How social media data are being used to research the experience of mourning: A scoping review

Published: July 22, 2022Background: Increasingly, people are using social media (SM) to express grief, and researchers are using this data to investigate the phenomenon of mourning. As this research progresses, it is important to understand how studies are being conducted and how authors are approaching ethical challenges related to SM data. Objective: The aim of this review was to explore how SM data are being used to research experiences of mourning through the following questions: a) ‘Which topics related to mourning are being studied?’; b) ‘What study designs have been used to analyse SM data’; c) ‘What type of data (natural or generated) have been used?’; and d) ‘How are ethical decisions being considered?’. Methods: The JBI Scoping Review methodology guided this review. Eligibility criteria were determined using the PCC framework, and relevant key words and phrases derived from these criteria were used to search eight databases in September 2021 (CINAHL, Embase, LILACS, OpenGrey, ProQuest, PsycINFO, PubMed and Scopus). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were used to report the results of this review. Results: Database searches resulted in 3418 records, of which, 89 met eligibility criteria. Four categories of grief and mourning were identified. Most records were qualitative in nature and used natural data. Only 20% of records reported ethics approval by an Institutional Review Board, with several including measures to protect participants, for example, using pseudonyms. Conclusions: This unique review mapped the diverse range of mourning-related topics that have been investigated using SM data and highlighted the variability in approaches to data analysis. Ethical concerns relating to SM data collection are identified and discussed. This is an emerging and rapidly changing field of research that offers new opportunities and challenges for exploring the phenomenon of mourning.Julia Muller Spiti, Ellen Davies, Paul McLiesh, Janet Kell

Orthopaedic nursing and the COVID19 pandemic: the first few months

This is an accepted manuscript of an article published by Elsevier in International Journal of Orthopaedic and Trauma Nursing on 17/06/2020, available online: https://doi.org/10.1016/j.ijotn.2020.100794 The accepted version of the publication may differ from the final published version.At the time of writing (early June 2020), the COVID19 pandemic has affected almost every aspect of life in every part of the globe. This frightening disease has devastated families, communities, and society. Despite this, the hard work and astounding adaptability of healthcare organisations and their staff has been making headlines everywhere. The planning, alterations to existing systems, new rules and guidelines and managing staff and patient expectations has created significant pressure and stress at all levels. The exisiting shortages of nurses and variations in nurses’ working conditions in some countries forms the background to this significant increase in activity. The global economic impact of the pandemic will ultimately lead to a deeper fiscal crisis in many economies that will place additional pressure on future resourcing of healthcare and, perhaps, motivate governments to rethink how healthcare is funded.Published versio

Knowledge translation within a population health study: how do you do it?

BACKGROUND Despite the considerable and growing body of knowledge translation (KT) literature, there are few methodologies sufficiently detailed to guide an integrated KT research approach for a population health study. This paper argues for a clearly articulated collaborative KT approach to be embedded within the research design from the outset. DISCUSSION Population health studies are complex in their own right, and strategies to engage the local community in adopting new interventions are often fraught with considerable challenges. In order to maximise the impact of population health research, more explicit KT strategies need to be developed from the outset. We present four propositions, arising from our work in developing a KT framework for a population health study. These cover the need for an explicit theory-informed conceptual framework; formalizing collaborative approaches within the design; making explicit the roles of both the stakeholders and the researchers; and clarifying what counts as evidence. From our deliberations on these propositions, our own co-creating (co-KT) Framework emerged in which KT is defined as both a theoretical and practical framework for actioning the intent of researchers and communities to co-create, refine, implement and evaluate the impact of new knowledge that is sensitive to the context (values, norms and tacit knowledge) where it is generated and used. The co-KT Framework has five steps. These include initial contact and framing the issue; refining and testing knowledge; interpreting, contextualising and adapting knowledge to the local context; implementing and evaluating; and finally, the embedding and translating of new knowledge into practice. SUMMARY Although descriptions of how to incorporate KT into research designs are increasing, current theoretical and operational frameworks do not generally span a holistic process from knowledge co-creation to knowledge application and implementation within one project. Population health studies may have greater health impact when KT is incorporated early and explicitly into the research design. This, we argue, will require that particular attention be paid to collaborative approaches, stakeholder identification and engagement, the nature and sources of evidence used, and the role of the research team working with the local study community.Alison Kitson, Kathryn Powell, Elizabeth Hoon, Jonathan Newbury, Anne Wilson, Justin Beilb

