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  1. 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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  2. Article ; Online: What constitutes a quality community aged care service-client perspectives: An international scoping study.

    Smith, Sandra / Martin-Khan, Melinda / Travers, Catherine

    Health & social care in the community

    2022  Volume 30, Issue 6, Page(s) e3593–e3628

    Abstract: Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who ... ...

    Abstract Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who require assistance to remain living at home, the Federal Government provides a wide range of community care services, the provision of which has increased substantially over the last 15 years. The importance of client preferences, prefaced by the introduction of consumer directed care across community aged care services, has gathered momentum in Australia following legislation in 2015. Older peoples' preferences differ in comparison to younger people with disability and those with mental health concerns. Older people focus more on the provision of services rather than the notion of independent living itself. This scoping review aimed to explore what aspects people aged 65 years and older consider to be important qualities of aged care services delivered in the community. A computerised search in MEDLINE, CINAHL, PubMed and PsychINFO and hand searches of the Cochrane database and Google Scholar were completed in May 2022. Sixty-two articles met the selection criteria and were included in the review. Data were extracted using a fit-for-purpose protocol and analysed using the Miles and Huberman Model for thematic analysis. Results identified five themes representing quality domains that describe features that are important to clients: staff knowledge, respect for clients, a person-centred approach, a collaborative partnership with clients and clear communication. When providers of community aged care services are planning to assess the quality of their services, these findings could be used to guide their evaluation. This will ensure that future services delivered accommodate the needs and preferences of clients who receive them.
    MeSH term(s) Humans ; Aged ; Native Hawaiian or Other Pacific Islander ; Australia ; Independent Living ; Communication
    Language English
    Publishing date 2022-09-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1155902-0
    ISSN 1365-2524 ; 0966-0410
    ISSN (online) 1365-2524
    ISSN 0966-0410
    DOI 10.1111/hsc.13998
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A systematic scoping review of change management practices used for telemedicine service implementations.

    Kho, Joanna / Gillespie, Nicole / Martin-Khan, Melinda

    BMC health services research

    2020  Volume 20, Issue 1, Page(s) 815

    Abstract: Background: Telemedicine improves access to health care services enabling remote care diagnosis and treatment of patients at a distance. However, the implementation of telemedicine services often pose challenges stemming from the lack of attention to ... ...

    Abstract Background: Telemedicine improves access to health care services enabling remote care diagnosis and treatment of patients at a distance. However, the implementation of telemedicine services often pose challenges stemming from the lack of attention to change management (CM). Health care practitioners and researchers agree that successful telemedicine services require significant organizational and practice change. Despite recognizing the importance of the "people-side" of implementation, research on what constitutes best practice CM strategies for telemedicine implementations remains fragmented, offering little cohesive insight into the specific practices involved in the change process. We conducted a systematic scoping review of the literature to examine what and how CM practices have been applied to telemedicine service implementation, spanning a variety of health care areas and countries.
    Methods: Three bibliographic databases (CINAHL, PubMed, and ISI Web of Science) and four specialist telehealth journals were searched. To keep the review manageable and relevant to contemporary telemedicine technologies and contexts, the search was limited to articles published from 2008 to 2019. Forty-eight articles were selected for inclusion.
    Results: From the 48 articles, 16 CM practices were identified relating to either strategic or operational aspects of telemedicine implementations. We identify the key CM practices that are recognized in the broader CM literature as essential for successful and sustained change but are not commonly reported in telemedicine implementation studies. We draw on the CM literature to provide a comprehensive process-based, researched-informed, organizing framework to guide future telemedicine service implementations and research.
    Conclusions: Our findings suggest that the slow rate of adoption of telemedicine may be due to a piecemeal approach to the change process, and a lack of understanding of how to plan, manage and reinforce change when implementing telemedicine services.
    MeSH term(s) Change Management ; Delivery of Health Care ; Health Services ; Humans ; Telemedicine/methods
    Language English
    Publishing date 2020-09-01
    Publishing country England
    Document type Journal Article ; Systematic Review
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-020-05657-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Examining the adaptability and validity of interRAI acute care quality indicators in a surgical context.

    Wood, Timothy / Chatfield, Mark / Gray, Leonard / Peel, Nancye / Freeman, Shannon / Martin-Khan, Melinda

    SAGE open medicine

    2022  Volume 10, Page(s) 20503121221103221

    Abstract: Background: Currently, the use of quality indicators in the surgical setting may be challenged by diverse patient needs, clinical complexity, and health trajectories. Therefore, the objective of this study was to examine the adaptability of existing ... ...

