https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52943 Wed 28 Feb 2024 16:14:20 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27198 Wed 11 Apr 2018 14:24:41 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27195 Wed 11 Apr 2018 12:06:12 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18743 Wed 11 Apr 2018 10:46:04 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:15205 Wed 11 Apr 2018 09:45:15 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:48570 Tue 21 Mar 2023 18:40:40 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:41945 Tue 16 Aug 2022 14:24:17 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:54575 Tue 14 May 2024 14:40:10 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:44864 0.7; 0.45–0.90). Item-rest correlations indicated that most ACT items (50 of 56 items) within any concept related well to the total score of the concept. Average inter-item correlations indicated potential redundant items for three concepts (feedback processes, leadership, staffing) that were above the threshold of 0.5. While identifying a few shortcomings for some ACT concepts in an ED context, the majority of findings confirm reliability and validity of the original ACT in an Australian population of ED nurses.]]> Thu 27 Oct 2022 13:57:10 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:21364 11 mmol/L). We also recorded swallow screening and assessment during the first 24 h of admission. Results: Data for 718 (98%) patients were available; 138 (19%) had four hourly or more temperature readings and 204 patients (29%) had a fever, with 44 (22%) receiving paracetamol. A quarter of patients (n = 102/412, 25%) had six hourly or more glucose readings and 23% (95/412) had hyperglycemia, with 31% (29/95) of these treated with insulin. The majority of patients received a swallow assessment (n = 562, 78%) by a speech pathologist in the first instance rather than a swallow screen by a nonspeech pathologist (n = 156, 22%). Of those who passed a screen (n = 108 of 156, 69%), 68% (n = 73) were reassessed by a speech pathologist and 97% (n = 71) were reconfirmed to be able to swallow safely. Conclusions: Our results showed that acute stroke patients were: undermonitored and undertreated for fever and hyperglycemia; and underscreened for swallowing dysfunction and unnecessarily reassessed by a speech pathologist, indicating the need for urgent behavior change.]]> Sat 24 Mar 2018 07:51:25 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:28777 11 mmol/l), and swallowing dysfunction in intervention stroke units. Results: Data from 1804 patients (718 preintervention; 1086 postintervention) showed that significantly more patients admitted to hospitals allocated to the intervention group received care according to the fever (n = 186 of 603, 31% vs. n = 74 of 483, 15%, P < 0·001), hyperglycemia (n = 22 of 603, 3·7% vs. n = 3 of 483, 0·6%, P = 0·01), and swallowing dysfunction protocols (n = 241 of 603, 40% vs. n = 19 of 483, 4·0%, P ≤ 0·001). Significantly more patients in these intervention stroke units received four-hourly temperature monitoring (n = 222 of 603, 37% vs. n = 90 of 483, 19%, P < 0·001) and six-hourly glucose monitoring (194 of 603, 32% vs. 46 of 483, 9·5%, P < 0·001) within 72 hours of admission to a stroke unit, and a swallowing screen (242 of 522, 46% vs. 24 of 350, 6·8%, P ≤ 0·0001) within the first 24 hours of admission to hospital. There was no difference between the groups in the treatment of patients with fever with paracetamol (22 of 105, 21% vs. 38 of 131, 29%, P = 0·78) or their hyperglycemia with insulin (40 of 100, 40% vs. 17 of 57, 30%, P = 0·49). Interpretation Our intervention resulted in better protocol adherence in intervention stroke units, which explains our main trial findings of improved patient 90-day outcomes. Although monitoring practices significantly improved, there was no difference between the groups in the treatment of fever and hyperglycemia following acute stroke. A significant link between improved treatment practices and improved outcomes would have explained further the success of our intervention, and we are still unable to explain definitively the large improvements in death and dependency found in the main trial results. One potential explanation is that improved monitoring may have led to better overall surveillance of deteriorating patients and faster initiation of treatments not measured as part of the main trial.]]> Sat 24 Mar 2018 07:23:45 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:32413 Mon 23 Sep 2019 12:03:48 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46403 Mon 21 Nov 2022 10:00:52 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:45490 Fri 28 Oct 2022 15:46:27 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27085 40 medical patients each year were targeted to receive the intervention which consisted of a one-to-one educational visit on VTE prevention from a trained peer facilitator. The EOV protocol was designed by a multidisciplinary group of healthcare professionals using social marketing theory. Results: Nineteen (73%) of 26 eligible participants received an EOV. The majority (n = 16, 85%) felt the EOV was effective or extremely effective at increasing their knowledge about VTE prophylaxis and 15 (78%) gave a verbal commitment to provide evidence-based prophylaxis. The average length of each visit was 15 minutes (IQ range 15 to 20) and the average time spent arranging and conducting each visit was 92 minutes (IQ range 78 to 129). There was a significant improvement in the proportion of medical patients receiving appropriate pharmacological VTE prophylaxis following the intervention (54% to 70%, 16% improvement, 95% CI 5 to 26, p = 0.004). Conclusions: EOV is effective at improving doctors’ provision of pharmacological VTE prophylaxis to hospitalised medical patients. It was also found to be an acceptable implementation strategy by the majority of participants; however, it was resource intensive requiring on average 92 minutes per visit.]]> Fri 24 May 2019 12:29:42 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52657 Fri 20 Oct 2023 09:10:15 AEDT ]]>