- Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | | | - Hazim M. Almalki
- Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Fayez A. Alwadani
- Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | - Renan A. Alabbasi
- Faculty of Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia
| | | | - Mohammad Alfelali
- Family and Community Medicine Department, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah 25732, Saudi Arabia
| | - Ramon Z. Shaban
- New South Wales Biocontainment Centre, Western Sydney Local Health District, Westmead, NSW 2145, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, NSW 2145, Australia
| | - Robert Booy
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- The Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
- National Centre for Immunisation Research and Surveillance, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
- Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, NSW 2145, Australia
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13
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Mahdi HA, Rashid H, Qashqari FS, Hariri SH, Marglani OA, Barasheed O, Albutti A, Alwashmi AS, Shaban RZ, Booy R, Alfelali M. Syndromic surveillance of respiratory-tract infections and hand hygiene practice among pilgrims attended Hajj in 2021: a cohort study. BMC Infect Dis 2022; 22:578. [PMID: 35761226 PMCID: PMC9238003 DOI: 10.1186/s12879-022-07559-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/16/2022] [Indexed: 12/15/2022] Open
Abstract
Background The risk of transmission of viral respiratory tract infections (RTIs) is high in mass gatherings including Hajj. This cohort study estimated the incidence of symptomatic RTIs and hand hygiene compliance with its impact among Hajj pilgrims during the COVID-19 pandemic. Methods During the week of Hajj rituals in 2021, domestic pilgrims were recruited by phone and asked to complete a baseline questionnaire. Pilgrims were followed up after seven days using a questionnaire about the development of symptoms, and practices of hand hygiene. Syndromic definitions were used to clinically diagnose ‘possible’ influenza-like illnesses (ILI) and COVID-19 infection. Results A total of 510 pilgrims aged between 18 and 69 (median of 50) years completed the questionnaire, 280 (54.9%) of whom were female, and all of them (except for one) were vaccinated against COVID-19 with at least one dose. The mean (± SD) of pilgrims’ hand hygiene knowledge score (on a scale of 0 to 6) was 4.15 (± 1.22), and a higher level of knowledge was correlated with a higher frequency of handwashing using soap and water. Among those 445 pilgrims who completed the follow-up form, 21 (4.7%) developed one or more respiratory symptoms, of which sore throat and cough were the commonest (respectively 76.2% and 42.8%); ‘possible ILI’ and ‘possible COVID-19’ were present in 1.1% and 0.9% of pilgrims. Obesity was found to be a significant factor associated with the risk of developing RTIs (odds ratio = 4.45, 95% confidence interval 1.15–17.13). Conclusions Hajj pilgrims are still at risk of respiratory infections. Further larger and controlled investigations are needed to assess the efficacy of hand hygiene during Hajj.
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Huang BH, Inan-Eroglu E, Shaban RZ, Hamer M, Britton A, Stamatakis E. Alcohol intake and mortality risk of COVID-19, pneumonia, and other infectious diseases: An analysis of 437191 UK biobank participants. Prev Med Rep 2022; 26:101751. [PMID: 35251915 PMCID: PMC8883723 DOI: 10.1016/j.pmedr.2022.101751] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/23/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
This study aims to investigate the association between alcohol consumption and COVID-19, infectious diseases, and pneumonia mortality. This is a prospective analysis of 437,191 UK Biobank participants (age 56.3 years, 54% female). The main exposure was self-reported alcohol consumption. In addition to never and previous drinkers, we applied quartiles-based and UK guidelines-based criteria to divide current drinkers by weekly consumption into four groups. Outcomes included COVID-19, infectious diseases, and pneumonia mortality, obtained from the national death registries until May 2020. After an 11-year follow-up, compared to never drinkers, previous drinkers had higher mortality risks of infectious diseases and pneumonia (adjusted HR: 1.29 [95% CI 1.06-1.57] and 1.35 [1.07-1.70], respectively), but not COVID-19. There was a curvilinear association of alcohol consumption with infectious diseases and pneumonia mortality. Drinking within-guidelines (<14 UK units/wk) and amounts up to double the recommendation (14 to < 28 UK units/wk) was associated with the lowest mortality risks of infectious diseases (0.70 [0.59-0.83] and 0.70 [0.59-0.83], respectively) and pneumonia (0.71 [0.58-0.87] and 0.72 [0.58-0.88], respectively). Alcohol consumption was associated with lower risks of COVID-19 mortality (e.g., drinking within-guidelines: 0.53 [0.33-0.86]). Drinkers reporting multiples of the recommended alcohol drinking amounts did not have higher mortality risks of COVID-19 and other infectious diseases than never drinkers. Despite the well-established unfavorable effects on general health, we found no deleterious associations between alcohol consumption and the risk of infectious diseases, including COVID-19. Future research with other study designs is needed to confirm the causality.
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Affiliation(s)
- Bo-Huei Huang
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
| | - Elif Inan-Eroglu
- the Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Faculty of Medicine and Health, the University of Sydney, New South Wales, Australia
| | - Ramon Z. Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney and Western Sydney Local Health District, New South Wales Ministry of Health, New South Wales, Australia
| | - Mark Hamer
- Institute Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, UK
| | - Annie Britton
- Institute of Epidemiology & Health Care, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
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15
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Robinson PA, Levy DC, Hooker LC, Shaban RZ, Nahidi S, Leask J, Wiley KE. COVID-19 testing decisions and behaviours in two Australian cities. Health Promot J Austr 2022; 34:587-594. [PMID: 35332631 PMCID: PMC9087490 DOI: 10.1002/hpja.599] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/23/2022] [Accepted: 03/23/2022] [Indexed: 11/11/2022] Open
Abstract
Issue addressed High levels of testing are crucial for minimising the spread of COVID‐19. The aim of this study is to investigate what prevents people from getting a COVID‐19 test when they are experiencing respiratory symptoms. Methods Semi‐structured, qualitative interviews were conducted with 14 purposively sampled adults between 20 November 2020 and 3 March 2021 in two capital cities of Australia and analysed thematically. The analysis included people who reported having respiratory symptoms but who did not undergo a COVID‐19 test. Results Participants appraised risks of having COVID‐19, of infecting others or being infected whilst attending a testing site. They often weighed these appraisals against practical considerations of knowing where and how to get tested, inconvenience or financial loss. Conclusions Clear public health messages communicating the importance of testing, even when symptoms are minor, may improve testing rates. Increasing the accessibility of testing centres, such as having them at transport hubs is important, as is providing adequate information about testing locations and queue lengths. So what? The findings of our study suggest that more needs to be done to encourage people to get tested for COVID‐19, especially when symptoms are minor. Clear communication about the importance of testing, along with easily accessible testing clinics, and financial support for those concerned about financial impacts may improve testing rates.
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Affiliation(s)
- Penelope A Robinson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - David C Levy
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - L Claire Hooker
- Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia.,Sydney Health Ethics, University of Sydney, NSW, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia.,Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, NSW, Australia.,New South Wales Biocontainment Centre, Western Sydney Local Health District and NSW Ministry of Health, Australia
| | - Shizar Nahidi
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,Queensland Emergency Medical Foundation, Milton, QLD, Australia
| | - Julie Leask
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW, Australia.,Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia
| | - Kerrie E Wiley
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
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16
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Sotomayor-Castillo C, Li C, Kaufman-Francis K, Nahidi S, Walsh LJ, Liberali SA, Irving E, Holden AC, Shaban RZ. Australian dentists' knowledge, preparedness, and experiences during the COVID-19 pandemic. Infect Dis Health 2022; 27:49-57. [PMID: 34750088 PMCID: PMC8523486 DOI: 10.1016/j.idh.2021.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND COVID-19 is a global health crisis. Close contact with the mucous membranes and respiratory secretions of patients and aerosol-generating procedures renders dentists and other oral health professionals at high risk of exposure to SARS-CoV-2. We examined dentists' knowledge, preparedness, and experiences of managing COVID-19 in Australia. METHODS A cross-sectional online survey of dentists with a current membership with The Australian Dental Association (ADA) was conducted between March and April 2021. RESULTS Of the 368 survey responses, most dentists (72.3%) reported having a good level of knowledge about COVID-19, with most visiting the ADA Federal COVID-19 (74.7%) and state/territory department of health websites (62.8%), respectively to source up-to-date information. Most dentists (87.6%) felt prepared to manage COVID-19 into the future, although 66% reported not receiving training or certification in the use of PPE. Over half (58.7%) reported not being concerned about contracting SARS-CoV-2 at work, with some (28.9%, n = 98/339) feeling more stressed than usual and having heavier workloads. CONCLUSION COVID-19 had significant impact in oral healthcare in Australia. Dentistry has adapted to the varied challenges raised by the pandemic. Comprehensive training and detailed guidelines were fundamental for successful patient management during the COVID-19 outbreak.
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Affiliation(s)
- Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Keren Kaufman-Francis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.
| | - Shizar Nahidi
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia
| | - Laurence J Walsh
- School of Dentistry, The University of Queensland, Herston, QLD, Australia.
| | - Sharon Ac Liberali
- Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia; Special Needs Unit, Adelaide Dental Hospital, SA Dental, Adelaide, SA, Australia.
| | | | - Alexander Cl Holden
- Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, NSW, Australia; Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia.
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia.