    Abstract Background: Currently, the use of quality indicators in the surgical setting may be challenged by diverse patient needs, clinical complexity, and health trajectories. Therefore, the objective of this study was to examine the adaptability of existing quality indicators to a surgical context and propose new time points.
    Methods: A multi-method approach included an environmental scan of the literature, consultation with multinational experts, and analysis of surgical patient data. Quality indicators from the nurse-administered interRAI Acute Care instrument were examined within a surgical context using secondary data from a hospital in Brisbane, Australia (N = 1006 surgical cases).
    Results: A lack of relevancy of existing time points can preclude meaningful quality indicator measurement. Definitions of some quality indicators were adapted to ensure relevancy for the surgical population. As well, a surgical baseline (measured preoperative and post-injury) and a 48-h postoperative time point were added to the existing measurement timeline.
    Conclusion: Distinct measurement timelines were created for elective and non-elective surgical patients. The use of surgery-specific time points that can be embedded into an existing Acute Care measurement framework supports consistent quality indicator reporting. This study represents the first steps towards standardized quality reporting for health information systems across different care settings.
    Language English
    Publishing date 2022-06-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2735399-0
    ISSN 2050-3121
    ISSN 2050-3121
    DOI 10.1177/20503121221103221
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A comparison of prospective observations and chart audits for measuring quality of care of musculoskeletal injuries in the emergency department.

    Coombes, Fiona C A / Strudwick, Kirsten / Martin-Khan, Melinda G / Russell, Trevor G

    Australasian emergency care

    2022  Volume 26, Issue 2, Page(s) 132–141

    Abstract: Background: Accurate and efficient data collection is crucial for effective evaluation of quality of care. The objective of this study is to compare two methods of data collection used to score quality indicators for musculoskeletal injury management in ...

    Abstract Background: Accurate and efficient data collection is crucial for effective evaluation of quality of care. The objective of this study is to compare two methods of data collection used to score quality indicators for musculoskeletal injury management in Emergency departments: prospective observation, and chart audit.
    Methods: An analysis was undertaken of data collected from 633 patients who presented with a musculoskeletal injury to eight emergency departments in Queensland, Australia in 2016-17. Twenty-two quality indicators were scored using both prospective observation and chart audit data for each occasion of service. Quality indicators were included if they were originally published with both collection methods. Analyses were performed to compare firstly, the quality indicator denominators, and secondly, the quality indicator trigger rates, scored using each collection method. Chi Square statistics were used to identify significant differences.
    Results: Prospectively collected data scored quality indicator denominators significantly (p value<0.05) more often than chart audit data for five (22.7 %) of the 22 quality indicators. The remaining 17 quality indicators (77.3 %) showed no statistical differences. When comparing quality indicator trigger rates, 16 (72.7 %) had significantly different results between methods with 12 (54.5 %) scoring higher using prospective data and four (18.2 %) with chart audit data. The remaining six quality indicators (27.3 %) in this comparison showed no significant difference between chart and prospective data.
    Conclusion: Quality indicators including aspects of care associated with patient safety, and those relying on clinician written orders or forms were adequately scored using either prospective observation or chart audit data. Whereas quality indicators relying on time-sensitive information, elements of a social history, general physical exams and patient education and advice scored higher using prospective observation data collection.
    MeSH term(s) Humans ; Prospective Studies ; Emergency Service, Hospital ; Australia ; Musculoskeletal Diseases ; Queensland
    Language English
    Publishing date 2022-09-22
    Publishing country Australia
    Document type Journal Article
    ISSN 2588-994X
    ISSN (online) 2588-994X
    DOI 10.1016/j.auec.2022.09.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Identification and information management of cognitive impairment of patients in acute care hospitals: An integrative review.

    Xiong, Beibei / Bailey, Daniel X / Prudon, Paul / Pascoe, Elaine M / Gray, Leonard C / Graham, Frederick / Henderson, Amanda / Martin-Khan, Melinda

    International journal of nursing sciences

    2023  Volume 11, Issue 1, Page(s) 120–132

    Abstract: Objectives: Recognition of the cognitive status of patients is important so that care can be tailored accordingly. The objective of this integrative review was to report on the current practices that acute care hospitals use to identify people with ... ...

