ORCID Profile
0000-0002-7670-0703
Current Organisations
University of Queensland
,
Children's Health Queensland Hospital and Health Service
,
Monash University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 29-05-2019
DOI: 10.1111/JPC.14505
Abstract: Tonsillectomy procedures are a core element of paediatrics however, perioperative management differs. This study aimed to describe tonsillectomy management, including the burden of pain, nausea and delayed recovery. A prospective cohort study was undertaken through an audit of tonsillectomy perioperative practice and recovery and survey interviews with family members 7-14 days post-surgery. The study was undertaken at an Australian tertiary referral paediatric hospital between June and September 2016. The audit included 255 children undergoing tonsillectomy, with 127 family members interviewed. Most participants underwent adenotonsillectomy (n = 216 85%), with a primary diagnosis of obstructive sleep apnoea (n = 205 80%) and a mean age of 7 years (standard deviation 3.9). A variety of intra-operative pain relief and antiemetics was administered. Pain was present in 29% (n = 26) of participants at ward return, increasing to 32-45% at 4-20 h and decreasing to 21% (n = 15) at discharge. A third of the children (32% n = 41) had moderate to severe pain at post-discharge interview, and 30% (n = 38) experienced nausea at home. Most parents (82% n = 104) were still giving regular paracetamol at 7 days post-operatively, and 31% (n = 39) had finished their oxycodone. Of the participants, 14% (n = 26) presented to the emergency department within 7 days of discharge 8% (n = 20) of the total cohort were re-admitted. There was variety in perioperative and post-discharge care. Pain scores were infrequently documented post-tonsillectomy, and parents are generally dissatisfied with the management of post-operative pain and nausea. Further research is needed to provide a more consistent approach to perioperative management to promote recovery.
Publisher: John Wiley & Sons, Ltd
Date: 16-05-2012
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.AUCC.2009.11.002
Abstract: Ventilator Associated Lung Injury (VALI) is an iatrogenic phenomena that significantly impacts on the morbidity and mortality of critically ill patients. The hazards associated with mechanical ventilation are becoming increasingly understood courtesy of a large body of research. Barotrauma, volutrauma and biotrauma all play a role in VALI. Concomitant to this growth in understanding is the development of strategies to reduce the deleterious impact of mechanical ventilation. The majority of the research is based upon adult populations but with careful extrapolation this review will focus on paediatrics. This review article describes the physiological basis of VALI and discusses the various lung protective strategies that clinicians can employ to minimise its incidence and optimise outcomes for paediatric patients.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.NEPR.2017.11.016
Abstract: A learning needs analysis was undertaken in a newly formed workforce. The goal of the learning needs analysis was to establish both the skill set and educational needs in the nursing workforce prior to moving to a new purpose built facility. The results would then enable nurse educators to develop, plan and deliver appropriate educational strategies. Staff (73%) completed an online survey the results were collated and analysed. The results of the learning needs analysis suggested an experienced workforce that had great capacity to care for children across a wide spectrum of acute clinical needs. Interestingly the results of the learning needs analysis conflicted with the clinical reality. To investigate possible reasons for this difference we conducted a focus group session with nurse educators. The focus group findings highlighted the significance of change and how that impacted on the clinical capacity of experienced staff. We concluded that the results of the learning needs analysis were representative however they needed careful interpretation in the context of substantial change.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.AUCC.2013.05.004
Abstract: High flow nasal cannula is an emerging treatment option in Paediatric Intensive Care Units for paediatric patients in acute respiratory distress. Yet there is a paucity of literature describing its clinical application in various presenting pathophysiologies. To describe three cases with differing underlying pathophysiologies and their response to high flow nasal cannula oxygen therapy. Patients admitted to the Paediatric Intensive Care Unit with bronchiolitis, asthma and cardiomyopathy, and treated with high flow nasal cannula therapy were searched in the Paediatric Intensive Care database. The most representative cases were chosen to review. One infant and two children were reviewed. All were commenced on high flow nasal cannula therapy in the Paediatric Intensive Care Unit and all demonstrated an improvement in their work of breathing. There was also a substantial improvement in their haemodynamic status. No patient required escalation to other forms of respiratory therapy. High flow nasal cannula therapy is a viable treatment option for a range of patients presenting to the Paediatric Intensive Care Unit with acute respiratory distress. More invasive methods of respiratory support may be avoided by the use of high flow nasal cannula therapy.
Publisher: Wiley
Date: 04-03-2014
Publisher: Wiley
Date: 07-03-2014
Publisher: Wiley
Date: 25-03-2019
DOI: 10.1111/JOCN.14842
Abstract: To synthesise the evidence on the use of evaluation frameworks by nurses and midwives in research designed to improve healthcare services and practice. A secondary aim was to identify the attributes and elements of evaluation frameworks. Evaluation is an integral component of any initiative to improve outcomes or change clinical practice. Yet often an evaluation may not yield the information required to sustain or integrate an initiative into practice. Evaluation frameworks can support effective evaluations, but there is a lack of consensus regarding elements and attributes of frameworks that support use. We undertook an integrative review to synthesise the use of evaluation frameworks in practice guided by the Preferred Reporting Items for Systematic review and Meta-Analysis flow diagram and checklist 2009 (Supporting Information File 4). The protocol was registered with PROSPERO (CRD42018087033). A broad range of electronic databases were systematically searched using keywords. Twenty-five papers were included from a erse range of clinical areas and across high-, middle- and low-income nations. Twenty of the research projects had used nine existing frameworks, and five had developed an evaluation specific to an initiative. Frameworks supported the processes of evaluation and made them more meaningful by simplifying a complex process (providing structure and guidance for the evaluation processes) identifying and including stakeholders explaining reasons for outcomes generating transferable lessons and identifying the mechanisms driving or inhibiting change. Nurses and midwives reported that frameworks were useful in undertaking evaluations. Each framework had positive attributes and missing or confusing elements. When undertaking an evaluation, it is pertinent to review the elements and attributes of a framework to ensure it includes evaluation measures that are relevant to specific projects. Nurses are actively involved in evaluation of clinical practice. This review identifies important elements to consider when choosing a framework for evaluation.
