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Article ; Online: The implementation and impacts of national standards for comprehensive care in acute care hospitals: An integrative review.

Xiong, Beibei / Stirling, Christine / Martin-Khan, Melinda

International journal of nursing sciences

2023 Volume 10, Issue 4, Page(s) 425–434

Abstract: Objectives: To synthesise current evidence addressing implementation approaches, challenges and facilitators, and impacts of national standards for comprehensive care in acute care hospitals.: Methods: Using Whittemore & Knafl's five-step method, a ... ...

Abstract	Objectives: To synthesise current evidence addressing implementation approaches, challenges and facilitators, and impacts of national standards for comprehensive care in acute care hospitals. Methods: Using Whittemore & Knafl's five-step method, a systematic search was conducted across five databases, including Medline (EBSCO), CINAHL (EBSCO), Cochrane Library, Web of Science, and Scopus, to identify primary studies and reviews. In addition, grey literature (i.e., government reports and webpages) was also searched via Google and international government/organisation websites. All searches were limited to January 1, 2000 to January 31, 2023. Articles relevant to the implementation or impacts of national standards for comprehensive care in acute care hospitals were included. Included articles underwent a Joanna Briggs Institute quality review, followed by qualitative content analysis of the extracted data adhering to PRISMA reporting guidelines. Results: A total of 16 articles were included in the review (5 primary studies, 5 government reports, and 6 government webpages). Three countries (Australia, Norway, and the United Kingdom [UK]) were identified as having a national standard for comprehensive care. The Australian standard contains a unique component of minimising patient harm. Norway does not have a defined implementation framework for the standard, whereas Australia and the UK do. Limited research suggests that challenges in implementing a national standard for comprehensive care in acute care hospitals include difficulties in implementing governance processes, end-of-life care actions, minimising harms actions, and developing comprehensive care plans with multidisciplinary teams, the absence of standardised care plans and patient-centred goals in documentation, and excessive paperwork. Implementation facilitators include a new care plan template using the Identify, Situation, Background, Assessment and Recommendation framework for handover, promoting efficient documentation, clinical decision-making and direct patient care, and proactivity among patients and care professionals with collaboration skills. Limited research suggests introducing the Australian standard demonstrated some positive effects on patient outcomes. Conclusion: The components and implementation approaches of the national standards for comprehensive care in Australia, Norway and the UK were slightly different. The scarcity of studies found during the review highlights the need for further research to evaluate the implementation challenges and facilitators, and impacts of national standards for comprehensive care in acute care hospitals.
Language	English
Publishing date	2023-09-22
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2800296-9
ISSN	2352-0132 ; 2352-0132
ISSN (online)	2352-0132
ISSN	2352-0132
DOI	10.1016/j.ijnss.2023.09.008
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Corrigendum: Evaluations of the disease surveillance centre network in Scotland: what parts has it reached?

Duncan, Andrew J / Eze, Jude I / Brülisauer, Franz / Stirling, Julie M / Jennings, Amy / Tongue, Sue C

Frontiers in veterinary science

2023 Volume 10, Page(s) 1192445

Abstract: This corrects the article DOI: 10.3389/fvets.2023.1099057.]. ...

Abstract	[This corrects the article DOI: 10.3389/fvets.2023.1099057.].
Language	English
Publishing date	2023-04-12
Publishing country	Switzerland
Document type	Published Erratum
ZDB-ID	2834243-4
ISSN	2297-1769
ISSN	2297-1769
DOI	10.3389/fvets.2023.1192445
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Article: Evaluations of the Disease Surveillance Centre network in Scotland: What parts has it reached?

Duncan, Andrew J / Eze, Jude I / Brülisauer, Franz / Stirling, Julie M / Jennings, Amy / Tongue, Sue C

Frontiers in veterinary science

2023 Volume 10, Page(s) 1099057

Abstract: Regular evaluation is a prerequisite for systems that provide surveillance of animal populations. Scotland's Rural College Veterinary Services' Disease Surveillance Centre (DSC) network plays an integral part in surveillance to detect new and re-emerging ...

