Resident-to-resident elder mistreatment in residential aged care services : a systematic review of event frequency, type, resident characteristics, and history
- Authors: Woolford, Marta , Stacpoole, Susan , Clinnick, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Journal of the American Medical Directors Association Vol. 22, no. 8 (2021), p. 1678-1691.e6
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- Description: Objectives: Resident-to-resident elder mistreatment (R-REM) between residents living in residential aged care (RAC) services is a challenging issue in relation to the care of older people. Evidence suggests that R-REM, such as verbal, physical, and sexual conflict between residents, is a common and pervasive issue. This review examines the frequency with which R-REM occurs in RAC services; identifies the types of R-REM that occur; and provides an overview of the reported characteristics of both the victim and perpetrator involved in the R-REM event. Design: A systematic review was conducted. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Ageline, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Setting and Participants: Residents living in RAC services. Measures: Data on frequency and characteristics were collated, and aggregate proportions were calculated where possible. Results: Twenty-six studies were identified; most (n = 20) were published in the United States. The overall proportion of residents engaged in R-REM was provided by 7 quantitative studies with the estimated frequency reported to be 12% to 23%. For qualitative studies, the number of care staff reporting to have observed R-REM ranged from 18.7% to 98.0%. Physical and verbal abuse were the most commonly reported types of mistreatment. Characteristics of the perpetrator of R-REM were reported in 12 (46.2%) studies. Overall, the mean age of perpetrators was 80.93 years, most were men (83.2%), and 64.4% had dementia and/or Alzheimer diagnosis. Characteristics of the victim and the history of R-REM were largely omitted from the published studies. Conclusion and Implications: The findings from the review broaden understanding on the extent of R-REM; the individual and event characteristics and ultimately support care planning, policy, and direction for future research. To improve understanding, quality of care, and RAC residents’ well-being, further studies are recommended to address the identified gaps in knowledge. © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Detection of low pathogenicity influenza a(H7n3) virus during duck mortality event, Cambodia, 2017
- Authors: Suttie, Annika , Yann, Sokhoun , Phalla, Y. , Tum, Sothyra , Deng, Yi-Mo , Hul, Vibol , Horm, Viseth , Barr, Ian , Greenhill, Andrew , Horwood, Paul , Osbjer, Kristina , Karlsson, Erik , Dussart, Philippe
- Date: 2018
- Type: Text , Journal article
- Relation: Emerging Infectious Diseases Vol. 24, no. 6 (2018), p. 1103-1107
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- Description: In January 2017, an estimated 3,700 (93%) of 4,000 Khaki Campbell ducks (Anas platyrhynchos domesticus) died in Kampong Thom Province, Cambodia. We detected low pathogenicity avian influenza A(H7N3) virus and anatid herpesvirus 1 (duck plague) in the affected flock; however, the exact cause of the mortality event remains unclear.
Effect of a mass media campaign on ambulance use for chest pain
- Authors: Nehme, Zlad , Cameron, Peter , Akram, Muhammad , Patsamanis, Harry , Bray, Janet , Meredith, Ian , Smith, Karen
- Date: 2017
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 206, no. 1 (2017), p. 30-35
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- Description: Objectives: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. Design, setting and participants: A retrospective analysis of 253 428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 e December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use. Main outcome measure: Monthly ambulance attendances. Results: The median number of monthly ambulance attendances for chest pain was 3609 (IQR, 3011e3891), but was higher in campaign months than in non-campaign months (3880 v 3234, P < 0.001). After adjustments, campaign activity was associated with a 10.7% increase (95% CI, 6.5e14.9%; P < 0.001) in monthly ambulance use for chest pain, and a 15.4% increase (95% CI, 10.1e20.9%; P < 0.001) when the two-month lag periods were included. Clinical presentations for suspected acute coronary syndromes, as determined by paramedics, increased by 11.3% (95% CI, 6.9e15.9%; P < 0.001) during campaigns. Although the number of patients transported to hospital by ambulance increased by 10.0% (95% CI, 6.1e14.2%; P < 0.001) during campaign months, the number of patients not transported to hospital also increased, by 13.9% (95% CI, 8.3e19.8%; P < 0.001). Conclusion: A public awareness campaign about responding to prodromal acute myocardial infarction symptoms was associated with an increase in EMS use by people with chest pain and suspected acute coronary syndromes. Campaign activity may also lead to increased EMS use in low risk populations. © 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.
