Nurses' Pain Management Decisions In The Post Surgery Context: A Naturalistic Study
Funder
National Health and Medical Research Council
Funding Amount
$56,368.00
Summary
In the hospital environment, doctors often prescribe medications for pain using an as required format on the drug order chart. Very often, this form of prescription occurs in the surgical wards of a hospital, where a patient may need a lot of pain relieving medication in the early period following the operation, and very little medication a few days following the operation. In the as required form of prescribing, the nurse caring for the patient has enormous flexibility in determining when and h ....In the hospital environment, doctors often prescribe medications for pain using an as required format on the drug order chart. Very often, this form of prescription occurs in the surgical wards of a hospital, where a patient may need a lot of pain relieving medication in the early period following the operation, and very little medication a few days following the operation. In the as required form of prescribing, the nurse caring for the patient has enormous flexibility in determining when and how much medication should be administered. Previous work has consistently shown that nurses do not administer adequate medication, which often results in poor pain control. Several nurse-related reasons have been proposed for poor pain management, including the fear of addiction, the fear of producing difficulties in breathing, and inadequate education about the medications administered. The focus of previous work has relied on examining small areas in isolation. Primarily, researchers have examined information on the drug order charts following patient discharge from hospital. They have also relied on analysing nurses' views on pain management relating to hypothetical patient situations. Overall, the research fails to address the multiple and interconnected factors faced by the nurse which could impact on pain management. Sources of these factors may be the patient, nurse, medication or environment. Examples of these factors include the presence or absence of the doctor, nurses' communication with doctors and other nurses about patient care, layout of the hospital ward, ward management structure, and methods used by the nurse to assess patient pain. By identifying the complex factors that impinge on decisions for managing pain, this study will provide opportunities to address the barriers that prevent adequate pain management. Nurses will then be in a position to change their practice in order to improve the management of patients' pain.Read moreRead less
Pain is a prevalent condition and a major cause of disease burden. The research program will address important questions in the clinical management of pain to reduce its the enormous burden. The program will: 1) investigate whether opioid medicines and oral steroids are effective in treating acute low back pain and neck pain, and sciatica, and 2) assess and improve the appropriate use of strong pain medicines in primary care.
Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
Modernizing The Knowledge Base For Reproductive Health Care: Individual Patient Data Meta-analysis As The New Standard For Evidence Synthesis In Reproductive Health.
Funder
National Health and Medical Research Council
Funding Amount
$575,662.00
Summary
Characteristics of sick persons differ, and criteria that have been used to include them in studies may not match the individual profile of individuals who typically present to the health system. I propose a step towards more personalised medicine, which is new in the field of reproductive health. In a global collaboration, we plan to collect individual participant data of studies, and develop clinical rules and guidelines that tailor the individual profile of the sick individual.
Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses ....Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses in Australian hospitals. This project aims to address this need by providing nurses with wireless handheld access to such resources. This project is extremely significant, as the outcomes will provide nurses, in Australia and overseas, a set of guidelines for managing wireless handheld computers in clinical units, to enhance patient safety and quality of care.Read moreRead less
Optimising Primary Care Management Of Knee Osteoarthritis: The PARTNER Project.
Funder
National Health and Medical Research Council
Funding Amount
$1,155,444.00
Summary
Our overall aim is to implement a cost-effective, sustainable, evidence-based model of co-ordinated primary care targeting both the general practitioner and the patient that improves management and outcomes for overweight/obese people with knee osteoarthritis (OA) and reduces health care costs.
Improving Evidence Based Care For Locally Advanced Prostate Cancer
Funder
National Health and Medical Research Council
Funding Amount
$533,442.00
Summary
There is an urgent need to improve care for men with advanced prostate cancer if we wish to improve their survival. Compelling new evidence suggests we need to alter current practice by offering radiotherapy to high risk men – but will clinicians change their practice? We will develop and test ways to change practice within a network of 9 hopsitals. The study will provide crucial evidence about how to embed the recommended care into practice to improve outcomes for men with prostate cancer.
Improving Oesophageal Adenocarcinoma Outcomes Through Understanding Genomics And Treatment Toxicity.
Funder
National Health and Medical Research Council
Funding Amount
$1,013,282.00
Summary
Oesophageal adenocarcinoma is an aggressive cancer, as most patients will not survive for more than 5 years. Therefore we need to find better ways to treat patients. In this study we will identify the DNA mutations in oesophageal cancers that were part of clinical trial. The data allow us to determine why some tumours responded well to therapy, and why some patients had serious side effects to the treatment. The results will help inform on selection of therapy for future patients.