ORCID Profile
0000-0002-2417-2216
Current Organisations
University of Wollongong
,
University of Technology Sydney
,
Western Sydney University
,
Western Sydney Local Health District
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Publisher: Elsevier BV
Date: 06-2014
DOI: 10.1016/J.COLEGN.2014.03.002
Abstract: The World Wide Web has changed the way in which people communicate and consume information. More importantly, this innovation has increased the speed and spread of information. There has been recent increase in the percentage of cardiovascular professionals, including journals and associations using Twitter to engage with others and exchange ideas. Evaluating the reach and impact in scientific meetings is important in promoting the use of social media. This study evaluated Twitter use during the recent 61st Annual Scientific Meeting at the Cardiac Society of Australia and New Zealand. During the Cardiac Society of Australia and New Zealand 2013 61st Annual Scientific Meeting Symplur was used to curate conversations that were publicly posted with the hashtag #CSANZ2013. The hashtag was monitored with analysis focused on the influencers, latest tweets, tweet statistics, activity comparisons, and tweet activity during the conference. Additionally, Radian6 social media listening software was used to collect data. A summary is provided. There were 669 total tweets sent from 107 unique Twitter accounts during 8th August 9 a.m. to 11th August 1 p.m. This averaged nine tweets per hour and six tweets per participant. This assisted in the sharing of ideas and disseminating the findings and conclusions from presenters at the conference with a total 1,432,573 potential impressions in Twitter users tweet streams. This analysis of Twitter conversations during a recent scientific meeting highlights the significance and place of social media within research dissemination and collaboration. Researchers and clinicians should consider using this technology to enhance timely communication of findings. The potential to engage with consumers and enhance shared decision-making should be explored further.
Publisher: Scientific Scholar
Date: 2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-01-2019
Abstract: This eH ealth implementation study aimed to evaluate strategies to promote opportunistic atrial fibrillation ( AF ) screening using electronic screening prompts and improve treatment using electronic decision support ( EDS ) software. An electronic screening prompt appeared whenever an eligible patient's (aged ≥65 years, no AF diagnosis) medical record was opened in participating general practices. General practitioners and practice nurses offered screening using a smartphone ECG, with validated AF algorithm. Guideline‐based EDS was provided to assist treatment decisions. Deidentified data were collected from practices using a data extraction tool. General practices (n=8) across Sydney, Australia, screened for a median of 6 months. A total of 1805 of 11 476 (16%) eligible patients who attended were screened (44% men, mean age 75.7 years). Screening identified 19 (1.1%) new cases of AF (mean age, 79 years mean CHA 2 DS 2 ‐ VAS c, 3.7 53% men). General practitioners (n=30) performed 70% of all screenings (range 1–448 patients per general practitioner). The proportion of patients with AF who had CHA 2 DS 2 ‐ VAS c ≥2 for men or ≥3 for women prescribed oral anticoagulants was higher for those diagnosed during the study: 15 of 18 (83%) for screen‐detected and 39 of 46 (85%) for clinically detected, compared with 933 of 1306 (71%) patients diagnosed before the study ( P .001). The EDS was accessed 111 times for patients with AF and for 4 of 19 screen‐detected patients. The eH ealth tools showed promise. Adherence to guideline‐based oral anticoagulant prescription was significantly higher in patients diagnosed during the study period, although the EDS was only used in a minority. While the proportion of eligible patients screened and EDS use was relatively low, further refinements may improve uptake in clinical practice. URL : www.anzctr.org.au . Unique identifier: ACTRN 12616000850471.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Informa UK Limited
Date: 03-07-2020
Publisher: Oxford University Press (OUP)
Date: 03-08-2023
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/135812
Abstract: Background . Bibliometrics are an essential aspect of measuring academic and organizational performance. Aim . This review seeks to describe methods for measuring bibliometrics, identify the strengths and limitations of methodologies, outline strategies for interpretation, summarise evaluation of nursing and midwifery performance, identify implications for metric of evaluation, and specify the implications for nursing and midwifery and implications of social networking for bibliometrics and measures of in idual performance. Method . A review of electronic databases CINAHL, Medline, and Scopus was undertaken using search terms such as bibliometrics, nursing, and midwifery. The reference lists of retrieved articles and Internet sources and social media platforms were also examined. Results . A number of well-established, formal ways of assessment have been identified, including h - and c -indices. Changes in publication practices and the use of the Internet have challenged traditional metrics of influence. Moreover, measuring impact beyond citation metrics is an increasing focus, with social media representing newer ways of establishing performance and impact. Conclusions . Even though a number of measures exist, no single bibliometric measure is perfect. Therefore, multiple approaches to evaluation are recommended. However, bibliometric approaches should not be the only measures upon which academic and scholarly performance are evaluated.
Publisher: Medknow
Date: 2012
Publisher: Elsevier BV
Date: 02-2023
Publisher: Wiley
Date: 04-09-2014
DOI: 10.1111/JAN.12244
Abstract: To describe the results of a study of images of men in nursing on television. Previous research has highlighted stereotypical images around nursing, such as the battle-axe, naughty nurse and handmaiden. More recent research focuses on images of nurses who are men, because of the growing numbers of men in the nursing workforce. Given that negative images can harm recruitment and retention in the profession, it is important to interrogate how men in nursing are portrayed in popular culture. Representations on television are particularly critical to explore because of the medium's wide audience. Qualitative study. Five American medical television programmes appearing between 2007 and 2010 were analysed for their construction of men in nursing: Grey's Anatomy, Hawthorne, Mercy, Nurse Jackie and Private Practice. Men in nursing on television were portrayed in ways that engaged with explicit and implicit stereotypes. The men were often subject to questions about their choice of career, masculinity and sexuality and their role usually reduced to that of prop, minority spokesperson or source of comedy. Thus, rather contradictorily, although the programmes often sought to expose common stereotypes about men in nursing, they nonetheless often reinforced stereotypes in more implicit ways. This research has implications for better understanding not only the status of nursing in our society but also for nursing practice and education and attracting more men to the profession.
Publisher: Springer Science and Business Media LLC
Date: 20-01-2018
DOI: 10.1007/S11897-018-0373-0
Abstract: The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure. Frailty assessment is an important predictive measure for mortality and hospitalisation in in iduals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty the appropriateness a purely physical measure of frailty in in iduals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure. There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/JOCN.14848
Publisher: Scientific Scholar
Date: 2014
Publisher: Oxford University Press (OUP)
Date: 17-11-2019
Abstract: Stabilising blood glucose levels (BGL) after starting or changing insulin and related therapies can be challenging for diabetes services and the patient with type 2 diabetes. Traditionally, a credentialled diabetes educator (CDE) would talk with the patient over the phone to obtain a history of their BGLs over the previous week and provide advice on the insulin dose adjustments as required. This study trialled a smartphone application for sharing BGLs, with the ability to digitally transmit advice back to patients compared with their usual care. The aim of this study was to compare desirability, efficiency and ease of use. Participants were enrolled in either the traditional ( n=50) or Health2Sync (H2S) ( n=42) treatment group by patient preference. All insulin stabilisations were conducted by the CDE. Descriptive statistics were used for analysis. The average total time taken to titrate patients was similar in both groups ( p .05), however there were fewer failure of contacts reported with H2S ( p .01) and time per interaction was also lower ( p .01). Sensitivity analysis revealed that, excluding the influence of no contacts, H2S patients had a lower average time for titration ( p .01). There was no difference in clinical outcomes as measured by HbA 1c between the two groups ( p=0.75). We demonstrated a high acceptance and clinical utility of the H2S application. Clinicians were happy to use H2S and found it easy and convenient for most patients. Importantly, this reduced frequency of contacts with patients, time per interaction and average time for titration ( p .01). Patient selection for this communication intervention is important.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.SAPHARM.2018.05.125
Abstract: This paper describes a novel model to providing interprofessional education (IPE) and interprofessional collaboration (IPC) within a simulated healthcare environment, in the higher education setting. The RIPE Model (Reflective Interprofessional Education Model) was developed for the purpose of enhancing IPE and IPC, clinical judgement, and decision-making between health professional students (pharmacy and nursing students) at the patient's simulated hospital bedside. A foundation 'unfolding' case utilizing the RIPE model was piloted with first year Master of pharmacy students and postgraduate nursing students at an Australian university and included a pharmacy practitioner acting as a resident medical officer (RMO) for the purpose of the teaching module. The RIPE model rotated students through 10 stations (including 2 reflection stations) to unpack an unfolding case. The development of the RIPE model, processes, and future directions are included in this article. The RIPE Model provides the flexibility to adapt and tailor different cases and scenarios to include other health professional students to enhance educational outcomes, with the feedback of the learning to potentially improve future patient outcomes. Furthermore, the model has the potential to be tailored and utilized for the purpose of upskilling practicing pharmacists for Continuing Professional Development (CPD) and changing scopes of practice.
