Quality indicators for a community-based wound care centre : an integrative review
- Seaton, Philippa, Cant, Robyn, Trip, Henrietta
- Authors: Seaton, Philippa , Cant, Robyn , Trip, Henrietta
- Date: 2020
- Type: Text , Journal article
- Relation: International Wound Journal Vol. 17, no. 3 (2020), p. 587-600
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- Description: The purpose of this review was to identify the role and contribution of community-based nurse-led wound care as a service delivery model. Centres increasingly respond proactively to assess and manage wounds at all stages – not only chronic wound care. We conducted an integrative review of literature, searching five databases, 2007–2018. Based on inclusion and exclusion criteria, we systematically approached article selection and all three authors collaborated to chart the study variables, evaluate data, and synthesise results. Eighteen studies were included, representing a range of care models internationally. The findings showed a need for nurse-led clinics to provide evidence-based care using best practice guidelines for all wound types. Wound care practices should be standardised across the particular service and be integrated with higher levels of resources such as investigative services and surgical units. A multi-disciplinary approach was likely to achieve better patient outcomes, while patient-centred care with strong patient engagement was likely to assist patients' compliance with treatment. High-quality community-based wound services should include nursing leadership based on a hub-and-spoke model. This is ideally patient-centred, evidence-based, and underpinned by a commitment to developing innovations in terms of treatment modalities, accessibility, and patient engagement. © 2020 Medicalhelplines.com Inc and John Wiley & Sons Ltd
- Description: This study was supported by The Nurse Maude Association, Christchurch, New Zealand, a community‐based nursing service in New Zealand. We acknowledge the contribution of the following Nurse Maude Association staff: Mary‐Anne Stone (MPH), Senior Manager of Research, Innovation and Aged Residential Care. Cathy Hammond (MA–Clinical Nursing), Clinical Nurse Specialist – Specialist Wound Service. Denise Brankin (RN, PGDipHSc), Service Manager, Specialty Nursing Services. Gill Coe (BA), Research Officer.creative
Decade of Medicare : The contribution of private practice dietitians to chronic disease management and diabetes group services
- Authors: Cant, Robyn , Ball, Lauren
- Date: 2015
- Type: Text , Journal article
- Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
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- Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.
- Authors: Cant, Robyn , Ball, Lauren
- Date: 2015
- Type: Text , Journal article
- Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
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- Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.
- Willey, Suzanne, Cant, Robyn, Williams, Allison, McIntyre, Meredith
- Authors: Willey, Suzanne , Cant, Robyn , Williams, Allison , McIntyre, Meredith
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 27, no. 17-18 (2018), p. 3387-3396
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- Description: Aims and objectives: To explore service provision for Victorian regional refugee families from the perspective of maternal and child health nurses. Background: Increasingly, more families from a refugee background are resettling in regional Victoria. The refugee journey has significant effect on families. Refugee families with infants and young children can be provided with support by maternal and child health services; however, many families experience barriers to ongoing engagement with this service. Design: This descriptive study used focus group and questionnaire. A purposive sample of 26 maternal and child health nurses was drawn from six municipalities throughout regional Victoria, where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed, prior to inductive thematic analysis. Methods: This descriptive study used focus group and questionnaire. A purposive sample of 26 Maternal and Child Health nurses was drawn from six municipalities throughout regional Victoria where higher numbers of people from a refugee background resettle. Six focus groups were held in 2014. Audio-recorded narratives were transcribed verbatim, prior to inductive thematic analysis. Results: Participating nurses were experienced nurses, averaging 12 years in the service. Four major themes emerged from thematic analysis: “How to identify women from a refugee background”; “The Maternal and Child Health nurse role when working with families from a refugee background”; “Interpreting issues”; and “Access to other referral agencies.” Nurses worked to develop a relationship with families, attending to a complex mix of issues which were complicated by language barriers. Nurses found their role in supporting refugee families required additional time and more home visits. Conclusions: To provide best practice, maternal and child health nurses need (i) ongoing professional development; (ii) time, flexibility and creativity to build relationships with refugee families and (iii) better access to services that enhance communication, such as interpreting services and translated resources. Relevance to clinical practice: Nurses require ongoing professional development to help them address the multifaceted needs of families of refugee background. With limited resources available in regional areas, accessing further education can be challenging. Distance education models and organisational support could provide nurses with educational opportunities aimed at improving service provision and clinical practice. © 2018 John Wiley & Sons Ltd
Locating “gold standard” evidence for simulation as a substitute for clinical practice in prelicensure health professional education : a systematic review
- Bogossian, Fiona, Cant, Robyn, Ballard, Emma, Cooper, Simon, Levett-Jones, Tracy, McKenna, Lisa, Ng, Linda, Seaton, Phillippa
- Authors: Bogossian, Fiona , Cant, Robyn , Ballard, Emma , Cooper, Simon , Levett-Jones, Tracy , McKenna, Lisa , Ng, Linda , Seaton, Phillippa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 21-22 (2019), p. 3759-3775
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- Description: Aims and objectives: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. Background: Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. Methods: A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Results: Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr–2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. Conclusions: This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Relevance to clinical practice: Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health. © 2019 John Wiley & Sons Ltd
- Authors: Bogossian, Fiona , Cant, Robyn , Ballard, Emma , Cooper, Simon , Levett-Jones, Tracy , McKenna, Lisa , Ng, Linda , Seaton, Phillippa
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 21-22 (2019), p. 3759-3775
- Full Text:
- Reviewed:
- Description: Aims and objectives: To extract, examine and report the highest available levels of evidence from healthcare disciplines in the use of simulation-based education as substitution for clinical placement in prelicensure programmes. Background: Simulation is widely employed across prelicensure health professional education to create safe, realistic clinical learning experiences for students. Whether simulation can be employed to substitute for actual clinical placement, and if so, in what proportion, replacement ratio and duration, is unclear. Methods: A systematic review and quality appraisal of primary studies related to prelicensure students in all health disciplines, guided by the PRISMA checklist. Results: Ten primary studies were included, representing 2,370 students from three health disciplines in four countries. Nine studies were experimental and quasi-experimental and methodological quality was assessed as moderate to high with good to very good inter-rater agreement. Direct substitution of simulation for clinical practice ranged from 5% to 50%. With one exception, replacement ratios were 1:1 and duration of replacement ranged from 21 hr–2 years. Levels of evaluation included measures of reaction, knowledge and behaviour transfer; no negative outcomes were reported. We appraised practicalities for design of substitution, design limitations and knowledge transfer to accreditation standards for prelicensure programmes. Conclusions: This review synthesised highest levels and quality of available evidence for substitution of simulation for clinical placement in health professional education. Included studies were heterogenous in simulation interventions (proportion, ratio and duration) and in the evaluation of outcomes. Future studies should incorporate standardised simulation curricula, widen the health professions represented and strengthen experimental designs. Relevance to clinical practice: Current evidence for clinical educational preparation does not appear to be translated into programme accreditation standards governing clinical practice experience for prelicensure programmes in relevant jurisdictions. Overall, a stronger evidence base is necessary to inform future curricula and policy development, to strengthen clinical practice in health. © 2019 John Wiley & Sons Ltd
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