ORCID Profile
0000-0002-9246-3533
Current Organisation
University of South Australia
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Publisher: Elsevier BV
Date: 04-2019
Publisher: Rosemary Bryant AO Research Centre
Date: 2019
DOI: 10.25954/1J5Q-ZB08
Publisher: Informa UK Limited
Date: 08-2013
DOI: 10.2147/PROM.S42474
Publisher: Wiley
Date: 03-02-2023
DOI: 10.1111/JOCN.16632
Abstract: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse‐led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife‐led trials will be reported elsewhere. To quantify number, type and quality of nurse‐led randomised controlled trials registered between 2000–2021. A scoping review of RCTs. Medline, Emcare and Scopus were searched from 2000 to August 2021. ANZCTR, NHMRC, MRFF and HRC (NZ) registries were searched from inception to July 2021. This review was informed by the JBI scoping review framework using the PRISMA‐ScR. Our search yielded 188 nurse‐led publications and 279 registered randomised controlled trials. Multiple trials had the same nurse leaders. There were more registrations than publications. Publications were predominantly of high methodological quality however, there was a reliance on active controls and blinding was low. Trial registrations indicate that universities and hospital/healthcare organisations were the major sources of funding, while publications indicate that Governments and the National Health and Medical Research Council were the main funding bodies. A small number of high‐quality, large‐scale, nationally funded randomised controlled trials were identified, with a larger number of locally funded small trials. There was a disparity between the number of registered trials and those published. Additional infrastructure, funding and career frameworks are needed to enable nurses to design, conduct and publish clinical trials that inform the health system and improve health outcomes. Research initiated and led by nurses has the potential to improve the health and well‐being of in iduals and communities, and current nurse‐led research is of high methodological quality however, there were very few nurse‐led RCTs, conducted by a small pool of nurse researchers. This gap highlights the need for support in the design, conduct and publishing of nurse‐led RCTs. This is a scoping review therefore, patient or public contribution is not applicable.
Publisher: Wiley
Date: 19-02-2016
DOI: 10.1002/PRI.1659
Abstract: Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university. Pre-survey ost-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently. There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP. An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing confidence in the terminology used in research methods and EBP. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: Australian Nursing and Midwifery Federation
Date: 30-11-2021
Publisher: Wiley
Date: 31-05-2022
DOI: 10.1111/AJAG.13093
Abstract: Clinical pathways are used to improve the quality of care, reduce variation and maximise health or treatment outcomes in selected populations. The aim of this study was to develop a draft clinical pathway based on the best practice evidence for use in the management of behavioural and psychological symptoms of dementia (BPSD) in residential aged care facilities (RACFs). The pathway was developed using the best practice evidence from clinical practice guidelines, operational guides and a systematic literature review. A multidisciplinary team of health professionals and researchers worked in an iterative process to contextualise the proposed pathway to local needs and context, and improve its clarity and user‐friendliness. The pathway was then re‐assessed for accuracy and adherence to the evidence. The draft pathway outlines processes for BPSD prevention, watchful waiting for mild‐to‐moderate BPSD, and specific interventions for severe BPSD. Ongoing risk assessment is required throughout, and non‐pharmacological options are first‐line interventions. Person‐centred care was found to be an important care component across all three phases. An instruction guide with colour‐coded flow charts was developed to assist staff with determining the best care and treatment for each person living with dementia. Feasibility testing is underway. A draft clinical pathway based on clinical practice guidelines was developed to enhance the translation of evidence into practice for the management of BPSD, by nursing and clinical leaders in RACFs.
