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Article ; Online: Experiences of emergency department nurses using palliative care resources and associated tools in the provision of quality care of a dying patient.

Robson, Suzanne / Craswell, Alison

International journal of palliative nursing

2022 Volume 28, Issue 10, Page(s) 464–472

Abstract: Access to quality palliative and end-of-life care in the emergency department is as vitally important as care at any other stage of life. This study aimed to investigate nurses' perceptions of the use of a suite of dedicated resources to support the ... ...

Abstract	Access to quality palliative and end-of-life care in the emergency department is as vitally important as care at any other stage of life. This study aimed to investigate nurses' perceptions of the use of a suite of dedicated resources to support the provision of care to patients who are dying in the emergency environment. The study followed a qualitative descriptive design; 11 semi-structured interviews were conducted and analysed using thematic coding. Five themes were developed: facilitating care delivery; comfort and environmental adjustments; visual symbolism; developing knowledge to overcome fear; and perceptions of family experiences. There is an increasing need to access palliative care in the emergency department; the use of a suite of resources can play an important role in the provision of quality care to the dying.
MeSH term(s)	Humans ; Palliative Care ; Qualitative Research ; Terminal Care ; Hospice and Palliative Care Nursing ; Emergency Service, Hospital
Language	English
Publishing date	2022-10-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2115109-X
ISSN	2052-286X ; 1357-6321
ISSN (online)	2052-286X
ISSN	1357-6321
DOI	10.12968/ijpn.2022.28.10.464
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Article ; Online: Outcomes following perioperative red blood cell transfusion in patients undergoing elective major abdominal surgery: a systematic review and meta-analysis.

Morris, Fraser J D / Fung, Yoke-Lin / Craswell, Alison / Chew, Michelle S

British journal of anaesthesia

2023 Volume 131, Issue 6, Page(s) 1002–1013

Abstract: Background: Perioperative red blood cell transfusion is a double-edged sword for surgical patients. While transfusion of red cells can increase oxygen delivery by increasing haemoglobin levels, its impact on short- and long-term postoperative outcomes, ... ...

Abstract	Background: Perioperative red blood cell transfusion is a double-edged sword for surgical patients. While transfusion of red cells can increase oxygen delivery by increasing haemoglobin levels, its impact on short- and long-term postoperative outcomes, particularly in patients undergoing elective major abdominal surgery, is unclear. Methods: We conducted a systematic review and meta-analysis on the effect of perioperative blood transfusions on postoperative outcomes in elective major abdominal surgery. PubMed, Cochrane, and Scopus databases were searched for studies with data collected between January 1, 2000 and June 6, 2020. The primary outcome was short-term mortality, including all-cause 30-day or in-hospital mortality. Secondary outcomes included long-term all-cause mortality, any morbidity, infectious complications, overall survival, and recurrence-free survival. No randomised controlled trials were found. Thirty-nine observational studies were identified, of which 37 were included in the meta-analysis. Results: Perioperative blood transfusion was associated with short-term all-cause mortality (odds ratio [OR] 2.72, 95% confidence interval [CI] 1.89-3.91, P<0.001), long-term all-cause mortality (hazard ratio 1.35, 95% CI 1.09-1.67, P=0.007), any morbidity (OR 2.18, 95% CI 1.81-2.64, P<0.001), and infectious complications (OR 1.90, 95% CI 1.60-2.26, P<0.001). Perioperative blood transfusion remained associated with short-term mortality in the sensitivity analysis after excluding studies that did not control for preoperative anaemia (OR 2.27, 95% CI 1.59-3.24, P<0.001). Conclusions: Perioperative blood transfusion in patients undergoing elective major abdominal surgery is associated with poorer short- and long-term postoperative outcomes. This highlights the need to implement patient blood management strategies to manage and preserve the patient's own blood and reduce the need for red blood cell transfusion. Trial registration: PROSPERO (CRD42021254360).
MeSH term(s)	Humans ; Erythrocyte Transfusion/adverse effects ; Anemia ; Blood Transfusion ; Elective Surgical Procedures ; Hospital Mortality
Language	English
Publishing date	2023-09-21
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2023.08.032
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Article ; Online: Evidence-based guidelines for intrapartum maternal hydration assessment and management: A scoping review.

Kearney, Lauren / Craswell, Alison / Dick, Nellie / Massey, Debbie / Nugent, Rachael

Birth (Berkeley, Calif.)

2023

Abstract: Problem: Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons.: Background: Labor and birth are physically demanding, and adequate nutrition ... ...

