ORCID Profile
0000-0003-2128-8907
Current Organisation
University of South Australia
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Publisher: Elsevier BV
Date: 05-2016
Publisher: Wiley
Date: 08-2020
DOI: 10.1002/AJUM.12219
Publisher: Association for Vascular Access
Date: 12-2013
DOI: 10.1016/J.JAVA.2013.08.001
Abstract: Background: Peripherally inserted central catheters (PICCs) are increasingly inserted by trained registered nurses, necessitating the development of specialized skills such as the use of ultrasound. The selection of an adequately sized vein is an important factor in reducing adverse events such as deep vein thrombosis. However, PICC nurses may receive minimal training in the use of ultrasound for vein measurement. Objective: We aimed to demonstrate the reliability of a vein measurement protocol using ultrasound by a PICC nurse trained in sonography. Methods: The diameter of the basilic, brachial, and cephalic veins in the left arms of healthy participants (n =12) were measured using ultrasound by a PICC nurse and a sonographer. A PICC nurse performed the measurement twice and the sonographer once the PICC nurse's results were compared for intra-rater reliability and compared with the sonographer for inter-rater reliability. The results were analyzed using intraclass correlation coefficients (ICCs). Results: Inter-rater reliability between the PICC nurse and the sonographer was adequate, the ICC for the brachial vein was 0.60 (95% confidence interval [CI], 0.06–0.87), basilic vein ICC was 0.87 (95% CI, 0.58–0.96) and cephalic vein ICC was 0.77 (95% CI, 0.39–0.93). Intra-rater reliability of the PICC nurse was higher the ICC for the brachial vein was 0.80 (95% CI, 0.44–0.94), basilic vein ICC was 0.92 (95% CI, 0.67–0.98), and cephalic vein ICC was 0.78 (95% CI, 0.40–0.93). Conclusions: Using a suitable protocol, a PICC nurse was able to measure vein diameter reliably when compared with a sonographer and consistently replicate these results.
Publisher: Oxford University Press (OUP)
Date: 2022
Abstract: Professional competencies are important for enhancing alignment between the needs of education, industry and health consumers, whilst describing public expectations around health professionals. The development of competency standards for the sonography profession defines the behaviours, skills and knowledge sonographers should demonstrate for each learning and experience level. The objective of this project was to develop a set of professional competency standards for the sonography profession which described in depth the behaviours, skills and knowledge sonographers should demonstrate across multiple learning and experience levels. Representatives of three Australian ultrasound professional associations and seven tertiary institutions involved in entry-level sonographer education in Australia formed a research team (RT). The RT recruited an expert panel that responded to six survey rounds. Using a Delphi methodology, the results and free-text comments from each previous round were fed back to participants in the subsequent survey rounds to achieve a consensus. The project developed a professional competency framework for sonographers, which included four major domains: detailed competency standards, sonographer knowledge, sonographer attitudes and a holistic competency matrix [0.6084/m9.figshare.17148035.v2.] The Delphi methodology is an effective way to develop professional competency standards. This paper describes the methods and challenges in developing such standards for sonographers which could be translated to other health professionals.
Publisher: SAGE Publications
Date: 11-09-2020
Abstract: Arteriovenous fistula (AVF) management for haemodialysis (HD) is one of the most challenging aspects of clinical care. A successful cannulation outcome when an AVF or arteriovenous graft (AVG) is used for the first time can be influenced by many factors, including access maturity, staff skill, and patient factors. This study examined AVF/AVG outcomes at initiation of HD across two major metropolitan public hospitals. Electronic medical records were reviewed to collect data retrospectively for a cohort of all newly commencing ESRD HD starts during 2018 to identify cannulation outcomes in the first 6 weeks. Of the 117 patients included, AVG use was low (5%). Twenty-four percent of patients required a surgical intervention to salvage a poorly functioning AVF prior to commencing HD. About 32.5% of the cohort had an uneventful start with all successful cannulations. For the remainder of the cohort the number of treatments with unsuccessful cannulation ranged from 1 to 4 or more. About 36% required a surgical intervention for a poorly functioning AVF after commencing HD. Commencing HD with a CVC is associated with a lower likelihood of subsequent successful cannulation ( p 0.001). Even in experienced centres, a subset of patients experienced complicated cannulation in the first 6 weeks of HD. Several areas of improvement could be considered for these patients timely referral for access creation, post-operative surveillance to ensure AVF maturation inclusive of duplex ultrasonography, gentle induction using small gauge needles and low blood flows, and consideration of a single needle HD initiation pathway.