Publisher: Springer Science and Business Media LLC
Date: 20-08-2013
Abstract: Functional decline (FD) is a largely preventable feature of aging, characterized as gradual erosion of functional autonomy. This reduces an older person’s capacity for safe, independent community living. The healthcare needs of an unprecedented aging population places pressure on health systems to develop innovative approaches to ensuring older people live healthy and independent lives for as long as possible. TRIIFL aims to demonstrate that: Incipient FD in older people can be identified using a simple telephone-screening process within four weeks of discharge from an emergency department presentation for a minor health event and Early engagement into a person-centered in idualized intervention arrests or reduces the rate of FD over the next 12 months. A randomized controlled trial (RCT) nested within a 13-month longitudinal cohort study. The RCT (conducted over 12 months) tests the effectiveness of a novel, early, home-based, personalized program (compared with no intervention) in arresting or slowing FD. TRIIFL focuses on older adults living independently in the community, who have not yet had a serious health event, yet are potentially on the cusp of FD. Participants in the longitudinal cohort study will be recruited as they present to one large tertiary hospital Emergency Department, providing they are not subsequently admitted to a ward. S le size calculations indicate that 570 participants need to be recruited into the longitudinal study, with 100 participants randomized into the trial arms. Measures from all subjects will be taken face-to-face at baseline (recruitment), then subsequently by telephone at one, four, seven and thirteen months later. Measures include functional abilities, quality of life, recent falls, mobility dependence, community supports and health service usage. Specific to the nested RCT, the quality of life tool (SF12) applied at one month, will identify in iduals with low mental component quality of life scores, who will be invited to enter the RCT. Assessors will be blinded to RCT arm allocation, and subjects in the RCT will be blinded to the intervention being received by other subjects. Australian & New Zealand Clinical Trials Registry: ACTRN12613000234718
Publisher: MDPI AG
Date: 12-11-2019
DOI: 10.3390/HEALTHCARE7040142
Abstract: Background: Nurses and midwives are central to the implementation and delivery of quality care through evidence-based practice (EBP). However, implementation of EBP in nursing and midwifery is under-researched with few ex les of systematic and sustained change. The Registered Nurses Association of Ontario’s Best-Practice Spotlight Organization (BPSO) Program was adopted in South Australia as a framework to systematically implement EBP in two erse and complex healthcare settings. Methods: The study was a post-implementation, mixed-method evaluation conducted at two healthcare settings in Adelaide, South Australia utilizing qualitative and quantitative data. Proctor’s implementation evaluation framework guided the evaluation design. Information sources included interviews, focus groups, questionnaires, and document review. Results: Clinical and executive staff (n = 109 participants) from a broad range of stakeholder groups participated in the interviews, focus groups, and returned questionnaires. A number of facilitators directly affecting program implementation were identified these pertained to embedding continuity into the program’s implementation and delivery, a robust governance structure, and executive sponsorship. Barriers to implementation were also identified. These barriers pertained to organizational or workforce challenges staff turnover and movement (e.g., secondment), insufficient staff to allow people to attend training, and a lack of organizational commitment to the program, especially at an executive level. As a result of successful implementation, it was observed that over three years, the BPSO program positively influenced the uptake and implementation of EBP by clinicians and the organizations into which they were introduced. Conclusions: The BPSO model can be translocated to new healthcare systems and has the potential to act as a mechanism for establishing and sustaining EBP change. This study was the first to apply an implementation evaluation framework to the BPSO program, which allowed for structured analysis of facilitating or impeding factors that affected implementation success. The findings have important implications for other health systems looking to translocate the same or similar EBP programs, as well as contributing to the growing body of implementation evaluation literature.
Publisher: Rosemary Bryant AO Research Centre
Date: 2017
DOI: 10.25954/4PW5-JQ86
Publisher: Wiley
Date: 10-10-2015
DOI: 10.1111/GGI.12379
Abstract: Functional decline is an insidious-onset manifestation of aging, which can be overlooked in its early stages. Current screening measures for incipient functional decline are generally applied at one point-in-time, in hospital wards or emergency departments when older people are in health crisis. This potentially provides an imprecise estimate of the situation. In line with internationally recognized challenges of dealing with the needs of aging populations, it is essential that sensitive screening for incipient functional decline occurs much earlier, in familiar community settings. The present review presents an evidence-based synthesis of features, measures and/or manifestations of early functional decline in community-dwelling older in iduals. A systematic search was carried out to collate indicators of early functional decline. These were then organized into constructs, which reflected the principal measurement intent as identified by the author of each article. A total of 146 articles (reporting 195 psychometrically sound measurement tools, representing 107 constructs) were included in the review. The constructs were then clustered into six broad health domains: medical status, performance capacity, participation, demographics, anthropometry and relationships with health providers. These domains were developed after consultation with a range of allied health professionals and a consumer representative. The present review provides the first known evidence-based synthesis of indicators of early functional decline in older community-dwelling people, and shows the range of constructs that need to be considered in assessment for early functional decline.