Abstract	Regular evaluation is a prerequisite for systems that provide surveillance of animal populations. Scotland's Rural College Veterinary Services' Disease Surveillance Centre (DSC) network plays an integral part in surveillance to detect new and re-emerging threats within animal populations, predominantly livestock. In response to surveillance reviews and proposed changes to the network, an initial evaluation of diagnostic submissions data in 2010 to mid-2012 established a baseline “footprint,” while highlighting challenges with the data. In this recent evaluation for the period 2013–2018, we developed a new denominator using a combination of agricultural census and movement data, to identify relevant holdings more accurately. Iterative discussions between those processing submissions data and those involved in collection at source took place to understand the intricacies of the data, establish the most appropriate dataset, and develop the processes required to optimise the data extraction and cleansing. The subsequent descriptive analysis identifies the number of diagnostic submissions, the number of unique holdings making submissions to the network and shows that both the surrounding geographic region of, and maximum distance to the closest DSC vary greatly between centres. Analysis of those submissions classed as farm animal post-mortems also highlights the effect of distance to the closest DSC. Whether specific differences between the time periods are due to changes in the behavior of the submitting holdings or the data extraction and cleaning processes was difficult to disentangle. However, with the improved techniques producing better data to work with, a new baseline footprint for the network has been created. This provides information that can help policy makers and surveillance providers make decisions about service provision and evaluate the impact of future changes. Additionally, the outputs of these analyses can provide feedback to those employed in the service, providing evidence of what they are achieving and why changes to data collection processes and ways of working are being made. In a different setting, other data will be available and different challenges may arise. However, the fundamental principles highlighted in these evaluations and the solutions developed should be of interest to any surveillance providers generating similar diagnostic data.
Language	English
Publishing date	2023-02-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2834243-4
ISSN	2297-1769
ISSN	2297-1769
DOI	10.3389/fvets.2023.1099057
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Article ; Online: Patient's posteroanterior chest radiographs are routinely displayed at different sizes on PACS: Cause and prevalence.

Stirling, A D / Murphy, M C / Murray, W L / Murray, J G

Clinical imaging

2022 Volume 90, Page(s) 59–62

Abstract: Objective: Sequential posteroanterior chest radiographs (CXRs) on any one patient are commonly displayed at different sizes on PACS monitors. The purpose of this study was to determine the cause of these differences, the percentage of radiographs ... ...

Abstract	Objective: Sequential posteroanterior chest radiographs (CXRs) on any one patient are commonly displayed at different sizes on PACS monitors. The purpose of this study was to determine the cause of these differences, the percentage of radiographs affected, the relative change in magnification seen and if radiologists were aware of this display difference. Methods: Differences in routine radiographer collimation pre-acquisition and image cropping (shuttering) post acquisition were noted. From three different hospitals, 300 posteroanterior (PA) erect CXRs with prior comparative studies were viewed side-by-side on a standard landscape display monitor. Variation in display size was calculated using the number of detector elements in the autofitted axis of the radiograph, when compared with the prior study. Correlation between patient gender and extent of magnification between images was recorded. Following this, a national survey was circulated to see if radiologists were aware of this phenomenon. Results: Large variations in display size were noted. The mean extent of magnification between sequential PA chest radiographs was ±6.8% (range 0-21.6%). 98% of CXRs had some degree of variability in display size. There was no significant difference in the extent of variation in magnification based on age or gender. 86% of the radiologists who responded to the survey (n = 132) were unaware of any display size variability. Conclusion: Sequential DR acquired chest radiographs are routinely displayed with varying degrees of magnification on PACS monitors due to differences in radiographer practice and auto-fit display settings. Most radiologists surveyed were unaware of these differences and their causation.
MeSH term(s)	Humans ; Prevalence ; Radiography ; Radiography, Thoracic/methods ; Radiologists
Language	English
Publishing date	2022-07-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2022.07.010
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Article ; Online: Long-term functional outcomes after total wrist arthrodesis.