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Curtis K, Sivabalan P, Bedford DS, Considine J, D'Amato A, Shepherd N, Fry M, Munroe B, Shaban RZ. Implementation of a structured emergency nursing framework results in significant cost benefit. BMC Health Serv Res 2021; 21:1318. [PMID: 34886873 PMCID: PMC8655998 DOI: 10.1186/s12913-021-07326-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
Background Patients are at risk of deterioration on discharge from an emergency department (ED) to a ward, particularly in the first 72 h. The implementation of a structured emergency nursing framework (HIRAID) in regional New South Wales (NSW), Australia, resulted in a 50% reduction of clinical deterioration related to emergency nursing care. To date the cost implications of this are unknown. The aim of this study was to determine any net financial benefits arising from the implementation of the HIRAID emergency nursing framework. Methods This retrospective cohort study was conducted between March 2018 and February 2019 across two hospitals in regional NSW, Australia. Costs associated with the implementation of HIRAID at the study sites were calculated using an estimate of initial HIRAID implementation costs (AUD) ($492,917) and ongoing HIRAID implementation costs ($134,077). Equivalent savings per annum (i.e. in less patient deterioration) were calculated using projected estimates of ED admission and patient deterioration episodes via OLS regression with confidence intervals for incremental additional deterioration costs per episode used as the basis for scenario analysis. Results The HIRAID-equivalent savings per annum exceed the costs of implementation under all scenarios (Conservative, Expected and Optimistic). The estimated preliminary savings to the study sites per annum was $1,914,252 with a payback period of 75 days. Conservative projections estimated a net benefit of $1,813,760 per annum by 2022–23. The state-wide projected equivalent savings benefits of HIRAID equalled $227,585,008 per annum, by 2022–23. Conclusions The implementation of HIRAID reduced costs associated with resources consumed from patient deterioration episodes. The HIRAID-equivalent savings per annum to the hospital exceed the costs of implementation across a range of scenarios, and upscaling would result in significant patient and cost benefit.
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Affiliation(s)
- Kate Curtis
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Office 169, RC Mills Building, Camperdown, NSW, Australia. .,Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong, NSW, Australia. .,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia. .,George Institute for Global Health, University of NSW, Kensington, Australia. .,Faculty of Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
| | - Prabhu Sivabalan
- Business School, University of Technology Sydney, Sydney, NSW, Australia
| | - David S Bedford
- Performance Analysis for Transformation in Healthcare (PATH) Group, UTS Business School, Ultimo, NSW, Australia
| | - Julie Considine
- Deakin University, School of Nursing and Midwifery, Geelong, NSW, Australia.,Deakin University, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Victoria, Australia
| | - Alfa D'Amato
- Performance Analysis for Transformation in Healthcare (PATH) Group, UTS Business School, Ultimo, NSW, Australia.,System Financial Performance, NSW Ministry of Health, North Sydney, NSW, Australia
| | - Nada Shepherd
- Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Margaret Fry
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Office 169, RC Mills Building, Camperdown, NSW, Australia.,School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia.,Research & Practice Development Unit, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia
| | - Belinda Munroe
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Office 169, RC Mills Building, Camperdown, NSW, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, Australia.,Division of Infectious Diseases and Sexual Health, Westmead Hospital and the New South Wales Biocontainment Centre, Western Sydney Local Heath District and New South Wales Ministry of Health, Westmead, NSW, Australia
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18
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Nahidi S, Li C, Sotomayor-Castillo C, Kaufman-Francis K, Shaban RZ. "We will have to learn to live with it": Australian dentists' experiences during the COVID-19 pandemic. Infect Dis Health 2021; 27:96-104. [PMID: 34916176 PMCID: PMC8666844 DOI: 10.1016/j.idh.2021.11.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Australian dentists are among the frontline healthcare workers providing dental and oral health care during the COVID-19 pandemic, and therefore have been affected in multiple ways. In this study, we explore their experiences of practising and living in this pandemic. METHODS A qualitative study analysed responses of 333 Australian dentists' who participated in a survey with open-ended questions about the challenges and positive outcomes of practising during the COVID-19 pandemic. The questions were embedded in a national online survey of Australian dentists' knowledge, preparedness and experiences conducted between March and April 2021. Data were analysed using content analysis. RESULTS Australian dentists reported their challenging experiences to be four-fold, including 'public health orders and restrictions', 'Infection prevention and control measures (IPC), 'Personal concerns about COVID-19' and 'Detracting opinions about COVID-19'. Conversely, they reported positive outcomes in relation to their practice during COVID-19, including 'Awareness of and adherence to IPC practices', 'Teamwork and interpersonal dynamics', 'Decompressed workload', 'Perceived support' and 'unintended positive outcomes'. CONCLUSION The COVID-19 pandemic generated several challenges for Australian dentists, but it also engendered some positive outcomes. Understanding of these can help tailor the professional support plans to address the needs and priorities of Australian dentists during the current and future pandemics.
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Affiliation(s)
- Shizar Nahidi
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.
| | - Keren Kaufman-Francis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia.
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19
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Munroe B, Curtis K, Fry M, Shaban RZ, Moules P, Elphick TL, Ruperto K, Couttie T, Considine J. Increasing accuracy in documentation through the application of a structured emergency nursing framework: A multisite quasi-experimental study. J Clin Nurs 2021; 31:2874-2885. [PMID: 34791742 DOI: 10.1111/jocn.16115] [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: 08/02/2021] [Revised: 09/30/2021] [Accepted: 10/16/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To determine if the use of an emergency nursing framework improves the accuracy of clinical documentation. BACKGROUND Accurate clinical documentation is a nursing professional responsibility essential for high-quality and safe patient care. The use of the emergency nursing framework "HIRAID" (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) improves emergency nursing care by reducing treatment delays and improving escalation of clinical deterioration. The effect of HIRAID on the accuracy of nursing documentation is unknown. DESIGN A quasi-experimental pre-post study was conducted and the report was guided by the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. METHODS HIRAID was implemented in four regional/rural Australian emergency departments (ED) using a range of behaviour change strategies. The blinded electronic healthcare records of 120 patients with a presenting problem of shortness of breath, abdominal pain or fever were reviewed. Quantity measures of completeness and qualitative measures of completeness and linguistic correctness of documentation adapted from the D-Catch tool were used to assess accuracy. Differences between pre-post groups were analysed using Wilcoxon rank-sum and two-sample t-tests for continuous variables. Pearson's Chi-square and Fisher exact tests were used for the categorical data. RESULTS The number of records containing the essential assessment components of emergency care increased significantly from pre- to post-implementation of HIRAID. This overall improvement was demonstrated in both paediatric and adult populations and for all presentation types. Both the quantitative and qualitative measures of documentation on patient history and physical assessment findings improved significantly. CONCLUSION Use of HIRAID improves the accuracy of clinical documentation of the patient history and physical assessment in both adult and paediatric populations. RELEVANCE TO CLINICAL PRACTICE The emergency nursing framework "HIRAID" is recommended for use in clinical practice to increase the documentation accuracy performed by emergency nurses.
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Affiliation(s)
- Belinda Munroe
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Building 32 University of Wollongong, Wollongong, NSW, Australia
| | - Kate Curtis
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Building 32 University of Wollongong, Wollongong, NSW, Australia.,Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,George Institute for Global Health, University of NSW, Newtown, NSW, Australia.,Faculty of Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Margaret Fry
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,University of Technology Sydney School of Nursing and Midwifery, Sydney, NSW, Australia.,Northern Sydney Local Health District, St Leonards, NSW, Australia.,New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, Sydney, NSW, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, Sydney, NSW, Australia.,Sydney Institute for Infectious Diseases, University of Sydney, Camperdown, NSW, Australia.,Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia
| | - Peter Moules
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Tiana-Lee Elphick
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.,Research Central, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Kate Ruperto
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Tracey Couttie
- Division of Kids and Families, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute of Health Transformation, Deakin University, Geelong, Vic., Australia.,Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Vic., Australia
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20
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Shaban RZ, Mitchell BG, Russo PL, Macbeth D. Epidemiology of healthcare-associated infections in Australia: New data and challenges. Infect Dis Health 2021. [DOI: 10.1016/j.idh.2021.09.006] [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: 10/19/2022]
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21
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Moore N, Dempsey K, Hockey P, Jain S, Poronnik P, Shaban RZ, Ahmadpour N. Innovation During a Pandemic: Developing a Guideline for Infection Prevention and Control to Support Education Through Virtual Reality. Front Digit Health 2021; 3:628452. [PMID: 34713100 PMCID: PMC8521867 DOI: 10.3389/fdgth.2021.628452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Nathan Moore
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kathy Dempsey
- Clinical Excellence Commission, Sydney, NSW, Australia
| | - Peter Hockey
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Susan Jain
- Clinical Excellence Commission, Sydney, NSW, Australia
| | - Philip Poronnik
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.,Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia.,New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Ministry of Health, Sydney, NSW, Australia
| | - Naseem Ahmadpour
- Design Lab, School of Architecture, Design, and Planning, The University of Sydney, Sydney, NSW, Australia
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22
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Curtis K, Kourouche S, Asha S, Considine J, Fry M, Middleton S, Mitchell R, Munroe B, Shaban RZ, D’Amato A, Skinner C, Wiseman G, Buckley T. Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation. PLoS One 2021; 16:e0256027. [PMID: 34618825 PMCID: PMC8496821 DOI: 10.1371/journal.pone.0256027] [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: 04/05/2021] [Accepted: 07/28/2021] [Indexed: 12/03/2022] Open
Abstract
Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury—respiratory support, analgesia and complication prevention. ChIP was implemented using a multi-faceted implementation plan developed using the Behaviour Change Wheel. Methods This controlled pre-and post-test study (two intervention and two non-intervention sites) was conducted from July 2015 to June 2019. The primary outcome measures were unplanned Intensive Care Unit (ICU) admissions, non-invasive ventilation use and mortality. Results There were 1790 patients included. The intervention sites had a 58% decrease in non-invasive ventilation use in the post- period compared to the pre-period (95% CI 0.18–0.96). ChIP was associated with 90% decreased odds of unplanned ICU admissions (95% CI 0.04–0.29) at the intervention sites compared to the control groups in the post- period. There was no significant change in mortality. There were higher odds of health service team reviews (surgical OR 6.6 (95% CI 4.61–9.45), physiotherapy OR 2.17 (95% CI 1.52–3.11), ICU doctor OR 6.13 (95% CI 3.94–9.55), ICU liaison OR 55.75 (95% CI 17.48–177.75), pain team OR 8.15 (95% CI 5.52 –-12.03), analgesia (e.g. patient controlled analgesia OR 2.6 (95% CI 1.64–3.94) and regional analgesia OR 8.8 (95% CI 3.39–22.79), incentive spirometry OR 8.3 (95% CI 4.49–15.37) and, high flow nasal oxygen OR 22.1 (95% CI 12.43–39.2) in the intervention group compared to the control group in the post- period. Conclusion The implementation of a chest injury care bundle using behaviour change theory was associated with a sustained improvement in evidence-based practice resulting in reduced unplanned ICU admissions and non-invasive ventilation requirement. Trial registration ANZCTR: ACTRN12618001548224, approved 17/09/2018
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Affiliation(s)
- Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
- * E-mail:
| | - Sarah Kourouche
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Stephen Asha
- Emergency Department, St George Hospital, Kogarah, NSW, Australia
- St George Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Experience in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Centre for Quality and Patient Safety Experience–Eastern Health Partnership, Box Hill, VIC, Australia
| | - Margaret Fry
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Northern Sydney Local Health District, Hornsby, NSW, Australia
| | - Sandy Middleton
- Nursing Research Institute, St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne, Fitzroy, Australia
- Australian Catholic University, Sydney, NSW, Australia
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Belinda Munroe
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, NSW, Australia
| | - Ramon Z. Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Camperdown, NSW, Australia
- Division of Infectious Diseases and Sexual Health, Department of Infection Prevention and Control, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia
- New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, Warwick Farm, NSW, Australia
| | - Alfa D’Amato
- NSW Activity Based Funding Taskforce, NSW Ministry of Health, Sydney, Australia
| | - Clare Skinner
- Emergency Department, Hornsby Ku-ring-ai Hospital, Hornsby, NSW, Australia
| | - Glen Wiseman
- Emergency Services, Canterbury Hospital, Campsie, NSW, Australia
| | - Thomas Buckley
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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23
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Li C, Sotomayor-Castillo C, Nahidi S, Kuznetsov S, Considine J, Curtis K, Fry M, Morgan D, Walker T, Burgess A, Carver H, Doyle B, Tran V, Varshney K, Shaban RZ. Emergency clinicians' knowledge, preparedness and experiences of managing COVID-19 during the 2020 global pandemic in Australian healthcare settings. Australas Emerg Care 2021; 24:186-196. [PMID: 34120888 PMCID: PMC7998048 DOI: 10.1016/j.auec.2021.03.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 03/10/2021] [Accepted: 03/21/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Emergency clinicians have a crucial role during public health emergencies and have been at the frontline during the COVID-19 pandemic. This study examined the knowledge, preparedness and experiences of Australian emergency nurses, emergency physicians and paramedics in managing COVID-19. METHODS A voluntary cross-sectional study of members of the College of Emergency Nursing Australasia, the Australasian College for Emergency Medicine, and the Australasian College of Paramedicine was conducted using an online survey (June-September 2020). RESULTS Of the 159 emergency nurses, 110 emergency physicians and 161 paramedics, 67.3-78% from each group indicated that their current knowledge of COVID-19 was 'good to very good'. The most frequently accessed source of COVID-19 information was from state department of health websites. Most of the respondents in each group (77.6-86.4%) received COVID-19 specific training and education, including personal protective equipment (PPE) usage. One-third of paramedics reported that their workload 'had lessened' while 36.4-40% of emergency nurses and physicians stated that their workload had 'considerably increased'. Common concerns raised included disease transmission to family, public complacency, and PPE availability. CONCLUSIONS Extensive training and education and adequate support helped prepare emergency clinicians to manage COVID-19 patients. Challenges included inconsistent and rapidly changing communications and availability of PPE.
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Affiliation(s)
- Cecilia Li
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Cristina Sotomayor-Castillo
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Shizar Nahidi
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Sergey Kuznetsov
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Julie Considine
- Deakin University, Geelong, School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, VIC, Australia; Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, VIC, Australia
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, NSW, Australia; George Institute for Global Health, NSW, Australia; Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Margaret Fry
- Faculty of Health, University of Technology Sydney, NSW, Australia; Northern Sydney Local Health District, Royal North Shore Hospital, Kolling Building, St Leonards, NSW, Australia
| | | | - Tony Walker
- Ambulance Victoria, Doncaster, VIC, Australia; College of Health and Biomedicine, Victoria University, VIC, Australia
| | | | | | - Brian Doyle
- Emergency Department, Royal Hobart Hospital, TAS, Australia
| | - Viet Tran
- Emergency Department, Royal Hobart Hospital, TAS, Australia; Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kavita Varshney
- Emergency Department, Westmead Hospital, NSW, Australia; Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Ramon Z Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; New South Wales Biocontainment Centre and Department of Infectious Diseases and Sexual Health, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead, NSW, Australia.
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24
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Sotomayor-Castillo C, Nahidi S, Li C, Hespe C, Burns PL, Shaban RZ. General practitioners' knowledge, preparedness, and experiences of managing COVID-19 in Australia. Infect Dis Health 2021; 26:166-172. [PMID: 33676878 PMCID: PMC7891055 DOI: 10.1016/j.idh.2021.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND COVID-19 has brought unprecedented demands to general practitioners (GPs) worldwide. We examined their knowledge, preparedness, and experiences managing COVID-19 in Australia. METHODS A cross-sectional online survey of GPs members of the Royal Australian College of General Practitioners (RACGP) was conducted between June and September 2020. RESULTS Out of 244 survey responses, a majority of GPs (76.6%) indicated having good knowledge of COVID-19, relying mostly on state/territory department of health (84.4%) and the RACGP (76.2%) websites to source up-to-date information. Most felt prepared to manage patients with COVID-19 (75.7%), yet over half reported not receiving training in the use of PPE. The majority were concerned about contracting SARS-CoV-2, more stressed than usual, and have heavier workloads. Their greatest challenges included scarcity of PPE, personal distress, and information overload. CONCLUSION Access to PPE, training, accurate information, and preparedness are fundamental for the successful role of general practices during outbreaks.
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Affiliation(s)
- Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Shizar Nahidi
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Charlotte Hespe
- General Practice and Primary Care Research, School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia
| | - Penelope L Burns
- Academic Unit of General Practice, Australian National University Medical School, The Australian National University, Canberra, ACT, Australia; Department of General Practice, School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia.
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25
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Kourouche S, Curtis K, Munroe B, Asha SE, Carey I, Considine J, Fry M, Lyons J, Middleton S, Mitchell R, Shaban RZ, Unsworth A, Buckley T. Implementation of a hospital-wide multidisciplinary blunt chest injury care bundle (ChIP): Fidelity of delivery evaluation. Aust Crit Care 2021; 35:113-122. [PMID: 34144864 DOI: 10.1016/j.aucc.2021.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/07/2021] [Revised: 04/08/2021] [Accepted: 04/11/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Ineffective intervention for patients with blunt chest wall injury results in high rates of morbidity and mortality. To address this, a blunt chest injury care bundle protocol (ChIP) was developed, and a multifaceted plan was implemented using the Behaviour Change Wheel. OBJECTIVE The purpose of this study was to evaluate the reach, fidelity, and dose of the ChIP intervention to discern if it was activated and delivered to patients as intended at two regional Australian hospitals. METHODS This is a pretest and post-test implementation evaluation study. The proportion of ChIP activations and adherence to ChIP components received by eligible patients were compared before and after intervention over a 4-year period. Sample medians were compared using the nonparametric median test, with 95% confidence intervals. Differences in proportions for categorical data were compared using the two-sample z-test. RESULTS/FINDINGS Over the 19-month postimplementation period, 97.1% (n = 440) of eligible patients received ChIP (reach). The median activation time was 134 min; there was no difference in time to activation between business hours and after-hours; time to activation was not associated with comorbidities and injury severity score. Compared with the preimplementation group, the postimplementation group were more likely to receive evidence-based treatments (dose), including high-flow nasal cannula use (odds ratio [OR] = 6.8 [95% confidence interval {CI} = 4.8-9.6]), incentive spirometry in the emergency department (OR = 7.5, [95% CI = 3.2-17.6]), regular analgesia (OR = 2.4 [95% CI = 1.5-3.8]), regional analgesia (OR = 2.8 [95% CI = 1.5-5.3]), patient-controlled analgesia (OR = 1.8 [95% CI = 1.3-2.4]), and multiple specialist team reviews, e.g., surgical review (OR = 9.9 [95% CI = 6.1-16.1]). CONCLUSIONS High fidelity of delivery was achieved and sustained over 19 months for implementation of a complex intervention in the acute context through a robust implementation plan based on theoretical frameworks. There were significant and sustained improvements in care practices known to result in better patient outcomes. Findings from this evaluation can inform future implementation programs such as ChIP and other multidisciplinary interventions in an emergency or acute care context.
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Affiliation(s)
- Sarah Kourouche
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia.
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong NSW, Australia; Illawarra Health and Medical Research Institute, Building 32 University of Wollongong, Northfields Avenue, Wollongong NSW, Australia.
| | - Belinda Munroe
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Crown St, Wollongong NSW, Australia.
| | - Stephen Edward Asha
- Emergency Department, St George Hospital, Kogarah, NSW, Australia; St George Clinical School, Faculty of Medicine, University of New South Wales, NSW, Australia.
| | - Ian Carey
- School of Medicine, Medicine and Health, University of Wollongong, Wollongong 2522, NSW, Australia.
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Experience in the Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; Centre for Quality and Patient Safety Experience - Eastern Health Partnership, Box Hill, VIC, Australia.
| | - Margaret Fry
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; University of Technology Sydney Faculty of Health, NSW, Australia; Northern Sydney Local Health District, NSW, Australia.
| | - Jack Lyons
- School of Medicine, Medicine and Health, University of Wollongong, Wollongong 2522, NSW, Australia.
| | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, NSW Australia.
| | - Rebecca Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2113.
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Camperdown, NSW 2006, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, 2145, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, 2145, Australia.
| | - Annalise Unsworth
- South West Sydney Clinical School, Faculty of Medicine, University of New South Wales, NSW 2006, Australia
| | - Thomas Buckley
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, NSW 2006, Australia.