Publisher: Informa UK Limited
Date: 09-2013
DOI: 10.2147/IJGM.S50243
Publisher: Rosemary Bryant AO Research Centre
Date: 2021
DOI: 10.25954/ZVGD-3984
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 11-2020
Publisher: Wiley
Date: 24-11-2022
DOI: 10.1111/JAN.15094
Abstract: To develop evidence‐based recommendations for provision of culturally safe, high‐quality services for breast cancer screening for transgender people. The scoping review will follow the JBI methodological guidance for scoping reviews. A search using MEDLINE (PubMed), Embase (Ovid), Scopus, the Cochrane Library, including the Cochrane Methodology Register, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and the World Health Organization, Australia Government Department of Health and Google Scholar will be undertaken. The review will include people of any age and ethnicity defined in the source of evidence as transgender. The review will include in iduals who have used gender‐affirming interventions or not and sources of evidence that report information relevant to the provision of culturally safe, high‐quality breast cancer screening services for transgender people. English language sources of evidence published from database inception with information from any country will be eligible for inclusion. Sources will be screened for inclusion by three independent reviewers. Results will be extracted using a purpose‐built tool and presented in relation to the review questions and objective in the final report using tables, figures and corresponding narrative. Project funding was approved by the Australian Government Department of Health in June 2020. There are a range of factors that impact on the equity of health access and outcomes for people who are not cisgender. Transgender people are at risk of breast cancer but there is relatively little evidence about how their risks may or may not differ substantially from cis‐gendered in iduals and little guidance for health providers to ensure inclusive, culturally safe, high‐quality breast cancer screening services for both transgender males, transgender females and gender erse people who may not identify as male or as female. It is important to provide culturally safe, high‐quality services for breast cancer screening for transgender people.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15011
Abstract: Objective The aim of the present study was to identify opportunities to improve the reach and impact of the Australian Medicare 75+ Health Assessment (75+HA) to detect early functional decline (FD). Methods A comparison of two published review articles produced two outputs: (1) assessments identified in the systematic review that underpinned the 75+HA items were ranked for evidence of effectiveness and compared with the volume of research into assessment areas identified by a recent review on indicators of early FD and (2) items in the 75+HA were compared with those in the recent review. Results The review underpinning the 75+HA found 19 assessment areas, with strongest evidence of effectiveness for vision/hearing, teeth/oral, balance/gait, cognitive and service use. The more recent review reported on six domains (eight subdomains) of FD assessment: physical and cognitive elements of the performance capacity domain were the least well assessed, whereas the most comprehensively assessed domains were health service use, performance capacity (mental subdomain), participation (motivation/volition subdomain) and demographics. The 75+HA addresses only some items related to early FD as identified by the recent literature. Conclusion Reassessment of the 75+HA with a view to including current evidence-based assessments for early FD is recommended. Updating the 75+HA items with ways to detect FD earlier may increase its relevance to Australia’s ageing population. What is known about the topic? There are consistent predictions of increasing lifespan of Australians, increasing numbers of older Australians wanting to live independently in the community and the increasing burden on already scarce hospital resources associated with managing the ramifications of declining function in older Australians. The 75+HA is now 15 years old and has not been updated. The imperative is to identify and address early FD in primary care before it becomes a problem. What does this paper add? This paper highlights how the 75+HA can be updated to support a comprehensive and multifactorial assessment of early FD, making it more relevant to the current climate of aging Australians and their desire to age in place. Adding the elements suggested in this paper to the 75+HA may assist in increasing the relevance of the assessment and in the earlier detection of FD. What are the implications for practitioners? A regular comprehensive assessment of key antecedents and features of early FD from multiple stakeholder perspectives will provide a stronger and more evidence-based framework within which to support older Australians to age in place.
Publisher: Rosemary Bryant AO Research Centre
Date: 2019
DOI: 10.25954/YKED-PR88
Publisher: Wiley
Date: 26-05-2017
DOI: 10.1111/IWJ.12772
Publisher: Informa UK Limited
Date: 04-2015
DOI: 10.2147/CIA.S74613
Publisher: Wiley
Date: 02-08-2021
DOI: 10.1111/AJAG.12990
Abstract: We aimed to identify a clinical pathway, or practice guidelines to inform a clinical pathway, for the management of behavioural and psychological symptoms of dementia (BPSD) in residential aged care facilities (RACFs). Fifteen evidence sources were searched, and publications were appraised for methodological quality. Seven publications met the inclusion criteria, but no clinical pathways were found. These publications emphasised prevention via respectful, person‐centred care non‐pharmacological interventions prioritised and potential dangers of antipsychotic use. Pharmacological management was only recommended: when there is a high risk of harm as a short‐term option, to be regularly monitored and discontinued as soon as possible and used in conjunction with investigation into the causes of BPSD and the introduction of non‐pharmacological therapies. This rapid review provided high‐quality, current guidelines and recommendations on the prevention and management of BPSD that can inform the development of an evidence‐based clinical pathway for use in Australian RACFs.