Abstract	Problem: Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons. Background: Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored. Aim: The aim of this scoping review was to identify and collate evidence-based guidelines for intrapartum hydration assessment and management of maternal hydration during labor and birth. Methods: PubMed, Embase, and CINAHL databases were searched, in addition to professional college association websites. Inclusion criteria were intrapartum clinical guidelines in English, published in the last 10 years. Findings: Despite searching all appropriate databases in maternity care, we were unable to identify evidence-based guidelines specific to hydration assessment and management, therefore resulting in an "empty review." A subsequent review of general intrapartum care guidelines was undertaken. Our adapted review identified 12 guidelines, seven of which referenced the assessment and management of maternal hydration during labor and birth. Three guidelines recommend that "low-risk" women in spontaneous labor at term should hold determination over what they ingest in labor. No recommendations with respect to assessment and management of hydration for women undergoing induction of labor were found. Discussion: Despite the increasing use of intravenous fluid as an adjunct to oral intake to maintain maternal intrapartum hydration, there is limited evidence and, subsequently, guidelines to determine best practice in this area. How hydration is assessed was also largely absent from general intrapartum care guidelines, further perpetuating potential clinical variation in this area. Conclusion: There is an absence of guidelines specific to the assessment and management of maternal hydration during labor and birth, despite its importance in ensuring labor progress and safe care.
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604869-9
ISSN	1523-536X ; 0730-7659
ISSN (online)	1523-536X
ISSN	0730-7659
DOI	10.1111/birt.12773
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Article: Overcoming barriers to perinatal data entry.

Craswell, Alison

Australian nursing & midwifery journal

2015 Volume 22, Issue 9, Page(s) 37

MeSH term(s)	Databases, Factual ; Electronic Health Records/statistics & numerical data ; Female ; Humans ; Infant, Newborn ; Midwifery/education ; Midwifery/organization & administration ; Midwifery/statistics & numerical data ; Pregnancy ; Workload
Language	English
Publishing date	2015-04
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2741144-8
ISSN	2202-7114
ISSN	2202-7114
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Article: Experiences of Caregivers of Patients With Conservatively Managed Kidney Failure: A Mixed Methods Systematic Review.

Walavalkar, Anisha / Craswell, Alison / Gray, Nicholas A

Canadian journal of kidney health and disease

2022 Volume 9, Page(s) 20543581221089080

Abstract: Background: Older people with kidney failure often choose conservative kidney care. The experiences and quality of life (QOL) of caregivers who support them are incompletely characterized.: Objective: To determine the burden, QOL, and understand ... ...

Abstract	Background: Older people with kidney failure often choose conservative kidney care. The experiences and quality of life (QOL) of caregivers who support them are incompletely characterized. Objective: To determine the burden, QOL, and understand experiences of caregivers supporting patients managed conservatively. Design: Systematic review of quantitative and qualitative studies. Sources of information: PubMed, Embase, PsycINFO, CINAHL, and MEDLINE electronic databases were systematically searched for quantitative and qualitative studies published between January 2000 and July 2020. Subjects: Caregivers of adults with kidney failure (estimated glomerular filtration rate < 15 mL/min/1.73 m Methods: Data were extracted by 2 independent reviewers using a prespecified extraction tool. Study quality was assessed using the Critical Appraisal Skills Program (CASP) tool. Measurements: Descriptive reports of demographics, measurement scales, and outcomes. Thematic synthesis of qualitative data. Results: Six studies met inclusion criteria, including 3 quantitative and 3 descriptive qualitative studies. Caregivers of patients receiving conservative kidney management (CKM) experienced significant caregiver burden and similar impacts to their QOL as those caring for patients receiving dialysis. Thematic synthesis revealed 5 themes: Understanding the concept of CKM, Need for involvement in the decision for CKM, Identifying available supports, Uncertainty about the future and negotiating deteriorations and dying, and Burden of care impacting on QOL. Limitations: Low numbers of included studies, data collection and recruitment biases in qualitative studies and small caregiver numbers in quantitative studies, limit transferability of findings. Heterogeneity in study design and outcome measures precluded meta-analysis. Conclusions: Caregivers of patients with conservatively managed kidney failure suffer significant burden and experience QOL comparable with those caring for patients on dialysis. Limited understanding and involvement in conservative management decision making, and a fear of deterioration and dying, result in anxiety in caregivers. Further research into the experiences of caregivers will help support both caregivers and the patients who choose conservative management. Registration: PROSPERO registration number CRD42021209811.
Language	English
Publishing date	2022-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2765462-X
ISSN	2054-3581
ISSN	2054-3581
DOI	10.1177/20543581221089080
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Article ; Online: Establishing the Geriatric Emergency Department Intervention in Queensland emergency departments: a qualitative implementation study using the i-PARIHS model.