Publisher: Informa UK Limited
Date: 03-07-2020
Publisher: Wiley
Date: 31-03-2017
DOI: 10.1111/JOCN.13759
Abstract: The purpose of this study was to elucidate the barriers and enablers to adherence to anticoagulation in in iduals with chronic heart failure (CHF) with concomitant atrial fibrillation (AF) from the perspective of patients and providers. CHF and AF commonly coexist and are associated with increased stroke risk and mortality. Oral anticoagulation significantly reduces stroke risk and improves outcomes. Yet, in approximately 30% of cases, anticoagulation is not commenced for a variety of reasons. Qualitative study using narrative inquiry. Data from face-to-face in idual interviews with patients and information retrieved from healthcare file note review documented the clinician perspective. This study is a synthesis of the two data sources, obtained during patient clinical assessments as part of the Atrial Fibrillation And Stroke Thromboprophylaxis in hEart failuRe (AFASTER) Study. Patient choice and preference were important factors in anticoagulation decisions, including treatment burden, unfavourable or intolerable side effects and patient refusal. Financial barriers included cost of travel, medication cost and reimbursement. Psychological factors included psychiatric illness, cognitive impairment and depression. Social barriers included homelessness and the absence of a caregiver or lack of caregiver assistance. Clinician reticence included fear of falls, frailty, age, fear of bleeding and the challenges of multimorbidity. Facilitators to successful prescription and adherence were caregiver support, reminders and routine, self-testing and the use of technology. Many barriers remain to high-risk in iduals being prescribed anticoagulation for stroke prevention. There are a number of enabling factors that facilitate prescription and optimise treatment adherence. Nurses should challenge these treatment barriers and seek enabling factors to optimise therapy. Nurses can help patients and caregivers to understand complex anticoagulant risk-benefit information, and act as a patient advocate when making complex stroke prevention decisions.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.NEDT.2016.10.002
Abstract: Nurses are required to interpret and apply knowledge so communities will receive care based on best available evidence, as opposed to care that is simply based on tradition or authority. Fostering nursing students' critical appraisal skills will assist in their capacity to engage with, interpret and use best evidence. Journal clubs are frequently used approach to engage learners with research and develop critical appraisal skills. Given new flipped and blended approaches to teaching and learning there is need to rejuvenate how research is utilised and integrated within journal clubs to maximise engagement and translation of evidence. This paper provides a case study of a single site Australian university experience of transitioning a traditional physical journal club, to a social media-facilitated club within a postgraduate health subject to stimulate and facilitate engagement with the chosen manuscripts. This case study is based on our own experiences, supported by literature and includes qualitative comments obtained via student feedback surveys during November 2015. Case study. Social media-facilitated journal clubs offer an efficient way to continue developing critical appraisal skills in nursing students. The integration of a social media-facilitated journal clubs increased student attention, engagement with presented activities and overall student satisfaction within this evidence-based practice subject. Future rigorously-designed, large-scale studies are required to evaluate the impact of online journal clubs on the uptake of evidence-based practice, including those resulting in improved patient outcomes.
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2018-023130
Abstract: Screening for atrial fibrillation (AF) in people ≥65 years is now recommended by guidelines and expert consensus. While AF is often asymptomatic, it is the most common heart arrhythmia and is associated with increased risk of stroke. Early identification and treatment with oral anticoagulants can substantially reduce stroke risk. The general practice setting is ideal for opportunistic screening and provides a natural pathway for treatment for those identified. This study aims to investigate the feasibility of implementing screening for AF in rural general practice using novel electronic tools. It will assess whether screening will fit within an existing workflow to quickly and accurately identify AF, and will potentially inform a generalisable, scalable approach. Screening with a smartphone ECG will be conducted by general practitioners and practice nurses in rural general practices in New South Wales, Australia for 3–4 months during 2018–2019. Up to 10 practices will be recruited, and we aim to screen 2000 patients aged ≥65 years. Practices will be given an electronic screening prompt and electronic decision support to guide evidence-based treatment for those with AF. De-identified data will be collected using a clinical audit tool and qualitative interviews will be conducted with selected practice staff. A process evaluation and cost-effectiveness analysis will also be undertaken. Outcomes include implementation success (proportion of eligible patients screened, fidelity to protocol), proportion of people screened identified with new AF and rates of treatment with anticoagulants and antiplatelets at baseline and completion. Results will be compared against an earlier metropolitan study and a ‘control’ dataset of practices. Ethics approval was received from the University of Sydney Human Research Ethics Committee on 27 February 2018 (Project no.: 2017/1017). Results will be disseminated through various forums, including peer-reviewed publication and conference presentations. ACTRN12618000004268 Pre-results.
Publisher: Informa UK Limited
Date: 09-07-2020
Publisher: Informa UK Limited
Date: 04-05-2017
Publisher: Springer Science and Business Media LLC
Date: 17-03-2021
DOI: 10.1186/S12903-021-01501-7
Abstract: Stroke is a serious cerebrovascular disease and is one of the world’s leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings. A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed. Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors. There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes.
Publisher: Wiley
Date: 08-2017
DOI: 10.1111/JOCN.13470
Publisher: Springer Science and Business Media LLC
Date: 03-01-2020
DOI: 10.1007/S10741-019-09910-1
Abstract: International clinical practice guidelines recommend that patients with chronic heart failure receive timely and high-quality palliative care. However, integrating palliative care is highly variable and dependent on decision-making and care models. This meta-synthesis aimed to examine health care professionals' decision-making processes and explore factors impacting decisions to refer or deliver palliative care in chronic heart failure. The electronic databases SCOPUS, CINAHL, and Medline were searched. Included studies were those that reported health care professionals' perceptions of palliative care in chronic heart failure through qualitative data collection, were written in English, and were peer-reviewed articles. Included articles were analysed using Thomas and Harden's approach. The dual-process theory was used and applied a priori to organise the findings. The perception of palliative care as a transition and active treatment failure fit within the intuitive system of thinking in the dual-process theory. The theme that overlapped into both intuitive and analytical systems of thinking was acquiring patient and illness information themes reflecting the analytical system of thinking were professional role and experience, pre-existing decision pathways, and balancing viewpoints. This meta-synthesis identified factors influencing the decision-making process in referring patients with chronic heart failure to palliative care. The findings from this review highlight the need for further development of decision-making tools or facilitate guidelines to assist health care professionals' shared decision-making to improve patient outcomes.
Publisher: Wiley
Date: 28-11-2022
DOI: 10.1111/JAN.15104
Abstract: To describe a protocol for the pilot phase of a trial designed to test the effect of an mHealth intervention on representation and readmission after adult cardiac surgery. A multisite, parallel group, pilot randomized controlled trial (ethics approval: HREC2020.331‐RMH69278). Adult patients scheduled to undergo elective cardiac surgery (coronary artery bypass grafting, valve surgery, or a combination of bypass grafting and valve surgery or aortic surgery) will be recruited from three metropolitan tertiary teaching hospitals. Patients allocated to the control group with receive usual care that is comprised of in‐patient discharge education and local paper‐based written discharge materials. Patients in the intervention group will be provided access to tailored ‘GoShare’ mHealth bundles preoperatively, in a week of hospital discharge and 30 days after surgery. The mHealth bundles are comprised of patient narrative videos, animations and links to reputable resources. Bundles can be accessed via a smartphone, tablet or computer. Bundles are evidence‐based and designed to improve patient self‐efficacy and self‐management behaviours, and to empower people to have a more active role in their healthcare. Computer‐generated permuted block randomization with an allocation ratio of 1:1 will be generated for each site. At the time of consent, and 30, 60 and 90 days after surgery quality of life and level of patient activation will be measured. In addition, rates of representation and readmission to hospital will be tracked and verified via data linkage 1 year after the date of surgery. Interventions using mHealth technologies have proven effectiveness for a range of cardiovascular conditions with limited testing in cardiac surgical populations. This study provides an opportunity to improve patient outcome and experience for adults undergoing cardiac surgery by empowering patients as end‐users with strategies for self‐help. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000082808.
Publisher: JMIR Publications Inc.
