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"An ounce of prevention is worth a pound of cure."
Benjamin Franklin


Hand hygiene compliance: the burden is not equal

“Nurses have 3 times more hand hygiene opportunities (HHOs) than physicians, yet nurses have 1.5 times higher compliance than physicians. Hand hygiene compliance in physicians cannot be explained by burden of HHOs.”

Source: American Journal of Infection Control 2016; online first: 31 March

Further reading

Hand hygiene compliance
An automated system utilising low-power wireless radio to measure hand hygiene compliance has been trialled in Australia and compared to human auditing methods. The authors concluded that automation "collects 4 times the amount of data on each ward per day than a human auditor usually collects for a quarterly compliance report." The National Hand Hygiene Initiative requires auditing of hand hygiene compliance as a mandatory patient safety activity and hospitals bear a significant proportion of the cost. The authors state that use of an automated system provides: more comprehensive 24/7 data; the ability to provide real-time feedback; a reduction in bias associated human auditing; and reduces the cost of mandatory reporting.

Source: American Journal of Infection Control 2016; online first: 31 March

Hand hygiene compliance - the alternative perspective
Hand hygiene compliance continues to be an area of concern for hospitals despite many years of research being conducted on the topic. This paper outlines possible explanations for low levels of compliance among health care workers, and questions whether the use of high compliance targets is effective. "In an era of multi-resistant Gram-negative bacteria, it is now time to take stock and consider that we have spent a number of years performing research on hand hygiene with little evidence that any particular strategy works. Perhaps future research should be focused not on campaigns to improve hand hygiene at all costs, but on understanding when hand hygiene is most beneficial, setting reasonable, achievable targets, and then monitoring using validated, reproducible methods."

Source: Journal of Hospital Infection 2016; 92(4): 307-308


Patient safety in Victorian public hospitals

The report includes 13 recommendations, 4 of which address the need for hospitals to improve their incident investigation management and 9 relate to the role of the Department of Health & Human Services (DHHS) in providing oversight of and support for improving patient safety outcomes. The audit is critical of DHHS for ultimately "failing to adequately protect the safety of hospital patients". Hospitals are encouraged to: ensure timely feedback following incident reporting; evaluate the effectiveness of incident investigation recommendations; identify risk prevention opportunities; and comply with DHHS policy.

Source: Victorian Auditor - General's Report March 2016


Australian veterans: identification of mental health issues

"To ensure the early identification and effective treatment of mental health disorders in the veteran population, general practitioners (GPs) need to be aware that the traditional profile of an Australian veteran has changed, and that more than combat service can give rise to mental health issues." This article examines findings that have emerged from research undertaken with participants from three veteran cohorts to highlight mental health issues that should be considered in general practice.

Source: Australian Family Physician 2016; 45(3): 98

Further reading

Veteran's Health - is a special issue of Australian Family Physician and includes articles on management of Department of Veterans' affairs patients in general practice, and supporting Australia's new veterans.


Saving babies' lives: a care bundle for reducing stillbirth

NHS England has produced this guidance as part of an effort to halve the rate of stillbirths from 4.7 per thousand to 2.3 per thousand by 2030, potentially avoiding the tragedy of stillbirth for more than 1,500 families every year. While the majority of women receive high quality care, there is around a 25% variation in stillbirth rates across England. The guidance seeks to ameliorate this variation by bringing together four key elements of care based on best available evidence and practice. The four elements are:

  1. Reducing smoking in pregnancy
  2. Risk assessment and surveillance for foetal growth restriction
  3. Raising awareness of reduced foetal movement
  4. Effective foetal monitoring during labour

Source: NHS England 2016; p.30


Hep B vaccinations - SMS reminders!

"Text message reminders do not improve hepatitis B vaccination rates in an Australian sexual health setting." Researchers in Sydney assessed the impact of SMS reminders on hepatitis B virus (HBV) vaccination completion rates. Authors found that second and third dose completion rates were significantly lower in the SMS group compared to the pre-SMS group among sex workers, travellers, and people who reported sex overseas. The paper concludes "clinician prompts to reduce missed opportunities and multiple recall interventions may be needed to increase HBV vaccination completion in this high risk population."