Improving the non-technical skills of hospital medical emergency teams : The Team Emergency Assessment Measure (TEAM™)
- Authors: Cant, Robyn , Porter, Joanne , Cooper, Simon J. , Roberts, Kate , Wilson, Ian , Gartside, Christopher
- Date: 2016
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 28, no. 6 (2016), p. 641-646
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- Description: Objectives: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Methods: Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. Results: In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Conclusion: Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Measuring teamwork performance: Validity testing of the Team Emergency Assessment Measure (TEAM) with clinical resuscitation teams
- Authors: Cooper, Simon J. , Cant, Robyn , Connell, Cliff , Sims, Lyndall , Porter, Joanne , Symmons, Mark , Nestel, Debra , Liaw, Sok Ying
- Date: 2016
- Type: Text , Journal article
- Relation: Resuscitation Vol. 101, no. (2016), p. 97-101
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- Description: AimTo test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). BackgroundNon-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes. MethodsA quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM. ResultsMost rated events were for full cardiac resuscitation (43%) with 3–15 team members present for an average of 45min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p=<0.001), respectively, and a single ‘teamwork’ construct was identified. Non-technical skills overall were good but leadership was rated notably lower than task and teamwork performance indicating a need for leadership training. ConclusionThe TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing.
Team Emergency Assessment Measure (TEAM) for the assessment of non-technical skills during resuscitation : Validation of the french version
- Authors: Maignan, Maxime , Koch, Francois-Xavier , Chaix, Jordane , Phellouzat, Pierre , Binauld, Gery , Collomb Muret, Roselyne , Cooper, Simon J. , Labarère, José , Danel, Vincent , Viglino, Damien , Debaty, Guillaume
- Date: 2016
- Type: Text , Journal article
- Relation: Resuscitation Vol. 101, no. (2016), p. 115-120
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- Description: Aim: Evaluation of team performances during medical simulation must rely on validated and reproducible tools. Our aim was to build and validate a French version of the Team Emergency Assessment Measure (TEAM) score, which was developed for the assessment of team performance and non-technical skills during resuscitation. Methods: A forward and backward translation of the initial TEAM score was made, with the agreement and the final validation by the original author. Ten medical teams were recruited and performed a standardized cardiac arrest simulation scenario. Teams were videotaped and nine raters evaluate non-technical skills for each team thanks to the French TEAM Score. Psychometric properties of the score were then evaluated. Results: French TEAM score showed an excellent reliability with a Cronbach coefficient of 0.95. Mean correlation coefficient between each item and the global score range was 0.78. The inter-rater reliability measured by intraclass correlation coefficient of the global score was 0.93. Finally, expert teams had higher French TEAM score than intermediate and novice teams. Conclusion: The French TEAM score shows good psychometric properties to evaluate team performance during cardiac arrest simulation. Its utilization could help in the assessment of non-technical skills during simulation. © 2015 Elsevier Ireland Ltd.
A new way of categorising recurrent, repeat and multiple sports injuries for injury incidence studies - the subsequent injury categorisation (SIC) model
- Authors: Finch, Caroline , Cook, Jill , Gabbe, Belinda , Orchard, John
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 22-25
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Injuries are a major contributor to healthcare costs and individuals' health and disability status. In response to the overall public health burden, injuries were one of the first medical conditions identified as an Australian National Health Priority Area. Our previous epidemiological research has shown that sports injuries, especially those sustained through formal and highly competitive sport, are often associated with considerable pain and dysfunction. They have significant ongoing impact on quality of life and need for medical treatment, including in the hospital setting.They are also a major barrier towards both the uptake and continuance of health-generating physical activity guidance.
