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"One treatment rarely, if ever, is definitively shown to improve outcomes for all important end points. Trade-offs between outcomes are inevitable"
Karan Chhabra, Greg Sacks & Justin Dimick

 

Medication policies for nurses in Victoria

"Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration." Medication management policies from several Victorian health services were analysed for consistency in governance and practice. Variations were identified between health service policies including: requirements for medication checking; administration rights; phone orders; and nurse-initiated medications. "Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors."

Source: Australian Health Review 2016; 40(5)
Full text available for Austin & MHW Heidelberg staff via document delivery 

 

Patient-reported safety concerns

This study presents an exploratory pilot of three mechanisms for collecting data on safety concerns from patients during their hospital stay. The researchers found that interviewing at the patient's bedside was the most effective method for obtaining patient feedback about safety concerns.

Source: BMJ Quality & Safety 2017; 26: 42-53

 

Surgical decision making

Should routine appendectomy for uncomplicated appendicitis be abandoned, or is the research evidence not sufficient to change practice? Is knee surgery the best option for relieving osteoarthritis even if it results in more complications? In this JAMA opinion piece the lead author and colleagues tackle the question of how clinicians and patients can interpret trial results when even the experts do not agree. The authors suggest utilising the shared decision making model to guide surgical decision preferences when multiple treatment options are available. Steps involved in achieving a culture "in which patients' values determine the treatment outcomes that matter most" are also outlined.

Source: Journal of the American Medical Association 2017; 317(4): 357-8

Further reading
Australian Commission of Safety and Quality in Health Care: Shared decision making

 

Improving communication at discharge

Clear communication at hospital discharge with a patient's GP is essential to ensure a safe transition to home and further follow-up care. A quality improvement initiative, utilising Lean methodology, was implemented in a US academic children's hospital and resulted in discharge communication rates increasing from 59% to 80%. Key to the initiative's success was the engagement of frontline providers (frequently residents), and improving workflows in the electronic medical record.

Source: The Joint Commission Journal on Quality and Patient Safety 2017; 43(2): 80-88

 

Health assistants - impact on patient outcomes

Adverse patient outcomes increased in wards where assistants in nursing (AINs) were employed as additional staff, according to new Australian research. Statistically significant increases were observed in: failure to rescue; urinary tract infection (UTI); and falls with injury. Researchers found a correlation between the time a patient spent on a ward which employed AINs, and the chances of developing either a UTI or pneumonia. To reduce increased adverse outcomes, the authors recommend:

  • ongoing monitoring of the quality of care delivered by AINs
  • ensuring AINs are practising within their scope of practice
  • maintaining sufficient RNs on the ward to provide appropriate supervision for AINs

Source: International Journal of Nursing Studies 2016; 63: 189-200
Link to full text is available with ClinicalKey remote access when you are offsite

 

Imaging use – choosing wisely

Appropriateness of imaging services has been highlighted by the Choosing Wisely campaign as an area requiring scrutiny. Health services defined as low-value are those which provide little or no health benefit to patients or may cause harm. Identification of low-value services in radiology is controversial and this paper discusses the implications of "reforms that have a dampening effect on imaging use". The authors encourage radiologists to eliminate inappropriate imaging use, engage in comparative effectiveness research, and collaborate with other disciplines in order to move from volume-based to value-based practice.

Source: Radiology 2017; 4 February: 162187

 

Did you know?

Have you used the Emcare database yet?
Elsevier's Emcare covers all nursing specialties, provides international coverage of allied health, and contains subject matter from health economics through to education, psychiatry, and traumatology. Emcare uses the Ovid platform and includes unique content not found in other nursing and allied health databases.
We look forward to getting your feedback

DynaMed Plus is a point-of-care resource that provides evidence-based information to support clinical care. Mobile access is available with the DynaMed Plus app if downloaded using Austin WiFi. Please consider using your User Preferences in Cerner to put this link into a quick link tab.

This trial runs until 28 February 2017 - after reviewing DynaMed Plus please complete our survey to provide your input.

 

Austin Health Research Online - recent submissions

Outcomes from massive paracetamol overdose: a retrospective observational study
Marks DJB, Dargan PI, Archer JRH, et al. British Journal of Clinical Pharmacology 2017; online first: 25 January

Dietary supplement use in older people attending memory clinics in Australia
Cross AJ, George J, Woodward MC, et al. Journal of Nutrition, Health & Aging 2017; 21(1): 46-50

Bibliometric analysis of the top-cited gastroenterology and hepatology articles
Azer SA, Azer S. BMJ Open 2016; 6(2): e009889

Quality of health information on the internet for urolithiasis on the Google search engine
Chang DTS, Abouassaly R, Lawrentschuk N. Advances in Urology 2016; 2016: 8243095

Self-reported confusion is related to global and regional β-amyloid: data from the Women's healthy ageing project
McCluskey GE, Yates PA, Villemagne VL, et al. Brain Imaging and Behavior 2017; online first: 20 January

See more at AHRO, Austin Health Research Online

 

eBooks spotlight

ACCCN's critical care nursing / edited by Leanne Aitken, Andrea Marshall and Wendy Chaboyer - 3rd ed. Elsevier, 2016.
With a new chapter in post anaesthesia recovery, revised coverage of metabolic and nutritional considerations for the critically ill, this new edition features the most recent evidence based research and up-to-date advances in clinical practice technology, procedures and practice.

Pharmacology for health professionals / Bronwen Bryant, Kathleen Knights - 4th ed., Mosby Elsevier, 2015.
This updated edition includes the latest information on the clinical use of drugs, as well as their application to specific disciplines within the health professions. Written specifically for the Australasian region, it reflects local generic drug names, drug availability and clinical uses, along with local aspects of scheduling, drug legislation and ethical issues.

New books on display

AMH 2017 / Nick Buckley - 18th ed. Australian Medicines Handbook, 2017.
Widely recognised as Australia's leading independent medicines reference it provides concise, practical and reliable drug information. AMH structure is broken into easy to use chapters, drug classes and monographs, treatments and appendices.

 

Journals spotlight

These links provide access to the current table of contents:

3D Printing and Additive Manufacturing

American Journal of Perinatology

Australian Journal of Advanced Nursing

Child and Adolescent Mental Health

JAMA

Journal of Clinical Gastroenterology

Journal of Emergency Nursing

Journal of Trauma and Acute Care Surgery

Lancet

Seminars in Respiratory and Critical Care Medicine

Looking for the latest journal issues?
All our journal titles with electronic access are available via the Journal List
(outside the Austin Health network use your Library barcode no. & PIN for access)

If you require an article from a journal that is not in the Journal List, please use our online document delivery form.

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Sign up now & start using BrowZine - all you need is the free app and a Library card! 

 

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