ORCID Profile
0000-0003-1809-9259
Current Organisation
Charles Darwin University
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Publisher: Elsevier BV
Date: 12-2020
Publisher: Mark Allen Group
Date: 02-05-2015
DOI: 10.12968/GASN.2015.13.4.26
Abstract: Bowel cancer is one of the most common and potentially preventable cancers. There is strong demand for bowel cancer screening programmes within the community. Nurses may play a vital role in the success of such programmes. The review aims to evaluate the effectiveness of nurse-led endoscopy in colorectal cancer screening. A systematic search of the literature identified 226 articles published in English between 1994 and 2012. Of these articles, six were included for analysis. Three outcome measures were identified, namely quality and safety, patient satisfaction, and cost-effectiveness. Nurse-led endoscopy was comparable to physician-led endoscopy procedures with regards to indicators of quality and safety. Overall, greater patient satisfaction was reported with nurse-led endoscopy procedures and there was some evidence of improved cost-effectiveness. Nurse-performed endoscopy appears to be as safe and effective as physician-performed endoscopy procedures in suitably selected patient populations. Further research and application of standardised training programmes and settings will be vital to ensuring ongoing safety and efficiency of nurse-led endoscopy.
Publisher: Springer Science and Business Media LLC
Date: 23-01-2014
DOI: 10.1007/S11657-013-0167-7
Abstract: The aim of this study was to identify the effect a dedicated osteoporosis health professional on screening and treatment in outpatients presenting with acute low trauma fracture. A dedicated osteoporosis health professional improved investigation and management of osteoporosis. Osteoporosis management was enhanced, leading to the potential for future fracture prevention. This study aimed to review the effect a dedicated osteoporosis health professional on screening and treatment in outpatients presenting with acute low trauma fracture. We searched the electronic databases of Medline, EMBASE, CINAHL, Current Contents Connect, Joanna Briggs Institute EBP, and Cochrane from database development to April 2013, examined grey literature, and completed manual searches of reference lists to identify English language research that examined the effect that dedicated health professional input had on osteoporosis management with acute low trauma non-hip fracture in the outpatient setting. Outcomes were defined as the proportion of patients with investigation (bone mineral density (BMD) or blood screen) treated with vitamin D supplementation or antiresorptive agent documented BMD reading change recurrent fracture occurrence or referral to specialist bone (osteoporosis) clinic. All studies with a suitable control group showed an increase in BMD screening in the intervention group (odds ratio (OR) 5.4, 95% confidence interval (CI) 4.3-6.9, P<0.0001). The effect on treatment initiation showed a significantly increased rate of antiresorptive±vitamin D therapy (OR 5.3, 95% CI 4.1-6.8, P<0.0001). No studies examined improvement or decline in BMD guiding clinical practice as an outcome. Two studies showed reduced fracture recurrence. The osteoporosis health professional significantly increased referrals to a specialist bone clinic (OR 9.6, 95% CI 6.2-14.6, P<0.0001). The presence of a dedicated osteoporosis health professional coordinating a targeted intervention for outpatients with low trauma non-hip fracture improves investigation and management of osteoporosis, resulting in the potential for future fracture prevention.
Publisher: Wiley
Date: 30-01-2020
DOI: 10.1111/IJN.12822
Abstract: To investigate effectiveness of the nurse clinician as a Non-Medical Surgical Assistant compared with the Medical Surgical Assistant. Non-Medical Surgical Assistants are clinicians who are not medical practitioners. The surgical assistant works directly with the primary surgeon intraoperatively. A pragmatic, retrospective, observational study on patients undergoing Laparoscopic Inguinal Hernia Repair or Primary Unilateral Total Hip Arthroplasty. Each patient received intraoperative care from a consultant surgeon and a Medical Surgical Assistant or Non-Medical Surgical Assistant. All surgical assistants were registered with the Australian Health Practitioner Regulation Agency. Data were collected between 01/07/2014 and 30/06/2017. The effect that surgical assistant choice had on patient outcomes was estimated using regression statistical models. Six dependent variables, including length of stay, for clinical outcome assessment were specified. The groups were equivalent in age, gender, and American Society of Anaesthesiologists scores. There were more emergency procedures in the Medical Surgical Assistant group and more hip surgery in the Non-Medical Surgical Assistant group. Patient outcome assessment showed no statistically significant differences for surgical assistant types. The nurse clinician in the role of Non-Medical Surgical Assistant was shown to be effective with equivalent patient outcomes compared with the Medical Surgical Assistant.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
DOI: 10.1111/J.1744-1609.2012.00253.X
Abstract: To compare the effectiveness of multidisciplinary care with traditional medical care on the progression of chronic kidney disease (CKD) in adult pre-dialysis patients (stages 3-5). Eleven databases were searched for articles published between January 1990 and July 2009. The Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument was used to assess the methodological quality of retrieved articles and extract data. Only four articles out of 927 were included in the systematic review. Two reported the results of randomised controlled trials and two reported observational studies. The data were not presented in a format that allowed a meta-analysis to be performed and therefore a narrative summary of these articles is presented. Multidisciplinary care is deemed to be effective in delaying the progression of CKD in adults who are in the pre-dialysis phase of this condition. Education that aims to increase the knowledge and understanding of the causes of CKD is an important component of the care. Members of the multidisciplinary team should draw on their specific expertise to educate the patient about CKD. The nephrologist or a nurse practitioner should devise a management plan jointly with the patient and provide regular reviews.
