ORCID Profile
0000-0001-9183-9175
Current Organisations
Queensland University of Technology
,
University of Technology Sydney
,
University of Queensland
,
Western Sydney University Online
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Publisher: Springer Science and Business Media LLC
Date: 20-05-2012
Publisher: Springer Science and Business Media LLC
Date: 07-10-2015
DOI: 10.1007/S40258-014-0132-7
Abstract: Evidence from economic evaluations is often not used to inform healthcare policy despite being well regarded by policy makers and physicians. This article employs the accessibility and acceptability framework to review the barriers to using evidence from economic evaluation in healthcare policy and the strategies used to overcome these barriers. Economic evaluations are often inaccessible to policymakers due to the absence of relevant economic evaluations, the time and cost required to conduct and interpret economic evaluations, and lack of expertise to evaluate quality and interpret results. Consistently reported factors that limit the translation of findings from economic evaluations into healthcare policy include poor quality of research informing economic evaluations, assumptions used in economic modelling, conflicts of interest, difficulties in transferring resources between sectors, negative attitudes to healthcare rationing, and the absence of equity considerations. Strategies to overcome these barriers have been suggested in the literature, including training, structured abstract databases, rapid evaluation, reporting checklists for journals, and considering factors other than cost effectiveness in economic evaluations, such as equity or budget impact. The factors that prevent or encourage decision makers to use evidence from economic evaluations have been identified, but the relative importance of these factors to decision makers is uncertain.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Springer Science and Business Media LLC
Date: 13-02-2015
Publisher: Elsevier BV
Date: 12-2009
Publisher: Cambridge University Press (CUP)
Date: 08-2014
DOI: 10.1086/677160
Abstract: Interventions that prevent healthcare-associated infection should lead to fewer deaths and shorter hospital stays. Cleaning hands (with soap or alcohol) is an effective way to prevent the transmission of organisms, but rates of compliance with hand hygiene are sometimes disappointingly low. The National Hand Hygiene Initiative in Australia aimed to improve hand hygiene compliance among healthcare workers, with the goal of reducing rates of healthcare-associated infection. We examined whether the introduction of the National Hand Hygiene Initiative was associated with a change in infection rates. Monthly infection rates for healthcare-associated Staphylococcus aureus bloodstream infections were examined in 38 Australian hospitals across 6 states. We used Poisson regression and examined 12 possible patterns of change, with the best fitting pattern chosen using the Akaike information criterion. Monthly bed-days were included to control for increased hospital use over time. The National Hand Hygiene Initiative was associated with a reduction in infection rates in 4 of the 6 states studied. Two states showed an immediate reduction in rates of 17% and 28%, 2 states showed a linear decrease in rates of 8% and 11% per year, and 2 showed no change in infection rates. The intervention was associated with reduced infection rates in most states. The failure in 2 states may have been because those states already had effective initiatives before the national initiative’s introduction or because infection rates were already low and could not be further reduced.
Publisher: Elsevier BV
Date: 11-2017
Publisher: Wiley
Date: 04-2015
DOI: 10.1071/HE14059
Publisher: The Sax Institute
Date: 2022
DOI: 10.17061/PHRP3222213
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.AJIC.2018.09.029
Abstract: Clinicians play an essential role in the implementation of infection prevention policy. Despite this, little is known about how infection control policy is implemented at an organizational level or what factors influence this process. In this study, we explore these factors and the policy implementation process in the context of the introduction of a national large-scale, government-directed infection prevention policy in Australia. Focus groups with infection control professionals were held in 3 states to investigate the perspectives of infection control professionals involved in the implementation of aseptic technique policy requirements in Australian hospitals. Data were analyzed using an interpretive description approach, with themes mapped to the Consolidated Framework for Implementation Research. Common contextual factors were identified across all levels of the healthcare system that influenced implementation of the infection control policy, including external factors associated with the policy itself and the regulatory nature of government-directed policy. This study suggests that there may be particular constructs and contextual factors that are specific to policy implementation in the hospital setting. A better understanding of these factors and their influence on policy implementation would present an opportunity for improved implementation planning, resource allocation, and more effective policy development.