Publisher: Wiley
Date: 08-04-2023
DOI: 10.1002/JMRS.676
Abstract: Linking in idual competencies to entrustable professional tasks provides a holistic view of Sonography graduate work readiness. The Australian Sonographers Accreditation Registry (ASAR) publishes a set of entrustable professional activities (EPAs) as part of its Standards for Accreditation of Sonography Courses. EPAs are distinct ultrasound examinations grouped within six critical practice units. This study reports on industry perspectives of current EPAs and their classification for graduates completing general sonography courses in Australia. The article also examines the value of EPAs and links their function to the assessment of graduate competency. An online survey tool elicited stakeholder feedback on graduate EPAs across six critical practice units and the potential for including a new Paediatric unit. From an original s le size of 655, 309 responded to questions about general sonography courses. A majority (55.3%) recommended no changes to the existing EPA list, and 44.7% recommended amending the list. From respondents that recommended changes (138/309), all current EPAs received % agreement to be retained in addition, nine new examinations received % agreement for inclusion at the graduate level. Whilst 42.7% (132/309) supported the current ASAR model requiring competency in five out of six critical practice units, 45.6% (141/309) recommended increasing it to all six. There was limited support, 11.7% (36/309), to reduce this number. Responding to the potential to add a new Paediatric specific critical practice unit, 61.8% (181/293) recommended its inclusion. The findings demonstrate that the current list of EPAs aligns with industry expectations. In contrast, there are ergent views on the modelling and grouping of critical practice units. The article's critical analysis of the results and implications provides stakeholders with a practical approach to clinical teaching and EPA assessment, and helps to inform any review of accreditation standards.
Publisher: Wiley
Date: 06-09-2018
DOI: 10.1002/SONO.12161
Publisher: Wiley
Date: 18-08-2021
DOI: 10.1002/SONO.12282
Abstract: Sonographers working for private practices within Australia face a myriad of emotionally challenging situations on a daily basis, potentially reducing their sense of well‐being. With limited literature currently available, this research aimed to report the current emotional well‐being of sonographers working in private practice within Australia. Eighty‐one eligible participants responded to a nation‐wide survey that gathered both quantitative and qualitative data for analysis. Participants working in private practice were feeling the toll of workplace stress with 48.1% ( n = 39) reporting they sometimes felt supported by colleagues or superiors and 45.7% ( n = 37) reporting they sometimes felt their work was appreciated. A further 39.5% ( n = 32) of participants stated they thought about leaving their current role at least a few times per month. Non‐supportive working environments, unrealistic performance expectations and managing patient related factors were reported as the key causes of workplace stress. The key strategies suggested by participants to overcome these emotionally challenging situations included: updating workplace protocols, autonomy for time management, a supportive working environment, support from referring doctors and Medicare and introducing well‐being programmes for sonographers. Australian private practice sonographers are experiencing workplace stress and provided valid suggestions for potential causes of and strategies to overcome workplace stress.