Date: 18-06-2020
DOI: 10.2196/17299
Abstract: New wearable devices (for ex le, AliveCor or Zio patch) offer promise in detecting arrhythmia and monitoring cardiac health status, among other clinically useful parameters in older adults. However, the clinical utility and usability from the perspectives of clinicians is largely unexplored. This study aimed to explore clinician perspectives on the use of wearable cardiac monitoring technology for older adults. A descriptive qualitative study was conducted using semistructured focus group interviews. Clinicians were recruited through purposive s ling of physicians, nurses, and allied health staff working in 3 tertiary-level hospitals. Verbatim transcripts were analyzed using thematic content analysis to identify themes. Clinicians representing physicians, nurses, and allied health staff working in 3 tertiary-level hospitals completed 4 focus group interviews between May 2019 and July 2019. There were 50 participants (28 men and 22 women), including cardiologists, geriatricians, nurses, and allied health staff. The focus groups generated the following 3 overarching, interrelated themes: (1) the current state of play, understanding the perceived challenges of patient cardiac monitoring in hospitals, (2) priorities in cardiac monitoring, what parameters new technologies should measure, and (3) cardiac monitoring of the future, “the ideal device.” There remain pitfalls related to the design of wearable cardiac technology for older adults that present clinical challenges. These pitfalls and challenges likely negatively impact the uptake of wearable cardiac monitoring in routine clinical care. Partnering with clinicians and patients in the co-design of new wearable cardiac monitoring technologies is critical to optimize the use of these devices and their uptake in clinical care.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-08-2022
Abstract: This study explored the educational and self‐management needs of adults living with atrial fibrillation (AF). This is a qualitative study of adults living with AF, clinicians, and expert key stakeholders. Interviews were conducted via a one‐to‐one semistructured videoconference or phone and transcribed verbatim for thematic analysis. A total of 34 participants were recruited and included in analyses (clinicians n=13 experts n=13, patients n=8). Interviews were on average 40 (range 20–70) minutes in duration. Three key themes were identified: (1) “Patient‐centered AF education” (2) “Prioritizing AF education” and (3) “Timing AF education.” The availability of credible information was perceived as highly variable. Information primarily focused on anticoagulation, or procedural information, as opposed to other aspects of management, such as risk factor reduction. Factors to optimize learning, such as multimedia, apps, case studies, or the use of visuals were perceived as important. Continuity of care, including engagement of caregivers, was important to help develop relationships, and facilitate understanding, while concurrently creating opportunities for timely targeted education. Clinicians described acute care as a suboptimal setting to deliver education. Competing interests aligned with the time‐pressured context of acute care were prioritized over patient education. In contrast, patients valued continuity of care. AF education strategies need to pivot from a “one size fits all” approach and modernize to implement a range of approaches. There remain many unmet needs in the provision of quality AF education to support self‐management. Multimodal offerings and the ability to tailor to in idual patient needs are important design considerations for new education programs.
Publisher: Oxford University Press (OUP)
Date: 10-2021
Abstract: Clinical registry participation is a measure of healthcare quality. Limited knowledge exists on Australian hospitals’ participation in clinical registries and whether this registry data informs quality improvement initiatives. To identify participation in clinical registries, determine if registry data inform quality improvement initiatives, and identify registry participation enablers and clinicians’ educational needs to improve use of registry data to drive practice change. A self-administered survey was distributed to staff coordinating registries in seven hospitals in New South Wales, Australia. Eligible registries were international-, national- and state-based clinical, condition-/disease-specific and device roduct registries. Response rate was 70% (97/139). Sixty-two (64%) respondents contributed data to 46 eligible registries. Registry reports were most often received by nurses (61%) and infrequently by hospital executives (8.4%). Less than half used registry data ‘always’ or ‘often’ to influence practice improvement (48%) and care pathways (49%). Protected time for data collection (87%) and benchmarking (79%) were ‘very likely’ or ‘likely’ to promote continued participation. Over half ‘strongly agreed’ or ‘agreed’ that clinical practice improvement training (79%) and evidence–practice gap identification (77%) would optimize use of registry data. Registry data are generally only visible to local speciality units and not routinely used to inform quality improvement. Centralized on-going registry funding, accessible and transparent integrated information systems combined with data informed improvement science education could be first steps to promote quality data-driven clinical improvement initiatives.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-12-2018
Abstract: Although frailty has been associated with increased risks for hospitalization and mortality in chronic heart failure, the precise average effect remains uncertain. We performed a systematic review and meta‐analysis to summarize the hazards for mortality and incident hospitalization in patients with heart failure and frailty compared with those without frailty and explored the heterogeneity underlying the effect size estimates. MEDLINE , EMBASE, and Cochrane databases were queried for articles published between January 1966 and March 2018. Predefined selection criteria were used. Hazard ratios ( HRs ) were pooled for meta‐analyses, and where odds ratios were used previously, original data were recalculated for HR . Overlapping data were consolidated, and only unique data points were used. Study quality and bias were assessed. Eight studies were included for mortality (2645 patients), and 6 studies were included for incident hospitalization (2541 patients) during a median follow‐up of 1.82 and 1.12 years, respectively. Frailty was significantly associated with an increased hazard for mortality ( HR , 1.54 95% confidence interval, 1.34–1.75 P .001) and incident hospitalization ( HR , 1.56 95% confidence interval, 1.36–1.78 P .001) in chronic heart failure. The Fried phenotype estimated a 16.9% larger effect size than the combined Fried/non‐Fried frailty assessment for the end point of mortality ( HR , 1.80 95% confidence interval, 1.41–2.28 P .001), but not for hospitalization ( HR , 1.57 95% confidence interval, 1.30–1.89 P .001). Study heterogeneity was found to be low (I 2 =0%), and high quality of studies was verified by the Newcastle‐Ottawa scale. Overall, the presence of frailty in chronic heart failure is associated with an increased hazard for death and hospitalization by ≈1.5‐fold.
Publisher: CRC Press
Date: 25-07-2022
Publisher: Elsevier BV
Date: 07-2021
Publisher: JMIR Publications Inc.
Date: 16-03-2023
DOI: 10.2196/38429
Abstract: A sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. This review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. CINAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. A total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity 38% (6/16) of studies investigated weight reduction and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies. Despite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. PROSPERO International Prospective Register of Systematic Reviews CRD42022311430 www.crd.york.ac.uk rospero/display_record.php?RecordID=311430
Publisher: Wiley
Date: 07-05-2018
DOI: 10.1111/AJAG.12540
Abstract: The objectives of this short report are to: (i) explore #Frailty Twitter activity over a six-month period and (ii) provide a snapshot Twitter content analysis of #Frailty usage. A mixed-method study was conducted to explore Twitter data related to frailty. The primary search term was #Frailty. Objective 1: data were collected using Symplur analytics, including variables for total number of tweets, unique tweeters (users) and total number of impressions. Objective 2: a retrospectively conducted snapshot content analysis of 1500 #Frailty tweets was performed using TweetReach Over a six-month period (1 January 2017-31 June 2017), there was a total of 6545 #Frailty tweets, generating 14.8 million impressions across 3986 participants. Of the 1500 tweets (814 retweets 202 replies 484 original tweets), 56% were relevant to clinical frailty. The main contributors ('who') were as follows: the public (29%), researchers (25%), doctors (21%), organisations (18%) and other allied health professionals (7%). Tweet main message intention ('what') was public health/advocacy (41%), social communication (28%), research-based evidence rofessional education (24%), professional opinion/case studies (15%) and general news/events (7%). Twitter is increasingly being used to communicate about frailty. It is important that thought leaders contribute to the conversation. There is potential to leverage Twitter to promote and disseminate frailty-related knowledge and research.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2017
Publisher: Oxford University Press (OUP)
Date: 14-08-2015
Abstract: Atrial fibrillation is a common arrhythmia and a risk factor for adverse events including stroke. People living with atrial fibrillation are commonly elderly and have multiple comorbidities. The role of a caregiver in supporting the in idual to manage a chronic and complex condition has received limited attention. This review aims to summarize available information on the caregiver role in atrial fibrillation, specifically in promoting adherence to thromboprophylaxis and evidence for strategies to support and enable the caregiver. A review of electronic databases and search engines was undertaken including Medline, Scopus and CINAHL. The search terms 'atrial fibrillation', 'anticoagulation', 'carer', 'caregiver', 'family support' were used. Dates searched were from January 1990 to November 2012. The review found limited original clinical research studies. The majority of the literature identified in the initial search included review papers and work which recommends the inclusion of the caregiver in the care of patients with atrial fibrillation but limited empirical evidence. Caregivers have an essential role to play in advocacy, family centred care and shared decision-making. This may influence thromboprophylaxis treatment choices and potentially adherence. Assessment of caregiver needs and support should be central to patient assessment and care planning. There is a need for clinical intervention studies which more target and address the caregiver role.
Publisher: Oxford University Press (OUP)
Date: 04-11-2019
Abstract: Maintaining good oral health remains a challenge among those hospitalised after stroke. Stroke nurses and allied health clinicians have a potential role in providing oral care, but no studies in Australia to date have explored their perceptions and needs. To explore the perspectives of nursing and allied health stroke clinicians regarding oral care for stroke patients across acute care and stroke rehabilitation settings. This study followed an exploratory qualitative design, using a constructivist approach. Participants from two metropolitan public hospitals were purposively recruited to participate in focus groups. Data was thematically analysed. Twenty-one clinicians participated. Clinicians’ knowledge and practices relating to oral healthcare for stroke patients were inadequate. Most staff felt they did not have adequate knowledge, resources and training to administer oral care in this setting and proposed enhancing education of stroke clinicians, patients and informal caregivers, as well as improving quality point of care resources. There was overall support for the integrated dental care after stroke model of care. This study revealed many gaps in current care and highlighted areas for improvement. Patients and their caregivers needed to be actively engaged as partners to improve oral healthcare within acute and rehabilitation stroke settings. This study provided insight into nurses’ and allied health stroke clinicians’ current knowledge and practices of oral care in various stroke settings. The findings from this study will inform development of a model of care to train stroke nurses in providing oral care.
