ORCID Profile
0000-0002-4750-3532
Current Organisations
Royal Melbourne Hospital
,
University of Melbourne
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Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.AUEC.2021.03.004
Abstract: Ecstasy and other recreational related drug use and substance related presentations to the emergency department (ED) are increasing. The aim of this study was to identify, quantify, and describe the ED resources used to care for patients diagnosed with ecstasy and related drug (ERD) use. A retrospective case study design. Eighty-nine patients (89%) needed one to one (n=25) and/or one to two nursing care (n=83). Security presence was required for 37 patients (37%) and the Emergency Psychiatric Service team reviewed 29 patients (29%). Most patients (n=80, 80%) received an Emergency Short Stay Unit admission, but continued to receive care in the ED, and were not transferred to the short stay unit (n=74, 92.5%). Most patients (n=86, 86%) were discharged home, after 5hr 49mins (median) in ED. Extensive human resources were required to care for patients diagnosed with ERD use. Nursing staffing levels required to care for this patient cohort during times of peak presentations should be reviewed. It is important the government acknowledges the National Emergency Access Target is not suitable for all presenting patients. A dedicated model of care is recommended to support care requirements and reduce pressure on busy EDs.
Publisher: Wiley
Date: 27-12-2022
DOI: 10.1111/JOCN.16188
Abstract: The study investigated: (a) the usage patterns of paracetamol, and (b) the association between paracetamol use and patient outcomes such as liver and kidney functions among older people. Paracetamol is a well-known analgesic and antipyretic drug, with an excellent safety profile when used within its recommended dose. It is a commonly used drug by people aged over 65 years to treat chronic pain. Prolonged use of paracetamol in the elderly is poorly understood. As such, there is a genuine risk among older people of unintentional overdose. A retrospective analysis of medical records in rehabilitation wards was undertaken from 1 July 2016 to 30 June 2017. Patients' paracetamol use, prescribing patterns and biochemical results were analysed to assess for differences in admission and discharge biochemistry results. The TREND Statement was utilised to guide study reporting (Enhancing the QUAlity and Transparency Of health Research, 2021). A total of 1119 patients were admitted for seven or more days in a metropolitan tertiary hospital in Melbourne. Almost three-quarters (74%) of patients were administered paracetamol 76.1% received 'Immediate-Release Paracetamol' (IRP), and 23.9% were given 'Sustained-Release Paracetamol' (SRP). A proportion (4.5%) of patients in both the IRP and SRP groups received more than the daily recommended dose. There were limited statistically significant differences between patients' admission and discharge biochemistry results group or time differences were observed, which were indicative of improvements within the paracetamol group. Paracetamol was a commonly used medication among long-stay elderly patients. Precaution to ensure paracetamol use does not exceed recommended daily doses is required. This study suggests that paracetamol used at a therapeutic level in older patients had limited, negative associations with liver and kidney function. The clinical practice regarding prolonged use of paracetamol is ambitious. The increased risk of paracetamol toxicity among the frail elderly is a concern. Optimising the dose adjustment in the elderly is important to avoid adverse outcomes.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.AUEC.2019.08.004
Abstract: Patients currently receive discharge summaries including investigation results, medical assessment and follow up requirements with health professionals on discharge from the emergency department (ED). This study aimed to evaluate if a simplified discharge information card in addition to current care improved patients' awareness of their discharge diagnosis and requirements for follow-up appointment. A prospective pre-post design interventional study was conducted. The pre-intervention phase collected data from patients who did not receive the discharge card. The post-intervention phase occurred after implementing the discharge card. Participants underwent brief interviews to assess awareness of diagnosis and follow-up appointment requirements after discharge. Responses were compared to the plan in the medical notes and concordance determined. There were 112 patients in the pre-intervention group and 117 in the post-intervention group. Awareness of discharge diagnosis improved from 73.2% (95% CI: 64.3-80.5) of pre-interventions participants to 89.7% (95% CI: 82.9-94.0) for participants receiving the discharge card (p<0.001 NNT 6.1 patients). Statistically significant improvements were observed regarding knowledge of follow-up destination and timing. A short discharge information card improved awareness of discharge diagnoses and follow-up requirements. Such interventions that empower patients with knowledge about their health, should be considered prior to discharge from EDs.
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.IENJ.2009.09.003
Abstract: In 1998 in Victoria, Australia, the Nurse Practitioner (NP) model was considered with projects exploring the potential for NP implementation in emergency departments (EDs). The aim of this study is to explore the perceived barriers to progression and sustainability of the NP role in Victoria. A survey of the 17 EDs involved in the initial projects was undertaken targeting NP candidates, nurse managers and project officers. A total of 48 in iduals were identified and contacted. The survey comprised of demographic details and statements about NP role sustainability and progression using a Likert scale A total of 37 participants (77%) completed the survey. Participants strongly agreed that there were barriers to sustainability, especially lack of ongoing funding from their own organisation and external sources. Other barriers included a lack of understanding from the organisation and medical staff about the role. The main barriers to role progression were the legislative constraints (n=29, 78%) and the cost of Masters programmes (n=29, 78%) This survey revealed a myriad of barriers to role sustainability and progression. These barriers need to be explored and progressed if the NP role is to continue to develop and expand.
Publisher: Elsevier BV
Date: 07-2020
No related grants have been discovered for John Thompson.