Publisher: Wiley
Date: 18-01-2023
DOI: 10.1002/AJUM.12331
Abstract: Many guidelines have been utilised to diagnose polycystic ovarian syndrome (PCOS). The most recent are the International Evidence Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018 (2018 IEBG). This study aimed to assess the awareness, knowledge, and attitudes of Australasian sonographers' regarding these guidelines. An online cross‐sectional survey was disseminated to sonographers. Qualitative and quantitative questions were asked around awareness, knowledge, and attitudes towards the 2018 IEBG. Statistical and thematic analyses of the results were performed. Ninety responses were included in the final analysis. Fifty‐two percent (52.2%) of participants were aware of the 2018 IEBG but only 31.1% used it in their workplaces. Fifty‐eight percent (57.9%) of participants correctly identified the sonographic features that suggest PCOS, and 3.5% correctly identified all minimum recommended inclusions for reporting a gynaecological ultrasound for PCOS. Prior to being supplied the 2018 IEBG, 15.8% of participants correctly answered clinical scenario‐based knowledge questions, which increased to 29.4% correctly after being supplied the guideline however, this difference was not statistically significant. There were no statistically significant associations between demographics and knowledge of the 2018 IEBG. Several areas of confusion surrounding wording and interpretation of the 2018 IEBG were highlighted. Consideration should be given to barriers of implementation and strategies to overcome these. More education surrounding the sonographic diagnosis of PCOS and the 2018 IEBG is needed. Scanning protocols used amongst sonographers varied, suggesting that inconsistency in sonographic diagnosis may exist. Future reviews of the 2018 IEBG should focus on reducing ambiguity in wording, which may be responsible for some of the varied interpretation of these guidelines.
Publisher: Wiley
Date: 28-05-2021
DOI: 10.1002/SONO.12263
Abstract: COVID‐19 has seen a series of lockdowns and suspension on non‐urgent elective surgeries. Subsequently, there was a drop in the number of diagnostic imaging services billed in April, May, 2020. A survey was undertaken from March to June 2020 to determine the initial impact of COVID‐19 on Australasian Sonographers. This article, the first in a 3‐part series presents and discusses the results of this survey pertaining to changes in the number of scans performed, and changes in the working hours of sonographers. The remaining two articles in this series address other initial COVID‐19 impacts on Australasian Sonographers. An online survey was conducted containing questions regarding changes to work hours and examination numbers. 444 participants answered the survey. Seventy eight percent of sonographers reported a decrease in the number of examinations being performed in their department A decrease in work hours was reported by 68% of sonographers with almost a quarter of these reporting that they had lost all their hours. A higher percentage of work hours changes were seenin private practices. Many reductions in work hours were reported to be voluntary. Scan numbers in ultrasound departments were affected by COVID‐19, as were sonographers' work hours.
Publisher: SAGE Publications
Date: 18-08-2019
Abstract: A functioning long-term vascular access is required for haemodialysis therapy however, establishing this can be challenging in the setting of advanced age and vessels damaged by diabetes. Complications include the inability to insert two needles for the treatment resulting in miscannulation trauma and in some cases insertion of a temporary central venous access device. The broad objective of this review is to define the evidence base regarding cannulation practices in the initiation of haemodialysis via an arteriovenous fistula or an arteriovenous graft. This review uses the framework recommended by the Joanna Briggs Institute and the process by which papers were included or excluded followed the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses group approach. A total of 20 primary research studies met the inclusion criteria. Cannulation in the 10- to 15-week period rather than delaying past this time frame is associated with the best outcomes. New vascular access given time to mature through single-needle haemodialysis treatments may improve long-term patency. Duplex ultrasound mapping prior to initiation of cannulation supports the clinical decision-making process on timing of and selection of cannulation sites. Cannulation trauma at the initiation of haemodialysis could potentially be reduced with a strategy of incremental haemodialysis using single-needle treatment supported with duplex ultrasonography assessment to ‘map’ the vascular access as a guide for clinicians prior to cannulation initiation.
