ORCID Profile
0000-0001-9930-8643
Current Organisations
Flinders University
,
Monash University
,
Northern Health
,
Royal Australasian College of Physicians
,
University of Melbourne
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Publisher: Informa UK Limited
Date: 19-07-2019
Publisher: Informa UK Limited
Date: 30-05-2020
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/IMJ.15434
Abstract: In the Australian state of Victoria, specialist doctors are central to the operation of voluntary assisted dying (VAD). However, a broad range of clinicians may be involved in the care of patients requesting or using VAD. To describe levels of support for and willingness to be involved in VAD and consider factors associated with clinician support for the VAD legislation and physicians' willingness to provide VAD in practice. A multisite, cross‐sectional survey of clinicians in seven Victorian hospitals. All clinicians were invited to complete an online survey measuring demographic characteristics, awareness of and support for the VAD legislation, willingness to participate in VAD related activities and reasons for willingness or unwillingness to participate in VAD. Of 5690 who opened the survey, 5159 (90.1%) were included in the final s le and 73% ( n = 3768) supported the VAD legislation. The strongest predictor of support for the VAD legislation was clinical role. Forty percent ( n = 238) of medical specialists indicated they would be willing to participate in either the VAD consulting or coordinating role. Doctors did not differ in willingness between high impact (44%) and low impact specialty (41%) however, doctors specialising in palliative care or geriatric medicine were significantly less willing to participate (27%). Approximately 73% of surveyed staff supported Victoria's VAD legislation. However, only a minority of medical specialists reported willingness to participate in VAD, suggesting potential access issues for patients requesting VAD in accordance with the legal requirements in Victoria.
Publisher: Wiley
Date: 27-08-2023
DOI: 10.1111/IMJ.15638
Abstract: There is increasing recognition that a proportion of hospitalised patients receive non‐beneficial resuscitation, with the potential to cause harm. To describe the prevalence of non‐beneficial resuscitation attempts in hospitalised patients and identify interventions that could be used to reduce these events. A retrospective analysis was conducted of all adult inhospital cardiac arrests (IHCA) receiving cardiopulmonary resuscitation (CPR) in a teaching hospital over 9 years. Demographics and arrest characteristics were obtained from a prospectively collected database. Non‐beneficial CPR was defined as CPR being administered to patients who had a current not‐for‐resuscitation (NFR) order in place or who had a NFR order enacted on a previous hospital admission. Further antecedent factors and resuscitation characteristics were collected for these patients. There were 257 IHCA, of which 115 (44.7%) occurred on general wards, with 19.8% of all patients surviving to discharge home. There were 39 (15.2%) instances of non‐beneficial CPR, of which 28 (72%) of 39 occurred in unmonitored patients on the ward comprising nearly one‐quarter (28/115) of all arrests in this patient group. A specialist had reviewed 30 (76.9%) of 39 of these patients, and 33.3% (13/39) had a medical emergency team (MET) review prior to their arrest. Over one in seven resuscitation attempts were non‐beneficial. MET reviews and specialist ward rounds provide opportunities to improve the documentation and visibility of NFR status.
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/IMJ.15628
Abstract: The COVID‐19 pandemic has significantly impacted those in residential aged care facilities (RACF). This research was undertaken to explore and better understand the effects of the pandemic on the experience of next‐of‐kin and carers who encountered the death of a loved one who resided within a RACF during the pandemic. To explore end‐of‐life experiences for residents who die in RACF and their next‐of‐kin/carers during the COVID‐19 pandemic, to identify areas of concern and areas for improvement. Prospective single‐centre mixed methods research was undertaken involving telephone interview with next‐of‐kin or carers of residents who died within 30 days of being referred to Austin Health Residential InReach Service during the ‘second wave’ of COVID‐19 in Melbourne, Australia, in 2020. Qualitative and quantitative data were collected. Qualitative description and aspects of grounded theory were used for analysing qualitative data. Thematic analysis of the interview transcripts used open and axial coding to identify initial themes and then to group these under major themes. Forty‐one telephone interviews were analysed. Major themes identified included: COVID‐19 pandemic, communication and technology, death and dying experience, bereavement and grief, and social supports and external systems. Findings identify the many COVID‐19 pandemic‐related challenges faced by participants and their dying loved one in RACF. Access to palliative care and bereavement support is crucial for dying residents and for grieving that has been made more difficult by the pandemic.
Publisher: Wiley
Date: 05-2022
DOI: 10.1111/IMJ.15374
Abstract: Advance care planning (ACP) is a process by which people communicate their healthcare preferences and values, planning for a time when they are unable to voice them. Within residential aged care facilities (RACF), both the completion and the clarity of ACP documents are varied and, internationally, medical treatment orders have been used to address these issues. In this study, goals of patient care (GOPC) medical treatment orders were introduced alongside usual ACP in three RACF to improve healthcare decision‐making for residents. This study explored the experiences of RACF healthcare providers with ACP and GOPC medical treatment orders. The study used an explanatory descriptive approach. Within three RACF where the GOPC medical treatment orders had been introduced, focus groups and interviews with healthcare providers were performed. The transcribed interviews were analysed thematically. Healthcare providers not only reported support for ACP and GOPC but also discussed many problematic issues. Analysis of the data identified four main themes: enablers, barriers, resident autonomy and advance documentation (ACP and GOPC). Healthcare providers identified ACP and GOPC as positive tools for assisting with medical decision‐making for residents. Although barriers exist in completion and activation of plans, healthcare providers described them as progressing resident‐centred care. Willingness to follow ACP instructions was reported to be reduced by lack of trust by clinicians. Families were also reported to change their views from those documented in family‐completed ACP, attributed to poor understanding of their purpose. Participants reported that GOPC led to clearer documentation of residents' medical treatment plans rather than relying on ACP documents alone.
No related grants have been discovered for Barbara Hayes.