ANZCTR search results

This proposal aims to establish the effectiveness, cost-effectiveness and student experience of simulation training for the prevention of falls amongst hospitalised inpatients. This will be undertaken through established undergraduate placements of Monash University health professional students across Peninsula Health acute and subacute inpatient wards. The research team comprises of leaders in interprofessional education (IPE), simulated learning, health economics and falls prevention from Monash University, Monash Health and Peninsula Health. Prevention of falls is an Australian quality and safety priority particularly within health care services. Peninsula Health provides various types of training for employed health care staff and has systems in place for managing falls risk and monitoring falls incidents. There is little education about falls prevention strategies provided to undergraduate health professional students, either during university subjects or on orientation to Peninsula Health. Simulation learning provides the ideal environments for teaching high and low fidelity tasks with students. Falls prevention is the responsibility of all health care professionals therefore is an ideal test case within Peninsula Health for a simulated interprofessional learning package. The research team will conduct a cluster, cross-over randomised controlled trial with a concurrent economic evaluation (cost per fall prevented). It will target the health professional (medical, nursing and allied health) undergraduate students who enter Peninsula Health for placement over 2015/2016. The intervention will include the use of an evidence based simulation training program with three modules targeting falls prevention strategies with the patient with delirium, the patient with dementia and the patient with risk taking behaviours without delirium or dementia. The primary outcome of this research will be measured falls (patients) across inpatient facilities with secondary outcomes including satisfaction with the simulation learning environment, knowledge gain, ward-level practice change and cost of acute / rehabilitation care for each patient measured using clinical costing data.

Our extant research has indicated that intrapersonal factors (e.g., coping and thinking) are related to poor mental health in people with low vision. In this study, we will build on past trials in this area and examine the effectiveness of an adapted guided self-help programme on depressive symptoms. Our programme will include “third-wave” cognitive-and-behavioural treatment (CBT) components as a modern approach to treat the factors we found in our previous research. We will examine whether participants with low vision and depressive symptoms who receive the acceptance-focussed CBT programme show reduced depressive symptomatology (primary outcome), changes in coping, thinking, and quality-of-life (secondary outcomes) after the intervention compared to a treatment as usual group that includes a referral to the patients GP. This project has two phases. Phase 1 involves conducting a pilot randomised-controlled trial (RCT) to determine the impact of the programme of interest. Phase 2 involves a participant evaluation of programme content, format, and delivery to guide further refinement. The intervention will be conducted by Dr BA Sturrock who has substantial experience in both clinical and research intervention. She has trained practitioners in CBT intervention previously in a research setting and practices acceptance and commitment therapy (ACT) regularly in a private practice setting. The guided self-help programme that we have adapted is made up of six modules designed to be used each week, in addition to three face-to-face visits and three telephone contacts of up to 50 minutes in duration. The six modules are: (1) Understanding emotional well-being in vision impairment, (2) Being present, (3) Doing what matters, (4) Opening up, (5) Effective communication, and (6) Wellness planning. Following intervention, participant views will be gathered on the programme content, convenience, delivery, participant-therapist relationship, and impact.

The proposed PhD study will involve the development and pilot testing of Tuning Relationships with Music (TRM), a new systemic intervention that aims to help parents with a history of childhood interpersonal trauma and their adolescent children (10-18 years) improve the quality of their relationship. Parents with a trauma history often struggle to connect to their children. Adolescent behaviour can trigger unresolved trauma memories for a parent, resulting in an escalation of conflictual parent-child interactions which may compromise a young person’s development, leading to problems with emotional and social functioning, and mental health difficulties. Therefore it is important to intervene early with families with these risk factors in order to prevent the emergence of problems and strengthen the parent-child relationship, which has been found to play an important protective role in supporting optimal developmental outcomes for young people. TRM aims to use music as a vehicle to work directly with nonverbal maladaptive patterns of communication, to teach parents and teens how to recognise, interrupt and repair negative cycles of interaction, to learn responsive ways of relating, and to help parents use emotion coaching strategies to identify and empathically respond to their teen’s nonverbal and verbal expressions of emotion.