Publisher: Wiley
Date: 06-2022
DOI: 10.1002/AGM2.12214
Abstract: The objectives of this study were to determine the prevalence of frailty in the context of atrial fibrillation (AF) to identify the most commonly used frailty instruments in AF and to describe the effect of frailty on non‐vitamin K oral anticoagulant (NOAC) prescription for stroke prevention in adults with AF. A systematic search of databases, including Medline, Embase, Web of Science, Cochrane Library, Scopus, and CINAHL, was conducted using search terms including “atrial fibrillation,” “frailty,” and “anticoagulation.” A narrative synthesis was undertaken. A total of 92 articles were screened, and 12 articles were included. The mean age of the participants ( n = 212,111) was 82 years (range = 77–85 years) with 56% of participants identified as frail and 44% identified non‐frail. A total of five different frailty instruments were identified: the Frailty Phenotype (FP n = 5, 42%), the Clinical Frailty Scale (CFS n = 4, 33%), Cumulative Deficit Model of Frailty (CDM n = 1, 8%), Edmonton Frail Scale ( n = 1, 8%) and the Resident Assessment Instrument – Minimum Data Set (RAI‐MDS 2.0 n = 1, 8%). Frailty was identified as an important barrier to anticoagulant therapy with 52% of the frail population anticoagulated vs 67% non‐frail. Frailty is an important consideration in anticoagulation decision making for stroke prevention in patients with AF. There is scope to improve frailty screening and treatment. Frailty status is an important risk marker and should be considered when evaluating stroke risk alongside congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke, transient ischemic attack, or thromboembolism, vascular disease, age 65–74 years, sex category (CHA 2 DS 2 ‐VASc) and Hypertension, Abnormal renal/liver function, Stroke, Bleeding, Labile, Elderly, and Drugs (HAS‐BLED) scores.
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.AUCC.2013.08.002
Abstract: Atrial fibrillation (AF) is a common arrhythmia and a risk factor for stroke and other, adverse events. Internationally there have been recent advancements in the therapies available for, stroke prevention in AF. Nurses will care for in iduals with AF across a variety of primary and acute, care settings and should be familiar with evidence based therapies. This paper provides a review of the epidemiology of AF and stroke, stroke and bleeding risk, assessment tools and evidence based treatments for the prevention of stroke in AF including the use of, novel anti-thrombin agents. A review of key databases was conducted from 2002 to 2012 using the key search terms 'atrial, fibrillation' 'anticoagulation' 'risk assessment' and 'clinical management'. The following electronic, databases were searched: CINAHL, Medline, Scopus, the Cochrane Library and Google Scholar., Reference lists were manually hand searched. Key clinical guidelines from National Institute for, Clinical Excellence (NICE, UK), American Heart Association (AHA, USA), American College of Cardiology, (ACC, USA) and the European Society of Cardiology (ESC) and key government policy documents were, also included. Articles were included in the review if they addressed nursing management with a focus, on Australia. Many treatment options exist for AF. Best practice guidelines make a variety of, recommendations which include cardioversion, ablation, pulmonary vein isolation, pharmacological, agents for rate or rhythm control approaches, and antithrombotic therapy (including anticoagulation, and antiplatelet therapy). Treatment should be patient centred and in idualised based upon, persistency of the rhythm, causal nature, risk and co-morbid conditions. AF is a common and burdensome condition where treatment is complex and not without, risk. Nurses will encounter in iduals with AF across a variety of primary and acute care areas, understanding the risk of AF and appropriate therapies is important across all care settings. Treatment, must be in idually tailored to the needs of the patient and balanced with the best available evidence.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.NEDT.2022.105319
Abstract: To identify subject matter, pedagogical approaches and assess outcomes of interventions implemented to educate nurses in urinary catheterisation care and management. A systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Databases (CINAHL MEDLINE ProQuest ERIC Scopus Cochrane and APA PsycINFO) were searched using key concepts: education interventions, indwelling urinary catheter and nurses, from inception to July 2021. Two researchers searched the databases, whereupon data were extracted using a standardised proforma and were analysed applying an abductive approach. The Joanna Briggs Institute Critical Appraisal tool was used to assess the quality of the included studies. Findings were analysed and reported using narrative synthesis. Out of 1159 studies screened, nine educational intervention studies related to upskilling nurses in catheter management were identified. Subject matter addressed included pathophysiology of the urinary system, clinical indications and management of indwelling catheter and associated complications. Although the subject matter and pedagogical approaches varied, all identified studies reported positive effects in improving participants' knowledge. Upskilling nurses and increasing their confidence to deliver patient-centred catheter care practices is an important intervention to improve outcomes for patients with long-term indwelling urinary catheters. However, actively engaging nurses who provide direct patient care is essential, in planning and implementing targeted educational interventions specific to learning needs. This review has identified a gap in the educational interventions for nurses, in better supporting the psychosocial needs of patients living with indwelling catheter. Codesigning educational interventions with nurses that are tailored to their contextual learning needs is likely to enhance behaviour change and improve current practice.
Publisher: Wiley
Date: 28-11-2017
DOI: 10.1111/JOCN.13771
Publisher: Informa UK Limited
Date: 11-07-2016
DOI: 10.1080/10376178.2016.1205458
Abstract: Social media platforms are useful for creating communities, which can then be utilised as a mean for supportive, professional and social learning. To explore first year nursing student experiences with social media in supporting student transition and engagement into higher education. Qualitative focus groups. Ten 1st year Bachelor of Nursing students were included in three face-to-face focus groups. Data were analysed using qualitative thematic content analysis. Three key themes emerged that illustrates the experiences of transition and engagement of first year student nurses using social media at university. (1) Facilitating familiarity and collaboration at a safe distance, (2) promoting independent learning by facilitating access to resources, and (3) mitigating hazards of social media. This study has demonstrated the importance of social media in supporting informal peer-peer learning and support, augmenting online and offline relationships, and building professional identity as a nurse.
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 06-2022
Publisher: Elsevier BV
Date: 04-2022
Publisher: Springer Science and Business Media LLC
Date: 05-09-2017
Publisher: Informa UK Limited
Date: 10-2013
Publisher: Mark Allen Group
Date: 02-10-2016
Publisher: Informa UK Limited
Date: 03-03-2020
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.SAPHARM.2019.01.019
Abstract: Simulation is an effective strategy for enhancing interprofessional education (IPE) and collaboration (IPC). A novel interprofessional learning model, The RIPE Model (Reflective Interprofessional Education Model) was applied for a pilot study during a simulation laboratory aimed to (i) enhance pharmacy and nursing students' understanding of the roles and responsibilities of professions within the multidisciplinary healthcare team and (ii) enhance the importance of working collaboratively in team-based care. The pilot study using a mixed-methods approach, including the administration of a 6-item student survey on a 6-point Likert-type scale as a pre-test (prior to participation in the simulation laboratory) and post-test (after participation in the simulation laboratory), and a debriefing session eliciting a follow up written reflective statement. Sixty-four students (n = 56 pharmacy n = 8 nursing) participated in the study which resulted n = 52 pharmacy students and n = 8 nursing students matched data to a pre-test and post-test survey, analyzed via paired t-tests. Statistically significant results (p < 0.05) reported a positive increase in pharmacy students' perceptions from the pre-test and post-test survey for all six items indicating the extent of agreement of IPC and for one item on the nursing student survey. Qualitative analysis of reflective statements (n = 62) was conducted via thematic analysis utilizing Braun and Clarke's 6-phase process. Thematic analysis generated one overarching theme: IPC: Developing appreciation and respect for healthcare team members to improve patient outcomes and three subthemes: (i) Enhanced decision-making (ii) Communication and collaboration (iii) New understandings of roles and responsibilities. Students perceived that utilizing the RIPE Model of learning involving simulation to enhance interprofessional collaboration assisted their understanding of the roles, functions and responsibilities of other healthcare professionals involved the patient care team. Effective collaboration was perceived to be beneficial to enhancing confidence with engagement and communication, appreciation and respect for the expertise of other healthcare professions.