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Sotomayor-Castillo C, Nahidi S, Li C, Macbeth D, Russo PL, Mitchell BG, Cruickshank M, Sorrell T, Gilroy N, Ferguson P, Watts MR, Shaban RZ. Infection control professionals' and infectious diseases physicians' knowledge, preparedness, and experiences of managing COVID-19 in Australian healthcare settings. Infect Dis Health 2021; 26:249-257. [PMID: 34266812 PMCID: PMC8162823 DOI: 10.1016/j.idh.2021.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND COVID-19 has placed unprecedented demands on infection control professionals (ICPs) and infectious disease (ID) physicians. This study examined their knowledge, preparedness, and experiences managing COVID-19 in the Australian healthcare settings. METHODS A cross-sectional study of ICPs and ID physician members of the Australasian College for Infection Prevention and Control (ACIPC) and the Australasian Society for Infectious Diseases (ASID) was conducted using an online survey. Descriptive statistics were used to summarise and report data. RESULTS A total of 103 survey responses were included in the analysis for ICPs and 45 for ID physicians. A majority of ICPs (78.7%) and ID physicians (77.8%) indicated having 'very good' or 'good' level of knowledge of COVID-19. Almost all ICPs (94.2%) relied on state or territory's department of health websites to source up-to-date information While most ID physicians (84.4%) used scientific literature and journals. A majority of ICPs (96%) and ID physicians (73.3%) reported feeling 'moderately prepared' or 'extremely prepared' for managing COVID-19. Most respondents had received specific training about COVID-19 within their workplace (ICPs: 75%; ID physicians: 66.7%), particularly training/certification in PPE use, which made them feel 'mostly or entirely confident' in using it. Most ICPs (84.5%) and ID physicians (76.2%) reported having 'considerably' or 'moderately more' work added to their daily duties. Their biggest concerns included the uncertainties under a rapidly changing landscape, PPE availability, and the community's compliance. CONCLUSION Harmonised information, specific COVID-19 training and education, and adequate support for front-line workers are key to successfully managing COVID-19 and other future outbreaks.
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Affiliation(s)
- Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, 2006, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia
| | - Shizar Nahidi
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, 2006, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia
| | - Cecilia Li
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, 2006, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia
| | - Deborough Macbeth
- Infection Control Department, Infectious Diseases and Immunology, Gold Coast Hospital and Health Service, Southport, QLD, 4215, Australia
| | - Philip L Russo
- Department of Nursing Research, Cabrini Institute, VIC, 3144, Australia; Nursing and Midwifery, Monash University, Clayton, VIC, 3800, Australia
| | - Brett G Mitchell
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, Newcastle University, NSW, 2308, Australia
| | - Marilyn Cruickshank
- Nursing Research Unit, Sydney Children's Hospitals Network, Sydney, NSW, 2031, Australia; Faculty of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Tania Sorrell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia; Infectious Diseases and Sexual Health Services, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Patricia Ferguson
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Matthew R Watts
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, 2006, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital & Western Sydney Local Health District, Westmead, NSW, 2145, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and NSW Health, NSW, 2145, Australia.
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Considine J, Fry M, Curtis K, Shaban RZ. Systems for recognition and response to deteriorating emergency department patients: a scoping review. Scand J Trauma Resusc Emerg Med 2021; 29:69. [PMID: 34022933 PMCID: PMC8140439 DOI: 10.1186/s13049-021-00882-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Assessing and managing the risk of clinical deterioration is a cornerstone of emergency care, commencing at triage and continuing throughout the emergency department (ED) care. The aim of this scoping review was to assess the extent, range and nature of published research related to formal systems for recognising and responding to clinical deterioration in emergency department (ED) patients. Materials and methods We conducted a scoping review according to PRISMA-ScR guidelines. MEDLINE complete, CINAHL and Embase were searched on 07 April 2021 from their dates of inception. Human studies evaluating formal systems for recognising and responding to clinical deterioration occurring after triage that were published in English were included. Formal systems for recognising and responding to clinical deterioration were defined as: i) predefined patient assessment criteria for clinical deterioration (single trigger or aggregate score), and, or ii) a predefined, expected response should a patient fulfil the criteria for clinical deterioration. Studies of short stay units and observation wards; deterioration during the triage process; system or score development or validation; and systems requiring pathology test results were excluded. The following characteristics of each study were extracted: author(s), year, design, country, aims, population, system tested, outcomes examined, and major findings. Results After removal of duplicates, there were 2696 publications. Of these 33 studies representing 109,066 patients were included: all were observational studies. Twenty-two aggregate scoring systems were evaluated in 29 studies and three single trigger systems were evaluated in four studies. There were three major findings: i) few studies reported the use of systems for recognising and responding to clinical deterioration to improve care of patients whilst in the ED; ii) the systems for recognising clinical deterioration in ED patients were highly variable and iii) few studies reported on the ED response to patients identified as deteriorating. Conclusion There is a need to re-focus the research related to use of systems for recognition and response to deteriorating patients from predicting various post-ED events to their real-time use to improve patient safety during ED care. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00882-6.
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Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia. .,Centre for Quality and Patient Safety Research, Deakin University, Geelong, Victoria, Australia. .,Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia. .,Centre for Quality and Patient Safety Research, Eastern Health Partnership, Box Hill, Victoria, Australia.
| | - Margaret Fry
- Faculty of Health, University of Technology Sydney, St Leonards, New South Wales, Australia.,Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia.,Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.,Western Sydney Local Health District, Westmead, New South Wales, Australia
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Nahidi S, Sotomayor-Castillo C, Li C, Currey J, Elliott R, Shaban RZ. Australian critical care nurses' knowledge, preparedness, and experiences of managing SARS-COV-2 and COVID-19 pandemic. Aust Crit Care 2021; 35:22-27. [PMID: 34462194 PMCID: PMC8114809 DOI: 10.1016/j.aucc.2021.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has again highlighted the crucial role of healthcare workers in case management, disease surveillance, policy development, and healthcare education and training. The ongoing pandemic demonstrates the importance of having an emergency response plan that accounts for the safety of frontline healthcare workers, including those working in critical care settings. Objectives The aim of the study was to explore Australian critical care nurses' knowledge, preparedness, and experiences of managing patients diagnosed with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) and COVID-19. Methods An exploratory cross-sectional study of Australian critical care nurses was conducted between June and September 2020. An anonymised online survey was sent to Australian College of Critical Care Nurses' members to collect information about their knowledge, preparedness, and experiences during the COVID-19 pandemic. Descriptive statistics were used to summarise and report data. Results A total of 157 critical care nurses participated, with 138 fully complete surveys analysed. Most respondents reported ‘good’ to ‘very good’ level of knowledge about COVID-19 and obtained up-to-date COVID-19 information from international and local sources. Regarding managing patients with COVID-19, 82.3% felt sufficiently prepared at the time of data collection, and 93.4% had received specific education, training, or instruction. Most participants were involved in assessing (89.3%) and treating (92.4%) patients with COVID-19. Varying levels of concerns about SARS-CoV-2 infection were expressed by respondents, and 55.7% thought the pandemic had increased their workload. The most frequent concerns expressed by participants were a lack of appropriate personal protective equipment (PPE) and fear of PPE shortage. Conclusions While most nurses expressed sufficient preparedness for managing COVID-19 patients, specific education had been undertaken and experiential learning was evident. Fears of insufficient or lack of appropriate PPE made the response more difficult for nurses and the community. Preparedness and responsiveness are critical to successful management of the COVID-19 pandemic and future outbreaks of emerging infectious diseases.
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Affiliation(s)
- Shizar Nahidi
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Cristina Sotomayor-Castillo
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Cecilia Li
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.
| | - Judy Currey
- Centre for Quality and Patient Safety Research in Institute of Health Transformation; School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia; Office of the Deputy Vice Chancellor (Education), Deakin University, Geelong, Victoria, Australia.
| | - Rosalind Elliott
- Nursing and Midwifery Research Centre, Nursing and Midwifery Directorate, and Intensive Care Unit, Royal North Shore Hospital, Northern Sydney Local Health District, NSW, Australia; Faculty of Health, University of Technology, Ultimo, NSW, Australia.
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia.
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Kam AW, King N, Sharma A, Phillips N, Nayyar V, Shaban RZ. Short research paper: Personal protective equipment for the care of suspected and confirmed COVID-19 patients - Modelling requirements and burn rate. Infect Dis Health 2021; 26:214-217. [PMID: 33972186 PMCID: PMC8064831 DOI: 10.1016/j.idh.2021.04.001] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 11/19/2022]
Abstract
Background The COVID-19 pandemic has caused unprecedented global demand for personal protective equipment (PPE). A paucity of data on PPE burn rate (PPE consumption over time) in pandemic situations exacerbated these issues as there was little historic research to indicate volumes of PPE required to care for surges in infective patients and thus plan procurement requirements. Methods To better understand PPE requirements for care of suspected or confirmed COVID-19 patients in our Australian quaternary referral hospital, the number of staff-to-patient interactions in a 24-h period for three patient groups (ward-based COVID suspect, ward-based COVID confirmed, intensive care COVID confirmed) was audited prospectively from 1st to 30th April 2020. Results The average number of staff-to-patient interactions in a 24-h period was: 13.1 ± 5.0 (mean ± SD) for stable ward-managed COVID-19 suspect patients; 11.9 ± 3.8 for stable ward-managed confirmed COVID-19 patients; and 30.0 ± 5.3 for stable, mechanically ventilated, ICU-managed COVID-19 patients. This data can be used in PPE demand simulation modelling for COVID-19 and potentially other respiratory illnesses. Conclusion Data on the average number of staff-to-patient interactions needed for the care of COVID-19 patients is presented. This data can be used for PPE demand simulation modelling.