Publisher: Wiley
Date: 27-11-2015
DOI: 10.1002/SONO.12043
Publisher: Wiley
Date: 04-07-2021
DOI: 10.1002/SONO.12264
Abstract: The wellbeing of front‐line healthcare workers can be impacted during a pandemic. This paper reports the initial impact on the wellbeing of COVID‐19 on Australasian sonographers. An online qualitative and quantitative survey was conducted between March and June 2020 to explore the wellbeing of Australasian sonographers in the early stages of the COVID‐19 pandemic. Whilst most sonographers felt supported at work (300/379), those working in public hospitals felt more so than those in private practice. Sonographers in private practice felt more as though their job was at risk and were more likely to consider an alternate source of income. Sonographers felt they were working on the front line and many felt anxious about themselves (74%) or family (78%) contracting COVID‐19 due to their employment. Forty‐one percent of sonographers felt more isolated than normal, with younger age groups (18‐34 years) feeling less like they had enough hobbies or selfcare activities to get them through. Twelve percent of sonographers reported never, or rarely, coping with the juggle of work and home life. The initial impact of the COVID‐19 pandemic on the wellbeing of sonographers is evident. Longitudinal data will enable wellbeing to be tracked over time.
Publisher: SAGE Publications
Date: 07-06-2022
DOI: 10.1177/13674935221095647
Abstract: Developmental hip dysplasia is an abnormality of the hip joint which is associated with an unstable or dislocatable hip. During infancy, hips should be screened to determine whether they are stable, unstable or dislocated. In Australia, this screening is often performed by nurses using physical assessment. Physical examination includes a number of assessments which seek to identify underlying abnormalities in hip joint anatomy and function. This scoping review outlines the physical assessments used by nurses in the screening and surveillance of developmental hip dysplasia. A review of the literature identified 15 ( N = 15 100%) sources of evidence, which included original research articles ( n = 6 40%), expert opinion pieces ( n = 2 13.3%) and practice guidelines ( n = 7 46.7%). There were 18 physical assessments identified as being used by nurses in the screening process for developmental hip dysplasia. However, it is apparent that high quality research is required to examine the timing, specificity and sensitivity of the physical assessments identified.
Publisher: Wiley
Date: 28-11-2020
DOI: 10.1002/SONO.12243
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.APNR.2018.06.013
Abstract: Accessing the peripheral veins for blood s ling and short-term peripheral intravenous catheter insertion is common in contemporary healthcare. Clinicians may apply heat or promote oral hydration to increase vein diameter and reveal veins to improve success rates. However, there is limited research that has examined the effect of these interventions on vein diameter and depth. To determine the effect of localised heat and oral hydration on vein diameter and depth. A three arm parallel randomised controlled trial was undertaken with 39 healthy participants from a University. All participants fasted from food and fluid from midnight. At 10 am the next day, a mark was made at the cephalic (120 mm proximal from the radial styloid) and median cubital veins (at cubital fossa) with non-permanent ink and participants underwent baseline vein diameter and depth measurement using ultrasound. Participants were randomised to either a control, heat or hydration group. Participants in the hydration arm consumed 1 L of room temperature tap water, those in the heat group had a wheat bag applied to the area for 10 min and those in the control group had no intervention and were asked to sit quietly. A second measurement was undertaken immediately after the heat intervention and 1 h after the baseline measurement for those in the hydration and control groups. The application of localised heat and oral hydration did not affect the depth of the cephalic vein. Whilst hydration had no effect on median cubital vein depth, the application of heat did make this vein more superficial compared to the control group (p = 0.033). The application of heat resulted in a statistically significant (p = 0.006) increase in cephalic vein diameter compared to the control group, this effect did not occur with the median cubital vein (p = 0.087). Oral hydration resulted in a reduction in the mean diameter of both veins. Compared to the control group, the average median cubital vein diameter decreased by 0.57 mm (p = 0.003 95% CI -0.940 to -0.193) and the cephalic vein reduced by 0.33 mm (p = 0.015 95% CI -0.593 to -0.064) after oral hydration. The use of localised heat was inconsistent in its effect on vein diameter and depth. Oral hydration caused a reduction in vascular calibre in both the cephalic and median cubital veins. The promotion of water consumption to improve venepuncture success is not supported.
Publisher: Wiley
Date: 14-06-2017
DOI: 10.1002/SONO.12113
Publisher: Wiley
Date: 24-04-2019
DOI: 10.1002/SONO.12179
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2020-045895
Abstract: Determine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in in iduals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group. Retrospective cohort study. 4 tertiary hospitals in Australia and New Zealand. Adults who had undergone PICC insertion. Symptomatic thrombus of the limb in which the PICC was inserted. 2438 PICC insertions were included with 39 cases of thrombosis (1.6% 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30 95% CI 1.202 to 4.383 p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions. Adherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in in iduals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.