Publisher: Springer Science and Business Media LLC
Date: 30-05-2023
DOI: 10.1007/S11096-023-01583-Z
Abstract: Atrial fibrillation (AF) and obesity affect over 60 and 650 million people, respectively. This study aimed to explore clinician practices, beliefs, and attitudes towards the use of direct oral anticoagulants (DOACs) in obese adults (BMI ≥ 30 kg/m 2 ) with AF. Semi-structured interviews via video conference were conducted with multidisciplinary clinicians from across Australia, with expertise in DOAC use in adults with AF. Clinicians were invited to participate using purposive and snowball s ling techniques. Data were analysed in NVIVO using thematic analysis. Fifteen clinicians including cardiologists (n = 5), hospital and academic pharmacists (n = 5), general practitioners (n = 2), a haematologist, a neurologist and a clinical pharmacologist participated. Interviews were on average 31 ± 9 min. Key themes identified were: Health system factors in decision-making Disparities between rural and metropolitan geographic areas, availability of health services, and time limitations for in-patient decision-making, were described Condition-related factors in decision-making Clinicians questioned the significance of obesity as part of decision-making due to the practical limitations of dose modification, and the rarity of the extremely obese cohort Decision-making in the context of uncertainty Clinicians reported limited availability, reliability and awareness of primary evidence including limited guidance from clinical guidelines for DOAC use in obesity. This study highlights the complexity of decision-making for clinicians, due to the limited availability, reliability and awareness of evidence, the intrinsic complexity of the obese cohort and limited guidance from clinical guidelines. This highlights the urgent need for contemporary research to improve the quality of evidence to guide informed shared decision-making.
Publisher: Elsevier BV
Date: 09-2021
DOI: 10.1016/J.AUCC.2021.08.010
Abstract: Oral care is a fundamental nurse-led intervention in the critical care setting that provides patient comfort and prevents adverse outcomes in critically ill patients. To date, there has been minimal focus on nurse-focused interventions to improve adherence to oral care regimens in the adult intensive care unit setting. The objectives of this study were to (i) identify types and characteristics of interventions to improve oral care adherence amongst critical care nurses and intervention core components, (ii) evaluate the effectiveness of interventions to improve adherence of oral care regimens, and (iii) identify the types of outcome measures used to assess oral care regimen adherence. This is a systematic review in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Key bibliographic databases and platforms, including Scopus, Cochrane, MEDLINE, CINAHL, Embase, PsycINFO, ProQuest, and Web of Science, were searched for studies published before July 2020. The Joanna Briggs Institute's quality appraisal tool was used to assess risk of bias in included studies. A total of 21 original research studies were identified, of which 18 studies used multifaceted interventions. In accordance with the Joanna Briggs Institute's quality appraisal tools, four of the 20 quasi-experimental studies were rated as high quality. The one randomised control trial was of moderate quality. Outcome measures included oral care adherence behaviours, oral care knowledge, self-reported adherence, and documentation. Improved effectiveness in oral care adherence was reported in 20 studies. Review findings confirm interventions to change behaviours improve oral care adherence. The most effective interventional approach could not be determined owing to heterogeneity in intervention design and outcome measures. Oral care in the intensive care unit is a vital, nurse-led activity that reduces the risk of hospital-acquired infection. It is recommended that future research adopt implementation science methods to ensure stakeholder engagement and feasibility. This review was submitted and subsequently registered on PROSPERO, the International Perspective Register of Systematic Reviews PROSPERO 2019 CRD42019123142.
Publisher: Maad Rayan Publishing Company
Date: 09-2019
Abstract: Introduction: The purpose of this study was to explore the characteristics of undergraduate nursing students, which may determine the nature of their relationship with clinical nurses. Relationships between nursing students and clinical nurses are critical to maximize student learning outcomes and produce skilled graduates for the future health workforce. Methods: This qualitative content analysis study was conducted from January to August 2016. Twenty nine semi-structured in-depth interviews were conducted with 20 undergraduate nursing students in Tabriz nursing and midwifery faculty. Interviews were recorded and transcribed verbatim (in Persian), and analyzed using conventional content analysis to identify themes. Results: Four key themes emerged: educational factors (cognitive knowledge and practical skills, and learning motivation) communication skills perceived support (perceived support from nurses and educators) and psychological state (fear of the relationship and self-confidence). Self-confidence is an emphasized concept in nursing students' willingness and ability to relate with clinical nurses. Conclusion: The results of the study showed that educational, communicative and psychological factors are important determinants of student communication with nurses. However, self-confidence is the most important factor in establishing such relationship. Self-confidence could be further assessed to identify nursing students who need greater support or would benefit from greater educational interventions to achieve relational skills.
Publisher: Wiley
Date: 12-03-2020
DOI: 10.1111/JOCN.15222
Publisher: Oxford University Press (OUP)
Date: 27-10-2023
Abstract: To compare the frailty prevalence and predictive performance of six frailty instruments in adults with heart failure and determine the feasibility of study methods. Prospective cohort pilot study. Adults aged 18 years or older with a confirmed diagnosis of heart failure in Sydney, New South Wales, Australia. The Frailty Phenotype the Survey of Health, Ageing, and Retirement in Europe Frailty Instrument (SHARE-FI) St Vincent’s Frailty instrument St Vincent’s Frailty instrument plus cognition and mood The Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight (FRAIL) scale and the Deficit Accumulation Index (DAI) were compared. Multiple logistic regression was used to develop six frailty instrument models to evaluate the association between each frailty instrument and composite all-cause rehospitalization and mortality at 12 months. One hundred and thirty-one patients were included with a mean age of 54 [± 14(SD)]. Frailty prevalence ranged from 33 to 81%. All instruments except one (the FRAIL scale) appeared to signal an increased odds of rehospitalization and/or mortality, yet these results were non-significant. The six frailty instrument models displayed sensitivity between 88–92% and C-statistic values of 0.71–0.73, suggesting satisfactory discrimination. The prevalence of frailty varied across six frailty instruments yet was in the higher range despite a ‘younger’ heart failure cohort. Further research is required to confirm the psychometric properties of these instruments for routine clinical use in an adequately powered and more erse heart failure cohort.
Publisher: Research Square Platform LLC
Date: 15-09-2021
DOI: 10.21203/RS.3.RS-900097/V1
Abstract: BackgroundThe battery-operated hand-held fan (‘fan’) is an inexpensive and portable non-pharmacological intervention for chronic breathlessness that has few if any harms and has been shown to reduce breathlessness intensity, improve physical activity and functioning, and reduce anxiety in patients with chronic obstructive pulmonary disease (COPD) and other conditions. This study aimed to explore barriers and facilitators to the fan’s implementation in specialist respiratory care as a non-pharmacological intervention for chronic breathlessness in patients with COPD.Methods A qualitative approach was taken, using focus groups. Participants were clinicians from any discipline working in specialist respiratory care at two hospitals. Questions asked about current fan-related practice and perceptions regarding benefits, harms and mechanisms, and factors influencing its implementation. Analysis used a mixed inductive/deductive approach.ResultsForty-nine participants from nursing (n=30), medical (n=13) and allied health (n=6) disciplines participated across 9 focus groups. The most influential facilitator was a belief that the fan’s benefits outweighed disadvantages. Clinicians’ beliefs about the fan’s mechanisms determined which patient sub-groups they targeted, for ex le anxious or palliative/end-stage patients. Barriers to implementation included a lack of clarity about whose role it was to implement the fan, what advice to provide patients, and limited access to fans in hospitals. Few clinicians implemented the fan for acute-on-chronic breathlessness or in combination with other interventions.ConclusionImplementation of the fan in specialist respiratory care may require service- and clinician-level interventions to ensure it is routinely recommended as a first-line intervention for chronic breathlessness in patients with COPD of any stage.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Informa UK Limited
Date: 04-07-2022
Publisher: Springer Science and Business Media LLC
Date: 27-02-2018
Publisher: Oxford University Press (OUP)
Date: 24-02-2023
Abstract: Online surveys are increasingly popular in research given their cost-effectiveness and potential reach. However, low response rates remain a key contributor to bias and the overall quality of results. Having a well-designed survey, providing financial remunerations, sending personalized invitations, offering regular reminders, and using more than one recruitment strategy are evidence-based approaches to improve response rates. Given the potential for illegitimate responses to online surveys, approaches that minimize illegitimate participation are discussed.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Informa UK Limited
Date: 04-03-2021
Publisher: Springer Science and Business Media LLC
Date: 24-03-2018
DOI: 10.1007/S11886-018-0975-X
Abstract: The objectives of this review were to (1) discuss how multimorbidity and polypharmacy contributes to the complexity of management among in iduals with AF and (2) identify any interventions to manage polypharmacy in relation to AF. Based on the four landmark clinical trials of novel anticoagulants, the most common comorbidities with AF are hypertension, heart failure, diabetes, stroke and myocardial infarction. Polypharmacy was also found prevalent in 76.5% of patients with AF, with a median of six drugs per patient. Despite the consequences of polypharmacy in AF, there is very little evidence-based intervention designed to manage it. Hence, there is a need for further research to examine interventions to manage polypharmacy in relation to AF. Atrial fibrillation (AF) is the most common type of cardiac arrhythmia requiring treatment in adults. Due to the structural and/or electrophysiological abnormalities that occur in AF, patients are managed through the use of prophylactic anticoagulant and rate and/or rhythm control medications. However, these medications are considered high risk and can increase the chances of medication misadventure. Additionally, AF rarely occurs in isolation and is known to coexist with multiple other medical comorbidities, i.e. multimorbidity. This also increases the number of medications, i.e. polypharmacy and pill burden which results in treatment non-compliance to prescribed therapy.