Publisher: Wiley
Date: 21-01-2016
DOI: 10.1111/NEP.12557
Abstract: Patients with chronic kidney disease (CKD) have a significant burden of dyspnoea and fatigue in spite having normal left ventricular (LV) ejection fraction (EF). Global longitudinal strain (GLS) can detect subtle changes in LV function. This study aimed to evaluate the relationship between LV function, functional capacity and quality of life (QOL) in CKD patients with preserved EF. A cross-sectional study of patients with stage 3/4 CKD (n = 108). Clinical characteristics, biochemical data, functional capacity (6-min walk test (6MWT), timed up and go (TUG) test) and QOL (short form-12 (SF-12v2™) ) were measured. Echocardiogram was used to assess GLS, EF and diastolic function (E/A, e' and E/e'). The mean age was 58.1 ± 9.9 years, 55.6% were men, estimated glomerular filtration rate was 44.8 ± 10.6 mL/min/1.73 m(2), GLS was -18.5 ± 3.6% and 19.4% had impaired GLS (>-16%). Patients with impaired GLS had a significantly shorter 6MWT and slower TUG test compared with patients with preserved GLS. Bivariate analysis showed GLS and E/e' correlated with distance walked in 6MWT (GLS (r = -0.24, P = 0.02) E/e'(r = -0.38, P = 0.002) ). Following adjustment for potential confounders, GLS remained independently associated with 6MWT (model R(2) = 0.37, P < 0.001). Mean physical component summary scores (PCS) and mental component summary scores (MCS) were 43.0 ± 10.2 and 50.9 ± 9.5. There was no cardiac parameter that was independently associated with PCS. However women, lower systolic blood pressure and GLS was associated with lower MCS (model R(2) = 0.30, P < 0.001). GLS was associated with measures of functional capacity and QOL in CKD patients with preserved EF.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1053/J.AJKD.2014.09.017
Abstract: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations. Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control). Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital. Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training. Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures adherence, as assessed by self-reported physical activity and safety, as assessed by reported serious adverse events, were recorded. 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36 control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3 post, 9.7±3.6), 6-minute walk distance (pre, 485±110m post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2) post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training. This study was not powered to evaluate the safety of exercise training on serious adverse events. The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.NEDT.2011.11.014
Abstract: This paper reports on a pilot project aimed at exploring postgraduate distance students' experiences using personal video capture technology to complete competency assessments in physical examination. A pre-intervention survey gathered demographic data from nurse practitioner students (n=31) and measured their information communication technology fluency. Subsequently, thirteen (13) students were allocated a hand held video camera to use in their clinical setting. Those participating in the trial completed a post-intervention survey and further data were gathered using semi-structured interviews. Data were analysed by descriptive statistics and deductive content analysis, and the Unified Theory of Acceptance and Use of Technology (Venkatesh et al., 2003) were used to guide the project. Uptake of the intervention was high (93%) as students recognised the potential benefit. Students were video recorded while performing physical examinations. They described high level of stress and some anxiety, which decreased rapidly while assessment was underway. Barriers experienced were in the areas of facilitating conditions (technical character e.g. upload of files) and social influence (e.g. local ethical approval). Students valued the opportunity to reflect on their recorded performance with their clinical mentors and by themselves. This project highlights the demands and difficulties of introducing technology to support work-based learning.
No related grants have been discovered for Haakan Strand.