Publisher: Wiley
Date: 27-07-2021
DOI: 10.1002/SONO.12279
Abstract: Ultrasound is a safe and inexpensive way to image the adult liver. Recently a valid and reliable equation was developed to determine the size of the adult liver using three simple ultrasound measurements. An upper limit of normal using this equation of 2223 cm 3 has been reported. This study aimed to determine the sensitivity, specificity, and predictive values of this cut off to determine hepatomegaly. A low‐risk and a high‐risk group participant group were recruited, each with 30 participants. Each participant had a liver ultrasound and liver volume calculated from the equation and an MRI where liver volume was calculated. The ultrasound volume equation using a hepatomegaly cut off 2223 cm 3 , was compared to the reference standard of MRI volume using a hepatomegaly cut off of 2185 cm 3 as reported by Kromrey et al. The ultrasound demonstrated a sensitivity of 90.9% (CI 58.7–99.7), a specificity of 97.9% (CI 89.1–99.9), a positive predictive value of 90.9 (CI 58.7–98.6) and a negative predictive value of 97.9% (CI 88.1–99.7). Liver volume calculated by using three linear ultrasound measurements in an equation, and an upper limit of 2223 cm 3 , has high diagnostic accuracy to determine hepatomegaly.
Publisher: BMJ
Date: 06-2023
DOI: 10.1136/BMJOPEN-2022-071203
Abstract: There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19. To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals. Systematic literature review. Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May–October 2022. Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included. Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes. A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used in idually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in in iduals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression. The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.
Publisher: SAGE Publications
Date: 04-09-2014
Abstract: Sonography is an effective, noninvasive, safe, and inexpensive technique for measurement of the liver. Measurements of the liver using 2D ultrasound aid in diagnosing and tracking liver disease and in surgical planning. Multiple studies have developed techniques to measure the adult liver using 2D ultrasound. The aim of this systematic literature review was to determine whether a correctly developed, reliable, and reproducible technique for measuring the liver using 2D ultrasound has been reported. Analysis of studies meeting the inclusion criteria showed that none of these studies has been rigorously undertaken in terms of s le size justification, validity, reliability, and/or statistical analysis.
Publisher: Wiley
Date: 11-05-2020
DOI: 10.1002/SONO.12219
Publisher: Wiley
Date: 21-02-2020
DOI: 10.1002/JUM.15246
Publisher: Sciedu Press
Date: 27-07-2015
DOI: 10.5430/JBGC.V5N2P17
Publisher: Wiley
Date: 05-12-2022
DOI: 10.1002/AJUM.12288
Abstract: This study aimed to determine the additional time needed to perform an endometriosis transvaginal ultrasound (eTVUS) compared to routine transvaginal ultrasound (rTVUS). A retrospective case–control study was performed. The study group included 199 eTVUS performed between September 2019 and September 2020. The control group comprised 105 consecutive rTVUS studies performed in the same time period. The time st s on the ultrasound images of all cases in both groups were reviewed to determine the time taken to perform each study. Mean, median, minimum and maximum scan times for both groups were calculated as was percentage difference between scan times. A two‐tailed, unpaired t‐test of the normalised data and a Mann–Whitney U test assessing time difference of scans between two groups were performed with P value .05 considered statistically significant. Performing eTVUS took significantly longer than rTVUS with increases in the mean (8.4 vs 13.8 min, 64%), median (7 vs 12 min, 71%), minimum (4 vs 7 min, 75%) and maximum (19 vs 42 min, 121%) scan times. The Mann–Whitney U test indicated a statistically significant difference in the median scan times (5.0, CI 4.0–6.0), P 0.001. An independent t‐test of the normalised data revealed a significantly larger mean scan time for eTVUS than rTVUS, Mean = 9.05 95%CI [13.17–4.94], t(302) = 4.327, P 0.001. R 2 = 0.583. Endometriosis transvaginal ultrasound added an average 5.4 min to rTVUS, which is statistically significant. For ultrasound departments wanting to offer this technique, doubling the scan time allocated to perform a transvaginal ultrasound (TVUS) is suggested.