Analysis of interrupted time-series relating to statewide sports injury data
- Authors: Akram, Muhammad , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 29-31
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- Description: This study aims to present a new approach towards the analysis of intervention time-series studies in the context of sports-related injury data. We used Victoria-wide hospital admission injury data associated with the sport of Australian football during the period 2006 to 2013. To estimate the state-wide effect of an implemented exercise training intervention that aimed to reduce the number of football-related injuries, time-series analysis was performed using a generalised least square (GLS) method. We show how the GLS method can be used to evaluate the impact of the intervention. Trend and seasonal patterns time series were also assessed using the 'Seasonal and Trend decomposition using Loess' nonparametric seasonal decomposition procedure. The model identified a decreasing trend in the seasonally adjusted number of injuries after the implementation of the intervention in the hospital admission data. The seasonal decomposition plots also indicate strong seasonal patterns in the injury time series.
Behind every active and sporting population, there is an Epidemiologist
- Authors: Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 3-4
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- Description: This Round Table on The Epidemiology of Fitness, Sport and Physical Recreation makes for compelling reading. Australia has long been regarded as a sports-mad nation and one that has achieved major international sporting achievements because of its long-term investment in sports medicine and sports science research. Sports spectatorship is also a major pastime in Australia, underpinning the value of using sport to promote a range of health promotion messages (e.g. in relation to tobacco, alcohol, social tolerance and most recently violence prevention). People of all ages now enjoy participating in a wide range of activities from general physical activity to fitness training to cycling to team ball sports such as Australian football to combat sports. All of these feature in papers in this issue.
Biomechanical epidemiology : A novel approach for fitness activity injury prevention
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 26-28
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: There have been limited epidemiological studies that delve into injuries sustained during fitness activities, and fewer that have explored injury prevention strategies and evaluated their success. Popular individual and team sports such as athletics, swimming, basketball and various codes of football have enjoyed extensive epidemiological attention for years, and due to the sports' popularity and public profile, will continue to be highly researched areas. Other epidemiological research has focused on sports injuries more generally, or on specific injury types such as concussion, anterior cruciate ligament injury and hamstring injury. According to the Australian Bureau of Statistics' Exercise Recreation and Sport Survey (ERASS), fitness/gym is the second most popular recreation or sport activity participated in by Australians aged 15+ years. Considering the number of people who participate in fitness activities, and the devastating impact that injuries can have on the individual, their family and friends, and society, it is necessary to devote some research to preventing these.
How healthy is Australian sport?
- Authors: Eime, Rochelle , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 9-10
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- Description: Behavioural epidemiology in health promotion has been defined as having five phases: establishing links between behaviours and health; developing measures of the behaviour; identifying influences on the behaviour; evaluating interventions to change the behaviour; and translating the research into practice. This article outlines some recent developments in the application of behavioural epidemiology to the issue of sport participation in Australia and its consequential health benefits.
Online pathways for dementia care
- Authors: Ollerenshaw, Alison
- Date: 2015
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 44, no. 7 (2015), p. 510-513
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- Description: Background: Dementia is one of the fastest growing diseases in Australia. General practitioners (GPs) are at the forefront of dementia diagnosis and management. However, the disease is complex and this can prevent timely diagnosis. A recent initiative in the Grampians region, Victoria, is addressing some of these challenges through a comprehensive, intuitive, online tool. Objective: The aim of this article is to describe the process of developing and reasons for implementing the Dementia Pathways Tool, in the Grampians region, Victoria. Discussion: Designed in collaboration with GPs and practice nurses, the Dementia Pathways Tool promotes awareness of the first signs of dementia. It offers an informed approach to diagnosis, referral and ongoing management of people with the symptoms of dementia. This Tool provides practitioners - irrespective of their practice location - with access to an intuitive, online web-based repository of information. The Tool is publicly available and therefore accessible to all practitioners and the general public. Initial indications from statistics of the website are positive, but an evaluation will help inform the potential for broader applications of this Tool in the future. © The Royal Australian College of General practitioners 2015.