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Affiliation(s)
- Andrew W Kam
- Department of Ophthalmology, Westmead Hospital, Westmead, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Executive Unit, Westmead Hospital, Westmead, New South Wales, Australia.
| | - Nicole King
- Intensive Care Unit, Westmead Hospital, Westmead, NSW, Australia
| | - Ashima Sharma
- Intensive Care Unit, Westmead Hospital, Westmead, NSW, Australia
| | - Nicole Phillips
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Executive Unit, Concord Repatriation General Hospital, Concord, New South Wales, Australia; Department of Anaesthetics, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Vineet Nayyar
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Intensive Care Unit, Westmead Hospital, Westmead, NSW, Australia
| | - Ramon Z Shaban
- New South Wales Biocontainment Centre & Division of Infectious Diseases and Sexual Health, Western Sydney Local Health District, Westmead, New South Wales, Australia; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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30
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Jones T, Curtis K, Shaban RZ. Practice expectations for Australian graduate emergency nursing programs: A Delphi study. Nurse Educ Today 2021; 99:104811. [PMID: 33636653 DOI: 10.1016/j.nedt.2021.104811] [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] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Practice standards in nursing provide minimum expectations to enable the provision of high quality and safe care. There are currently no practice standards for post-registration graduate emergency nursing programs in Australia, leading to variation in graduate attributes and clinical expectations on completion of their program. OBJECTIVES The aim of this study was to establish consensus-based practice standards for graduate emergency nursing programs in Australia. DESIGN Delphi approach. PARTICIPANTS Australian nurses who identified as an emergency nurse and currently worked, or previously worked, in an emergency care environment. METHODS A modified two-round Delphi method was used. The survey was divided into four sections of data collection, including demographics, graduate emergency nursing course entry requirements, graduate expectations, and clinical care capabilities. Data were analysed using descriptive statistics including calculation of content validity index (CVI). RESULTS There were 204 respondents in Round One and 153 respondents in Round Two. Respondents agreed that nurses wanting to undertake graduate studies in emergency nursing require prior experience in the emergency care environment and should be working a minimum of 0.5 full time equivalent (FTE) whilst completing their studies. Thirty-nine statements presented under graduate attributes achieved a CVI of >0.8. All 70 clinical care capability statements presented in Round Two achieved a CVI of >0.8. CONCLUSION This study generated the evidence to establish minimum practice standards for Australian graduate emergency nursing programs. The standards centre around three key areas: graduate entry requirements, graduate attributes and clinical care capabilities. The standards provide a clear guide for employers, educators and clinicians, and inform capabilities for early career emergency nurses.
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Affiliation(s)
- Tamsin Jones
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.
| | - Kate Curtis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Emergency services, Illawarra Shoalhaven Local Health District, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead. NSW, Australia
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Shaban RZ, Li C, O'Sullivan MVN, Gerrard J, Stuart RL, Teh J, Gilroy N, Sorrell TC, White E, Bag S, Hackett K, Chen SCA, Kok J, Dwyer DE, Iredell JR, Maddocks S, Ferguson P, Varshney K, Carter I, Barratt R, Robertson M, Baskar SR, Friend C, Robosa RS, Sotomayor-Castillo C, Nahidi S, Macbeth DA, Alcorn KAD, Wattiaux A, Moore F, McMahon J, Naughton W, Korman TM, Catton M, Kanapathipillai R, Romanes F, Rowe E, Catford J, Kennedy B, Qiao M, Shaw D. COVID-19 in Australia: our national response to the first cases of SARS-CoV-2 infection during the early biocontainment phase. Intern Med J 2021; 51:42-51. [PMID: 33196128 PMCID: PMC7753759 DOI: 10.1111/imj.15105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND On 31 December 2019, the World Health Organization recognised clusters of pneumonia-like cases due to a novel coronavirus disease (COVID-19). COVID-19 became a pandemic 71 days later. AIM To report the clinical and epidemiological features, laboratory data and outcomes of the first group of 11 returned travellers with COVID-19 in Australia. METHODS This is a retrospective, multi-centre case series. All patients with confirmed COVID-19 infection were admitted to tertiary referral hospitals in New South Wales, Queensland, Victoria and South Australia. RESULTS The median age of the patient cohort was 42 years (interquartile range (IQR), 24-53 years) with six men and five women. Eight (72.7%) patients had returned from Wuhan, one from Shenzhen, one from Japan and one from Europe. Possible human-to-human transmission from close family contacts in gatherings overseas occurred in two cases. Symptoms on admission were fever, cough and sore throat (n = 9, 81.8%). Co-morbidities included hypertension (n = 3, 27.3%) and hypercholesterolaemia (n = 2, 18.2%). No patients developed severe acute respiratory distress nor required intensive care unit admission or mechanical ventilation. After a median hospital stay of 14.5 days (IQR, 6.75-21), all patients were discharged. CONCLUSIONS This is a historical record of the first COVID-19 cases in Australia during the early biocontainment phase of the national response. These findings were invaluable for establishing early inpatient and outpatient COVID-19 models of care and informing the management of COVID-19 over time as the outbreak evolved. Future research should extend this Australian case series to examine global epidemiological variation of this novel infection.
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Affiliation(s)
- Ramon Z Shaban
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Cecilia Li
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew V N O'Sullivan
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - John Gerrard
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Rhonda L Stuart
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.,Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Teh
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Tania C Sorrell
- Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth White
- Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Public Health Unit, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Kate Hackett
- Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sharon C A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Dominic E Dwyer
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan R Iredell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Susan Maddocks
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Patricia Ferguson
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kavita Varshney
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Emergency Department Westmead Hospital, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Ruth Barratt
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Infectious Diseases and Sexual Health Services, Westmead Hospital, Sydney, New South Wales, Australia
| | - Mark Robertson
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Microbiology and Infectious Diseases, NSW Health Pathology, Gosford Hospital, Central Coast, New South Wales, Australia
| | - Sai R Baskar
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia.,Department of Microbiology and Infectious Diseases, NSW Health Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Caren Friend
- Counter Disaster Unit, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Roselle S Robosa
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Shizar Nahidi
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Deborough A Macbeth
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Kylie A D Alcorn
- Department of Infectious Diseases and Immunology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Andre Wattiaux
- Gold Coast Public Health Unit, Gold Coast, Queensland, Australia
| | - Frederick Moore
- Public Health Virology Laboratory, Forensic and Scientific Services, Brisbane, Queensland, Australia
| | - Jamie McMahon
- Public Health Virology Laboratory, Forensic and Scientific Services, Brisbane, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - William Naughton
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia
| | - Tony M Korman
- Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.,Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mike Catton
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infections and Immunity, Melbourne, Victoria, Australia
| | | | - Finn Romanes
- Department of Health and Human Services, State Government Victoria, Melbourne, Victoria, Australia
| | - Emily Rowe
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Jennifer Catford
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Brendan Kennedy
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Communicable Disease Control Branch, SA Health, Adelaide, South Australia, Australia
| | - Ming Qiao
- Directorate of Microbiology and Infectious Diseases, South Australia Pathology, Adelaide, South Australia, Australia
| | - David Shaw
- Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Affiliation(s)
- Elissa J Zhang
- Westmead Hospital, Westmead, NSW, Australia
- Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Lucy P Aitchison
- Faculty of Medicine, University of New South Wales, Randwick, NSW, Australia
| | - Nicole Phillips
- Concord Repatriation General Hospital, Concord, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Ramon Z Shaban
- Westmead Hospital, Westmead, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Andrew W Kam
- Westmead Hospital, Westmead, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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Shaban RZ, Nahidi S, Sotomayor-Castillo C, Li C, Gilroy N, O'Sullivan MV, Sorrell TC, White E, Hackett K, Bag S. SARS-CoV-2 infection and COVID-19: The lived experience and perceptions of patients in isolation and care in an Australian healthcare setting. Am J Infect Control 2020; 48:1445-1450. [PMID: 32890549 PMCID: PMC7466942 DOI: 10.1016/j.ajic.2020.08.032] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 11/30/2022]
Abstract
Background Isolation and quarantine are key measures in outbreak management and disease control. They are, however, associated with negative patient experiences and outcomes, including an adverse impact on mental health and lower quality of care due to limited interaction with healthcare workers. In this study, we explore the lived experience and perceptions of patients in isolation with COVID-19 in an Australian healthcare setting. Methods Using a phenomenological approach from a Heideggerian hermeneutical perspective, we conducted individual semistructured interviews with the first 11 COVID-19 patients admitted to a designated COVID-19 facility in Australia. Interviews were audiorecorded, transcribed verbatim, and imported into NVivo 12 for coding and analysis. Results Participants’ lived experience and perceptions of COVID-19 were represented by 5 themes: “Knowing about COVID-19,” “Planning for, and responding to, COVID-19,” “Being infected,” “Life in isolation and the room,” and “Post-discharge life.” Within these, participants conveyed both positive and negative lived experiences of infection, isolation, and illness. The contextual aspects of their social and physical environment together with their individual resources contributed to the framing of their planning for, and response to, the outbreak, and were important mediators in their experience. Conclusions Findings from this study provide a valuable insight into the lived experiences of patients with COVID-19, which reflect those of patients with other infectious diseases who require isolation.
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Shaban RZ, Li C, O'Sullivan MVN, Kok J, Dempsey K, Ramsperger M, Brown M, Nahidi S, Sotomayor-Castillo C. Outbreak of community-acquired Staphylococcus aureus skin infections in an Australian professional football team. J Sci Med Sport 2020; 24:520-525. [PMID: 33303369 DOI: 10.1016/j.jsams.2020.11.006] [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: 06/02/2020] [Revised: 10/14/2020] [Accepted: 11/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Skin and soft tissue infections commonly affect athletes and can lead to cluster outbreaks if not managed appropriately. We report the findings of an investigation into an outbreak of community-acquired Staphylococcus aureus infection in an Australian professional football team. DESIGN Retrospective cross-sectional study. METHODS Nose, axilla, groin and throat swab were collected from 47 participants. MRSA and MSSA isolates underwent antibiotic susceptibility testing, binary typing and whole genome sequencing. Infection control practitioners (ICPs) investigated the training grounds for risk factors in the transmission of S. aureus. RESULTS Almost half of the participants (n=23, 48.9%) were found to be colonised with MSSA. An outbreak cluster of MRSA ST5 closely related to the fusidic acid-resistant New Zealand NZAK3 clone was identified in a group of four players. MSSA ST15 and MSSA ST291 strains were found to have colonised and spread between two and five players, respectively. All participants were advised to undergo decolonisation treatment consisting of 4% chlorhexidine body wash and mupirocin nasal ointment for ten days. The ICP team identified several unhygienic practices within the club's shared facilities that may have played a role in the transmission of S. aureus. CONCLUSIONS We report for the first time a community-associated S. aureus outbreak involving the highly successful fusidic acid-resistant MRSA ST5 clone in a professional football club associated with inadequate hygiene procedures. Management and prevention of S. aureus relies heavily on hygiene education and adherence to personal and environmental hygiene practices and policies.