Publisher: Wiley
Date: 27-01-2020
DOI: 10.1111/JOCN.15185
Abstract: To assess the impact of a Twitterchat focusing on antimicrobial resistance and it is feasibility for integration within a nursing prelicensure research methods class. Antimicrobial resistance is one of the greatest threats to global health and food security. Consequently, developing a global approach with large outreach is critical. Twitter, as a popular social media platform, is useful for creating communities of practice and communities of interest. A case study design using a Twitterchat is a hosted, convened and focussed discussion on a particular topic using a discrete hashtag. Using a standardised protocol, a Twitterchat was undertaken over a 24-hr period and digital metrics assessed at 72 hr. A summary of impact was undertaken using an online tool provided by Union Metrics (unionmetrics.com/). At 72 hr, 2,632,762 accounts were reached and over 10 million impressions achieved. Twitterchats can be useful in creating awareness and fostering a community of interest and demonstrating the role of nurses in thought leadership. A formalised research study will draw on this case study to evaluate the impact on the Twitter participants and nursing students. Social media are an accessible and useful tool to harness focus and attention on clinical issues with global relevance. Demonstrating the utility and leverage to nursing students is important in increasing their understanding of the importance of communication and diffusion of information.
Publisher: Informa UK Limited
Date: 25-06-2018
Publisher: Oxford University Press (OUP)
Date: 26-07-2019
Abstract: The purpose of this systematic review was to (a) examine the effects of interventions delivered by a heart failure professional for mild cognitive impairment and dementia on cognitive function, memory, working memory, instrumental activities of daily living, heart failure knowledge, self-care, quality of life and depression and (b) identify the successful elements of these strategies for heart failure patients with mild cognitive impairment or dementia. During March 2018, an electronic search of databases including CINAHL, MEDLINE, EMBASE and PsycINFO was conducted. All randomised controlled trials, which examined an intervention strategy to help heart failure patients with mild cognitive impairment or dementia cope with self-care, were included. An initial search yielded 1622 citations, six studies were included ( N= 595 participants, mean age 68 years). There were no significant improvements in cognitive function and depression. However, significant improvements were seen in memory ( p=0.015), working memory ( p=0.029) and instrumental activities of daily living ( p=0.006). Nurse led interventions improved the patient’s heart failure knowledge ( p=0.001), self-care ( p .05) and quality of life ( p=0.029). Key elements of these interventions include brain exercises, for ex le, syllable stacks, in idualised assessment and customised education, personalised self-care schedule development, interactive problem-solving training on scenarios and association techniques to prompt self-care activities. Modest evidence for nurse led interventions among heart failure patients with mild cognitive impairment or dementia was identified. These results must be interpreted with caution in light of the limited number of available included studies.
Publisher: Wiley
Date: 04-01-2021
DOI: 10.1111/JOCN.15619
Publisher: Forum for Medical Ethics Society
Date: 2014
Publisher: Informa UK Limited
Date: 10-09-2020
Publisher: Wiley
Date: 26-08-2019
Publisher: JMIR Publications Inc.
Date: 04-2022
Abstract: sedentary lifestyle and being overweight or obese are well-established cardiovascular risk factors and contribute substantially to the global burden of disease. Changing such behavior is complex and requires support. Social media interventions show promise in supporting health behavior change, but their impact is unclear. Moreover, previous reviews have reported contradictory evidence regarding the relationship between engagement with social media interventions and the efficacy of these interventions. his review aimed to critically synthesize available evidence regarding the impact of social media interventions on physical activity and weight among healthy adults. In addition, this review examined the effect of engagement with social media interventions on their efficacy. INAHL and MEDLINE were searched for relevant randomized trials that were conducted to investigate the impact of social media interventions on weight and physical activity and were published between 2011 and 2021 in the English language. Studies were included if the intervention used social media tools that provided explicit interactions between the participants. Studies were excluded if the intervention was passively delivered through an app website or if the participants had a known chronic disease. Eligible studies were appraised for quality and synthesized using narrative synthesis. total of 17 papers reporting 16 studies from 4 countries, with 7372 participants, were identified. Overall, 56% (9/16) of studies explored the effect of social media interventions on physical activity 38% (6/16) of studies investigated weight reduction and 6% (1/16) of studies assessed the effect on both physical activity and weight reduction. Evidence of the effects of social media interventions on physical activity and weight loss was mixed across the included studies. There were no standard metrics for measuring engagement with social media, and the relationship between participant engagement with the intervention and subsequent behavior change was also mixed. Although 35% (6/16) of studies reported that engagement was not a predictor of behavior change, engagement with social media interventions was found to be related to behavior change in 29% (5/16) of studies. espite the promise of social media interventions, evidence regarding their effectiveness is mixed. Further robust studies are needed to elucidate the components of social media interventions that lead to successful behavior change. Furthermore, the effect of engagement with social media interventions on behavior change needs to be clearly understood. ROSPERO International Prospective Register of Systematic Reviews CRD42022311430 www.crd.york.ac.uk rospero/display_record.php?RecordID=311430
Publisher: Oxford University Press (OUP)
Date: 29-11-2022
Abstract: Internationally there is urgency to implement guidelines supporting integration of palliative care into stroke clinical practice. Despite considerable advances in acute stroke management approximately 20% of all acute stroke patients die within the first 30 days. Palliative care is well established in diseases such as cancer or advanced heart failure, but evidence base interventions of high quality are limited in stroke populations. This systematic review aims to identify and evaluate quantitative studies that describe palliative care interventions and end of life care as reported by patient's post-stroke and their families. A systematic review following PRISMA guidelines was conducted in CINAHL, PubMed, Cochrane, Embase, Ovid, Proquest and Scopus from 1990 - April 2021. The National Heart, Lung and Blood Institute (NHLBI) standardised quality rating tools for quality assessment was used. The protocol was registered in PROSPERO. Seven studies were identified and all used descriptive quantitative designs. There were no interventional studies. Results were synthesised narratively according to the elements of palliative care interventions and end of life care: symptom burden and satisfaction, loss of autonomy and end of life and acknowledging uncertainty. This review highlights the limited empirical evidence that describe palliative care interventions and end of life care as reported by patient's post-stroke and their families. Most of the current evidence focuses on the provision of care during the final days and hours of life, or end-of-life care, with little evidence to guide the integration of palliative care into post-stroke clinical care, especially for patients with an uncertain prognosis. Acute stroke is sudden, unexpected and life-changing, and patients and families would benefit from well-designed targeted interventions to determine strategies that address the erse palliative needs of this patient population. PROSPERO CRD42021254536.
Publisher: SAGE Publications
Date: 27-12-2021
Publisher: Wiley
Date: 09-08-2017
DOI: 10.1111/JOCN.13834
Publisher: Wiley
Date: 20-08-2019
Publisher: JMIR Publications Inc.
Date: 04-02-2020
Abstract: n array of wearable cardiac monitoring technologies have become available to consumers in recent years. A primary focus of research has been on the performance, accuracy, specificity and sensitivity of devices, with limited understanding of the barriers and enablers informing acceptance or uptake of these technologies, specifically in older adults his review aimed to explore experiences of older adults and health professionals in relation to using wearable cardiac health monitoring technologies and identify barriers and enablers of acceptance and uptake of these devices. meta-synthesis was undertaken to synthesise qualitative studies. total of seven studies were included. Four interrelated themes emerged: (1) Feelings of trust, safety and confidence (2) Functionality and affordability (3) Risk of stigmatisation and (4) Assurance of device data. his systematic review provides evidence of barriers and enablers in acceptability and uptake of wearable telemonitoring devices based on experiences of older adult, health professionals, and carers. Most significant factors that impact the uptake directly relate to the design aspects of the devices, appropriate and timely feedback, user-friendly technology and issues related to the affordability and cost. Findings highlight the need for end user engagement in the co-design and implementation of such interventions /A
Publisher: Elsevier BV
Date: 06-2014
Publisher: Informa UK Limited
Date: 06-05-2016
Publisher: Informa UK Limited
Date: 04-03-2021
Publisher: Oxford University Press (OUP)
Date: 08-2019
Abstract: There is a need to improve cardiovascular nurses’ knowledge and practices related to stroke prevention, atrial fibrillation and anticoagulation therapy. The aim of this study was to evaluate the efficacy of EVICOAG – a novel mHealth, smartphone-based, spaced-learning intervention on nurses’ knowledge of atrial fibrillation and anticoagulation. Nurses employed in four clinical specialties (neuroscience, stroke, rehabilitation, cardiology) across three hospitals were invited to participate. In this quasi-experimental study, 12 case-based atrial fibrillation and anticoagulation learning scenarios (hosted by an mHealth platform) were delivered to participants’ smartphones over a 6-week period (July–December 2016) using a spaced timing algorithm. Electronic surveys to assess awareness and knowledge were administered pre (T1) and post (T2) intervention. From 74 participants recruited to T1, 40 completed T2. There was a 54% mean improvement in knowledge levels post-intervention. The largest improvement was achieved in domains related to medication interaction and stroke and bleeding risk assessment. Post-intervention, those who completed T2 were significantly more likely to use CHA 2 DS 2 -VASc (2.5% vs. 37.5%) and HAS-BLED (2.5% vs. 35%) tools to assess stroke and bleeding risk, respectively ( P .01). The EVICOAG intervention improved nurses’ knowledge of atrial fibrillation and anticoagulation, and influenced their uptake and use of stroke and bleeding risk assessment tools in clinical practice. Future research should focus on whether a similar intervention might improve patient-centred outcomes such as patients’ knowledge of their condition and therapies, medication adherence, time in the therapeutic range and quality of life.