Publisher: University of Otago Library
Date: 31-03-2023
Abstract: Background: Students often have difficulty engaging with evidenced-based practice (EBP) courses that are largely theoretical and lack clinical relevance. This may result in graduates lacking vital skills to critique practice and participate in quality improvement. Approach: This paper describes the development and implementation of a collaborative academic and healthcare industry-based course that linked theoretical aspects of EBP. Students undertook a quality improvement project during clinical practice experience. Course assessments were designed to provide feedback on the progression of projects, the integration of theoretical and practical aspects of EBP and dissemination of findings. Conclusions: The course required substantial collaboration between the university and industry partners to identify clinically relevant projects and coordinate academic and clinical mentorship to support the students. The course demonstrated a significant level of clinical and academic partnership that resulted in relevant clinical quality improvements and increased student engagement with learning about, producing and implementing EBP.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.PRRV.2014.02.003
Abstract: Lung recruitment is used as an adjunct to lung protective ventilation strategies. Lung recruitment is a brief, deliberate elevation of transpulmonary pressures beyond what is achieved during tidal ventilation levels. The aim of lung recruitment is to maximise the number of alveoli participating in gas exchange particularly in distal and dependant regions of the lung. This may improve oxygenation and end expiratory levels. Restoration of end expiratory levels and stabilisation of the alveoli may reduce the incidence of ventilator induced lung injury (VILI). Various methods of lung recruitment have been studied in adult and experimental populations. This review aims to establish the evidence for lung recruitment in the pediatric population.
Publisher: Elsevier BV
Date: 02-2014
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.AUCC.2018.11.063
Abstract: The complexity and variation in ventilator associated pneumonia (VAP) definitions in paediatrics may pose threats to the reliable identification of VAP. The revision of the surveillance definition to ventilator-associated event (VAE) has been mandated in adult populations, to overcome these issues. However, the evidence for application of the definition is unknown in children. To review the evidence on the application of the new VAE surveillance definition in paediatric population and examine the potential challenges in clinical practice. A systematic approach was used to locate and synthesise the relevant paediatric literature. Studies were appraised according to epidemiological appraisal instrument (EAI) and the grades of evidence in the National Health Medical Research Council (NHMRC) guidelines. Seven studies met the inclusion criteria. Quality of study methods was above 50% on the EAI. The overall grade of evidence was assessed as C (satisfactory). The incidence of VAE in children ranged from 1.1 to 20.9 per 1000 ventilator days as a result of variations in surveillance criteria across included studies. There is little agreement between the new VAE and PNU/VAP surveillance definition in the identification of VAP. Challenges in the application of VAE surveillance were related to the difference in modes of ventilation used in children versus adults, inconclusive criteria tailored to paediatric s les and a lack of data that support for automatic data extraction applied in paediatric studies. This review demonstrated promising evidence using the new VAE surveillance definition to define the VAE in children, but the level of the evidence is low. Before the possibility of real implementation in clinical settings, challenges related to VAE paediatric specific criteria' and the value of automated data collection need to be considered.
Publisher: Informa UK Limited
Date: 02-08-2016
Publisher: Wiley
Date: 03-2016
Publisher: John Wiley & Sons, Ltd
Date: 08-12-2010
Publisher: Wiley
Date: 11-07-2012
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.AUCC.2009.06.004
Abstract: Recruitment manoeuvres play an important role in minimising ventilator associated lung injury (VALI) particularly when lung protective ventilation strategies are employed and as such clinicians should consider their application. This paper provides evidence-based recommendations for clinical practice with regard to alveolar recruitment. It includes recommendations for timing of recruitment, strategies of recruitment and methods of measuring the efficacy of recruitment manoeuvres and contributes to knowledge about the risks associated with recruitment manoeuvres. There are a range of methods for recruiting alveoli, most notably by manipulating positive end expiratory pressure (PEEP) and peak inspiratory pressure (PIP) with consensus as to the most effective not yet determined. A number of studies have demonstrated that improvement in oxygenation is rarely sustained following a recruitment manoeuvre and it is questionable whether improved oxygenation should be the clinician's goal. Transient haemodynamic compromise has been noted in a number of studies with a few studies reporting persistent, harmful sequelae to recruitment manoeuvres. No studies have been located that assess the impact of recruitment manoeuvres on length of ventilation, length of stay, morbidity or mortality. Recruitment manoeuvres restore end expiratory lung volume by overcoming threshold opening pressures and are most effective when applied after circuit disconnection and airway suction. Whether this ultimately improves outcomes in adult or paediatric populations is unknown.
Publisher: Elsevier BV
Date: 05-2012
Location: Australia
No related grants have been discovered for Jacqueline Jauncey-Cooke.