Congratulations to SWSLHD staff on their recently published articles
Brady B, Sidhu B, Jennings M, Boland R, Hassett G, Chipchase L, Tang C, Yaacoub S, Pavlovic N, Sayad S, Andary T, Ogul S, Naylor J. The feasibility of implementing a cultural mentoring program alongside pain management and physical rehabilitation for chronic musculoskeletal conditions: results of a controlled before-and-after pilot study. BMC Musculoskelet Disord. 2023 Jan 19;24(1):47. doi: 10.1186/s12891-022-06122-x. PMID: 36658511; PMCID: PMC9850562.
Background: Culturally diverse communities face barriers managing chronic musculoskeletal pain conditions including navigation challenges, sub-optimal healthcare provider engagement and difficulty adopting self-management behaviours.
Objectives: To explore the feasibility and trends of effectiveness of implementing a cultural mentoring program alongside clinical service delivery.
Methods: This quasi-experimental controlled before-and-after multiple case study was conducted in three hospital-based services that provide treatment for patients with musculoskeletal pain. Two prospective cohorts, a pre-implementation and a post-implementation cohort, of adults with chronic musculoskeletal pain who attended during the 6-month recruitment phase, were eligible if they self-identified with one of the cultures prioritised for mentoring by the clinic. The pre-implementation cohort received routine care for up to 3-months, while the post-implementation cohort received up to 3-months of cultural mentoring integrated into routine care (3 to 10 sessions), provided by a consumer (n = 6) with lived experience. Feasibility measures (recruitment and completion rates, attendance, satisfaction), and trends of effectiveness (Patient Activation Measure and Health Literacy Questionnaire items one and six) were collated over 3-months for both cohorts. Outcomes were presented descriptively and analysed using Mann-Whitney U-tests for between-group comparisons. Translation and transcription of post-treatment semi-structured interviews allowed both cohorts' perspectives of treatment to be analysed using a Rapid Assessment Process.
Results: The cultural mentor program was feasible to implement in clinical services with comparable recruitment rates (66% pre-implementation; 61% post-implementation), adequate treatment attendance (75% pre-implementation; 89% post-implementation), high treatment satisfaction (97% pre-implementation; 96% post-implementation), and minimal participant drop-out (< 5%). Compared to routine care (n = 71), patients receiving mentoring (n = 55) achieved significantly higher Patient Activation Measure scores (median change 0 vs 10.3 points, p < 0.01) at 3-months, while Health Literacy Questionnaire items did not change for either cohort over time. Three themes underpinned participant experiences and acceptability of the mentoring intervention: 'expectational priming', 'lived expertise' and 'collectivist orientation' to understand shared participant experiences and explore the potential differential effect of the mentoring intervention.
Conclusion: Participant experiences and observations of improved patient activation provide support for the acceptability of the mentoring intervention integrated into routine care. These results support the feasibility of conducting a definitive trial, while also exploring issues of scalability and sustainability.
Poulos RG, Cole AM, Warner KN, Faux SG, Nguyen TA, Kohler F, Un FC, Alexander T, Capell JT, Hilvert DR, O'Connor CM, Poulos CJ. Developing a model for rehabilitation in the home as hospital substitution for patients requiring reconditioning: a Delphi survey in Australia. BMC Health Serv Res. 2023 Feb 3;23(1):113. doi: 10.1186/s12913-023-09068-5. PMID: 36737750; PMCID: PMC9895972.
Background: Reconditioning for patients who have experienced functional decline following medical illness, surgery or treatment for cancer accounts for approximately 26% of all reported inpatient rehabilitation episodes in Australia. Rehabilitation in the home (RITH) has the potential to offer a cost-effective, high-quality alternative for appropriate patients, helping to reduce pressure on the acute care sector. This study sought to gain consensus on a model for RITH as hospital substitution for patients requiring reconditioning.
Methods: A multidisciplinary group of health professionals working in the rehabilitation field was identified from across Australia and invited to participate in a three-round online Delphi survey. Survey items followed the patient journey, and also included items on practitioner roles, clinical governance, and budgetary considerations. Survey items mostly comprised statements seeking agreement on 5-point Likert scales (strongly agree to strongly disagree). Free text boxes allowed participants to qualify item answers or make comments. Analysis of quantitative data used descriptive statistics; qualitative data informed question content in subsequent survey rounds or were used in understanding item responses.