The Hospital in the Home (HITH) Service is a new model of care in Townsville Hospital and Health Service (THHS) whereby acute patients are treated in their own home by experienced nursing staff. This model of care has been employed at various locations across Australia and indeed the rest of the world for the past 25 years and has been established as a safe model of care with respect to patient morbidity and mortality. The current service provision model involves patients being visited up to three times per day by nursing staff to perform observations and provide wound care, IV antibiotics and physical review. In many instances a patient would only be visited once per day if they are physiologically stable. In comparison, admitted inpatients receive observations on average four times per day. This has implications for the perception of the quality of care provided under the HITH model by both patients and referring clinicians. In the literature there are many examples of the use of Telemedicine and tablet based Telemonitoring devices in the management of chronic diseases such as Diabetes, Chronic Obstructive Pulmonary Disease and Congestive Cardiac Failure. There is a paucity of evidence for the use of this technology in the acute sphere such as that seen in HITH with only one article published reviewing outcomes in 41 patients. The goal of this project is to implement and evaluate the use of a wireless TGA approved home monitoring device into the HITH Service at The Townsville Hospital.

Hidradenitis Suppurativa (HS) is a chronic skin disease that appears as pea-sized to marble-sized lumps under the skin. The lumps form most often in the armpits, under the breasts, inner thighs, groin and buttocks. HS can be painful and cause scarring and pus in affected areas. Flare-ups may be triggered by perspiration, hormonal changes (such as monthly cycles in women), humidity and heat, and friction from clothing. The objectives of this study are to determine the prevalence of HS in the Australian population and characterize the patterns of disease severity in this patient population. A cross-sectional, observational, population-based study will be used to investigate the epidemiology of HS. The study will be administered via a survey. If responses indicate that the participant potentially has HS, they will be contacted by a researcher to invite them to attend a dermatology clinic for further assessment.

Aim: To develop and pilot test an intervention to improve nurses’ abilities to manage interruptions during the administration of medications, thereby reducing medication errors and potentially, patient’s length of stay. Primary hypothesis: Interruptions associated with medication administration events will be reduced by 40%% where nurses undertake education and simulation experiences compared to nurses not receiving any education. Secondary hypothesis: There will be a 25% reduction in clinical and procedural errors during medication administration where nurses undertake and education program and / or simulation experience compared to nurses not receiving any education. Design: A CRCT is proposed to test these hypotheses as the simulation experiences, by their nature, need to be applied to groups of nurses or wards. Clinical and procedural error data will be collected at the nurse level, targeting nurses per ward. Sample and Setting: clusters of medical and surgical units and nurses (and patients) from SWSLHD hospitals form the sample. Randomisation: wards will be randomly assigned to the education or control arm. Due to the nature of the intervention, no blinding of ward nurses will be possible. Research staff involved in group allocation and analysis will be blinded to the allocation. Developing the intervention: Preliminary studies have been completed identifying sources of interruptions, extent of the problem, and use of behavioural strategies (positive and negative). Cognitive load and processing and strategies to manage the range of interrupters (nurses, doctors, patients, equipment), combined with strategies gleaned from focus group studies and observations of nurses form a 20 minute educational program including simulations.

This study will evaluate the effectiveness of Collaborative Therapy in reducing the risk of depression and anxiety in patients with chronic kidney disease and near end stage kidney disease (ESKD) who are transitioning on to dialysis treatment.

Hospitals face high levels of emergency presentations and demand for inpatient care particularly for Aboriginal Australian people from remote communities. Readmissions lead to overcrowded emergency departments and poorer patient outcomes. We will undertake a project to evaluate the efficacy of a multidimensional case-based management intervention in a regional Australian hospital with the aim of reducing hospital readmission and improving patient outcomes.

This study aims to compare the efficacy of two psychological interventions for disordered eating. Males and females, aged between 18-65 years, will be randomised into either a cognitive-behavioural guided self-help or a health at every size guided self-help condition. Participation is free and is running in Melbourne between September 2015 and September 2016.

A feasibility study for a larger, randomized, controlled trial investigating chiropractic treatment for adolescent low back pain.