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Affiliation(s)
- Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Australia; New South Wales Biocontainment Centre and the Department of Infection Prevention and Control, Division of Infectious Diseases and Biosecurity, Westmead Hospital and Western Sydney Local Health District, Australia.
| | - Cecilia Li
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Australia
| | - Matthew V N O'Sullivan
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Australia; Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Australia
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Australia
| | - Kathy Dempsey
- Clinical Excellence Commission, NSW Health, Australia
| | - Marc Ramsperger
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Australia
| | - Mitchell Brown
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Australia
| | - Shizar Nahidi
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Australia
| | - Cristina Sotomayor-Castillo
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Australia
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Bailey J, Dutton T, Hawke C, Illife J, Kirkby M, Smart SL, O'Brien P, Paxton K, Shaban RZ, Thomas L, Wharton S. Exploring rural patients' understanding of the types, risk factors and measures to prevent healthcare-associated infections in Australia. Infect Dis Health 2020; 26:31-37. [PMID: 33051153 DOI: 10.1016/j.idh.2020.08.006] [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: 05/19/2020] [Revised: 08/04/2020] [Accepted: 08/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Australia, there are approximately 165,000 healthcare-associated infections (HAIs) per year. Improving patient knowledge on HAIs and actively involving them in infection prevention is essential. This study assessed patient knowledge on types of and risk factors for HAIs and their perceptions of HAI information provision and hospital infection control practices in rural New South Wales, Australia. METHODS Medical and surgical ward patients in three rural hospitals completed a questionnaire between February and March 2019. Open ended responses were grouped under categories, decided upon by two researchers, one of which is an infection prevention and control nurse. Descriptive analysis was completed. RESULTS A total of 153 patients completed the survey. Most (n = 126, 82%) participants were previously aware of HAIs, with common sources of education/information being family/friends (n = 55, 36%), television (n = 28, 18%), newspapers (n = 27, 18%), and previous experience of a HAI (n = 20, 13%). Satisfaction with infection control measures and hospital cleanliness was high. Over half (n = 83, 54%) of participants thought they received too little information on HAIs, and only 35% (n = 21) of those that had surgery reported receiving information. Participants suggested that more education for the general public (n = 117, 76%) and patients (n = 110, 72%) in both written form and verbally from hospital staff, and education outside of the hospital in various mediums, could help reduce the risk and rates of HAI. CONCLUSION Awareness of HAIs amongst respondents was high, however, education appeared to be lacking. More can be done to inform patient, family and general public education programs in rural and regional Australian hospitals.
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Affiliation(s)
- Jannine Bailey
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst NSW 2795, Australia; Western NSW Health Research Network, NSW, Australia
| | - Tegan Dutton
- Bathurst Rural Clinical School, School of Medicine, Western Sydney University, PO Box 9008, Bathurst NSW 2795, Australia; Western NSW Health Research Network, NSW, Australia.
| | - Catherine Hawke
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Jessica Illife
- Dubbo Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Michelle Kirkby
- Dubbo Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Suzanne Lovell Smart
- Orange Health Service, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Peta O'Brien
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Karen Paxton
- School of Rural Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Orange, 2800, Australia; Western NSW Health Research Network, NSW, Australia
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Infectious Diseases and Sexual Health, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Linda Thomas
- Bathurst Base Hospital, Western New South Wales Local Health District, NSW, Australia; Western NSW Health Research Network, NSW, Australia
| | - Sandra Wharton
- Western New South Wales Local Health District, Australia; Western NSW Health Research Network, NSW, Australia
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Curtis K, Nahidi S, Gabbe B, Vallmuur K, Martin K, Shaban RZ, Christey G. Identifying the priority challenges in trauma care delivery for Australian and New Zealand trauma clinicians. Injury 2020; 51:2053-2058. [PMID: 32698960 DOI: 10.1016/j.injury.2020.07.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/09/2020] [Accepted: 07/14/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Injury is a leading cause of death and disability world-wide. Little is known about the day-to-day challenges the trauma clinicians face in their practice that they feel could be improved through an increased evidence base. This study explored and ranked the trauma clinical practice research priorities of trauma care professionals across Australia and New Zealand. METHODS A modified-Delphi study was conducted between September 2019 and January 2020. The study employed two rounds of online survey of trauma professionals from relevant Australia and New Zealand professional organisations using snowballing method. Participants were asked to rank the importance of 29 recommendations, each corresponding to a key challenge in trauma care delivery. Decisions on the priorities of the challenges were determined by a consensus of >70% of respondents ranking the challenge as important or very important. RESULTS One hundred and fifty-five participants completed Round One, and 106 participants completed Round Two. A total of 15 recommendations reached >70% in Round One. Nine recommendations also reached >70% consensus in Round Two. Recommendations ranked highest were 'Caring for elderly trauma patients', 'Identifying and validating key performance indicators for trauma system benchmarking and improvement', and 'Management of traumatic brain injury'. CONCLUSION This study identified the priority areas for trauma research as determined by clinician ranking of the most important for informing and improving their practice. Addressing these areas generates potential to improve the quality and safety of trauma care in Australian and New Zealand.
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Affiliation(s)
- Kate Curtis
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, Australia; Trauma Quality Improvement Sub-Committee, Royal Australasian College of Surgeons, Australia; Australasian Trauma Society, Australia; Australian Trauma Quality Improvement Program (AusTQIP), Australia; Illawarra Shoalhaven Local Health District, NSW, Australia; University of Wollongong, Faculty of Science, Medicine and Health, Wollongong, Australia.
| | - Shizar Nahidi
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, Australia
| | - Belinda Gabbe
- Australasian Trauma Society, Australia; Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Kirsten Vallmuur
- Australian Trauma Quality Improvement Program (AusTQIP), Australia; Queensland University of Technology, Australian Centre for Health Services Innovation, Faculty of Health, School of Public Health and Social Work, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Queensland Health, Australia
| | - Katherine Martin
- Trauma Quality Improvement Sub-Committee, Royal Australasian College of Surgeons, Australia; Australasian Trauma Society, Australia
| | - Ramon Z Shaban
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Centre for Infectious Diseases and Microbiology and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Grant Christey
- Trauma Quality Improvement Sub-Committee, Royal Australasian College of Surgeons, Australia; Australasian Trauma Society, Australia; Australian Trauma Quality Improvement Program (AusTQIP), Australia; Centre for Infectious Diseases and Microbiology and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia; Waikato District Health Board, Hamilton, New Zealand; Waikato Clinical School, University of Auckland, Auckland, New Zealand
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Shaban RZ, Sotomayor-Castillo C, Macbeth D, Russo PL, Mitchell BG. Scope of practice and educational needs of infection prevention and control professionals in Australian residential aged care facilities. Infect Dis Health 2020; 25:286-293. [PMID: 32711966 DOI: 10.1016/j.idh.2020.06.001] [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: 03/16/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Healthcare-associated infections are serious and significant complications present across healthcare services, including residential aged care facilities. Although ensuring high quality personal and clinical care delivered to older people residing in these facilities is a high national priority, there is a paucity of evidence published about outbreaks, governance and education programs held for healthcare workers within Australian residential aged care facilities. The aim of this study is to examine the scope of practice of Infection Prevention and Control professionals within Australian residential aged care facilities and the types of infection prevention and control education and training delivered. METHODS A cross-sectional study was conducted inviting all Australian residential aged care facilities to participate in an online survey. RESULTS A total of 134 residential aged care facilities completed the survey. The majority (88.1%) reported having a designated Infection Prevention and Control professional responsible for surveillance and educational activities. Hand hygiene (94%), personal protective equipment (PPE) (79.9%) and environmental cleaning (70.1%) were some of the available Infection Prevention and Control programs. The lack of access to Infection Prevention and Control education (69.5%) and lack of Infection Prevention and Control expert advice (67.2%) were also reported by some Residential aged care facilities. CONCLUSION Australian residential aged care facilities recognise the importance of Infection Prevention and Control training programs to manage infection surveillance and outbreaks. Considerable activities are carried out to increase knowledge on breaking the chain of infection. Yet, more support and resources are needed to assist these efforts.
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Affiliation(s)
- Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia.
| | - Cristina Sotomayor-Castillo
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Deborough Macbeth
- Infection Control Department, Infectious Diseases and Immunology, Gold Coast Hospital and Health Service, Southport, QLD, Australia
| | - Philip L Russo
- Department of Nursing Research, Cabrini Institute, Malvern, VIC, Australia; Nursing and Midwifery, Monash University, Clayton, Frankston, VIC, Australia
| | - Brett G Mitchell
- School of Nursing and Midwifery, Faculty of Health and Medicine, Newcastle University, NSW, Australia; School of Nursing, Avondale University College, Wahroonga, NSW, Australia
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Barratt R, Shaban RZ, Gilbert GL. Characteristics of personal protective equipment training programs in Australia and New Zealand hospitals: A survey. Infect Dis Health 2020; 25:253-261. [PMID: 32600965 PMCID: PMC7318937 DOI: 10.1016/j.idh.2020.05.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 12/19/2022]
Abstract
Background Using personal protective equipment (PPE) is one of several fundamental measures to prevent the transmission of infection and infectious diseases and is particularly pertinent in the current COVID-19 pandemic. Appropriate use of PPE by healthcare workers is, however, often suboptimal. Training and monitoring of PPE competency are essential components of an infection prevention and control program but there is a paucity of research and data on the content of such training programs across Australasia. This paper reports the results of a survey that characterised the nature of PPE training in Australian and New Zealand hospitals. Methods A population-based online survey was distributed to members of three major Australasian colleges representing infection prevention and control. Results Results indicate that, although training is frequently provided at orientation, many healthcare workers do not receive regular updates. Training programmes combine online and classroom sessions, but over a third do not include a practical component. The frequency of monitoring PPE competency is variable with one third of respondents indicating that no auditing occurs. PPE items used for high-level training are variable, with use of powered air purifying respirators (PAPRs) uncommon. Conclusion The results of this study suggest that HCWs’ confidence, competence and familiarity with PPE are a concern, which in the context of the current global COVID-19 pandemic is problematic. More research is needed into how PPE training programs could be better designed, to prepare HCWs for practice using PPE safely and confidently. Most HCW orientation programmes include PPE training but fewer than half are updated annually. One third of PPE programmes do not include a practical component. Only two thirds of PPE training programmes monitor PPE compliance. Future research should consider the design of PPE training programs to optimise HCW PPE practice.