Publisher: Springer Science and Business Media LLC
Date: 26-01-2023
DOI: 10.1186/S13012-023-01260-9
Abstract: Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing difficulties (FeSS Protocols) in 19 Australian stroke units resulted in reduced death and dependency for stroke patients. However, a significant gap remains in translating this evidence-based care bundle protocol into standard practice in Australia and New Zealand. Facilitation is a key component for increasing implementation. However, its contribution to evidence translation initiatives requires further investigation. We aim to evaluate two levels of intensity of external remote facilitation as part of a multifaceted intervention to improve FeSS Protocol uptake and quality of care for patients with stroke in Australian and New Zealand acute care hospitals. A three-arm cluster randomised controlled trial with a process evaluation and economic evaluation. Australian and New Zealand hospitals with a stroke unit or service will be recruited and randomised in blocks of five to one of the three study arms—high- or low-intensity external remote facilitation or a no facilitation control group—in a 2:2:1 ratio. The multicomponent implementation strategy will incorporate implementation science frameworks (Theoretical Domains Framework, Capability, Opportunity, Motivation – Behaviour Model and the Consolidated Framework for Implementation Research) and include an online education package, audit and feedback reports, local clinical ch ions, barrier and enabler assessments, action plans, reminders and external remote facilitation. The primary outcome is implementation effectiveness using a composite measure comprising six monitoring and treatment elements of the FeSS Protocols. Secondary outcome measures are as follows: composite outcome of adherence to each of the combined monitoring and treatment elements for (i) fever ( n =5) (ii) hyperglycaemia ( n =6) and (iii) swallowing protocols ( n =7) adherence to the in idual elements that make up each of these protocols comparison for composite outcomes between (i) metropolitan and rural/remote hospitals and (ii) stroke units and stroke services. A process evaluation will examine contextual factors influencing intervention uptake. An economic evaluation will describe cost differences relative to each intervention and study outcomes. We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas. ACTRN12622000028707. Registered 14 January, 2022.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2019
DOI: 10.1007/S40258-019-00477-4
Abstract: There is a need for the application of theory in understanding the use of evidence from economic evaluations in healthcare decision making. The purpose of this study is to review the published literature on the use of evidence from economic evaluations for healthcare decision making and to map the findings to the Consolidated Framework for Implementation Research (CFIR). A systematic search strategy was used to identify studies investigating the factors that determine the use of evidence from economic evaluation in healthcare decision making. Barriers and facilitators identified in the included studies were mapped across the five CFIR domains, with the "intervention" referring to the use of economic evaluations in decision making. Gaps, inconsistencies and emergent relations were identified through the mapping process. Fifty-three studies met eligibility criteria and were included in the review. The CFIR constructs associated with the Intervention Characteristics and those associated with the knowledge and beliefs of users of economic evaluations were widely cited in the identified barriers and facilitators. Other constructs from the CFIR had not been reported in the literature, such as 'organisational networks' and 'in idual stage of change'. Most of the stages in the implementation process as described by the CFIR were reflected in the identified barriers and facilitators. By categorising barriers and facilitators into domains, the CFIR provides a systematic approach to assess how these factors interact. Literature gaps in the literature regarding the use of economic evaluation in healthcare decision making were identified, specifically issues regarding organisational networks and the role of feedback. Through mapping findings from studies of the use of evidence from economic evaluations in healthcare decision making, we present an implementation framework based on the CFIR for understanding the use of economic evaluations into practice.
Publisher: Cambridge University Press (CUP)
Date: 04-2013
DOI: 10.1086/669862
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1071/HI14033
Publisher: Elsevier BV
Date: 04-2010
Publisher: Elsevier BV
Date: 02-2010
Publisher: Informa UK Limited
Date: 12-2007
DOI: 10.1080/02640410701275219
Abstract: The home advantage is a widely acknowledged sporting phenomenon, especially in association football. Here, we examine the second leg home advantage, an effect that is discussed in the public domain but which has received very little scientific attention. The second leg home advantage effect occurs when on average teams are more likely to win a two-stage knock-out competition when they play at home in the second leg. That is, both teams have a home advantage but this advantage is significantly greater for the team that plays at home second. Examining data from three different European Cup football competitions spanning 51 years, we show that the second leg home advantage is a real phenomenon. The second leg home team has more than a 50% probability to qualify for the next round in the competition even after controlling for extra time and team ability as possible alternative explanations. The second leg home advantage appears, however, to have decreased significantly over the past decade. Possible reasons for its existence and subsequent decline are presented.