    Abstract Objectives: Recognition of the cognitive status of patients is important so that care can be tailored accordingly. The objective of this integrative review was to report on the current practices that acute care hospitals use to identify people with cognitive impairment and how information about cognition is managed within the healthcare record as well as the approaches required and recommended by policies.
    Methods: Following Whittemore & Knafl's five-step method, we systematically searched Medline, CINAHL, and Scopus databases and various grey literature sources. Articles relevant to the programs that have been implemented in acute care hospitals regarding the identification of cognitive impairment and management of cognition information were included. The Mixed Methods Appraisal Tool and AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance) Checklist were used to evaluate the quality of the studies. Thematic analysis was used to present and synthesise results. This review was pre-registered on PROSPERO ( CRD42022343577).
    Results: Twenty-two primary studies and ten government/industry publications were included in the analysis. Findings included gaps between practice and policy. Although identification of cognitive impairment, transparency of cognition information, and interaction with patients, families, and carers (if appropriate) about this condition were highly valued at a policy level, sometimes in practice, cognitive assessments were informal, patient cognition information was not recorded, and interactions with patients, families, and carers were lacking.
    Discussion: By incorporating cognitive assessment, developing an integrated information management system using information technology, establishing relevant laws and regulations, providing education and training, and adopting a national approach, significant improvements can be made in the care provided to individuals with cognitive impairment.
    Language English
    Publishing date 2023-12-01
    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.2023.11.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Factors associated with teletrauma utilization in rural areas: a review of the literature.

    Wood, Timothy / Freeman, Shannon / Banner, Davina / Martin-Khan, Melinda / Hanlon, Neil / Flood, Frank

    Rural and remote health

    2021  Volume 21, Issue 1, Page(s) 6354

    Abstract: Introduction: Trauma patients residing in rural areas face increased challenges to accessing timely and appropriate health services as a result of large geographic distances and limited resource availability. Virtual trauma supports, coined 'teletrauma', ...

    Abstract Introduction: Trauma patients residing in rural areas face increased challenges to accessing timely and appropriate health services as a result of large geographic distances and limited resource availability. Virtual trauma supports, coined 'teletrauma', are one solution offered to address gaps in rural trauma care. Teletrauma represents a new and innovative solution to addressing health system gaps and optimizing patient care within rural settings. Here, the authors synthesize the empirical evidence on teletrauma research.
    Methods: A review of literature, with no date limiters, was guided by Arksey and O'Malley's (2005) scoping review methodology. The aim of the review was to provide an overview of the current landscape of teletrauma research while identifying factors associated with utilization.
    Results: Following a systematic search of key health databases, 1484 articles were initially identified, of which 28 met the inclusion criteria and were included for final analysis. From the review of the literature, the benefits of teletrauma for rural and remote areas were well-recognized. Several factors were found to be significantly associated with teletrauma utilization, including younger patient age, penetrating injury, and higher injury or illness severity. Lack of access to resources and clinician characteristics were also identified as reasons that sites adopted teletrauma services.
    Conclusion: By identifying factors associated with teletrauma utilization, teletrauma programs may be used more judiciously and effectively in rural areas as a means of enhancing access to definitive trauma care in rural areas. Gaps in current knowledge were also identified, along with recommendations for future research.
    MeSH term(s) Humans ; Rural Population ; Telemedicine
    Language English
    Publishing date 2021-03-15
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 2105620-1
    ISSN 1445-6354 ; 1445-6354
    ISSN (online) 1445-6354
    ISSN 1445-6354
    DOI 10.22605/RRH6354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Higher quality of care in emergency departments with physiotherapy service models.

    Strudwick, Kirsten / Martin, Romany / Coombes, Fiona / Bell, Anthony / Martin-Khan, Melinda / Russell, Trevor

    Emergency medicine Australasia : EMA

    2021  Volume 34, Issue 2, Page(s) 209–222

    Abstract: Objective: To investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs).: Methods: An analysis was undertaken of prospective ... ...

    Abstract Objective: To investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs).
    Methods: An analysis was undertaken of prospective observational and chart audit data collected from 628 patients who presented with a musculoskeletal injury in any of the eight participating EDs in Queensland in 2016-2017. The care provided was scored against 46 musculoskeletal QIs. Quality of care was first compared between EDs with physiotherapists to EDs with a limited physiotherapy service, and second between EDs with primary contact physiotherapists to EDs without. χ
    Results: In the first comparison, EDs with physiotherapists performed significantly higher on 15 QIs and EDs with only limited physiotherapy performed higher on two QIs. In the second comparison, EDs with primary contact physiotherapists performed significantly higher on 17 QIs when compared to EDs without and three QIs demonstrated significance in favour of EDs without primary contact physiotherapists. Performance differences occurred across both process and outcome QIs, including musculoskeletal assessment, diagnostics, pain assessment and management, fracture management, medication safety, mobility, patient information, referrals and follow-up, re-presentations and patient experience.
    Conclusions: EDs with physiotherapists provide at least equivalent or higher quality of care for patients with musculoskeletal injuries than those EDs with limited access to physiotherapists. This may be because of their specialised training in musculoskeletal diagnosis and treatment, as well as the impact of teaching and mentoring for other ED clinicians.
    MeSH term(s) Emergency Service, Hospital ; Humans ; Musculoskeletal Diseases/therapy ; Physical Therapists ; Physical Therapy Modalities ; Quality of Health Care
    Language English
    Publishing date 2021-10-06
    Publishing country Australia
    Document type Journal Article ; Observational Study
    ZDB-ID 2161824-0
    ISSN 1742-6723 ; 1742-6731 ; 1035-6851
    ISSN (online) 1742-6723
    ISSN 1742-6731 ; 1035-6851
    DOI 10.1111/1742-6723.13868
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Exploring user perspectives of factors associated with use of teletrauma in rural areas.

