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"Knowing is not enough; we must apply. Willing is not enough; we must do"
Johann Wolfgang von Goethe

 

4 E’s of a reporting culture

Creating a culture of safety and high reliability in hospitals requires: the identification and reporting of unsafe conditions before harm is caused; trust that staff and leadership will act on reports; and taking personal responsibility for our actions. This report outlines suggested actions to protect patients from harm. 


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Source: The Joint Commission, 2019

 

Integrated care – do patients benefit?

"Although there is a compelling story for why integrated care should be better for patients and enable the health service to be sustainable financially, evidence for many of the initiatives is lacking". Presented as a scrolling data story, this UK report investigates if the drive to integrate services has led to improvements for patients. Overall there was limited evidence that patients are benefitting from more integrated care with only one of seven quality indicators showing improvement. Important variations between different groups of patients are highlighted.

Source: Nuffield Trust & The Health Foundation 2019

 

Adverse drug events - elderly

Older adults are at significantly greater risk of being hospitalised due to adverse drug events. This study assessed a new pharmacist-driven combined approach which uses medication reconciliation and the evaluation of potentially inappropriate medications (PIMs). Using this method, patients were discharged with significantly less PIMs than on admission. Authors also address possible obstacles to service implementation.

Source: Drugs & Aging 2019; online first: 23 January

Further reading
Usefulness of STOPP/START criteria to assess appropriateness of medicines prescribed to older adults in a resource-limited setting
Source: International Journal of Clinical Pharmacy 2019; online first: 22 January

 

SUCCESS – quality improvement

Insertion of peripheral intravenous catheter (PIVC) has a high failure rate in vulnerable populations such as paediatrics. This Australian quality initiative delivers a multi-level care bundle to improve the insertion and management of PIVC. Authors created the mnemonic SUCCESS PIVCS to prompt best practice, and the project design can be replicated in other hospitals.

Source: Journal of Paediatrics and Child Health 2019; online first: 31 January

 

Wearable sensors – deteriorating patient

Accurate monitoring of vital signs assists in identifying deteriorating patients, however deterioration may occur between observation times.  The development of new wireless wearable sensors allows for continuous monitoring in order to capture deterioration earlier. Authors report on the accuracy of two devices tested in a general ward setting.

Source: Resuscitation 2019; 136: 47-53

Further reading
Wearable sensors to improve detection of patient deterioration
Source: Expert Review of Medical Devices 2019 16(2): 145-154
Full text available for Austin & MHW Heidelberg staff via document delivery

 

AIHW reports

Recent reports from the Australian Institute of Health and Welfare:

 

Austin Health Research Online - recent submissions

The Australasian Resuscitation In Sepsis Evaluation: FLUid or vasopressors In Emergency Department Sepsis, a multicentre observational study (ARISE FLUIDS observational study): Rationale, methods and analysis plan
Keijzers G, Macdonald SPJ, Udy AA, et al. Emergency Medicine Australasia : EMA 2019; 31(1): 90-96

Achievement of patients' preferences for participation in oncological symptom management and its association with perceived quality of care
Lin C, Cohen E, Livingston PM, et al. Patient Preference and Adherence 2019; 13: 83-90

Prevalence and profile of "seasonal frequent flyers" with chronic heart disease: analysis of 1598 patients and 4588 patient-years follow-up
Loader J, Chan Y, Hawley JA, et al. International Journal of Cardiology 2019; 279: 126-132

Prevalence and correlates of advance care directives among older Australians accessing health and residential aged care services: multicentre audit study
Detering KM, Buck K, Ruseckaite R, et al. BMJ Open 2019; 9(1): e025255

Outcome and safety of targeted liver biopsies for indeterminate lesions in patients with chronic liver disease: A single centre experience
Chen X, Kutaiba N, Ngo B, et al. Journal of Medical Imaging and Radiation Oncology 2019; online first: 16 January

See more at AHRO, Austin Health Research Online

 

eBooks Spotlight

Critical care nephrology / Claudio Ronco, Rinaldo Bellomo, John A Kellum, et al., Z - 3rd ed., 2019.
A multidisciplinary review of the issues related to kidney diseases in critically ill patients, covering the basic principals of the fields, in addition to experimental research (also available in hardcopy).

Netter's sports medicine / Christopher C Madden, Margot Putukian, Eric C McCarty, et al. - 2nd ed., 2018
A useful resource for health care professionals treating sports and athletic injuries. Topics covered range from sports nutrition to musculoskeletal injurers to infections. With special chapters focusing on a variety of popular sports and athletic pursuits.

Clinical obstetrics and gynaecology / Brian Magowan, Philip Owen and Andrew J Thomson - 4th ed., 2019.
Provides an introduction to issues relating to the health of women at all ages. Useful for medical students - the book includes case-based and multiple-choice questions for testing understanding.

 

Journals Spotlight

Each bulletin we highlight a selection of journals from our collection
Links provide access to the current table of contents:

Journal of the American College of Cardiology

Gut

Trends in Immunology

Endocrine Reviews

Gastroenterology

JAMA Psychiatry

Journal of Clinical Investigation

The Lancet Infectious Diseases

Acta Neuropathologica

European Heart Journal

Looking for the latest evidence?

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