Publisher: Elsevier BV
Date: 11-2015
Publisher: Elsevier BV
Date: 02-2015
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 26-07-2019
DOI: 10.1212/WNL.0000000000007937
Abstract: To determine whether early and more frequent mobilization after stroke affects health-related quality of life. A Very Early Rehabilitation Trial (AVERT) was an international, multicenter (56 sites), phase 3 randomized controlled trial, spanning 2006–2015. People were included if they were aged ≥18 years, presented within 24 hours of a first or recurrent stroke (ischemic or hemorrhagic), and satisfied preordained physiologic criteria. Participants were randomized to usual care alone or very early and more frequent mobilization in addition to usual care. Quality of life at 12 months was a prespecified secondary outcome, evaluated using the Assessment of Quality of Life 4D (AQoL-4D). This utility-weighted scale has scores ranging from −0.04 (worse than death) to 1 (perfect health). Participants who died were assigned an AQoL-4D score of 0. No significant difference in quality of life at 12 months between intervention (median 0.47, interquartile range [IQR] 0.07–0.81) and usual care (median 0.49, IQR 0.08–0.81) groups was identified ( p = 0.86), nor were there any group differences across the 4 AQoL-4D domains. The same lack of group difference in quality of life was observed at 3 months. When cohort data were analyzed (both groups together), quality of life was strongly associated with acute length of stay, independence in activities of daily living, cognitive function, depressive symptoms, and anxiety symptoms (all p 0.001). Quality of life in AVERT participants was substantially lower than population norms, and the gap increased with age. Earlier and more frequent mobilization after stroke did not influence quality of life. anzctr.org.au ACTRN12606000185561 This study provides Class II evidence that for people with stroke, earlier and more frequent mobilization did not influence quality of life over the subsequent year.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.JHIN.2013.03.006
Abstract: Previous attempts at costing infection control programmes have tended to focus on accounting costs rather than economic costs. For studies using economic costs, estimates tend to be quite crude and probably underestimate the true cost. One of the largest costs of any intervention is staff time, but this cost is difficult to quantify and has been largely ignored in previous attempts. To design and evaluate the costs of hospital-based infection control interventions or programmes. This article also discusses several issues to consider when costing interventions, and suggests strategies for overcoming these issues. Previous literature and techniques in both health economics and psychology are reviewed and synthesized. This article provides a set of generic, transferable costing guidelines. Key principles such as definition of study scope and focus on large costs, as well as pitfalls (e.g. overconfidence and uncertainty), are discussed. These new guidelines can be used by hospital staff and other researchers to cost their infection control programmes and interventions more accurately.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Springer Science and Business Media LLC
Date: 2006
Publisher: Elsevier BV
Date: 08-2016
Publisher: Elsevier BV
Date: 11-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 29-06-2018
DOI: 10.1161/01.CIR.99.25.3292
Abstract: Background —Platelet-derived growth factor (PDGF), a purported mediator of arterial response to injury, stimulates proliferation, chemotaxis, and matrix production by activation of its membrane receptor tyrosine kinase. Because these activities underlie restenosis, inhibition of the PDGF-receptor tyrosine kinase (PDGFr-TK) is postulated to decrease restenosis. Methods and Results —RPR101511A is a novel compound which selectively and potently inhibits the cell-free and in situ PDGFr-TK and PDGFr-dependent proliferation and chemotaxis in vascular smooth muscle cells (VSMC). To evaluate the effect of RPR101511A (30 mg · kg −1 · d −1 BID for 28 days following PTCA) on coronary restenosis, PTCA was performed in hypercholesterolemic minipigs whose left anterior descending (LAD) coronary artery had been injured by overdilation and denudation, yielding a previously existing lesion. Angiographically determined prePTCA minimal lumen diameters (MLD) were similar in vehicle and RPR101511A-treated pigs (1.98±0.09 versus 2.01±0.08 mm) and increased to the same extent in the 2 groups following successful PTCA (2.30±0.06 versus 2.52±0.13). At termination, there was an average 50% loss of gain in the vehicle-treated group but no loss of gain with RPR101511A (2.16±0.05 versus 2.59±0.11, P .001). Morphometric analysis of the LAD showed that RPR101511A caused a significant decrease in total intimal/medial ratio (0.96±0.58 versus 0.67±0.09, P .05). Conclusions —RPR101511A, which acts by inhibition of the PDGFr-TK, completely prevented angiographic loss of gain following PTCA and significantly reduced histological intimal hyperplasia.