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Affiliation(s)
- Ruth Barratt
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; The University of Sydney Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
| | - Ramon Z Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney. Camperdown. NSW, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead. NSW, Australia.
| | - Gwendolyn L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; The University of Sydney Westmead Clinical School, Faculty of Medicine and Health, NSW, Australia.
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Cruickshank M, Shaban RZ. COVID-19: Lessons to be learnt from a once-in-a-century global pandemic. J Clin Nurs 2020; 29:3901-3904. [PMID: 32498115 PMCID: PMC7301028 DOI: 10.1111/jocn.15365] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Marilyn Cruickshank
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.,Sydney Children's Hospitals Network, Randwick, NSW, Australia.,Faculty of Health, School of Nursing and Midwifery, Griffith University, Brisbane, QLD, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia.,Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Penrith, NSW, Australia
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40
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Curtis K, Gabbe B, Vallmuur K, Martin K, Nahidi S, Shaban RZ, Pollard C, Christey G. Challenges to trauma care delivery for Australian and New Zealand trauma clinicians. Injury 2020; 51:1183-1188. [PMID: 31926611 DOI: 10.1016/j.injury.2020.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/13/2019] [Accepted: 01/03/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The availability and implementation of evidence-based care is essential to achieving safe, quality trauma patient outcomes. Little is documented, however, about the challenges trauma clinicians face in their day-to day practice, or their views on the availability of evidence. This paper presents the most significant clinical practice challenges reported by multidisciplinary trauma care professionals in Australia and New Zealand, in particular those that may be resolved with focussed research or enhanced implementation activity. METHODS An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted between September 2018 and February 2019 using the Snowballing Method. Participants were recruited via a non-random sampling technique to complete an online survey. Thematic analyses were conducted. RESULTS There were nine significant clinical practice challenge themes in trauma care, arising from 287 individual clinical practice challenges reported. The most reported being clinical management (bleeding, spinal, older patients) and operationalisation of the trauma system. There was no consensus as to the availability of evidence to guide each theme. CONCLUSION Future research should seek to address the clinical practice challenge of Australian and New Zealand trauma community to enable safe, quality trauma patient outcomes.
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Affiliation(s)
- Kate Curtis
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia; Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee, Australia; Australasian Trauma Society, Australia; Australian Trauma Quality Improvement Program (AusTQIP), Australia; Illawarra Shoalhaven Local Health District, NSW, Australia; University of Wollongong, Faculty of Science, Medicine and Health, Australia.
| | - Belinda Gabbe
- Australasian Trauma Society, Australia; Monash University, School of Public Health and Preventive Medicine, Australia
| | - Kirsten Vallmuur
- Australian Trauma Quality Improvement Program (AusTQIP), Australia; Queensland University of Technology, Australian Centre for Health Services Innovation, Faculty of Health, School of Public Health and Social Work, Australia; Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Queensland Health, Australia
| | - Katherine Martin
- Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee, Australia; Australasian Trauma Society, Australia; Trauma Service, Alfred Hospital, Victoria, Australia
| | - Shizar Nahidi
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia
| | - Ramon Z Shaban
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Centre for Infectious Diseases and Microbiology and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Cliff Pollard
- Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee, Australia; Australasian Trauma Society, Australia
| | - Grant Christey
- Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee, Australia; Australasian Trauma Society, Australia; Australian Trauma Quality Improvement Program (AusTQIP), Australia; Waikato District Health Board, Hamilton, New Zealand; Waikato Clinical School, University of Auckland, New Zealand
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Curtis K, Brysiewicz P, Shaban RZ, Fry M, Considine J, Gamboa FEA, Holden M, Heyns T, Peden M. Nurses responding to the World Health Organization (WHO) priority for emergency care systems for universal health coverage. Int Emerg Nurs 2020; 50:100876. [PMID: 32446745 PMCID: PMC7188622 DOI: 10.1016/j.ienj.2020.100876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Emergency Services, Illawarra Shoalhaven Local Health District, NSW, Australia; George Institute for Global Health, Australia.
| | - Petra Brysiewicz
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery and Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Australia.
| | - Margaret Fry
- School of Nursing and Midwifery Faculty of Health, University of Technology Sydney, Australia.
| | - Julie Considine
- School of Nursing and Midwifery; Centre for Quality and Patient Safety Research; Institute for Health Transformation, Deakin University, Geelong, Australia.
| | | | - Maria Holden
- School of Health Sciences, University of Nottingham, United Kingdom
| | - Tanya Heyns
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Margie Peden
- The George Institute for Global Health United Kingdom, Oxford University, United Kingdom and University of New South Wales, Sydney, Australia
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Jones T, Curtis K, Shaban RZ. Academic and professional characteristics of Australian graduate emergency nursing programs: A national study. Australas Emerg Care 2020; 23:173-180. [PMID: 32115399 DOI: 10.1016/j.auec.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/04/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Specialist graduate emergency nursing education programs are essential to the delivery of high quality and safe healthcare to patients with complex needs in emergency care. Little is known about tertiary emergency nursing programs in Australia. This study aimed to determine the academic and professional characteristics of Australian emergency programs. METHOD This embedded mixed-method study examined the academic and professional characteristics of Australian emergency programs in two interdependent phases: (1) document and content analysis of Australian graduate emergency nursing program websites; and (2) semi-structured interviews with the associated convenors. The data underwent framework analysis using eight pre-identified categories of (i) course entry, (ii) fee arrangement, (iii) mode of delivery, (iv) volume of learning, (v) clinical assessment, (vi) employment requirements, (vii) graduate expectations, and (viii) influence of healthcare employers and professional engagement. RESULTS Prior clinical experience and the requirement for concurrent practising in an emergency care environment influenced were common, however fee arrangements were not clearly articulated. The College of Emergency Nursing Australasia Practice Standards for the Emergency Nursing Specialist featured in part within 12 programs, principally to guide development of clinical assessments. CONCLUSION Establishment of emergency nursing graduate practice standards could better inform the design and delivery of emergency nurse programs, and yield benefits in terms of graduate expectations and satisfaction and improved patient care.
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Affiliation(s)
- Tamsin Jones
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Nursing and Midwifery, Monash University, 47-49 Moorooduc Highway, Frankston, Victoria, Australia.
| | - Kate Curtis
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Emergency Services, Illawarra Shoalhaven Local Health District, NSW, Australia
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
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Mckay KJ, Shaban RZ, Ferguson P. Hand hygiene compliance monitoring: Do video-based technologies offer opportunities for the future? Infect Dis Health 2020; 25:92-100. [PMID: 31932242 DOI: 10.1016/j.idh.2019.12.002] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/18/2022]
Abstract
Hand hygiene is universally recognised as the primary measure to reduce healthcare-associated infections. Studies have convincingly demonstrated a link between increased hand hygiene compliance and reductions in rates of healthcare-associated infections. Direct observation is considered the gold standard method for monitoring hand hygiene compliance. Despite the acknowledged benefits of this approach, recent literature has highlighted a range of issues impacting on the reliability and validity of this data collection technique. The rise of technology in healthcare provides opportunity for alternative methods that promise advantages over direct human observation. There have been no published examples of systems that are able to capture data consistent with all the WHO '5 Moments for Hand Hygiene'. In this paper we explore current human-based auditing practises for monitoring hand hygiene compliance and raise for discussion and debate video-based technologies to monitor hand hygiene compliance. We raise questions regarding hybrid approaches that incorporate both direct human observation and indirect video-based surveillance, and the possible advantages and disadvantages therein for monitoring hand hygiene compliance. We suggest that such methods have the potential to ameliorate, or minimise, the inherent biases associated with direct observation, notably the Hawthorne Effect. Future research into the utility of a hybrid approach to auditing, including the technical specifications, efficacy, cost effectiveness and acceptability of such a model is warranted.
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Affiliation(s)
- Katherine J Mckay
- Infection Prevention and Control, Eastern Health, Box Hill, Victoria, Australia; Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
| | - Ramon Z Shaban
- Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead, NSW, Australia; Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia.
| | - Patricia Ferguson
- School of Medicine & Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia.
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Shaban RZ, Sotomayor-Castillo CF, Jakrot H, Jiang P. Passenger travel health advice regarding infection control and the prevention of infectious diseases: What's in airline inflight magazines? Travel Med Infect Dis 2020; 33:101453. [DOI: 10.1016/j.tmaid.2019.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023]
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Shaban RZ, Sotomayor-Castillo CF, Malik J, Li C. Global commercial passenger airlines and travel health information regarding infection control and the prevention of infectious disease: What's in a website? Travel Med Infect Dis 2020; 33:101528. [PMID: 31760126 PMCID: PMC7110852 DOI: 10.1016/j.tmaid.2019.101528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/20/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Air travel has never been easier, cheaper or faster, with large volumes of people travelling around the world. These factors increase the risk of the spread of infectious diseases by air travel. Little is known, however, about the extent to which airlines provide information to passengers on infection control and measures to prevent the spread of infectious diseases. This study examined the websites of the global commercial passenger airlines to see if they contained information about infection control and prevention of infectious diseases and appraised the clinical usefulness of that information. METHOD A cross-sectional text-based analysis of the 73 airline websites from the six global commercial passenger airline conglomerates was performed to identify information about infection control and prevention of infectious between July and August 2019. RESULTS Of the 73 airline websites, less than half (n = 35, 28.6%) contained information deemed useful for passengers. While there was a range of general health advice within the websites, there was limited information about infection control and preventing infectious diseases. A minority of websites contained information about vaccination status prior to travel, and to a lesser extent handwashing and hand hygiene, with very few including disease-specific advice or preventive measures. CONCLUSIONS Airline websites are an underutilised source of information for infection control and the prevention of infectious diseases. Providing passengers with information on basic infection control and prevention measures may support the global efforts against the spread of infectious diseases.
