Factors contributing to COPD hospitalisations from 2010 to 2015 : Variation among rural and metropolitan Australians
- Terry, Daniel, Nguyen, Hoang, Kim, Jeong-Ah, Islam, Rafiqul
- Authors: Terry, Daniel , Nguyen, Hoang , Kim, Jeong-Ah , Islam, Rafiqul
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Respiratory Journal Vol. 13, no. 5 (2019), p. 306-313
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- Description: Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
- Authors: Terry, Daniel , Nguyen, Hoang , Kim, Jeong-Ah , Islam, Rafiqul
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Respiratory Journal Vol. 13, no. 5 (2019), p. 306-313
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- Description: Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
To err is human: medication patient safety in aged care, a case study
- Gilbert, Julia, Kim, Jeong-Ah
- Authors: Gilbert, Julia , Kim, Jeong-Ah
- Date: 2018
- Type: Text , Journal article
- Relation: Quality in Ageing and Older Adults Vol. 19, no. 2 (2018), p. 126-134
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- Description: Purpose: The purpose of this paper is to explore an identified medication error using a root cause analysis and a clinical case study. Design/methodology/approach: In this paper the authors explore a medication error through the completion of a root cause analysis and case study in an aged care facility. Findings: Research indicates that medication errors are highly prevalent in aged care and 40 per cent of nursing home patients are regularly receiving at least one potentially inappropriate medicine (Hamilton, 2009; Raban et al., 2014; Shehab et al., 2016). Insufficient patient information, delays in continuing medications, poor communication, the absence of an up-to-date medication chart and missed or significantly delayed doses are all linked to medication errors (Dwyer et al., 2014). Strategies to improve medication management across hospitalisation to medication administration include utilisation of a computerised medication prescription and management system, pharmacist review, direct communication of discharge medication documentation to community pharmacists and staff education and support (Dolanski et al., 2013). Originality/value: Discussion of the factors impacting on medication errors within aged care facilities may explain why they are prevalent and serve as a basis for strategies to improve medication management and facilitate further research on this topic.
- Authors: Gilbert, Julia , Kim, Jeong-Ah
- Date: 2018
- Type: Text , Journal article
- Relation: Quality in Ageing and Older Adults Vol. 19, no. 2 (2018), p. 126-134
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- Description: Purpose: The purpose of this paper is to explore an identified medication error using a root cause analysis and a clinical case study. Design/methodology/approach: In this paper the authors explore a medication error through the completion of a root cause analysis and case study in an aged care facility. Findings: Research indicates that medication errors are highly prevalent in aged care and 40 per cent of nursing home patients are regularly receiving at least one potentially inappropriate medicine (Hamilton, 2009; Raban et al., 2014; Shehab et al., 2016). Insufficient patient information, delays in continuing medications, poor communication, the absence of an up-to-date medication chart and missed or significantly delayed doses are all linked to medication errors (Dwyer et al., 2014). Strategies to improve medication management across hospitalisation to medication administration include utilisation of a computerised medication prescription and management system, pharmacist review, direct communication of discharge medication documentation to community pharmacists and staff education and support (Dolanski et al., 2013). Originality/value: Discussion of the factors impacting on medication errors within aged care facilities may explain why they are prevalent and serve as a basis for strategies to improve medication management and facilitate further research on this topic.
The impact of web-based and face-to-face simulation on patient deterioration and patient safety : Protocol for a multi-site multi-method design
- Cooper, Simon J., Kinsman, Leigh, Chung, Catherine, Cant, Robyn, Boyle, Jayne, Bull, Loretta, Cameron, Amanda, Connell, Cliff, Kim, Jeong-Ah, McInnes, Denise, McKay, Angela, Nankervis, Katrina, Penz, Erika, Rotter, Thomas
- Authors: Cooper, Simon J. , Kinsman, Leigh , Chung, Catherine , Cant, Robyn , Boyle, Jayne , Bull, Loretta , Cameron, Amanda , Connell, Cliff , Kim, Jeong-Ah , McInnes, Denise , McKay, Angela , Nankervis, Katrina , Penz, Erika , Rotter, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p. 1-8
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- Description: Background: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. Methods/design: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST2ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST2ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. Discussion: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016). © 2016 The Author(s).
- Authors: Cooper, Simon J. , Kinsman, Leigh , Chung, Catherine , Cant, Robyn , Boyle, Jayne , Bull, Loretta , Cameron, Amanda , Connell, Cliff , Kim, Jeong-Ah , McInnes, Denise , McKay, Angela , Nankervis, Katrina , Penz, Erika , Rotter, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p. 1-8
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- Reviewed:
- Description: Background: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. Methods/design: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST2ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST2ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. Discussion: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016). © 2016 The Author(s).