Publisher: Wiley
Date: 08-03-2016
DOI: 10.1002/SONO.12051
Publisher: Wiley
Date: 04-07-2021
DOI: 10.1002/SONO.12275
Abstract: COVID‐19 brought with it the requirement for healthcare workers to limit community transmission of the virus as much as possible by limiting patient contact and wearing Personal Protective Equipment (PPE). This study aimed to capture the initial adaptations to sonographic examination protocols within ultrasound departments and sonographer access to PPE. An online survey was used to gather data on sonographer reflections of sonographic examination protocol changes seen in their departments and access to PPE between the 11th of March 2020 and the 14th of June 2020. To reduce the time sonographers spent with the patients and hence reduce the risk of exposure to COVID‐19, sonographers reported adjustments to sonographic examination protocols including their duration and scheduling. Access to PPE was reported as poor. Numerous sonographic examination protocol changes were observed within ultrasound departments in Australasia in the initial response to COVID‐19. Access to PPE was varied along with sonographer feelings around the impact of these changes.
Publisher: Wiley
Date: 08-2014
Publisher: American Chemical Society (ACS)
Date: 27-09-2017
DOI: 10.1021/ACS.LANGMUIR.7B02692
Abstract: Metal-phenolic networks (MPNs) are a versatile class of self-assembled materials that are able to form functional thin films on various substrates with potential applications in areas including drug delivery and catalysis. Different metal ions (e.g., Fe
Publisher: Wiley
Date: 12-2019
DOI: 10.1002/SONO.12202
Publisher: Wiley
Date: 29-03-2017
DOI: 10.1002/SONO.12104
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2015
Publisher: SAGE Publications
Date: 25-08-2023
DOI: 10.1177/11297298231194100
Abstract: Haemodialysis requires a permanent vascular access and relies on cannulation with two large bore needles. Point Of Care Ultrasound (POCUS) is a tool that may assist nursing staff with visualising cannula placement and prevent miscannulation. This can be particularly useful in regional hospitals with limited access to vascular access specialists. To examine the impact of POCUS provision and education for nursing staff on confidence in cannulation and to understand the patient experience at three regional hospital haemodialysis units in South Australia. A POCUS machine and dedicated nursing education were provided at each of the three sites. A pre-test post-test model was used to assess the in idual nurses perceived competency before and after the delivery of a series of online ultrasound education modules and face to face training. Patient reported outcome measures (PROMs) were collected to understand the use of POCUS from the client perspective. There was a shift towards ‘agree’ or ‘strongly agree’ for all nursing surveys in regard to perceived competency ( n = 15). This was statistically significant ( p ⩽ 0.05) for all questions other than question 1 ‘I am confident in my ability to physically assess vascular access’ ( p = 0.06). The patients that completed the PROMs ( n = 17) overall supported the ease and use of POCUS for haemodialysis cannulation and felt that it contributed to the nursing staff competency in cannulation. POCUS has the potential to be a valuable tool in regional haemodialysis units to support vascular access cannulation and potentially avoid metropolitan transfer due to cannulation difficulties. The non-significant change post intervention for question 1 likely reflects the haemodialysis nurses inherent pre-existing capacity to assess vascular access without the use of POCUS using the standard process of visual inspection, the use of a stethoscope and palpation (‘look, listen and feel’).