Publisher: Wiley
Date: 24-02-2016
DOI: 10.1002/PRI.1666
Abstract: Assisting physiotherapists to implement research evidence into clinical practice is essential to ensure the quality of practice and encourage lifelong learning and professional progression. However, many physiotherapists report barriers to implementing research, and there is little evidence regarding the sustainability of intended evidence-based practice (EBP) behaviours following EBP education programmes. This paper reports on intended and actual long-term EBP behaviours of physiotherapy students who completed an intensive EBP training programme embedded within a post-graduate coursework programme. An intensive 3-week course in quantitative health research methods and EBP was delivered annually from 2007 to 2014 as part of the programme to national and international students. Following the course, students were asked about their intention of using evidence to inform their future clinical practice. An online survey was used to evaluate EBP behaviours of graduates. Of a possible total of 202 students, contact details for 193 students were sourced, and 65 students responded to the survey (34% response rate). At course completion, 174 students (86%) indicated that they intended to use research to guide their clinical decisions at least once a week. At follow-up, most graduates reported frequently using research to inform their clinical practice indicated by a mean score of 6.5 (±1.9) from a possible range of 0 (not at all) to 10 (all the time). On average, students reported spending 2.2 (±2.2) hours accessing and reading research evidence per week. The most common barriers to implementing evidence were lack of time, limited access to evidence sources and a perceived lack of generalizability of research findings to specific patient groups. Graduates of an intensive EBP training programme embedded within an existing post-graduate physiotherapy programme regularly implemented EBP in clinical practice. Barriers to evidence implementation were time, access to research and perceived lack of generalizability of research findings. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH12034
Abstract: Objective. To estimate the risk of functional decline after discharge for older people presenting to, and discharged from, a large emergency department (ED) of a tertiary hospital. Methods. The cohort was generated by consecutive s ling of non-Indigenous males and females aged 65 years or over or Aboriginal and Torres Strait Islander males and females aged 45 years or more, without diagnosed dementia, who were living independently in the community before presenting at ED and who were not admitted to hospital as an inpatient after presenting to ED. The hospital assessment risk profile (HARP) was administered to all eligible participants. Sociodemographic information was collected. Results. Approximately 40 patients per day over two 14-week data collection periods were potentially eligible for inclusion in the study. In total, 597 (17.6% of in iduals who presented to ED) were eligible, agreed to participate and continued to be eligible on discharge from ED. Their HARP scores suggested that ~52% were at-risk of functional decline (14.1% high risk, 38.5% intermediate risk). Conclusions. Elderly patients present to and are discharged from ED every day. The routinely administered HARP instrument scores suggested that approximately half these in iduals were at-risk of functional decline in one large hospital ED. Given this instrument’s moderate diagnostic accuracy, the true figure may be higher. We suggest that all over-65 year olds presenting at ED without being admitted as an inpatient should be considered for routine screening for potential downstream functional decline, and for intervention if indicated. What is known about the topic? Older in iduals often present to ED in lieu of consulting a general medical practitioner, and are not admitted to a hospital bed. Patient demographics, functional and mental capacity and reasons for presentation may be flags for functional decline in the coming months. These could be used by ED staff to implement targeted assessment and intervention. What does this paper add? This paper highlights the high percentage of older in iduals who, at time of ED presentation, are at-risk of downstream functional decline. What are the implications for practitioners? Older people who are discharged from ED without a hospital admission may ‘slip through the net’, as an ED presentation presents a limited window of opportunity for ED staff to undertake targeted assessment, and intervention, to address the potential for downstream functional decline. The busy nature of ED, resource implications and the range of presenting conditions of older people may preclude this. This research suggests a reality that a large percentage of older people who present at ED but do not require a subsequent hospital admission have the potential for functional decline after discharge. Addressing this, in terms of specific screening processes and interventions, requires a rethink of hospital and community resources, and relationships.