Publisher: Mark Allen Group
Date: 02-10-2016
DOI: 10.12968/BJCA.2016.11.10.481
Abstract: Twitter is a social media platform often used by cardiac professional associations to engage and inform their members and the public. However, the effectiveness of the strategy is seldom assessed or published. This study evaluates the Twitter activities of nine cardiac professional associations. Each organisation's purpose and stakeholders were described in idually and classified. Extracted Tweets (n=3920) were content-analysed and metrics were determined. There was alignment between the associations' mission statements and their Twitter activities. However, most Tweets were one-directional, disseminating research-based evidence rofessional education materials and communicating association events and activities, as well as using hashtags to enable searching. Social media communication by cardiac professional associations through Tweets is an important activity however, at present, the use of dialogue and conversations are not fully realised and could be used more strategically.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Informa UK Limited
Date: 04-03-2023
Publisher: Wiley
Date: 16-12-2023
DOI: 10.1111/JAN.15545
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH17289
Abstract: Objective The aim of the present study was to compare the health status of South Australians with recent experience of caring for an adult with chronic disease with non-carers drawn from the same population. Methods Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Respondents were asked whether they had provided care or support in the last 5 years to someone with cancer, heart disease, respiratory disease, mental illness, neurological disease or dementia. Health status was measured using the Short Form-12 version 1 (SF-12) physical and mental component scale summary scores (PCS and MCS respectively), with poor health status defined as ≥0.5 standard deviation below the normative mean. Logistic regression explored characteristics associated with poor health status. Results Of 3033 respondents analysed, 987 (32.5%) reported caring experience. Poor PCS and MCS were associated with carer status, lower-than-degree-level education, employment status other than employed and annual household income less than A$60000. Being Australian born was a protective factor for PCS, whereas factors protective for MCS were being married or in a de facto relationship and age ≥65 years. Conclusions Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers. What is known about the topic? Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers. What does this paper add? Including recent as well as current carers in a population-based s le was associated with less effect on health status compared with studies focused on current carers only. This finding is consistent with the possibility that health status recovers during the 5 years after caring. What are the implications for practitioners? Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Wiley
Date: 09-06-2021
DOI: 10.1111/JOCN.15885
Abstract: Older adults living with dementia frequently transition between healthcare settings. Care transitions increase vulnerability and risk of iatrogenic harm. To examine the quality of transitional care arrangements within discharge documentation for older people living with dementia. Secondary analysis of cohort study data. A secondary analysis of the IDEAL Study [ACTRN12612001164886] discharge documents, following the STROBE guidelines. Participants had a confirmed diagnosis of dementia and were discharged from hospital to a nursing home. An audit tool was used to extract the data. This was developed through a synthesis of existing tools and finalised by an expert panel. The analysis assessed the quality of discharge documentation, in the context of transitional care needs, and presented results using descriptive statistics. Functional ability physical health cognition and mental health medications and socio environmental factors were assessed. Sixty participants were included in analyses, and half were male (52%), with a total participant mean age of 83 (SD 8.7) years. There was wide variability in the quality of core discharge information, ranging from excellent (37%), adequate (43%) to poor (20%). A sub‐group of these core discharge documentation elements that detailed the participants transitional care needs were rated as follows: excellent (17%), adequate (46%) and poor (37%). Discharge documentation fails to meet needs of people living with dementia. Improving the quality of discharge documentation for people living with dementia transitioning from hospital to nursing home is critical to provide safe and quality care. There is a need for safe, timely, accurate and comprehensive discharge information to ensure the safety of people living with dementia and prevent adverse harm.
Publisher: Public Library of Science (PLoS)
Date: 26-10-2018
Publisher: Oxford University Press (OUP)
Date: 10-09-2019
Publisher: JMIR Publications Inc.
Date: 12-12-2019
Abstract: ew wearable devices (for ex le, AliveCor or Zio patch) offer promise in detecting arrhythmia and monitoring cardiac health status, among other clinically useful parameters in older adults. However, the clinical utility and usability from the perspectives of clinicians is largely unexplored. his study aimed to explore clinician perspectives on the use of wearable cardiac monitoring technology for older adults. descriptive qualitative study was conducted using semistructured focus group interviews. Clinicians were recruited through purposive s ling of physicians, nurses, and allied health staff working in 3 tertiary-level hospitals. Verbatim transcripts were analyzed using thematic content analysis to identify themes. linicians representing physicians, nurses, and allied health staff working in 3 tertiary-level hospitals completed 4 focus group interviews between May 2019 and July 2019. There were 50 participants (28 men and 22 women), including cardiologists, geriatricians, nurses, and allied health staff. The focus groups generated the following 3 overarching, interrelated themes: (1) the current state of play, understanding the perceived challenges of patient cardiac monitoring in hospitals, (2) priorities in cardiac monitoring, what parameters new technologies should measure, and (3) cardiac monitoring of the future, “the ideal device.” here remain pitfalls related to the design of wearable cardiac technology for older adults that present clinical challenges. These pitfalls and challenges likely negatively impact the uptake of wearable cardiac monitoring in routine clinical care. Partnering with clinicians and patients in the co-design of new wearable cardiac monitoring technologies is critical to optimize the use of these devices and their uptake in clinical care.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.NEDT.2018.01.015
Abstract: The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.
Publisher: Oxford University Press (OUP)
Date: 14-04-2021
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.HLC.2021.08.012
Abstract: In iduals with chronic heart failure experience high symptom burden, reduced quality of life and high health care utilisation. Although there is growing evidence that a palliative approach, provided concurrently with usual treatment improves outcomes, the method of integrating palliative care for in iduals living with chronic heart failure across the care continuum remains elusive. To examine the key elements of integrated palliative care recommended for in iduals living with chronic heart failure across the care continuum. Scoping review. Databases searched were CINAHL, Ovid MEDLINE, Scopus and OpenGrey. Studies written in English and containing key strategic elements specific to chronic heart failure were included. Search terms relating to palliative care and chronic heart failure and the Joanna Briggs Institute methodology for scoping reviews was used. Seventy-nine (79) articles were selected that described key elements to integrate palliative care for in iduals with chronic heart failure. This review identifies four levels of key strategic elements: 1) clinical 2) professional 3) organisational and 4) system-level integration. Implementing strategies across these elements facilitates integrated palliative care for in iduals with chronic heart failure. Inter-sectorial collaborations across systems and the intersection of health and social services are essential to delivering integrated, person-centred palliative care. Further research focussing on patient and family needs at a system-level is needed. Research with strong theoretical underpinnings utilising implementation science methods are required to achieve and sustain complex behaviour change to translate key elements.
Publisher: Oxford University Press (OUP)
Date: 04-05-2018
Abstract: Frailty is an independent predictor of mortality across many conditions. Reported rates of frailty in heart failure range from 15% to 74%. There are several instruments available to assess frailty however, to date there has been no consensus on the most appropriate instrument for use in in iduals with heart failure. To identify how frailty is assessed in in iduals with heart failure and to elucidate which domains of frailty are most frequently assessed. Key electronic databases were searched (MEDLINE, COCHRANE Central and CINAHL) to identify studies that assessed frailty in in iduals with heart failure using a formal frailty instrument. Twenty studies published in 24 articles were included, for which a total of seven unique frailty instruments were identified. The most commonly used instrument was the Frailty Phenotype ( n= 11), with the majority of studies using a modified version of the Frailty Phenotype ( n= 8). The second most commonly used instrument identified was the Comprehensive Geriatric Assessment ( n= 4). There is an increasing interest in the assessment of frailty, but, to date, there is no frailty instrument validated specifically in the heart failure population.