Results: One-hundred and ninety-eight health professionals received an invitation to participate. Of these, 131/198 (66%) completed round 1, 101/131 (77%) completed round 2, and 78/101 (77%) completed round 3. Consensus (defined as ≥ 70% agreement or disagreement) was achieved on over 130 statements. These related to the RITH patient journey (including patient assessment and development of the care plan, case management and program provision, and patient and program outcomes); clinical governance and budgetary considerations; and included items for initial patient screening, patient eligibility and case manager roles. A consensus-based model for RITH was developed, comprising five key steps and the actions within each.
Conclusions: Strong support amongst survey participants was found for RITH as hospital substitution to be widely available for appropriate patients needing reconditioning. Supportive legislative and payment systems, mechanisms that allow for the integration of primary care, and appropriate clinical governance frameworks for RITH are required, if broad implementation is to be achieved. Studies comparing clinical outcomes and cost-benefit of RITH to inpatient rehabilitation for patients requiring reconditioning are also needed.
Lynette McEvoy 1 , Matthew Richter 2 , Tanghua Chen 1 , Ann Le 1 , Carol Wilson 3 , Lynda Marov 4 , Poumansing Gujraz 5 , Leeanne Gray 5 , Mandana Mayahi-Neysi 6 , Nevenka Francis 1 7 8 , Ha Thi Mai 9 , Steven He 8 9 , Danielle Ní Chróinín 1 7 , Steven A Frost 1 7 8 Frailty among older surgical patients and risk of hospital acquired adverse events: The South‐Western Sydney frailty and nurse sensitive indicators study. Journal of clinical nursing. doi:10.1111/jocn.16259
Abstract
BACKGROUND: While advances in healthcare mean people are living longer, increasing frailty is a potential consequence of this. The relationship between frailty among older surgical patients and hospital acquired adverse events has not been extensively explored. We sought to describe the relationship between increasing frailty among older surgical patients and the risk of hospital acquired adverse events. METHODS: We included consecutive surgical admissions among patients aged 70 years or more across the SWSLHD between January 2010 and December 2020. This study used routinely collected ICD-10-AM data, obtained from the government maintained Admitted Patient Data Collection. The relationships between cumulative frailty deficit items and risk of hospital acquired adverse events were assessed using Poisson regression modelling. This study followed the RECORD/STROBE guidelines. RESULTS: During the study period, 44,721 (57% women) older adults were admitted, and 41% (25,306) were planned surgical admissions. The risk of all adverse events increased with increasing number of frailty deficit items, the highest deficit items group (4-12 deficit items) compared with the lowest deficit items group (0 or 1 deficit item): falls adjusted rate ratio (adj RR) = 15.3, (95% confidence interval (CI) 12.1, 19.42); pressure injury adj RR = 21.3 (95% CI 12.53, 36.16); delirium adj RR = 40.9 (95% CI 31.21, 53.55); pneumonia adj RR = 16.5 (95% CI 12.74, 21.27); thromboembolism adj RR = 17.3 (95% CI 4.4, 11.92); and hospital mortality adj RR = 6.2 (95% CI 5.18, 7.37). CONCLUSION: The increase in number of cumulative frailty deficit items among older surgical patients was associated with a higher risk of adverse hospital events. The link offers an opportunity to clinical nursing professionals in the surgical setting, to develop and implement targeted models of care and ensure the best outcomes for frail older adults and their families.
1. Liverpool Hospital, Liverpool, Australia
3 Bankstown-Lidcombe Hospital, Bankstown, Australia
4 Campbelltown Hospital, Campbelltown, Australia
5 Fairfield Hospital, Fairfield, Australia
6 Bowral District Hospital, Bowral, Australia
8 South Western Sydney Nursing and Midwifery Research Alliance
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Ahmed, S., Grainger, R., Santosa, A., Adnan, A., Alnaqbi, K. A., Chen, Y. H., Amy Kelly. . . Traboco, L. (2022). APLAR recommendations on the practice of telemedicine in rheumatology. International Journal of Rheumatic Diseases. doi: 10.1111/1756-185X.14286
Assad, J., Femia, G., Pender, P., Badie, T., & Rajaratnam, R. (2022). Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management. Clinical Medicine Insights: Cardiology, 16. doi: 10.1177/11795468211065782.
Bamgboje-Ayodele, A., Avery, S., Pearson, J., Mak, M., Smith, K., Rincones, O., . . . Girgis, A. (2022). Adapting an integrated care pathway for implementing electronic patient reported outcomes assessment in routine oncology care: Lessons learned from a case study. Journal of Evaluation in Clinical Practice. https://doi.org/10.1111/jep.13688
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Does weight management after gestational diabetes mellitus diagnosis improve pregnancy outcomes? A multi-ethnic cohort study.
