Abstract Submission for University of Wollongong Bega Research Forum

Transcription

1 Abstract Submissin fr University f Wllngng Bega Research Frum Preference: Oral presentatin Title: The Glden Angels : Effects f trained vlunteers n specialling and readmissin rates fr peple with dementia and delirium in rural hspitals Objectives: Evaluate the clinical utcmes fr patients with dementia, delirium r at risk fr delirium supprted by the persn-centred vlunteer prgram in rural acute hspitals. Design: A nn-randmised, cntrlled trial. Participants: Older adults admitted t 7 acute hspitals in rural Australia. Interventin (n=270) patients were >65 years with a diagnsis f dementia r delirium r had risk factrs fr delirium and received vlunteer services. Cntrl (n=188) patients were admitted t the same hspital 12 mnths prir t the vlunteer prgram and wuld have met eligibility criteria fr the vlunteer prgram, had it existed. Interventin: Trained vlunteers prvided 1:1 persn centred care with a fcus n nutritin and hydratin supprt, hearing and visual aids, activities, and rientatin. Measures: Medical recrd audits prvided data n vlunteer visits, diagnses, length f stay (LOS), behaviural incidents, readmissin, specialling, mrtality, admissin t residential care, falls, pressure ulcers and medicatin use. Results: Acrss all sites, there was a significant reductin in rates f 1:1 specialling and 28 day readmissin fr patients receiving the vlunteer interventin. LOS was significantly shrter fr the cntrl grup. All ther patient utcmes were equivalent fr the interventin and cntrl grup. Cnclusin: The vlunteer interventin is a safe, effective and replicable way t supprt lder acute patients with dementia, delirium r risk factrs fr delirium in

2 rural hspitals. Further papers will reprt n cst effectiveness, family carer, vlunteer and staff experiences f the prgram Authrs: Annaliese BLAIR (BA (Hns Psych), M. Clin.Psych), Clinical Research Officer 1,2,3# Katrina ANDERSON (BSc., Grad Dip b, PhD (Clinical Psychlgy)) A/Directr Aged Care Evaluatin Unit 1,2,3# Catherine BATEMAN (Bachelr f Health Science (Nursing), Master f Nursing (Research)) Clinical Nurse Cnsultant 1,2,4# and 1 Aged Care Evaluatin Unit, Suthern NSW Lcal Health District, Queanbeyan, New Suth Wales, Australia 2 NHMRC Cgnitive Decline Partnership Centre, Sydney, Australia 3 Australian Natinal University, Canberra, Australia. 4 Agency fr Clinical Innvatin, NSW Health, Sydney, NSW Australia # AB, KA and CB cntributed equally t this wrk Crrespnding Authr: Annaliese Blair Aged Care Evaluatin Unit, PO Bx 1845, Queanbeyan, NSW 2620 Ph: Annaliese.Blair@health.nsw.gv.au

3 COORDINARE Suth Eastern NSW PHN Transfrming the shape f primary care service delivery in the Far Suth Cast Mving frm prcess t utcmes Authr(s): Abhijeet Ghsh (aghsh@crdinare.rg.au), Philippa Fetterplace (pfetterplace@crdinare.rg.au) COORDINARE Suth Eastern NSW PHN Backgrund The Cntinuus Quality Imprvement stream f the Sentinel Practices Data Surcing (SPDS) prject has been wrking with general practices in the Bega Valley area t imprve the verall effectiveness f rutine primary care cnsultatins thrugh rbust quality imprvement principles and by using innvative tls and cmprehensive resurces. Methds 9 f the 13 general practices in the Bega Valley have been partaking in SPDS prject since late Facilitated by a dedicated lcal prject supprt crdinatr, all 9 practices have been wrking n imprving the lcal health service delivery t residents f the Bega Valley thrugh nging cycles f Plan-D-Study-Act facilitated by the lcal prject supprt crdinatr. These imprvement cycles are tailred t the needs and gaps f each individual practice. Practices als underg regular perfrmance benchmarking n a quarterly basis. Results Results vary between the 9 practices but in 4 ut f the 10 indicatrs, all 9 practices have shwn significant imprvement cmpared t baseline figures. Additinally, fr imprtant indicatrs such as weight screening fr all adults visiting the general practice and adherence t clinical guidelines fr apprpriate management f diabetes in primary care; a Bega Valley practice emerges as the exemplar practice amngst ver 110 general practices in the Suth Eastern NSW PHN catchment fr each quarter. Cnclusin Systematic methds f cntinuus quality imprvement facilitated by peak bdy supprt and training can enable general practices t undertake lcal data driven service perfrmance mnitring, that has the ptential t dramatically imprve patient and ppulatin health utcmes fr Bega Valley. 250 wrds excluding title and authr details Preferred Presentatin Frmat Oral Versin - 2