Publisher: Springer Science and Business Media LLC
Date: 10-10-2017
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 04-2019
Publisher: Public Library of Science (PLoS)
Date: 09-02-2016
Publisher: Springer Science and Business Media LLC
Date: 29-04-2022
DOI: 10.1007/S11136-022-03138-7
Abstract: ‘Bolt-on’ dimensions are additional items added to multi-attribute utility instruments (MAUIs) such as EQ-5D that measure constructs not included in the core descriptive system. The use of bolt-ons has been proposed to improve the content validity and responsiveness of the descriptive system in certain settings and health conditions. EQ-5D bolt-ons serve a particular purpose and thus satisfy a certain set of criteria. The aim of this paper is to propose a set of criteria to guide the development, assessment and selection of candidate bolt-on descriptors. Criteria were developed using an iterative approach. First, existing criteria were identified from the literature including those used to guide the development of MAUIs, the COSMIN checklist and reviews of existing bolt-ons. Second, processes used to develop bolt-ons based on qualitative and quantitative approaches were considered. The information from these two stages was formalised into draft development and selection criteria. These were reviewed by the project team and iteratively refined. Overall, 23 criteria for the development, assessment and selection of candidate bolt-ons were formulated. Development criteria focused on issues relating to i) structure, ii) language, and iii) consistency with the existing EQ-5D dimension structure. Assessment and selection criteria focused on face and content validity and classical psychometric indicators. The criteria generated can be used to guide the development of bolt-ons across different health areas. They can also be used to assess existing bolt-ons, and inform their inclusion in studies and patient groups where the EQ-5D may lack content validity.
Publisher: Wiley
Date: 15-05-2018
DOI: 10.1111/AJO.12824
Abstract: Minimally invasive approaches to hysterectomy have been shown to be safe, effective and have recovery advantages over open hysterectomy, yet in Australia 36% of hysterectomies are still conducted by open surgery. In 2006, a survey of Australian gynaecological specialists found the main impediment to increasing laparoscopic hysterectomy to be a lack of surgical skills training opportunities. We resurveyed specialists to explore contemporary factors influencing surgeons' approaches to hysterectomy 258 (estimated ~19%) provided analysable responses. Despite >50% of surveyed specialists wishing to practise laparoscopic hysterectomy in the future, lack of surgical skills, arising from the lack of training opportunities, remains the main impediment.
Publisher: Elsevier BV
Date: 02-2016
Publisher: Elsevier BV
Date: 06-2017
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.JHIN.2014.06.005
Abstract: The Australian National Hand Hygiene Initiative (NHHI) is a major patient safety programme co-ordinated by Hand Hygiene Australia (HHA) and funded by the Australian Commission for Safety and Quality in Health Care. The annual costs of running this programme need to be understood to know the cost-effectiveness of a decision to sustain it as part of health services. To estimate the annual health services cost of running the NHHI the set-up costs are excluded. A health services perspective was adopted for the costing and collected data from the 50 largest public hospitals in Australia that implemented the initiative, covering all states and territories. The costs of HHA, the costs to the state-level infection-prevention groups, the costs incurred by each acute hospital, and the costs for additional alcohol-based hand rub are all included. The programme cost AU$5.56 million each year (US$5.76, £3.63 million). Most of the cost is incurred at the hospital level (65%) and arose from the extra time taken for auditing hand hygiene compliance and doing education and training. On average, each infection control practitioner spent 5h per week on the NHHI, and the running cost per annum to their hospital was approximately AU$120,000 in 2012 (US$124,000, £78,000). Good estimates of the total costs of this programme are fundamental to understanding the cost-effectiveness of implementing the NHHI. This paper reports transparent costing methods, and the results include their uncertainty.