Wallis, Marianne / Craswell, Alison / Marsden, Elizabeth / Taylor, Andrea

BMC health services research

2022 Volume 22, Issue 1, Page(s) 692

Abstract: Background: Frail older adults require specific, targeted care and expedited shared decision making in the emergency department (ED) to prevent poor outcomes and minimise time spent in this chaotic environment. The Geriatric Emergency Department ... ...

Abstract	Background: Frail older adults require specific, targeted care and expedited shared decision making in the emergency department (ED) to prevent poor outcomes and minimise time spent in this chaotic environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to help limit these undesirable consequences. This qualitative study aimed to explore the ways in which two hospital implementation sites implemented the structures and processes of the GEDI model and to examine the ways in which the i-PARIHS (innovation-Promoting Action on Research Implementation in Health Services) framework influenced the implementation. Methods: Using the i-PARIHS approach to implementation, the GEDI model was disseminated into two hospitals using a detailed implementation toolkit, external and internal facilitators and a structured program of support. Following implementation, interviews were conducted with a range of staff involved in the implementation at both sites to explore the implementation process used. Transcribed interviews were analysed for themes and sub-themes. Results: There were 31 interviews with clinicians involved in the implementation, conducted across two hospitals, including interviews with the two external facilitators. Major themes identified included: (i) elements of the GEDI model adopted or (ii) adapted by implementation sites and (iii) factors that affected the implementation of the GEDI model. Both sites adopted the model of care and there was general support for the GEDI approach to the management of frail older people in the ED. Both sites adapted the structure of the GEDI team and the expertise of the team members to suit their needs and resources. Elements such as service focus, funding, staff development and service evaluation were initially adopted but adaptation occurred over time. Resourcing and cost shifting issues at the implementation sites and at the site providing the external facilitators negatively impacted the facilitation process. Conclusions: The i-PARIHS framework provided a pragmatic approach to the implementation of the evidenced-based GEDI model. Passionate, driven clinicians ensured that successful implementation occurred despite unanticipated changes in context at both the implementation and host facilitator sites as well as the absence of sustained facilitation support.
MeSH term(s)	Aged ; Emergency Medical Services ; Emergency Service, Hospital ; Frail Elderly ; Humans ; Qualitative Research ; Queensland
Language	English
Publishing date	2022-05-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-08081-4
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Article ; Online: Predictive factors of the general public's willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey.

Dwyer, Trudy / Craswell, Alison / Browne, Matthew

Human resources for health

2021 Volume 19, Issue 1, Page(s) 21

Abstract: Background: Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of ... ...

Abstract	Background: Health care delivery in Australia is experiencing challenges with services struggling to keep up with the increasing demands of an aging population, rising levels of chronic disease and limited funding for care. Where adjunct models of health care such as the Nurse Practitioner (NP) have the potential to address this gap, in Australia, they remain an underutilised service. Clarifying the nature of the consumers 'willingness' to be seen by NPs warrants further investigation. Methods: Australia-wide, cross-sectional population-based survey was undertaken using computer-assisted telephone interviewing technique. Results: While just over 53% of the general public participants (n = 1318) had heard of an NP, once they became aware of their scope of practice, the majority agreed or strongly agreed they were willing to be seen by an NP in the community (91.6%), the emergency department 88.2%), to manage chronic conditions (86%), to have scrips written and referrals made (85.3%), and if they did not have to wait so long to see a medical doctor (81%). Factors significantly predicting willingness were being: female, less than 65 years of age, native English speakers, or residents from town/regional and rural settings. Conclusion: Despite limited awareness of the NP role, a large proportion of the Australian population, across different demographic groups, are willing to be seen and treated by an NP. Expansion of this role to support medical services in areas of need could improve healthcare delivery.
MeSH term(s)	Aged ; Australia ; Cross-Sectional Studies ; Female ; Humans ; Nurse Practitioners ; Nurse's Role ; Referral and Consultation
Language	English
Publishing date	2021-02-17
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1478-4491
ISSN (online)	1478-4491
DOI	10.1186/s12960-021-00562-7
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Article ; Online: Reasons for choosing or refusing care from a nurse practitioner: Results from a national population-based survey.

Craswell, Alison / Dwyer, Trudy

Journal of advanced nursing

2019 Volume 75, Issue 12, Page(s) 3668–3676

Abstract: Aim: To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services.: Design: This cross-sectional, population-based survey study used ... ...