Publisher: Rosemary Bryant AO Research Centre
Date: 2020
DOI: 10.25954/NK9G-1A75
Publisher: Rosemary Bryant AO Research Centre
Date: 2020
DOI: 10.25954/KEXW-A589
Publisher: Springer Science and Business Media LLC
Date: 12-07-2017
Publisher: Informa UK Limited
Date: 04-2013
DOI: 10.2147/CIA.S42528
Publisher: Informa UK Limited
Date: 2014
DOI: 10.2147/CIA.S56086
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.MIDW.2019.102589
Abstract: Shared decision making in pregnancy, labour, and birth is vital to woman-centred care and despite strong evidence for the effectiveness of shared decision making in pregnancy care, practical uptake has been slow. This scoping review aimed to identify and describe effective and appropriate shared decision aids designed to be provided to women in the antenatal period to assist them in making informed decisions for both pregnancy and birth. Two questions guided the enquiry: (i) what shared decision aids for pregnancy and perinatal care are of appropriate quality and feasibility for application in Australia? (ii) which of these decision aids have been shown to be effective and appropriate for Aboriginal and Torres Strait Islander peoples, culturally erse women, or those with low literacy? The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) was used to conduct the review. Five key databases and selected grey literature sources were examined. English language evidence from Australia, Europe, Canada, United Kingdom, New Zealand, and United States of America produced from 2009 was eligible for inclusion, checked against apriori inclusion criteria, and assessed for quality and usability using the International Patient Decision Aid Standards. From a total of 5,209 search results, 35 sources of evidence reporting on 27 decision aids were included following title/abstract and full-text review. Most of the decision aids concerned decisions around birth (52%, n = 14) or antenatal screening 37% (n = 10). The quality of the decision aids was moderate to high, with most communicating risks, benefits, and choice pathways via a mix of Likert-style scales, quizzes, and pictures or graphs. Use of decision aids resulted in significant reductions in decisional conflict and increased knowledge. The format of decision aids appeared to have no effect on these outcomes, indicating that paper-based are as effective as video- or audio-based decision aids. Eleven decision aids were suitable for low literacy or low health literacy women, and six were either developed for culturally erse groups or have been translated into other languages. No decision aids found were specific to Aboriginal and Torres Strait Islander peoples. The 27 decision aids are readily adoptable into westernised healthcare settings and can be used by midwives or multidisciplinary teams in conjunction with women. Decision aids are designed to support women, and families to arrive at informed choices and supplement the decision-making process rather than to replace consumer-healthcare professional interaction. If given before an appointment, high quality decision aids can increase a woman's familiarity with medical terminology, options for care, and an insight into personal values, thereby decreasing decisional conflict and increasing knowledge.
Publisher: Informa UK Limited
Date: 13-01-2023
Publisher: Rosemary Bryant AO Research Centre
Date: 2020
DOI: 10.25954/J6B9-SG84
Publisher: Mark Allen Group
Date: 02-11-2018
DOI: 10.12968/JOWC.2018.27.11.707
Abstract: To provide a synthesis of the best available, recent primary or secondary research evidence on early preventative activities taken to increase skin health, and reduce the incidence of facility-acquired skin tears and pressure ulcers (PUs) in community, residential and health-care institutions. An integrative review focusing on a 10-year period, 2007-2017. A literature search of health databases was carried out, as well as a search of grey literature in relevant skin, wound care and nursing association journals. A second search was also conducted focused on literature from policy and guideline development organisations. Primary outcomes of interest were reduction in dry skin (xerosis), friable skin, or increases in healthy skin maintenance activities. Secondary outcomes of interest were reductions in PU or skin tear occurrences. Opinion, non-systematic literature reviews and discussion papers were excluded. Of the 4932 references obtained from the searches, a total of 33 articles were included in the review: 27 peer-reviewed journal articles and six articles from the grey literature search. No guideline was found that focused on maintaining skin health as a person ages. Studies identified the main factors for maintaining skin health as nutrition, hydration and skin care regimen. Skin care regimens, including a focus on good nutrition and pH balance, should start immediately on arrival in institutions such as hospitals or residential aged care, and continue throughout the stay.
Publisher: Rosemary Bryant AO Research Centre
Date: 2019
DOI: 10.25954/SPY3-D417
No related grants have been discovered for Kate Kennedy.