Smith, M B / Stirling, P H C / McEachan, J E

Hand surgery & rehabilitation

2022 Volume 41, Issue 5, Page(s) 595–598

Abstract: Current literature surrounding functional outcomes after total wrist arthrodesis is limited by short follow-up or limited use of validated patient reported outcome measures (PROMs). The primary aim of this study was to describe long-term functional ... ...

Abstract	Current literature surrounding functional outcomes after total wrist arthrodesis is limited by short follow-up or limited use of validated patient reported outcome measures (PROMs). The primary aim of this study was to describe long-term functional outcomes following wrist arthrodesis. Secondary aims were to describe the incidence of complications and patient satisfaction. This was a retrospective single-center study. Patients with a minimum of 10-year follow-up completed a questionnaire including the Patient-Rated Wrist Evaluation (PRWE), the Quick version of the Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score, the EQ-5D-5L score, and a question assessing satisfaction. Presence of a complication was also assessed. During the study period 66 patients underwent total arthrodesis. At a median follow-up of 15 years, complete patient reported outcomes were available for 34 patients. Thirty-two patients were lost to follow-up. Mean age at surgery was 49 and 16 patients were female. Mean PRWE and Quick-DASH scores were 44.8 (SD 27.7; range 0-96) and 41.9 (SD 23.6; range 2.3-97.7) respectively. Twenty-eight patients were satisfied. Nine patients reported complications. There were six cases of hardware removal and two cases of prominent metalwork. One patient underwent revision surgery for non-union. Presence of a complication did not affect the Quick-DASH or PRWE scores. Median EQ-5D-5L score was 0.7. This long-term follow-up suggests high levels of patient satisfaction and health related quality of life, despite significant functional disability. The complication rates are not insignificant, although the presence of a complication did not affect functional outcomes.
MeSH term(s)	Arthrodesis ; Female ; Humans ; Male ; Quality of Life ; Retrospective Studies ; Wrist ; Wrist Joint/surgery
Language	English
Publishing date	2022-07-16
Publishing country	France
Document type	Journal Article
ZDB-ID	2848776-X
ISSN	2468-1210
ISSN (online)	2468-1210
DOI	10.1016/j.hansur.2022.07.003
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Article ; Online: Effects of elevated CO

Stirling, C M / Heddell-Cowie, M / Jones, M L / Ashenden, T W / Sparks, T H

The New phytologist

2021 Volume 140, Issue 2, Page(s) 343–354

Abstract: Whereas much is known of the short-term growth response to elevated atmospheric ... ...

Abstract	Whereas much is known of the short-term growth response to elevated atmospheric CO
Language	English
Publishing date	2021-03-09
Publishing country	England
Document type	Journal Article
ZDB-ID	208885-x
ISSN	1469-8137 ; 0028-646X
ISSN (online)	1469-8137
ISSN	0028-646X
DOI	10.1046/j.1469-8137.1998.00273.x
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Article ; Online: The 'fallacy of normalcy': A content analysis of women's online post-childbirth health-related support.

Rouhi, Maryam / Stirling, Christine / Crisp, Elaine Peta

Women and birth : journal of the Australian College of Midwives

2020 Volume 34, Issue 3, Page(s) e262–e270

Abstract: Background: Online forums have changed traditional sources of seeking help because they provide an anonymous and non-judgemental environment particularly suited for women with post-childbirth problems.: Question: What support is given to mothers who ... ...