Publisher: Elsevier BV
Date: 07-2013
Publisher: Springer Science and Business Media LLC
Date: 18-02-2020
DOI: 10.1186/S13756-020-0694-0
Abstract: Implementing sustainable practice change in hospital cleaning has proven to be an ongoing challenge in reducing healthcare associated infections. The purpose of this study was to develop a reliable framework-based approach to implement and quantitatively evaluate the implementation of evidence-based practice change in hospital cleaning. The Researching Effective Approaches to Cleaning in Hospitals (REACH) trial was a pragmatic, stepped-wedge randomised trial of an environmental cleaning bundle implemented in 11 Australian hospitals from 2016 to 2017. Using a structured multi-step approach, we adapted the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to support rigorous and tailored implementation of the cleaning bundle intervention in eleven erse and complex settings. To evaluate the effectiveness of this strategy we examined post-intervention cleaning bundle alignment calculated as a score (an implementation measure) and cleaning performance audit data collected using ultraviolet (UV) gel markers (an outcome measure). We successfully implemented the bundle and observed improvements in cleaning practice and performance, regardless of hospital size, intervention duration and contextual issues such as staff and organisational readiness at baseline. There was a positive association between bundle alignment scores and cleaning performance at baseline. This diminished over the duration of the intervention, as hospitals with lower baseline scores were able to implement practice change successfully. Using a structured framework-based approach allows for pragmatic and successful implementation of clinical trials across erse settings, and assists with quantitative evaluation of practice change. Australia New Zealand Clinical Trial Registry ACTRN12615000325505 , registered on 4 September 2015.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2017
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Pensoft Publishers
Date: 02-2017
DOI: 10.3897/RIO.3.E11931
Publisher: BMJ
Date: 10-2013
Publisher: SAGE Publications
Date: 25-04-2020
Abstract: To evaluate women’s experiences after hysterectomy and predictors of their contentment and regret with the surgical approaches. Cross-sectional, Patient-Reported Experience Measures survey in 2319 Australian women aged 21 to 90 years (median age of 52 years) who had received hysterectomy in the preceding 2 years. Overall, the vast majority of women ( %) did not regret having had the hysterectomy. Women who received an open abdominal hysterectomy reported slower recovery with about 7% of women still not fully recovered after 12 months compared to those whose surgery was through a less invasive approach. Women who reported no adverse events, having been given a choice of type of hysterectomy, women who received an alternative to open abdominal hysterectomy, and women who felt prepared for discharge from hospital were significantly more likely to be content with their hysterectomy and report positive patient experiences. Compared with those who received a less invasive approach to hysterectomy, women who received open surgery were more likely to express negative experiences relating to their hospital stay and recovery from surgery. The results inform future improvements of care for women planning a hysterectomy.
Publisher: Cambridge University Press (CUP)
Date: 17-10-2022
DOI: 10.1017/S1748499522000173
Abstract: One complication in mortality modelling is capturing the impact of risk factors that contribute to mortality differentials between different populations. Evidence has suggested that mortality differentials tend to diminish over age. Classical methods such as the Gompertz law attempt to capture mortality patterns over age using intercept and slope parameters, possibly causing an unjustified mortality crossover at advanced ages when applied independently to different populations. In recent research, Richards ( Scandinavian Actuarial Journal 2020 (2), 110–127) proposed a Hermite spline (HS) model that describes the age pattern of mortality differentials using one parameter and circumvents an unreasonable crossover by default. The original HS model was applied to pension data at in idual level in the age dimension only. This paper extends the method to model population mortality in both age and period dimensions. Our results indicate that in addition to possessing desirable fitting properties, the HS approach can produce accurate mortality forecasts, compared with the Gompertz and P-splines models.