Publisher: Oxford University Press (OUP)
Date: 07-07-2017
Abstract: Chronic heart failure (CHF) and atrial fibrillation (AF) are complex cardiogeriatric syndromes mediated by physical, psychological and social factors. Thromboprophylaxis is an important part of avoiding adverse events in these syndromes, particularly stroke. This study sought to describe the clinical characteristics of a cohort of patients admitted to hospital with CHF and concomitant AF and to document the rate and type of thromboprophylaxis. We examined the practice patterns of the prescription of treatment and determined the predictors of adverse events. Prospective consecutive participants with CHF and concomitant AF were enrolled during the period April to October 2013. Outcomes were assessed at 12 months, including all-cause readmission to hospital and mortality, stroke or transient ischaemic attack, and bleeding. All-cause readmission to hospital was frequent (68%) and the 12-month all-cause mortality was high (29%). The prescription of anticoagulant drugs at discharge was statistically significantly associated with a lower mortality at 12 months (23 vs. 40% p=0.037 hazards ratio 0.506 95% confidence interval 0.267-0.956), but was not associated with lower rates of readmission to hospital among patients with CHF and AF. Sixty-six per cent of participants were prescribed anticoagulant drugs on discharge from hospital. Self-reported self-care behaviour and 'not for cardiopulmonary resuscitation' were associated with not receiving anticoagulant drugs at discharge. Although statistical significance was not achieved, those patients who were assessed as frail or having greater comorbidity were less likely to receive anticoagulant drugs at discharge. This study highlights multi-morbidity, frailty and self-care to be important considerations in thromboprophylaxis. Shared decision-making with patients and caregivers offers the potential to improve treatment knowledge, adherence and outcomes in this group of patients with complex care needs.
Publisher: Wiley
Date: 23-03-2021
DOI: 10.1111/JOCN.15758
Publisher: Wiley
Date: 28-06-2021
DOI: 10.1111/JOCN.15916
Abstract: To highlight the need for the development of effective and realistic workforce strategies for critical care nurses, in both a steady state and pandemic. In acute care settings, there is an inverse relationship between nurse staffing and iatrogenesis, including mortality. Despite this, there remains a lack of consensus on how to determine safe staffing levels. Intensive care units (ICU) provide highly specialised complex healthcare treatments. In developed countries, mortality rates in the ICU setting are high and significantly varied after adjustment for diagnosis. The variability has been attributed to systems, patient and provider issues including the workload of critical care nurses. Discursive paper. Nursing workforce is the single most influential mediating variable on ICU patient outcomes. Numerous systematic reviews have been undertaken in an effort to quantify the effect of critical care nurses on mortality and morbidity, invariably leading to the conclusion that the association is similar to that reported in acute care studies. This is a consequence of methodological limitations, inconsistent operational definitions and variability in endpoint measures. We evaluated the impact inadequate measurement has had on capturing relevant critical care data, and we argue for the need to develop effective and realistic ICU workforce measures. COVID‐19 has placed an unprecedented demand on providing health care in the ICU. Mortality associated with ICU admission has been startling during the pandemic. While ICU systems have largely remained static, the context in which care is provided is profoundly dynamic and the role and impact of the critical care nurse needs to be measured accordingly. Often, nurses are passive recipients of unplanned and under‐resourced changes to workload, and this has been brought into stark visibility with the current COVID‐19 situation. Unless critical care nurses are engaged in systems management, achieving consistently optimal ICU patient outcomes will remain elusive. Objective measures commonly fail to capture the complexity of the critical care nurses’ role despite evidence to indicate that as workload increases so does risk of patient mortality, job stress and attrition. Critical care nurses must lead system change to develop and evaluate valid and reliable workforce measures.
Publisher: Oxford University Press (OUP)
Date: 21-07-2020
Abstract: Frailty is an important predictive measure of mortality and rehospitalisation in people with heart failure. To date, there are no frailty instruments validated for use in people with heart failure. The aim of this study was to evaluate the convergent and discriminant validity of three versions of the frailty phenotype in those with heart failure. A single site, prospective cohort study was undertaken among in iduals with a confirmed diagnosis of heart failure. Frailty was assessed concurrently using three versions of the frailty phenotype: the original frailty phenotype and two modified versions the Survey of Health, Ageing and Retirement in Europe frailty instrument (SHARE-FI) and the St Vincent’s frailty instrument. Convergent and discriminant validity were assessed by reporting the correlations between each version and related heart failure subconstructs, and by evaluating the ability of each version to discriminate between normal and abnormal scores of other physical and psychosocial scales specific to heart failure-related subconstructs. The New York Heart Association classes were moderately correlated with the St Vincent’s frailty instrument ( r=0.47, P⩽0.001), SHARE-FI ( r=0.42, P⩽0.001) and the frailty phenotype ( r=0.42, P⩽0.001). The SHARE-FI and the St Vincent’s frailty instrument were both able to discriminate consistently between normal and abnormal scores in three out of five of the physical and psychosocial subconstructs that were assessed. The SHARE-FI was also able to discriminate between inpatients and outpatients who were classified as frail. Both the SHARE-FI and the St Vincent’s frailty instrument displayed good convergent and discriminant validity.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Frontiers Media SA
Date: 08-10-2021
Abstract: Background: Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia. Obesity is an independent risk factor for AF. Anticoagulants have been strongly recommended by all international guidelines to prevent stroke. However, altered pathophysiology in obese adults may influence anticoagulant pharmacology. Direct oral anticoagulants (DOACs) in the context of obesity and AF have been examined in recent systematic reviews. Despite the similarities in included studies, their results and conclusions do not agree. Methods and Results: The protocol for this review was registered with PROSPERO (CRD42020181510). Seven key electronic databases were searched using search terms such as “atrial fibrillation,” “obese, * ” “overweight,” “novel oral anticoagulant,” “direct oral anticoagulant,” “DOAC,” “NOAC,” “apixaban,” dabigatran,” “rivaroxaban,” and “edoxaban” to locate published and unpublished studies. Only systematic reviews with meta-analyses that examined the effect of DOACs in overweight or obese adults with AF, published in the English language, were included. A total of 9,547 articles were initially retrieved. After removing the duplicates, title and abstract review and full-text review, five articles were included in the systematic review. From these only RCTs were included in the meta-analyses. There was disagreement within the published systematic reviews on DOACs in obesity. The results from our meta-analysis did not show any significant difference between all body mass index (BMI) groups for all outcomes at both 12 months and for the entire trial duration. Non-significant differences were seen among the different types of DOACs. Conclusion: There was no difference between the BMI classes in any of the outcomes assessed. This may be due to the limited number of people in the trial that were in the obese class, especially obese class III. There is a need for large prospective trials to confirm which DOACs are safe and efficacious in the obese class III adults and at which dose.
Publisher: Wiley
Date: 20-11-2019
Publisher: Springer Science and Business Media LLC
Date: 09-11-2022
DOI: 10.1186/S13643-022-02104-1
Abstract: Empirical evidence suggests data and insights from the clinical practice guidelines and clinical quality registries are not being fully utilised, leaving health service managers, clinicians and providers without clear guidance on how best to improve healthcare delivery. This lack of uptake of existing research knowledge represents low value to the healthcare system and needs to change. Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews) were systematically searched. Included studies were published between 2000 and 2020 reporting on the attributes, evidence usage and impact of clinical practice guidelines and clinical quality registries on health service delivery. Twenty-six articles including one randomised controlled trial, eight before-and-after studies, eight case studies/reviews, five surveys and four interview studies, covering a wide range of medical conditions and conducted in the USA, Australia and Europe, were identified. Five complementary strategies were derived to maximise the likelihood of best practice health service delivery: (1) feedback and transparency, (2) intervention sustainability, (3) clinical practice guideline adherence, (4) productive partnerships and (5) whole-of-team approach. These five strategies, used in context-relevant combinations, are most likely to support the application of existing high-quality data, adding value to health service delivery. The review highlighted the limitations of study design in opportunistic registry studies that do not produce clear, usable evidence to guide changes to health service implementation practices. Recommendations include exploration of innovative methodologies, improved coordination of national registries and the use of incentives to encourage guideline adherence and wider dissemination of strategies used by successful registries.
Publisher: Informa UK Limited
Date: 2013
DOI: 10.2147/VHRM.S39571
Publisher: BMJ
Date: 02-09-2017
Publisher: Informa UK Limited
Date: 04-07-2015
Publisher: Scientific Scholar
Date: 2014
Publisher: Elsevier BV
Date: 09-2020
Publisher: Springer Science and Business Media LLC
Date: 12-01-2016
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2019
End Date: 2021
Funder: National Heart Foundation of Australia
View Funded ActivityStart Date: 2021
End Date: 2025
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2022
End Date: 2026
Funder: National Health and Medical Research Council
View Funded Activity