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Cardona, M., Fien, S., Myooran, J., Hunter, C., Dillon, A., Lewis, E., . . . Chroinin, D. N.
Clinical and cost-effectiveness of telehealth for Indigenous and culturally and linguistically diverse (CALD) people: a scoping review. Ethnicity & Health. doi: 10.1080/13557858.2021.2023111.
Chow, J. S. F., D'Souza, A., Lane, B., Descallar, J., Ford, M., Marshall, S., & Pennings, S. (2022). Health workers' Perceptions and REsponses in implementing COVID-19 Immunisation StratEgy in South Western Sydney (PRECISE): An observational study [Article]. BMJ Open, 12(4), 8, Article e055034. https://doi.org/10.1136/bmjopen-2021-055034
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Chow, J., Harley, A., Chroinin, D. N., Kohler, F., Harlum, J., Jobburn, K., . . . Hillman, K. (2022). Understanding of advance care planning in primary care: A gap analysis. Australian Journal of Primary Health, -. https://doi.org/10.1071/py21253
Chung, D. (2022). Ischaemic gastritis and perforation. Annals of Medicine and Surgery, 73. doi: 10.1016/j.amsu.2021.103212.
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Leung, K. F. C., Golzan, M., Egodage, C., Rodda, S., Cracknell, R., Macken, P., & Kaushik, S. (2022). Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study.
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Makary, J., Galloway, P., & Mancuso, P. (2022). Uretero-duodenal fistula: Risk factors and management. Urology Case Reports, 41. doi: 10.1016/j.eucr.2021.101969
Maurer, M., Magerl, M., Betschel, S., Aberer, W., Ansotegui, I. J., Aygören-Pürsün, E., . . .Katelaris, C, . . . Craig, T. (2022). The international WAO/EAACI guideline for the management of hereditary angioedema—The 2021 revision and update. Allergy: European Journal of Allergy and Clinical Immunology. doi: 10.1111/all.15214
Osuagwu, U. L., Xu, M., Piya, M. K., Agho, K. E., & Simmons, D. (2022). Factors associated with long intensive care unit (ICU) admission among inpatients with and without diabetes in South Western Sydney public hospitals using the New South Wales admission patient data collection (2014–2017). BMC Endocrine Disorders, 22(1). doi: 10.1186/s12902-022-00933-8
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Smith, A. B., Rincones, O., Mancuso, P., Sidhom, M., Wong, K., Berry, M., Forstner, D., Ngo, D., Girgis, A. (2022). Low conflict and high satisfaction: Decisional outcomes after attending a combined clinic to choose between robotic prostatectomy and radiotherapy for prostate cancer. Urologic Oncology-Seminars and Original Investigations, 40(1). doi:10.1016/j.urolonc.2021.05.007
Stoyanov, A., Thompson, G., Lee, M., & Katelaris, C. (2022). Delayed hypersensitivity to the Comirnaty coronavirus disease 2019 vaccine presenting with pneumonitis and rash. Annals of Allergy, Asthma and Immunology, 128(3), 321-322. doi: 10.1016/j.anai.2021.11.014
Trompeter, N., Bussey, K., Forbes, M. K., Hay, P., Goldstein, M., Thornton, C., . . . Mitchison, D. (2022). Emotion Dysregulation and Eating Disorder Symptoms: Examining Distinct Associations and Interactions in Adolescents. Research on Child and Adolescent Psychopathology. doi: 10.1007/s10802-022-00898-1
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Warnatz, K., Jolles, S., Agostini, C., Vianello, F., Borte, M., Bethune, C., . . . Katelaris, C., . . . Cook, M. C. (2022). Subcutaneous Gammanorm® by pump or rapid push infusion: Impact of the device on quality of life in adult patients with primary immunodeficiencies. Clinical Immunology, 236. doi: 10.1016/j.clim.2022.108938
Young, F. P., Becker, T. M., Nimir, M., Opperman, T., Chua, W., Balakrishnar, B., . . . Ma, Y. F. (2022). Biomarkers of Castrate Resistance in Prostate Cancer: Androgen Receptor Amplification and T877A Mutation Detection by Multiplex Droplet Digital PCR.
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Zhou, J., Ho, V., & Javadi, B. (2022). New Internet of Medical Things for Home-Based Treatment of Anorectal Disorders.
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