Publisher: Oxford University Press (OUP)
Date: 20-11-2015
DOI: 10.1093/HER/CYV057
Abstract: Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The '5 critical moments' of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-s le (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.PEC.2017.09.006
Abstract: To explore factors influencing how well-informed women felt about hysterectomy, influences on their decision making, and on them receiving a less-invasive alternative to open surgery. Online questionnaire, conducted in 2015-2016, of women who had received a hysterectomy in Australia, in the preceding two years. Questionnaires were completed by 2319/6000 women (39% response). Most women (n=2225 96%) felt well-informed about hysterectomy. Women were more aware of the open abdominal approach (n=1798 77%), than of less-invasive vaginal (n=1552 67%), laparoscopic (n=1540 66%), laparoscopic-assisted (n=1303 56%), and robotic approaches (n=289 12%). Most women (n=1435 62%) reported their gynaecologist was the most influential information source. Women who received information about hysterectomy from a GP (OR=1.47 95% CI 1.15-1.90), or from a gynaecologist (OR=1.3 95% CI 1.06-1.58), were more likely to feel better informed (p<0.01). This study is important because it helps clinicians, researchers and health policy makers to understand why many women still receive an open abdominal approach despite many learned societies recommending to avoid it if possible. Additional information, or education about avoiding open abdominal approach where possible may lead to a greater number of women receiving less-invasive types of hysterectomy in the future.
Publisher: Springer Science and Business Media LLC
Date: 12-10-2016
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-053828
Abstract: The evaluation of the Victorian Healthy Homes Program (VHHP) will generate evidence about the efficacy and cost-effectiveness of home upgrades to improve thermal comfort, reduce energy use and produce health and economic benefits to vulnerable households in Victoria, Australia. The VHHP evaluation will use a staggered, parallel group clustered randomised controlled trial to test the home energy intervention in 1000 households. All households will receive the intervention either before (intervention group) or after (control group) winter (defined as 22 June to 21 September). The trial spans three winters with differing numbers of households in each cohort. The primary outcome is the mean difference in indoor average daily temperature between intervention and control households during the winter period. Secondary outcomes include household energy consumption and residential energy efficiency, self-reported respiratory symptoms, health-related quality of life, healthcare utilisation, absences from school/work and self-reported conditions within the home. Linear and logistic regression will be used to analyse the primary and secondary outcomes, controlling for clustering of households by area and the possible confounders of year and timing of intervention, to compare the treatment and control groups over the winter period. Economic evaluation will include a cost-effectiveness and cost-benefit analysis. Ethical approval was received from Victorian Department of Human Services Human Research Ethics Committee (reference number: 04/17), University of Technology Sydney Human Research Ethics Committee (reference number: ETH18-2273) and Australian Government Department of Veterans Affairs. Study results will be disseminated in a final report and peer-reviewed journals. ACTRN12618000160235.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.AJIC.2018.02.003
Abstract: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study tested a multimodal cleaning intervention in Australian hospitals. This article reports findings from a pre ost questionnaire, embedded into the REACH study, that was administered prior to the implementation of the intervention and at the conclusion of the study. A cross-sectional questionnaire, nested within a stepped-wedge trial, was administered. The REACH intervention was a cleaning bundle comprising 5 interdependent components. The questionnaire explored the knowledge, reported practice, attitudes, roles, and perceived organizational support of environmental services staff members in the hospitals participating in the REACH study. Environmental services staff members in 11 participating hospitals completed 616 pre- and 307 post-test questionnaires (n = 923). Increases in knowledge and practice were seen between the pre-and post-test questionnaires. Minimal changes were observed in attitudes regarding the role of cleaning and in perceived organizational support. To our knowledge, this is the first study to report changes in knowledge, attitudes, and perceived organizational support in environmental services staff members, in the context of a large multicenter clinical trial. In this underexplored group of hospital workers, findings suggest that environmental services staff members have a high level of knowledge related to cleaning practices and understand the importance of their role.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Oxford University Press (OUP)
Date: 30-07-2020
DOI: 10.1093/CID/CIZ717