4 Abstract Submissin 2018 Bega Health Research Frum Lcal Research, Lcal Impact 8 March 2018 Cncurent Stream: Structural Refrm: Impact n rural and remte lcatins and service prvisin; Keywrds: Rural Mental Health, Suicide, Triage, Hspital, Authrs: Lyne Tremblay; Margaret Rlfe and David Schmidt Abstract Title: What Benefits Can A Lcal Mental Health Telephne Triage Service Based In it s Own Rural Area Prvide Cmpared t a Metrplitan Based Service? Backgrund: This research explred the effectiveness f a new rural Triage and Emergency Care Supprt (TECS) service in Suthern NSW Lcal Health District (SNSWLHD) fr Mental Health cnsumers, their carer s, families, medical prfessinals, hspitals staff and thers calling the NSW Mental Health (MH) Line, seeking supprt and directin fr the right care fr them. The service is prvided by lcal, rural and experienced mental health clinicians. The primary bjective f this study was t examine if this mve back t a mre lcally based service ffered any benefits fr clients f the service. Methd: An audit f the MH line in SNSWLHD between March 2014 and April 2016 was perfrmed using archival data recrds frm calls t the MH Line and 5333 MH hspital presentatins t 12 hspitals in the LHD t explre any change in planned and unplanned emergency department (ED) presentatins. A review f 204 call recrdings was cmpleted t identify ptential factrs that culd be assciated with de escalatin in client symptms therefre reducing the hspital presentatins using the Behaviur Change frm. Results: Results using a paired t test indicated a significant decrease in the rate f ED presentatins pst TECS by 5.6 MH presentatins per 100 calls t the MH line. Expected Outcme f the study: Findings frm this study wuld infrm ther Lcal Health Districts, Mental Health Line Triage rganisatins in skills develpment, mental health clinicians, supprt wrkers, Help line rganisatins, gvernment agencies and cnsumers.

5 BHRF Abstract Submissin2018 What factrs influence the delivery f lifestyle risk cmmunicatin by registered nurses in Australian general practice? Preliminary findings. Backgrund/Intrductin As the burden f chrnic disease increases, nurses have the ptential t embrace engagement in lifestyle risk reductin activities. General practice nurses, in particular, have prlnged engagement with patients, which facilitate behaviur change interventins. Until nw, little is knwn abut what factrs influence its delivery in clinical practice. Methds/Strategies Embedded within a mixed methds apprach, this qualitative descriptive study sught t understand general practice nurse (GPN) experiences f lifestyle risk cmmunicatin. Thirteen GPNs were recruited frm Suth East New Suth Wales. Semi structured interviews were audi recrded with thematical analysis f verbatim transcriptins infrmed by Braun and Clarke (2006). Results/Outcmes Nurses perceived lifestyle risk cmmunicatin as cntingent upn GPN persnal and prfessinal needs, patient need and receptiveness, and structural supprts. Rle navigatin, rapprt building and GPN preparedness fr lifestyle risk cmmunicatin guided GPN persnal and prfessinal needs. Patient need and receptiveness was assessed thrugh the patient s willingness fr engagement and priritisatin f risk factrs. Structural supprts deemed necessary fr lifestyle risk cmmunicatin, such as time allcatin as well as rganisatinal and cllabrative supprt, were seen as bth enablers and barriers. Cnclusins/Implicatins Behaviurs impacting n lifestyle risk are mdifiable, ften requiring supprt fr lasting change. Behaviural cunselling f these risks is effective in general practice. Understanding factrs, which influence GPN prvisin f lifestyle risk cmmunicatin will prvide new knwledge infrming clinical practice, nurse educatin, service delivery and plicy. References Braun, V. and V. Clarke (2006). "Using thematic analysis in psychlgy." Qualitative Research in Psychlgy 3(2):