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Affiliation(s)
- Ramon Z Shaban
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia.
| | - Cristina F Sotomayor-Castillo
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
| | - Jeremy Malik
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia
| | - Cecilia Li
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Camperdown, NSW, 2050, Australia; The University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, NSW, 2145, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, 2145, Australia
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Barratt R, Gilbert GL, Shaban RZ, Wyer M, Hor SY. Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians. Australas Emerg Care 2019; 23:105-113. [PMID: 31810897 PMCID: PMC7104090 DOI: 10.1016/j.auec.2019.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/22/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 12/27/2022]
Abstract
Background The risk of healthcare-acquired infection increases during outbreaks of novel infectious diseases. Emergency department (ED) clinicians are at high risk of exposure to both these and common communicable diseases. Personal protective equipment (PPE) is recommended to protect clinicians from acquiring, or becoming vectors of, infection, yet compliance is typically sub-optimal. Little is known about factors that influence use of PPE—specifically gloves and masks—during routine care in the ED. Methods This was an ethnographic study, incorporating documentation review, field observations and interviews. The theoretical domains framework (TDF) was used to aid thematic analysis and identify relevant enablers of and barriers to optimal PPE use. Results Thirty-one behavioural themes were identified that influenced participants’ use of masks and gloves. There were significant differences, namely: more reported enablers of glove use vs more barriers to mask use. Reasons included more positive unit culture towards glove use, and lower perception of risk via facial contamination. Conclusion Emerging infectious diseases, spread (among other routes) by respiratory droplets, have caused global outbreaks. Emergency clinicians should ensure that, as with gloves, the use of masks is incorporated into routine cares where appropriate. Further research which examines items of PPE independently is warranted.
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Affiliation(s)
- Ruth Barratt
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia.
| | - Gwendolyn L Gilbert
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Ramon Z Shaban
- University of Sydney, Faculty of Medicine and Health, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia; University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia; University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead Hospital, Cnr Hawkesbury Road and, Darcy Rd, Westmead, NSW 2145, Australia
| | - Mary Wyer
- University of Sydney, Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia
| | - Su-Yin Hor
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Road, Westmead, NSW 2145, Australia; University of Sydney, Sydney Health Ethics, 92/94 Parramatta Rd, Camperdown, NSW, Australia; Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, Australia
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Ng WK, Shaban RZ, van de Mortel T. Hand hygiene beliefs and behaviours about alcohol-based hand rub use: Questionnaire development, piloting and validation. Infect Dis Health 2019; 25:43-49. [PMID: 31727595 DOI: 10.1016/j.idh.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/06/2019] [Revised: 10/03/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Behavioural theories are crucial to the development and success of effective hand hygiene interventions. Research demonstrates that hand hygiene behaviours can also be influenced by religious and cultural beliefs. In this paper we detail the processes undertaken to develop a valid and reliable questionnaire to examine healthcare workers' beliefs and behaviours related to the use of alcoholbased hand rub (ABHR), with particular emphasis on associated religious and cultural factors. METHODS Using the Theory of Planned Behaviour, an existing questionnaire was modified and pilot-tested on 35 staff in the Quality Department. Cronbach's alpha values and mean inter-item correlations of the scale items were the main outcome measures. A Pearson correlation was conducted to assess for social desirability response bias. RESULTS The questionnaire demonstrated high content and face validity and satisfactory internal consistency in most scales, except for the religious beliefs, cultural beliefs and perceived behavioural control scales, where the inter-item correlations were 0.10, 0.13, and 0.14, respectively. There was a significant correlation between scores on the social desirability scale and the attitude scale. Partial correlation should be used to control the effect of social desirability responding when analysing data from the attitudes scale. CONCLUSIONS A validation process allowed the introduction and subsequent modification of religious and cultural belief scales to an existing questionnaire examining behavioural and attitudinal influences on hand hygiene using ABHR. Such processes should be considered for questionnaire development and modification when considering religious and cultural factors as drivers of behaviour.
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Affiliation(s)
- Wai Khuan Ng
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia.
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead, NSW, Australia.
| | - Thea van de Mortel
- School of Nursing and Midwifery, Griffith University, Clinical Sciences 2 Building (G16), Parklands Drive, Southport, Qld, 4215, Australia.
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Mitchell BG, Shaban RZ, MacBeth D, Russo P. Organisation and governance of infection prevention and control in Australian residential aged care facilities: A national survey. Infect Dis Health 2019; 24:187-193. [PMID: 31279705 DOI: 10.1016/j.idh.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 03/31/2019] [Revised: 06/05/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Individuals in residential and aged care facilities (RACFs) are at risk of developing health care-associated infections (HAIs) due to factors such as age-related changes in physiology, immunity, comorbid illness and functional disability. The recent establishment of an Australian Royal Commission into the Quality of Residential and Aged Care Services highlights the challenges of providing care in this sector. This national study identified infection prevention and control (IPC) services, practice and priorities in Australian RACFs. METHODS A cross-sectional study of 158 Australian RACFs comprising a 42-question survey incorporating five key domains relating to IPC namely governance, education, practice, surveillance, competency and capability was undertaken in 2018. RESULTS Of the 131 respondents, the majority 92.4% of respondents reported having a documented IPC program, 22.9% (n = 30) operated with a dedicated infection control committee The majority of RACFs reported lacking specialist and qualified experienced IPC professionals (n = 67). The majority of RACFs (90.1%, n = 118) reported the existence of a designated employee with IPC responsibilities. Of these 118 staff members with IPC responsibilities, 42.5% had a qualification in IPC. The reported average funded hours per month for IPC professional or an external provider of IPC activities was 14 (95% CI 9.6-18.9 h). CONCLUSION The overwhelming majority of RACFs deliver IPC services and report doing so in ways that meet the needs of their own specific contexts in the absence of the lack of formal guidelines when compared to the hospital sector. Quality residential and aged care free from HAIs requires formal structure and organization strategies.
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Affiliation(s)
- Brett G Mitchell
- Discipline of Nursing, Avondale College of Higher Education, Wahroonga, NSW, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown. NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
| | - Deborough MacBeth
- Department of Infection Prevent and Control, Gold Coast Hospital and Health Service, Gold Coast, QLD, Australia
| | - Philp Russo
- Department of Nursing Research, Cabrini Institute, Malvern, Victoria, Australia; Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, NSW, Australia
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Barratt R, Shaban RZ, Gilbert GL. Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice. Infect Dis Health 2019; 24:169-176. [PMID: 30799181 PMCID: PMC7129171 DOI: 10.1016/j.idh.2019.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/06/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 11/18/2022]
Abstract
Outbreaks of emerging and re-emerging infectious diseases are global threats to society. Planning for, and responses to, such events must include healthcare and other measures based on current evidence. An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. Appropriate mask use during routine care is a forerunner to best practice in the event of an outbreak. However, little is known about the influences on decisions and behaviours of HCWs with respect to protective mask use when providing routine care. In this paper we argue that there is a need for more research to provide a better understanding of the decision-making and risk-taking behaviours of HCWs in respect of their use of masks for infectious disease prevention. Our argument is based on the ongoing threat of emerging infectious diseases; a need to strengthen workforce capability, capacity and education; the financial costs of healthcare and outbreaks; and the importance of social responsibility and supportive legislation in planning for global security. Future research should examine HCWs' practices and constructs of risk to provide new information to inform policy and pandemic planning. Emerging and remerging infectious diseases continue to pose a threat to human health and global security. Outbreaks of respiratory infection result in human and economic costs including staff illness and wider societal disruption. Clinicians' use of personal protective equipment is critical to reducing the risk of transmission of infectious disease. Training in the use of PPE should take account of clinicians' and patients' perceptions of risk. Individual and societal responsibility towards infection prevention may influence clinicians' use of protective masks.
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Affiliation(s)
- Ruth Barratt
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia; The Westmead Clinical School, University of Sydney, NSW 2145, Australia.
| | - Ramon Z Shaban
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW 2050, Australia; Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW 2145, Australia.
| | - Gwendoline L Gilbert
- Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW 2145, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW 2050, Australia.
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50
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Ng WK, Shaban RZ, van de Mortel T. The effect of a hand hygiene program featuring tailored religion-relevant interventions on healthcare workers' hand rubbing compliance and beliefs in the United Arab Emirates: A cohort study. Infect Dis Health 2019; 24:115-123. [PMID: 30795983 DOI: 10.1016/j.idh.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/20/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hand hygiene with ABHR is more effective, time-saving and skin-friendly than traditional handwashing. However, alcohol-based hand rub (ABHR) use can be an obstacle for specific religions. The study aimed to test the effect of a modified hand hygiene program featuring religion-relevant, culturally-specific interventions on compliance and beliefs about ABHR use. METHODS A cohort study design was employed between August and November 2017 at a large tertiary hospital in the United Arab Emirates. Hand hygiene audit data and a cross-sectional survey were used to measure the impact of the modified hand hygiene program on compliance with, and beliefs about, ABHR use. RESULTS The intervention group had higher mean compliance with overt (p = 0.002) and covert (p = 0.04) ABHR use post-intervention, and higher mean compliance with overt ABHR use (p = 0.002) than the control group. The intervention group had more positive religious beliefs (p = 0.01) about ABHR use than the control group. CONCLUSION Implementing a hand hygiene program featuring tailored religion-relevant interventions in a culturally appropriate way had a positive effect on compliance with, and beliefs about, ABHR use.
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Affiliation(s)
- Wai Khuan Ng
- Nursing Division, Mafraq Hospital, P.O. Box 2951, Abu Dhabi, United Arab Emirates; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia.
| | - Ramon Z Shaban
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, NSW, Australia; Nursing, Midwifery and Clinical Governance Directorate, Western Sydney Local Health District, Westmead, NSW, Australia.
| | - Thea van de Mortel
- School of Nursing and Midwifery, Griffith University, Clinical Sciences 2 Building (G16), Parklands Drive, Southport, Qld, 4215, Australia; Menzies Health Institute Queensland, Griffith University, Health Sciences Building (N48), 170 Kessels Road, Nathan, Qld, 4111, Australia.
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