    Wood, Timothy / Freeman, Shannon / Banner, Davina / Martin-Khan, Melinda / Hanlon, Neil / Flood, Frank

    Australasian emergency care

    2021  Volume 25, Issue 2, Page(s) 106–114

    Abstract: Background: Despite the existence of universal health care for Canadians, health inequalities persist and those residing in rural regions experience disparities when accessing appropriate services. To enhance access, a teletrauma program was implemented ...

    Abstract Background: Despite the existence of universal health care for Canadians, health inequalities persist and those residing in rural regions experience disparities when accessing appropriate services. To enhance access, a teletrauma program was implemented in a rural northern region in western Canada, connecting rural clinicians to urban emergency physicians and trauma specialists during emergency cases.
    Objective: To explore reasons why teletrauma is used in rural contexts from the perspectives of service users and stakeholders.
    Methods: 14 semi-structured interviews were conducted with stakeholders, clinicians (physicians, specialists), management, and researchers. Interpretive description methodology guided the study and analysis, and findings were organized thematically.
    Results: Teletrauma was used to connect clinicians, manage complex cases when weather or distance delayed transfer, and to enable appropriate and timely treatment locally. Teletrauma was more likely to be activated when clinicians were uncomfortable with clinical management, when relationships were established, and when technology was familiar and easy to use.
    Conclusions: Teletrauma is more than just the technology that is deployed. The establishment of relationships between teletrauma users was vital to the success of teletrauma. To design effective, integrated, and sustainable services, rural clinicians must remain at the center of teletrauma models.
    MeSH term(s) Canada ; Humans ; Physicians ; Rural Population
    Language English
    Publishing date 2021-05-08
    Publishing country Australia
    Document type Journal Article
    ISSN 2588-994X
    ISSN (online) 2588-994X
    DOI 10.1016/j.auec.2021.04.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Interim guidance for health-care professionals and administrators providing hospital care to adult patients with cognitive impairment, in the context of COVID-19 pandemic.

    Martin-Khan, Melinda / Bail, Kasia / Yates, Mark W / Thompson, Jane / Graham, Fred

    Australasian journal on ageing

    2020  Volume 39, Issue 3, Page(s) 283–286

    Abstract: Objective: We developed interim guidance for the care of patients with cognitive impairment in hospital during the COVID-19 pandemic.: Methods: A Guidance Committee and Readers Group were recruited. The content was identified by the Committee and ... ...

    Abstract Objective: We developed interim guidance for the care of patients with cognitive impairment in hospital during the COVID-19 pandemic.
    Methods: A Guidance Committee and Readers Group were recruited. The content was identified by the Committee and content-specific subgroups, resulting in a draft document, which was sent to the Readers for review. People with dementia and care partners were involved in all aspects of the process.
    Results: Infection control measures can lead to an escalation of distress. In an environment where visiting bans are applied to care partners/advocates, hospitals need to ensure care partners can continue to provide decision-making support. Health-care professionals can proactively engage care partners using videoconferencing technologies. Developing models of care that proactively support best practice can minimise the risk of delirium, mitigate escalating symptoms and guide the use of non-pharmacological, pharmacological (start low, go slow) or physical restraint in managing behavioural and psychological symptoms.
    MeSH term(s) Adult ; Australia ; Betacoronavirus ; COVID-19 ; Cognitive Dysfunction/psychology ; Cognitive Dysfunction/therapy ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Hospitalization ; Humans ; Infection Control/organization & administration ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-14
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1457406-8
    ISSN 1741-6612 ; 0726-4240 ; 1440-6381
    ISSN (online) 1741-6612
    ISSN 0726-4240 ; 1440-6381
    DOI 10.1111/ajag.12831
    Database MEDical Literature Analysis and Retrieval System OnLINE

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