Abstract	Aim: To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services. Design: This cross-sectional, population-based survey study used computer assisted telephone interviewing to elicit public opinions on the topic. Methods: Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open-ended responses. Results: Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life-threatening condition. Conclusion: Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role. Impact: This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners. Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Australia ; Cross-Sectional Studies ; Female ; Health Services ; Humans ; Male ; Middle Aged ; Nurse Practitioners ; Nurse's Role ; Nurse-Patient Relations ; Patient Acceptance of Health Care/psychology ; Patient Satisfaction ; Primary Health Care/methods ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2019-09-04
Publishing country	England
Document type	Journal Article
ZDB-ID	197634-5
ISSN	1365-2648 ; 0309-2402
ISSN (online)	1365-2648
ISSN	0309-2402
DOI	10.1111/jan.14176
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Article: Evaluation of Research Capacity and Culture of Health Professionals Working with Women, Children and Families at an Australian Public Hospital: A Cross Sectional Observational Study.

Frakking, Thuy / Craswell, Alison / Clayton, Anne / Waugh, John

Journal of multidisciplinary healthcare

2021 Volume 14, Page(s) 2755–2766

Abstract: Background: There is limited evidence for use of the Research Capacity and Culture tool across multidisciplinary health professionals. We explored using the Research Capacity and Culture tool among multidisciplinary health professionals at an Australian ...

Abstract	Background: There is limited evidence for use of the Research Capacity and Culture tool across multidisciplinary health professionals. We explored using the Research Capacity and Culture tool among multidisciplinary health professionals at an Australian secondary hospital. Methods: A cross-sectional observational study where online and paper-based surveys of the Research Capacity and Culture tool were disseminated between November 2020 and January 2021. Descriptive analyses of demographic variables and Likert scale items were summarized using median and inter-quartile ranges. Differences between organization, team and individual domains were checked using a Friedman test. Post-hoc Wilcoxon signed rank tests determined specific differences between domains. Results: Seventy-six multidisciplinary health professionals (female, 89.3%) reported overall perceptions of research success/skills highest in the organization (median 6), followed by the team (median 5) and individual domains (median 3.5). Only 21.3% agreed that research activities were a part of their role description. Mean scores across professions were highest for Medicine (5.47), Midwifery (4.52), Nursing (4.47) and Allied Health (3.56), respectively, for the team domain. Individual domain scores across all professions were below 50%. Commonly reported barriers to research were "lack of time for research," "other work roles taking priority" and "a lack of skill." "Developing skills" was the most common personal motivator. Conclusion: Multidisciplinary health professionals reported the highest overall perception of research success/skills in the organization domain. Medical health professionals perceived research success/skills highest compared to nursing, midwifery and allied health professionals.
Language	English
Publishing date	2021-10-01
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2453343-9
ISSN	1178-2390
ISSN	1178-2390
DOI	10.2147/JMDH.S330647
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Article ; Online: It takes a virtual village: Childbearing women's experience of a closed Facebook support group for mothers.

Gleeson, Danielle M / Craswell, Alison / Jones, Christian M

Women and birth : journal of the Australian College of Midwives

2021 Volume 35, Issue 2, Page(s) e172–e180

Abstract: Background: Childbearing women engage in large public pregnancy and parenting forums, primarily for the purpose of seeking information and advice. There is an absence of research related to women's engagement in closed and private online mothers' groups. ...

Abstract	Background: Childbearing women engage in large public pregnancy and parenting forums, primarily for the purpose of seeking information and advice. There is an absence of research related to women's engagement in closed and private online mothers' groups. Aim: The aim of this study was to explore the experiences of participation and support for members within a closed online mothers' group. Method: A qualitative study using in-depth interviews. Reflexive thematic analysis was used to analyse the data. Findings: This study demonstrated that a closed online mothers' group enabled a group of childbearing women to overcome isolation and form sustained, evolving and supportive friendships within a small, private and trusted group. The technology allowed women to engage and share at a level much deeper than what they would in "real life". The depth of sharing was enhanced in a closed online mothers' group due to a smaller, private audience of trusted friends. Virtual support felt safer than face-to-face support as information could not impact one's real world reputation, and communication was able to be controlled. This was particularly helpful to women experiencing social difficulties or isolation. Conclusion: This study has provided a unique and rare insight into the private world of closed online mothers' groups. As a virtual village, this closed group enabled childbearing women to form a small community with members sharing responsibility and working for the wellbeing and benefit of all. By encouraging, locating and establishing similar groups, maternity health professionals may assist women to access their own 'virtual village'.
MeSH term(s)	Female ; Humans ; Mothers ; Parenting ; Pregnancy ; Qualitative Research ; Self-Help Groups ; Social Media ; Social Support
Language	English
Publishing date	2021-05-11
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.2021.04.011
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