Spatial epidemiology : A new approach for understanding and preventing sport injuries
- Authors: Singh, Himalaya , Fortington, Lauren , Eime, Rochelle , Thompson, Helen , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 32-34
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: In order to develop effective strategies to prevent sports injuries, we need to have an understanding of the people and populations who are most at risk of injury as well as the risk factors associated with sustaining injury. Spatial epidemiology is a method used to address questions of when, where, to whom and how health outcomes such as sports injuries occur at a population level, taking into account geographic variation. The aim of this article is to outline the potential application of spatial epidemiology to achieve a better understanding of sports injuries to inform prevention strategies.
Threshold and subthreshold generalized anxiety disorder in later life
- Authors: Miloyan, Beyon , Byrne, Gerard , Pachana, Nancy
- Date: 2015
- Type: Text , Journal article
- Relation: American Journal of Geriatric Psychiatry Vol. 23, no. 6 (2015), p. 633-641
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- Description: Objective Symptoms and disorders of anxiety are highly prevalent among older adults; however, late-life anxiety disorders remain underdiagnosed. The objective of this study was to (1) estimate the prevalence of late-life threshold and subthreshold generalized anxiety disorder (GAD), (2) examine sociodemographic and health correlates associated with membership in these groups, (3) assess 3-year conversion rates of these groups, and (4) explore characteristics associated with 3-year conversion to GAD. Methods Using Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions, 13,420 participants aged 55-98 years were included in this study. Results Subthreshold GAD was more highly prevalent than threshold GAD and was interposed between asymptomatic and GAD groups in terms of severity of health characteristics. Although most participants with subthreshold and threshold GAD were asymptomatic by Wave 2, differences in disability persisted. Subthreshold GAD at baseline was not a predictor of threshold GAD at follow-up. Conclusion These findings suggest that late-life GAD should be conceptualized as a dimensional rather than categorical construct. The temporal stability of anxiety-associated disability further suggests that subthreshold GAD bears clinical significance. However, the suitability and efficacy of interventions for minimizing negative sequelae in this group remain to be determined.
Implementing person-environment approaches to prevent falls: A qualitative inquiry in applying the Westmead approach to occupational therapy home visits
- Authors: Clemson, Lindy , Donaldson, Alex , Hill, Keith , Day, Lesley
- Date: 2014
- Type: Text , Journal article
- Relation: Australian Occupational Therapy Journal Vol. 61, no. 5 (2014), p. 325-334
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- Description: Background/aims: Despite evidence of the effectiveness of home safety interventions for preventing falls, there is limited uptake of such interventions within community services. Therefore, as part of a broader translational project, we explored issues underlying the implementation of an evidence-based home safety fall prevention intervention. Method: We conducted in-depth interviews with eight occupational therapists and two programme coordinators engaged to deliver a home safety fall prevention intervention. Six community health centres within two metropolitan regions of Melbourne, Australia participated. The RE-AIM framework and Diffusion of Innovations theory underpinned the interviews which examine the enablers and barriers to implementing a home safety fall prevention intervention and integrating it into routine community preventive practice. Analysis involved thematic and content analysis. Results: Investment in the home safety for fall prevention intervention was supported and valued by coordinators and therapists alike, and a number of themes emerged which influenced implementation of this intervention. These included issues of: compatibility with organisational processes, individual practitioner practices and skills, a prevention approach, and client expectations; relative advantage in terms of flexibility of the process, client engagement and regional capacity building; complexity of implementing the intervention; and observability related to the invisible nature of fall prevention outcomes. Conclusion: Implementation of this home safety fall prevention intervention was influenced by a range of interrelated organisational, practitioner and client related factors. The findings from this project provide insights into, and opportunities to increase the sustainable implementation of the home safety fall prevention intervention into practice.