Publisher: Wiley
Date: 14-10-2014
DOI: 10.1002/SONO.12008
Publisher: SAGE Publications
Date: 15-08-2018
Abstract: While perceived as safe, diagnostic ultrasound has the potential to cause biological effects on the body tissues. The aim of this study was to evaluate knowledge, attitudes, and practices of Australasian sonographers on bioeffects and safety of ultrasound scanning. Focus groups were used to develop a questionnaire to explore knowledge, attitudes, and practices of ultrasound safety, which was then distributed to Australasian sonographers. Thematic (focus groups) and descriptive (questionnaires) analyses were undertaken. A 37-item questionnaire addressed knowledge, attitudes, and practices of ultrasound safety. In 47 collected responses, sonographers demonstrated good familiarity of thermal index (TI) (79%), mechanical index (MI) (68%), and “as low as reasonably achievable” (ALARA) principle (85%). However, most sonographers could not accurately define TI (13%) and had poor knowledge of safety guidelines relating to TI (19%) and MI (14%). Over 30% were uncertain about their attitudes to ultrasound safety issues. While 52% always and 30% most of the time adhere to ALARA, 37% of sonographers reported never monitoring TI and MI. While familiar with safety terms, knowledge of safety guidelines was lacking. Many sonographers were uncertain about their attitudes to the safety of scans, and safety practices involving monitoring for bioeffects were not a high priority.
Publisher: figshare
Date: 2021
Publisher: Wiley
Date: 25-04-2022
DOI: 10.1002/SONO.12309
Abstract: Sonographers possess a unique and complex body of knowledge and skills, providing real health benefits to the community. The value of competency frameworks rests on their capacity to support and facilitate professional practice in the interests of public safety. The commitment to act in the service of others carries with it a professional and ethical obligation to practice within the boundaries of accepted competency standards. The well‐accepted Australasian Sonographers Association (ASA) competency standards for entry‐level Australian sonographers were introduced a decade ago. At this time, ultrasound technology, its application and the sonographer's role as a critical interface to this technology continue to evolve. The article provides an overview of research used to develop a contemporary competency framework for sonographers. It describes each framework component and how these components have a potential role in sonographer education and clinical practice at different levels of expertise. Sonographer competencies were developed via a national collaborative research project led by a multi‐institutional research team of academic and industry professionals. A Delphi study design elicited consensus on multiple competency characteristics from an expert panel of 55 sonographers. The expert panel contained representatives from all Australian states and territories and represented all domains of practice. The resulting project outcome consisted of a competency framework containing four significant components: sonographer competency standards, sonographer knowledge, sonographer attitudes and a holistic competency matrix.
Publisher: Elsevier BV
Date: 2019
Publisher: Elsevier BV
Date: 06-2023
Publisher: Elsevier BV
Date: 05-2012
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2019-036542
Abstract: Epidemiological studies indicate an inverse association between nut consumption and body mass index (BMI). However, clinical trials evaluating the effects of nut consumption compared with a nut-free diet on adiposity have reported mixed findings with some studies reporting greater weight loss and others reporting no weight change. This paper describes the rationale and detailed protocol for a randomised controlled trial assessing whether the inclusion of almonds or carbohydrate-rich snacks in an otherwise nut-free energy-restricted diet will promote weight loss during 3 months of energy restriction and limit weight regain during 6 months of weight maintenance. One hundred and thirty-four adults aged 25–65 years with a BMI of 27.5–34.9 kg/m 2 will be recruited and randomly allocated to either the almond-enriched diet (AED) (15% energy from almonds) or a nut-free control diet (NFD) (15% energy from carbohydrate-rich snack foods). Study snack foods will be provided. Weight loss will be achieved through a 30% energy restriction over 3 months, and weight maintenance will be encouraged for 6 months by increasing overall energy intake by ~120–180 kcal/day (~500-750kJ/day) as required. Food will be self-selected, based on recommendations from the study dietitian. Body composition, resting energy expenditure, total daily energy expenditure (via doubly labelled water), physical activity, appetite regulation, cardiometabolic health, gut microbiome, liver health, inflammatory factors, eating behaviours, mood and personality, functional mobility and pain, quality of life and sleep patterns will be measured throughout the 9-month trial. The effects of intervention on the outcome measures over time will be analysed using random effects mixed models, with treatment (AED or NFD) and time (baseline, 3 months and 9 months) being the between and within factors, respectively in the analysis. Ethics approval was obtained from the University of South Australia Human Research Ethics Committee (201436). Results from this trial will be disseminated through publication in peer-reviewed journals, national and international presentations. Australian New Zealand Clinical Trials Registry (ACTRN12618001861246).