Abstract	Background: Online forums have changed traditional sources of seeking help because they provide an anonymous and non-judgemental environment particularly suited for women with post-childbirth problems. Question: What support is given to mothers who have posted questions about post-childbirth morbidities? Methods: A total of 333 messages posted on a post-childbirth online forum were loaded into NVIVO 12 Pro and were analysed using content and thematic analysis. Content analysis identified the major health problems, and thematic analysis was used for identifying motivations and the support offered. Findings: Seventeen different health problems were discussed on posts, with a strong emphasis on pelvic problems, followed by mental health concerns. The key motivation for seeking online help identified using 'typology of advice solicitation' was request for opinion or information (48.85%). The two main support themes were: peer to peer support (82%) and normalisation (not always appropriate) of post-childbirth problems (18%). Most of the support offered was emotional (56.9%) followed by practical (22.7%) and informational support (20.4%). Discussion: Postpartum adjustment of post-childbirth experiences can be supportive but if ill-informed may provide a barrier to safe and reliable health care. Conclusion: We recommend women have access to online forums moderated by healthcare providers who can notify participants when a problem requires support from a relevant health professional opinion.
MeSH term(s)	Adult ; Female ; Humans ; Mothers/psychology ; Motivation ; Parturition ; Peer Group ; Postpartum Period ; Pregnancy ; Qualitative Research ; Social Support
Language	English
Publishing date	2020-05-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2235085-8
ISSN	1878-1799 ; 1871-5192
ISSN (online)	1878-1799
ISSN	1871-5192
DOI	10.1016/j.wombi.2020.04.007
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Article ; Online: Nebulised sargramostim in pulmonary alveolar proteinosis.

Livingstone, Cameron / Corallo, Carmela / Siemienowicz, Miranda / Pilcher, David / Stirling, Robert G

British journal of clinical pharmacology

2022 Volume 88, Issue 7, Page(s) 3523–3528

Abstract: Five patients, comprising nine treatment courses of sargramostim use in pulmonary alveolar proteinosis, are described. The prevailing standard of treatment, whole lung lavage (WLL), is highly invasive, resource intensive and carries some procedural risk. ...

Abstract	Five patients, comprising nine treatment courses of sargramostim use in pulmonary alveolar proteinosis, are described. The prevailing standard of treatment, whole lung lavage (WLL), is highly invasive, resource intensive and carries some procedural risk. Nebulised recombinant human GM-CSF (sargramostim) offers a pharmacological treatment option, allowing patients to be treated at home, possessing potential advantages in patient experience and wider health resourcing. The majority of reported patients described subjective improvement in symptoms along with radiographical improvement, although this did not translate into significant improvement in pulmonary function testing. Drug scarcity and high drug cost remain potential barriers to accessing this treatment, and so careful patient selection and treatment outcome assessment remain as challenging needs. Incorporating the routine assessment of validated patient symptom scores with objective physiological measures will allow prediction of response to treatment and help guide management. This report describes the largest published experience of sargramostim use in Australia.
MeSH term(s)	Australia ; Bronchoalveolar Lavage ; Granulocyte-Macrophage Colony-Stimulating Factor/adverse effects ; Humans ; Pulmonary Alveolar Proteinosis/diagnosis ; Pulmonary Alveolar Proteinosis/drug therapy ; Recombinant Proteins
Chemical Substances	Recombinant Proteins ; sargramostim (5TAA004E22) ; Granulocyte-Macrophage Colony-Stimulating Factor (83869-56-1)
Language	English
Publishing date	2022-02-28
Publishing country	England
Document type	Journal Article
ZDB-ID	188974-6
ISSN	1365-2125 ; 0306-5251 ; 0264-3774
ISSN (online)	1365-2125
ISSN	0306-5251 ; 0264-3774
DOI	10.1111/bcp.15266
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Article ; Online: A comprehensive analysis of medium-term outcomes of open first dorsal compartment release for de Quervain's syndrome.

Stirling, Paul H C / Robertson, Fabienne M / McEachan, Jane E

Hand surgery & rehabilitation

2020 Volume 40, Issue 1, Page(s) 40–43

Abstract: The primary aim of this study is to describe medium-term functional outcomes following first dorsal compartment decompression using a longitudinal incision in patients with de Quervain's syndrome. The secondary aims are to describe the improvement in ... ...