Measuring the non-technical skills of medical emergency teams: an update on validity and reliability of Team Emergency Assessment Measure (Team).
- Authors: Cant, Robyn , Cooper, Simon J.
- Date: 2014
- Type: Text , Journal article
- Relation: Resuscitation Vol. 85, no. (2014), p. 31-33
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- Description: Medical emergency team performance including non-technical skills, is receiving increased attention due to the influences on patient safety. The Team Emergency Assessment Measure View the MathML source was developed to enable standardized performance assessment and structured team debriefing. From several studies, the View the MathML source has demonstrated a substantial body of normative data confirming its validity and reliability. This includes high uni-dimensional validity, significant subscale relationships between Teamwork and Leadership and between Teamwork and Task Management (p < 0.001), a Cronbach alpha of 0.92 and adequate construct validity. The tool has potential for team training to improve team's non-technical performance. Further testing is required in ‘real’ clinical settings.
Chiropractic Observation and Analysis Study (COAST): Providing an understanding of current chiropractic practice
- Authors: French, Simon , Charity, Melanie , Forsdike, Kirsty , Gunn, Jane , Polus, Barbara , Walker, Bruce , Chondros, Patty , Britt, Helena
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 199, no. 10 (2013), p. 687-691
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- Description: Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.
Increasing incidence of hospitalisation for sport-related concussion in Victoria, Australia
- Authors: Finch, Caroline , Clapperton, Angela , McCrory, Paul
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 198, no. 8 (2013), p. 427-430
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective: To describe trends in hospitalisation for sport-related concussion. Design, setting and patients: Analysis of routinely collected hospital admissions data from all Victorian hospitals (public and private) over the 2002-03 to 2010-11 financial years for patients aged ≥15 years with a diagnosis of concussion and an ICD-10-AM external cause activity code indicating sport. Main outcome measures: Number and cost of hospitalisations; rate of hospitalisation per 100000 participants overall and for specific sports; and percentage change in frequency and hospitalisation rate per 100000 participants over 9 years. Results: There were 4745 hospitalisations of people aged ≥15 years for sport-related concussion, with a total hospital treatment cost of $17944799. The frequency of hospitalisation increased by 60.5% (95% CI, 41.7%-77.3%) over the 9 years, but could only partially be explained by increases in sports participation, as the rate per 100000 participants also increased significantly, by 38.9% (95% CI, 17.5%-61.7%). After adjustment for participation, rates were highest for motor sports, equestrian activities, Australian football, rugby and roller sports. The greatest significant increases in rates were seen in roller sports, rugby, soccer and cycling. Conclusions: The frequency and participation-adjusted rate of hospitalisation for sport-related concussion, both overall and across several sports, increased significantly over the 9 years. These findings, along with high levels of public concern, make prevention of head injury in sport a population health priority in Australia.
- Description: 2003011025
Managing patient deterioration: assessing teamwork and individual performance
- Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Missen, Karen , Sparkes, Louise , McConnell-Henry, Tracy , Endacott, Ruth
- Date: 2013
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 30, no. 5 (2013), p.
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- Description: Objective To assess the ability of rural Australian nurse teams to manage deteriorating patients. Methods This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Results Knowledge in relation to patient deterioration management varied (mean 63%, range 27–100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17–83%, SD 14.03) with significantly higher levels in younger participants (r=−0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Conclusion Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
The Importance of Foot Care in Older People With Diabetes
- Authors: Fortington, Lauren , Geertzen, Jeertzen , Van Netten, Jaap , Van Baal, Jeff , Bus, Sicco , Schaper, Nicolaas
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of the American Medical Directors Association Vol. 14, no. 2 (February 2013 2013), p. 136
- Full Text: false
- Reviewed:
- Description: C1