Source: Journal of the American Medical Informatics Association (JAMIA) 2016; 23(e1):e88-e92

Further reading:

YouTube and HPV
This study focused on the content of YouTube videos related to human papillomavirus (HPV). "The videos included in this study were viewed ~17 million times, which indicates their potential for influencing public awareness and opinions. Of the videos devoted to HPV vaccination, few were encouraging. These videos may impede efforts to increase rates of HPV vaccination, which are already far below target levels."

Source: International Journal of Adolescent Medicine and Health 2016; online first: 9 April
Full text available for Austin & MHW Heidelberg staff via document delivery


Austin Health Research Online - recent submissions

Old but not forgotten: antibiotic allergies in general medicine (the AGM Study). Trubiano J, Pai Mangalore R, Baey YW, Le D, Graudins LV, Johnson D, Aung AK. The Medical Journal of Australia 2016; 204(7): 273

Perceived barriers to endovascular repair of ruptured abdominal aortic aneurysm among Australasian vascular surgeons. Lo J, Jedynak J, Cheun J. Journal of Vascular Surgery 2016; online first: 8 April

Kellum J, Bellomo R, Ronco C. Continuous Renal Replacement Therapy. 2nd ed. Oxford University Press; 2016. 306 p.

Jaderling G, Bellomo R. Do Early Warning Scores and Rapid Response Teams Improve Outcomes? In: Deutschman C, Neligan P, editors. Evidence-based practice of critical care. 2nd ed. Philadelphia: Elsevier; 2016. p. 21-28.

Denosumab reduces cortical porosity of the proximal femoral shaft in postmenopausal women with osteoporosis. Zebaze R, Libanati C, McClung MR, Zanchetta JR, Kendler DL, Høiseth A, Wang A, Ghasem-Zadeh A, Seeman E. Journal of Bone and Mineral Research 2016; online first: 15 April
Full text available for Austin & MHW Heidelberg staff via document delivery

A review of radiation protection solutions for the staff in the cardiac catheterisation laboratory. Badawy MK, Deb P, Chan R. Heart, Lung and Circulation 2016; online first: 13 April

Temozolomide-associated liver fibrosis. Parakh S, Hamid A, Cher L, Gan H. Heart, The Journal of Clinical Pharmacology 2016; online first: 20 April
Full text available for Austin & MHW Heidelberg staff via document delivery

See more at AHRO, Austin Health Research Online


eBooks spotlight

Netter’s orthopaedic clinical examination : an evidence based approach / Joshua A. Cleland, Shane Koppenhaver, Jonathan Su - 3rd ed. - Saunders Elsevier, 2016.
With its unique combination of artwork, exam photos and rigorous evidence-based approach, this edition helps you to quickly review the reliability and diagnostic utility of musculoskeletal physical exams.

The MD Anderson manual of medical oncology / edited by Hagop M. Kantarjian and Robert A. Wolff - 3rd ed. - McGraw Hill Education, 2016.
This text reflects the most recent advancements, including expanded coverage of the rapidly evolving area of biological and immune therapies of cancer.

Print and online

Evidence-based practice of critical care / edited by Clifford S. Deutschman, Patrick J. Neligan - 2nd ed. - Elsevier, 2016.
Presents objective data and expert guidance on managing critically ill patients in question-based chapters that focus on best practices.


Continuous renal replacement therapy / edited by John A. Kellum, Rinaldo Bellomo, Claudio Ronco - 2nd ed. - Oxford University Press, 2016.
This book provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians’ questions about treatments and situations encountered in daily practice.


Journals spotlight

These links provide access to the current table of contents:

Clinical Infectious Diseases

Current Opinion in Endocrinology, Diabetes & Obesity

Hormones and Cancer

Human Reproduction Update

International Journal for Quality in Health Care

Journal of Infection

Journal of Nursing Care Quality

Journal of Pain & Palliative Care Pharmacotherapy

Nephrology Dialysis Transplantation


Pigment Cell & Melanoma Research

Plastic & Reconstructive Surgery

Seminars in Fetal and Neonatal Medicine

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