Abstract	The primary aim of this study is to describe medium-term functional outcomes following first dorsal compartment decompression using a longitudinal incision in patients with de Quervain's syndrome. The secondary aims are to describe the improvement in health-related quality of life and patient satisfaction, and to determine the cost-effectiveness of this procedure. Pre- and postoperative QuickDASH, EQ-5D-5 L, and satisfaction scores were collected prospectively over five years. Paired data were available for 36 patients (90% at mean 32 months follow-up). The median QuickDASH score improved significantly from 50 to 9.1 (p < 0.01). Median EQ-5D-5L index scores improved from 0.65 preoperatively to 0.73 (p = 0.03). The satisfaction rate was 97% and there were no cases of superficial radial nerve injury or neuroma. The cost per quality-adjusted life year gained was £356 (€398; $449). First dorsal compartment release using a longitudinal incision results in a significant improvement in function, with high levels of patient satisfaction, and low complication rates. In addition, health economic analysis revealed that this is a cost-effective procedure for the treatment of de Quervain's syndrome. LEVEL OF EVIDENCE: III (cohort study).
MeSH term(s)	Cohort Studies ; De Quervain Disease/surgery ; Humans ; Patient Satisfaction ; Quality of Life ; Radial Nerve
Language	English
Publishing date	2020-10-21
Publishing country	France
Document type	Journal Article
ZDB-ID	2848776-X
ISSN	2468-1210
ISSN (online)	2468-1210
DOI	10.1016/j.hansur.2020.10.004
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Article ; Online: Perceived Health Status and Capability after Hip Fracture: Secondary Outcomes from an Randomized Controlled Trial.

Ashe, Maureen C / Grover, Sanya / Bryan, Stirling / Cook, Wendy L / Donaldson, Meghan G / Brasher, Penelope M A

Gerontology

2024 Volume 70, Issue 3, Page(s) 235–240

Abstract: Introduction: Hip fractures can have a significant impact on the lives of older people and their families. We conducted a pragmatic randomized controlled trial of post-discharge comprehensive geriatric care (CGC) for community-dwelling older adults ... ...

Abstract	Introduction: Hip fractures can have a significant impact on the lives of older people and their families. We conducted a pragmatic randomized controlled trial of post-discharge comprehensive geriatric care (CGC) for community-dwelling older adults after a surgically repaired hip fracture. The objective of this study was to conduct a secondary analysis to compare changes in health status and perceived capability from baseline to 12 months after randomization with: the EuroQol 5-Dimension (EQ-5D-5L) (1) utility score and (2) visual analog scale (VAS); and (3) well-being as measured by participants' perceptions of their ability (or capability) toward completing life activities using the ICEpop Capability Measure for Older People (ICECAP-O). Methods: We tested the effect of usual care (control) versus usual care and an outpatient CGC clinic (intervention) on mobility after hip fracture in community-dwelling older adults (65 years+). In this secondary analysis, we report the following outcomes: EQ-5D-5L utility score and VAS collected monthly via telephone and ICECAP-O collected in person three times at baseline, 6 months, and 12 months. Data were analyzed using area under the curve and regression adjusted for baseline values for utility scores and capability, and constrained longitudinal data analysis for VAS. Results: We enrolled 53 older adults, including 34 women and 19 men, with mean (SD) age of 80 (8) years. There were no statistical or clinically meaningful differences between groups (control group - intervention group values) for all variables: utility score = -0.028 (95% CI: -0.071, 0.014; p = 0.18); VAS: -0.03 (95% CI: -0.39 to 0.33; p = 0.86); and capability = -0.021 (95% CI: -0.090, 0.046; p = 0.54). Conclusions: There were no differences in outcomes between groups over 12 months, but values remained constant, contrary to a potential decline for this age group, especially after a major life event like a hip fracture.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Aged, 80 and over ; Aftercare ; Patient Discharge ; Hip Fractures/surgery ; Health Status ; Activities of Daily Living ; Quality of Life ; Surveys and Questionnaires
Language	English
Publishing date	2024-01-05
Publishing country	Switzerland
Document type	Randomized Controlled Trial ; News
ZDB-ID	193798-4
ISSN	1423-0003 ; 0304-324X
ISSN (online)	1423-0003
ISSN	0304-324X
DOI	10.1159/000536131
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