Foundations of nursing practice
- Cramer, Rhian, Coombs, Nicole, Lyons, Judith, Kim, Jeong-Ah
- Authors: Cramer, Rhian , Coombs, Nicole , Lyons, Judith , Kim, Jeong-Ah
- Date: 2019
- Type: Text , Book chapter
- Relation: The road to nursing Chapter 11 p. 168-182
- Full Text: false
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- Description: Becoming a safe and contemporary nurse is more than just being able to demonstrate clinical skills or understand disease processes. It is about critical thinking - understanding why we do what we do and how to do it in the most efficient and effective way. Achieving the best outcomes for the patients is always paramount. This chapter explores the foundational principles of contemporary nursing practice: evidence-based practice, person-centred care, and communication. It also introduces the growing role of technology in healthcare and looks at how numerous factors come together to influence health outcomes for the individual patient.
- Chung, Catherine, Cooper, Simon J., Cant, Robyn, Connell, Cliff, McKay, Angela, Kinsman, Leigh, Gazula, Swapnali, Boyle, Jayne, Cameron, Amanda, Cash, Penny, Evans, Lisa, Kim, Jeong-Ah, Masud, Rana, McInnes, Denise, Norman, Lisa, Penz, Erika, Rotter, Thomas, Tanti, Erin, Breakspear, Tom
- Authors: Chung, Catherine , Cooper, Simon J. , Cant, Robyn , Connell, Cliff , McKay, Angela , Kinsman, Leigh , Gazula, Swapnali , Boyle, Jayne , Cameron, Amanda , Cash, Penny , Evans, Lisa , Kim, Jeong-Ah , Masud, Rana , McInnes, Denise , Norman, Lisa , Penz, Erika , Rotter, Thomas , Tanti, Erin , Breakspear, Tom
- Date: 2018
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 64, no. (2018), p. 93-98
- Full Text: false
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- Description: Background: There are international concerns relating to the management of patient deterioration. The “failure to rescue” literature identifies that nursing staff miss cues of deterioration and often fail to call for assistance. Simulation-based educational approaches may improve nurses’ recognition and management of patient deterioration. Objectives: To investigate the educational impact of the First2Act web-based (WB) and face-to-face (F2F) simulation programs. Design & Setting: A mixed methods interventional cohort trial with nursing staff from four Australian hospitals. Participants: Nursing staff working in four public and private hospital medical wards in the State of Victoria. Methods: In 2016, ward nursing staff (n = 74) from a public and private hospital completed three F2F laboratory-based team simulations with a patient actor in teams of three. 56 nursing staff from another public and private hospital individually completed a three-scenario WB simulation program (First2ActWeb) [A 91% participation rate]. Validated tools were used to measure knowledge (multi-choice questionnaire), competence (check-list of actions) and confidence (self-rated) before and after the intervention. Results: Both WB and F2F participants’ knowledge, competence and confidence increased significantly after training (p ≤0.001). Skill performance for the WB group increased significantly from 61% to 74% (p ≤ 0.05) and correlated significantly with post-test knowledge (p = 0.014). No change was seen in the F2F groups’ performance scores. Course evaluations were positive with median ratings of 4/5 (WB) and 5/5 (F2F). The F2F program received significantly more positive evaluations than the WB program (p < 0.05), particularly with regard to quality of feedback. Conclusion: WB and F2F simulation are effective education strategies with both programs demonstrating positive learning outcomes. WB programs increase ease of access to training whilst F2F enable the development of tactile hands on skills and teamwork. A combined blended learning education strategy is recommended to enhance competence and patient safety. © 2018 Elsevier Ltd
- Kinsman, Leigh, Cooper, Simon J., Cant, Robyn, Kim, Jeong-Ah, Chung, Catherine
- Authors: Kinsman, Leigh , Cooper, Simon J. , Cant, Robyn , Kim, Jeong-Ah , Chung, Catherine
- Date: 2021
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 102, no. (2021), p.