Abstract: Healthcare-associated infections (HAIs) remain a significant patient safety issue, with point prevalence estimates being ~5% in high-income countries. In 2016–2017, the Researching Effective Approaches to Cleaning in Hospitals (REACH) study implemented an environmental cleaning bundle targeting communication, staff training, improved cleaning technique, product use, and audit of frequent touch-point cleaning. This study evaluates the cost-effectiveness of the environmental cleaning bundle for reducing the incidence of HAIs. A stepped-wedge, cluster-randomized trial was conducted in 11 hospitals recruited from 6 Australian states and territories. Bundle effectiveness was measured by the numbers of Staphylococcus aureus bacteremia, Clostridium difficile infection, and vancomycin-resistant enterococci infections prevented in the intervention phase based on estimated reductions in the relative risk of infection. Changes to costs were defined as the cost of implementing the bundle minus cost savings from fewer infections. Health benefits gained from fewer infections were measured in quality-adjusted life-years (QALYs). Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio and net monetary benefit of adopting the cleaning bundle over existing hospital cleaning practices. Implementing the cleaning bundle cost $349 000 Australian dollars (AUD) and generated AUD$147 500 in cost savings. Infections prevented under the cleaning bundle returned a net monetary benefit of AUD$1.02 million and an incremental cost-effectiveness ratio of $4684 per QALY gained. There was an 86% chance that the bundle was cost-effective compared with existing hospital cleaning practices. A bundled, evidence-based approach to improving hospital cleaning is a cost-effective intervention for reducing the incidence of HAIs.
Publisher: Springer Science and Business Media LLC
Date: 10-05-2021
DOI: 10.1186/S12913-021-06477-2
Abstract: Infection control practitioners (ICPs) are a group of specialized nurses fundamental to effective healthcare infection prevention and control initiatives. Relative to other groups of nurses much less is known about their working conditions. Organizational factors may impact ICPs’ levels of job dissatisfaction and emotional job burnout and, subsequently, their quality of practice. We measure a range of organizational factors to document the working conditions of ICPs and show how these are linked to job satisfaction and emotional burnout in a s le of Australian ICPs. We conducted a cross sectional study using an online survey. All employed ICPs in 50 of the largest public hospitals in Australia were invited to participate. One hundred and fifty three ICPs completed the survey. ICPs are moderately to highly satisfied with their job but show high levels of emotional burnout, time pressure and cognitive demands. Low job satisfaction was associated with less job control, low perceived organizational support and poor communication. In contrast, emotional burnout was associated with high time pressure and cognitive demands coupled with poor communication. This study provides new evidence about the organizational context of ICPs in Australia, and about the factors that impact on job satisfaction and emotional burnout. These findings may be used to modify national infection prevention and control programs to suit local organizational contexts. Further research is needed to determine the precise nature of these relationships and the downstream impacts on hospital-wide infection control outcomes. Organizational context and factors are important to consider when evaluating the impact and implementation of infection control programs.
Publisher: eLife Sciences Publications, Ltd
Date: 04-04-2022
DOI: 10.7554/ELIFE.76123
Abstract: When researchers’ careers are disrupted by life events – such as illness or childbirth – they often need to take extended time off. This creates a gap in their research output that can reduce their chances of winning funding. In Australia, applicants can disclose their career disruptions and peer reviewers are instructed to make appropriate adjustments. However, it is not clear if and how applicants use career disruption sections or how reviewers adjust and if they do it consistently. To examine career disruption, we used surveys of the Australian health and medical research community. We used both a random s le of Australian authors on PubMed and a non-random convenience s le. Respondents expressed concerns that sharing information on career disruption would harm their chances of being funded, with 13% saying they have medical or social circumstances but would not include it in their application, with concerns about appearing ‘weak’. Women were more reluctant to include disruption. There was inconsistency in how disruption was adjusted for, with less time given for those with depression compared with caring responsibilities, and less time given for those who did not provide medical details of their disruption. The current system is likely not adequately adjusting for career disruption and this may help explain the ongoing funding gap for senior women in Australia. National Health and Medical Research Council Senior Research Fellowship (Barnett).
Publisher: Elsevier BV
Date: 11-2016
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1071/HI12003
Publisher: Springer Science and Business Media LLC
Date: 04-2017
DOI: 10.1038/544161D
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1071/HI12048
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2014
End Date: 2016
Funder: National Health and Medical Research Council
View Funded Activity