6 Abstract Title: Trans-cultural nurse educatin: Student nurse experiences f a crss-cultural blgging activity. Purpse Internatinalisatin at Hme enables students t have a glbal experience and engage with internatinal students withut leaving hme (Teekens, 2015). The use f technlgy such as scial media can prvide a viable mechanism by which this can be achieved (Beleen & Jnes, 2015). This medium prvides students with an pprtunity t share ideas, develp digital cmmunicatin skills and enrich their learning experience (Schmitt, Sims-Giddens & Bth, 2012). The purpse f this prject was t explre and evaluate the use f a blg t stimulate discussin between Canadian and Australian nursing students fcusing n culture and family. Methds Australian and Canadian students participated in an internatinal, crss-cultural activity that prvided an pprtunity t engage with each ther thrugh a shared blg experience. This learning and teaching activity was imbedded within a Bachelr f Nursing subject at each University and included students frm reginal campuses including Bega campus. Students wh tk part in the internatinal blg were invited t evaluate the activity thrugh an annymus nline questinnaire. The survey assisted instructrs t identify the strengths and limitatins f the activity, illuminate areas fr imprvement and determine if it wuld be wrthwhile repeating the activity in future. Results: Students reprted the activity t be a wrthwhile learning experience using a unique learning medium that imprved their persnal and prfessinal knwledge f culture and family. In additin, the activity helped develp their digital technlgy skills and enhance their understanding f anther persn s perspective thrugh interactin with students frm anther cuntry.

7 References: Beelen, J & Jnes, (2015). Eurpe Calling: A new Definitin fr internatinalizatin at hme. Internatinal Higher Educatin. 83(SI), Schmitt, T., Sims-Giddens, A., & Bth, R. (2012). Scial media use in nursing educatin. Online Jurnal f Issues in Nursing,17(3), Teekens, H. (2015). The freedm t be: Internatinal educatin and crssing brders Mestenhauser Lecture n Internatinal Higher Educatin. Mineaplis, MN: Presenters/authrs: Sibhan Wragg RN. MSC. MEd. (presenter) Nancy Edgecmbe PhD. & Mira Stephens PhD

8 ABSTRACT SUBMISSION 2018 Bega Health Research Frum 8 th March UOW Bega Campus Abstract Title: Unplanned readmissins within 28 days the patient s experience Authr/s: Dt Hughes, Nurse Manager Prject and Innvatins, Suthern NSW LHD Ute Anne (Uta) Cnway, Research Supprt Officer, TRGs prject, Suthern NSW LHD David Schmidt, senir prject manager, HETI Rural Research Capacity Building Prgram Presentatin: Oral presentatin preferred Backgrund: Patients re-presenting t hspital after recently being discharged is an unwanted challenge fr patients, families and carers. Unplanned readmissins within 28 days reflect a breakdwn in the cntinuum f care and sme f these interruptins t the patient jurney may be avidable. This research was cnducted acrss hspitals in Suthern NSW LHD, including Suth East Reginal Hspital (SERH) at Bega, Cma and Eurbdalla hspitals. Findings can be used fr service imprvement. Infrmatin regarding unplanned readmissins frm the patients perspective it vital t understand cntributing factrs. A mixed methd research design with matched pair methdlgy was utilised. 114 patient interviews revealed issues regarding discharge infrmatin, medicatin infrmatin and referrals cntributed t unplanned related readmissins. Outcmes: 114 patients were interviewed. Quantitate and qualitative data was cllected. Findings included: Cmmunicatin: Cmmunicatin issues with staff t staff and staff t patient cmmunicatin and negative staff attitudes in cmmunicatin events can impact negatively n patient care. Discharge infrmatin that is missing, unclear, r verwhelming in vlume and is subsequently ignred Medicatin infrmatin n reasns fr a medicatin change, management f a new medicatin r side effects. Referrals t cmmunity-based services that were nt made, nt clear r nt cmmunicated. Limited prvisin f the Health Direct number saw patients representing t hspital seeking advice that culd have been prvided ver the phne. Recmmendatin: Pst-discharge phne calls fr all patients Take Hme Message: Imprving the patient experience and reducing unplanned readmissins can be enhanced by understanding the jurney frm the patient s perspective.