- Full Text: false
- Reviewed:
- Description: Background: Nurses' response to patient deterioration in acute hospital wards is a priority issue. Simulation education programs improve nurses' knowledge and confidence, but the translation into better care is largely unknown for both web based (WB) and face to face (F2F) simulation programs. Aim: To measure the impact of simulation education on nurses' response to patient deterioration in acute medical ward settings, and to compare the impact of WB and F2F versions. Design: An interrupted time series, non-randomised trial across four medical wards in Victoria, Australia. Wards were allocated to either web-based or face-to-face versions of the same simulation program, FIRST2ACT. Interrupted time series measurement for six fortnights both before and after the intervention were used to measure and compare responses to deterioration. Responses to patient deterioration were extracted from medical records and grouped into outcomes for escalation (e.g. initiation of clinical review), assessment and observation (e.g. increased recording of vital signs, conscious state and pain scores) and clinical interventions (e.g. oxygen administration). Results: 126 nurses (89%) participated across the four wards. 946 patient records (506 in the F2F; 440 in the WB group) were included in analyses. There were significant and sustained improvements between pre and post samples in outcomes for escalation (13.0% to 28.8%; p = 0.000) and assessment and observation (conscious state recorded increased from 91.1% to 100%; p = 0.000, and pain score recorded increased from 97.8% to 99.8%; p = 0.000). There were no differences between the web-based and face-to-face groups except in appropriate oxygen application which increased by 7.7% in the F2F group and decreased by 11.8% in the WB group (p = 0.046). Conclusions: There was a significant improvement in nurses' response to patient deterioration following both versions of simulation, indicating that both have a role to play in supporting nurses' response to patient deterioration. © 2021. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper, Robyn Cant, Jeong-Ah Kim, Catherine Chung” is provided in this record**
- Description: Background: Nurses' response to patient deterioration in acute hospital wards is a priority issue. Simulation education programs improve nurses' knowledge and confidence, but the translation into better care is largely unknown for both web based (WB) and face to face (F2F) simulation programs. Aim: To measure the impact of simulation education on nurses' response to patient deterioration in acute medical ward settings, and to compare the impact of WB and F2F versions. Design: An interrupted time series, non-randomised trial across four medical wards in Victoria, Australia. Wards were allocated to either web-based or face-to-face versions of the same simulation program, FIRST2ACT. Interrupted time series measurement for six fortnights both before and after the intervention were used to measure and compare responses to deterioration. Responses to patient deterioration were extracted from medical records and grouped into outcomes for escalation (e.g. initiation of clinical review), assessment and observation (e.g. increased recording of vital signs, conscious state and pain scores) and clinical interventions (e.g. oxygen administration). Results: 126 nurses (89%) participated across the four wards. 946 patient records (506 in the F2F; 440 in the WB group) were included in analyses. There were significant and sustained improvements between pre and post samples in outcomes for escalation (13.0% to 28.8%; p = 0.000) and assessment and observation (conscious state recorded increased from 91.1% to 100%; p = 0.000, and pain score recorded increased from 97.8% to 99.8%; p = 0.000). There were no differences between the web-based and face-to-face groups except in appropriate oxygen application which increased by 7.7% in the F2F group and decreased by 11.8% in the WB group (p = 0.046). Conclusions: There was a significant improvement in nurses' response to patient deterioration following both versions of simulation, indicating that both have a role to play in supporting nurses' response to patient deterioration. © 2021. *Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Simon Cooper” is provided in this record**
- Terry, Daniel, Kim, Jeong-Ah, Gilbert, Julia, Jang, Sunny, Nguyen, Hoang
- Authors: Terry, Daniel , Kim, Jeong-Ah , Gilbert, Julia , Jang, Sunny , Nguyen, Hoang
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Health Services Vol. 52, no. 2 (2022), p. 292-302
- Full Text: false
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- Description: The issue of medical errors, or adverse events caused within a health care context or by a health care provider, is largely under-researched. While the experience and perspective of health care professionals regarding medical errors have been explored, little attention is paid to the health care consumers regarding their perceptions and experiences. Therefore, there is a need to better understand the public’s views on medical errors to enhance patient safety and quality care. The current study sought to examine Australian public perceptions and experiences, especially concerning what errors had occurred, the perceived sources of the errors, and if the errors had been reported. This paper reports the qualitative findings of an online survey for Australian residents who have accessed or received medical services at any time in Australia. Responses from 304 surveys were analyzed and discussed, including demographic information and key themes about medical errors, which were categorized into engagement and patients’ voices being heard, the quality of care being provided, and the system’s accountability. Based on the findings, the study highlights the importance of effective health professional–patient communication, enhanced capacity to deliver high quality care, and improved mechanism for error reporting and resolution where patients feel safe and confident about positive changes being made. © The Author(s) 2019.
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