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.ULTRASMEDBIO.2018.07.011
Abstract: Ultrasound measurements of Achilles tendon size are used to assess the tendon's response to exercise, aging, rehabilitation, tendon loading and healing. It is important to understand and minimise the measurement error that occurs with these measurements. This review identified and synthesised studies reporting on intra- and inter-rater reliability of ultrasound measurements of Achilles tendon size. Analysis of 21 studies revealed that good to excellent intra- and inter-rater reliability can be achieved for ultrasound measurements of Achilles tendon size. Reliability can be optimised by using one experienced operator, standardising transducer pressure and orientation and averaging two or three measurements. There was a high risk of methodological bias across the included studies. Reporting of reliability studies needs to be improved by the use of existing reporting guidelines and expansion of these guidelines to include important elements of ultrasound imaging.
Publisher: Springer Science and Business Media LLC
Date: 25-08-2022
DOI: 10.1007/S11605-022-05438-2
Abstract: A very low-calorie diet (VLCD) or low-calorie diet (LCD) is often used prior to laparoscopic surgery to optimize access to the hiatus. Much debate exists in the literature regarding the required duration for a VLCD or LCD, and how to evaluate the presence of a fatty liver. The aim of our study was to determine the optimal amount of time on an LCD to achieve maximal liver volume reduction, and to assess the accuracy of the InBody 230® vs. bedside ultrasonography vs. magnetic resonance imaging (MRI) in the measurement of liver volume. Seventeen consecutive patients undergoing laparoscopic anti-reflux surgery were recruited into the study. Each patient underwent body composition analysis with the InBody® 230, liver ultrasound, and liver MRI. Patients then began an LCD with a weekly ultrasound assessment until the day before surgery when they underwent repeat body composition analysis, liver ultrasound, and MRI. The mean age was 54 years (range 21, 74). Maximal liver volume loss was noted within 3 weeks for 88% of participants, with 47% achieving their maximal liver volume reduction after the first week of an LCD. The mean reduction in liver volume was 16%, 18.6%, and 19% for MRI, ultrasound, and body composition analysis, respectively. Close to 90% of patients require 3 weeks or less on an LCD to achieve maximal liver volume loss prior to laparoscopic anti-reflux surgery. Body composition analysis and bedside ultrasonography were both as accurate as the gold standard MRI in the assessment of liver volume.
Publisher: Wiley
Date: 27-07-2023
Abstract: This study aimed to assess the accuracy of transvaginal ultrasound (TVUS) for the mapping of endometriosis before surgery when performed by sonographers in an outpatient women's imaging centre. A prospective longitudinal cohort study was performed. The study group comprised of 201 women who underwent a comprehensive TVUS assessment, performed by a sonographer. Laparoscopy was performed as the reference standard. Complete TVUS and surgical data were available for 53 women who were included in the final analysis. Endometriosis was confirmed at a surgery in 50/53 (94.3%) participants, with 25/53 (47.2%) having deep endometriosis (DE) nodules and/or endometriomas present. TVUS for mapping of DE had an overall sensitivity of 84.0%, specificity of 89.3%, PPV of 87.5%, NPV of 86.2%, LR+ of 7.85, LR− of 0.18, and accuracy of 86.8% ( P 0.001). Ovarian immobility had poor sensitivity for detecting localised superficial endometriosis, DE, adhesions, and/or endometriomas (Left = 61.9% and right = 13.3%) but high specificities (left = 87.5% and right = 94.7%). Site‐specific tenderness had low sensitivities and moderate specificities for the same. All soft markers of endometriosis failed to reach statistical significance except for left ovarian immobility ( P = .001). Sonographers well experienced in obstetric and gynaecological imaging, working in an outpatient women's imaging setting can accurately map DE however, the performance of soft markers for detection of SE was poor.
No related grants have been discovered for Jessie Childs.