9 ABSTRACT SUBMISSION 2018 Bega Health Research Frum 8/3/ UOW Campus Bega Abstract Title: Patients perspectives f their periperative care Authr/s: Ute Anne (Uta) Cnway, Peri-perative Nurse, Tllan Cnway, Peri-perative Nurse, Student Bachelr f Medicine/Surgery University f Wllngng Presentatin: Oral presentatin, but can submit additinal pster which had previusly been submitted t the 2017 NSW Rural Research Cnference at Wagga Wagga. Backgrund: Patient-centered care cntributes t increased patient satisfactin and better patient utcmes. The questin that arises is hw t make the patient s jurney thrugh the unfamiliar wrld f the perating theatre mre patient-centred. Obtaining infrmatin n the patients perspective f their care in this setting allws fr evaluatin f effectiveness f existing measures and identificatin f new issues fr service imprvements and s better health utcmes. This research was cnducted at Suth East Reginal Hspital (SERH) at Bega. Apprach: Data was btained via a custm designed questinnaire, jintly develped with the cnsumer cnsultancy cmmittee. The questinnaire explred every stage f the patient jurney frm the pre-perative stage thrugh t pst-discharge infrmatin. Data was evaluated using descriptive statistics, cmments were gruped int themes. 764 patients received the questinnaire, 349 patients returned it Outcmes / Results: This research in prgress is at the data analysis stage. Early results frm the preliminary analysis indicate that whilst mst patient were happy with their care, the peri-perative envirnment at SERH culd be made mre patient centred by: Imprving cmmunicatin abut pain management Enhancing discharge infrmatin, particularly abut wund care Greater family invlvement, such as keeping family infrmed f the patient s prgress thrugh the perating theatre envirnment Full results will be available at time f presentatin Take Hme Message: Imprving patients experience can be enhanced by understanding patient jurneys frm the patient s perspective. Findings frm this study will be f interest t cnsumer grups, peri-perative nurses, medical fficers, surgens, managers and executives alike.

10 ABSTRACT: Bega Health Research Frum 2018 Title: Medical cnsults via telehealth in rural emergency departments: a systematic review Authrs: Dt Hughes, Nurse Manager Initiatives & Prjects, Suthern NSW Lcal Health District, Queanbeyan, NSW, Australia Tania Dufty, Registered Nurse, ACT, Australia Ingrid Evans, Epidemilgist, Suthern NSW Lcal Health District, Queanbeyan, NSW, Australia Backgrund: Equitable access t health care in rural areas is limited by gegraphy, time and distance. Wrkfrce shrtages are cmmn, and a number f patients wh require a medical cnsult will present t small rural emergency departments (ED) when n dctr is available. Apprach: In 2018, the LHD intends t trial using telehealth t link the Delegate and Bmbala MPS Emergency Departments t a dctr in a larger hspital such as Cma r Queanbeyan. T supprt this wrk, we aimed t synthesise the literature regarding medical cnsultatins perfrmed via telehealth in rural EDs, and t identify factrs assciated with feasibility, effectiveness and sustainability. We cnducted a systematic review f the literature using accepted methds. We searched peer-reviewed electrnic databases fr articles published since Search terms were related t telehealth, telemedicine, rural, remte, emergency and cnsultatin. Of 833 recrds identified and screened, 98 full-text articles were assessed fr eligibility, and 20 studies were included in the final review. Outcmes: Telehealth was fund t be cst-effective (5 studies), technically feasible (6 studies) and imprved accessibility by enabling lcal treatment (4 studies). Telehealth was acceptable (8 studies), reduced transfer rates and increased discharge frm rural EDs (5 studies). Clinical care was determined as meeting required quality r safety (5 studies) and wrkfrce satisfactin, recruitment and retentin (4 studies). Cnclusin: Telehealth has the ptential t reslve the barriers t health care access experienced by rural cmmunities. Prviding equitable, safe and effective care using telehealth culd be cst effective and reduce the need fr sme patient grups t travel t referral hspitals. Oral presentatin preferred