An overview of research in orthopaedic and trauma nursing

Paul McLiesh, Philippa Rasmusse

Identifying and reducing the incidence of post discharge Venous ThromboEmbolism (VTE) in orthopaedic patients: a systematic review

JBI6923The risk of venous thromboembolism for orthopaedic patients is often high due to the length of surgery, damage from trauma to bone and soft tissues and lengthy periods of immobility or reduced mobility. Although venous thromboembolism occurs mainly in inpatients a significant number of patients develop venous thromboembolism post discharge OBJECTIVES: To synthesise the best available evidence on strategies that effectively reduce post discharge venous thromboembolism in orthopaedic patients.Patients regardless of age, gender or co-morbidities that have been admitted with an acute orthopaedic injury (unplanned) or a planned orthopaedic surgery/procedure and then followed up after discharge. Only papers describing the incidence and prophylaxis treatment used in non-Asian patients were considered for inclusion.Any interventions of combinations of chemoprophylaxis and/or mechanical prophylaxis to prevent venous thromboembolism incidence extending beyond hospital admission.Outcomes included diagnosis of venous thromboembolism following an orthopaedic admission/surgery for up to 6 months post discharge and the incidence of any significant bleeding or death related to venous thromboembolism or haemorrhage.The review considered any randomised controlled trials; in the absence of RCTs other research designs, such as non-randomised controlled trials and before and after studies, were considered SEARCH STRATEGY: Search strategy considered only papers in English from 2000 to March 2012.Papers selected for retrieval were assessed using standardised critical appraisal instruments from the Joanna Briggs Institute.Data was extracted from the studies using the standardised Johanna Briggs Institute data extraction form.Of the included studies none matched methodology, treatment or comparator that allowed meta-analysis. The results were therefore presented in a narrative form and were structured using patient population, then intervention and then analysis of results.20 articles were included in the systematic review. The overall incidence of post discharge venous thromboembolism in orthopaedic patients is not possible to determine due to the variability in reporting criteria and poor follow-up. Use of Low Molecular Weight Heparins was generally shown to be effective in preventing venous thromboembolism. The new generation Factor Xa inhibitors were shown to improve venous thromboembolism prevention however had a slightly higher risk of bleeding. There was limited high level research presented to allow effective assessment of aspirin and/or mechanical compression devices.Prevention of post discharge venous thromboembolism is complex due to the number of variables that can influence its occurrence. The risk of post discharge venous thromboembolism varies among different patient populations so consideration must be given to matching the risk for each of those groups with available interventions.For higher risk orthopaedic patient groups such as those with large joint replacements and femoral fractures low molecular weight heparins should be considered and continued where possible post discharge for thirty days however the risk profile for venous thromboembolism and bleeding must be considered for both populations and individuals.Consideration in future research design must be given to factors such as: adequate follow-up time, and standardised criteria to measure the incidence of post discharge venous thromboembolism.Paul McLiesh, Rick Wiechulahttp://connect.jbiconnectplus.org/JBIReviewsLibrary.asp

The effects of multiple sterilisations on titanium and stainless steel plates and screws

The way in which health care facilities store surgical plates and screws in Australia varies from state to state and even hospital to hospital. The prostheses are either obtained as individually packaged, pre-sterilised implants or stored in a screw caddy in an instrument tray, which is sterilised for multiple surgeries. The repeated exposure of the plates and screws to sterilisation methods may have the potential to negatively affect their strength or corrosion potential. A systematic review of the literature was conducted to identify any impact from repeated sterilisation on stainless steel and titanium prostheses. Detrimental effects to either the oxide layer, which protects the metal from corrosion, or the overall strength of the metal were found in both metals after repeated sterilisations. Stainless steel was more affected than titanium. While no clear evidence about the clinical implications of these changes was able to be derived, it is recommended that further studies are performed relating to the clinical implications of these changes in order to guide best practice in the clinical setting.Rebecca McEvoy, Paul McLieshhttp://search.informit.com.au/documentSummary;dn=798984363100830;res=IELHE

Are we providing the best possible pain management for our elderly patients in the acute-care setting?

Background: During 2008 seven practice improvement projects were conducted in an acute-care hospital under the banner of The Older Person and Improving Care (TOPIC 7). Each project team examined a discrete aspect of care of the elderly and this project focus was on pain management and in particular assessment of the older person with communication difficulties. Aims: The project intended to assess current practice and implement changes to match best practice in the management of pain in the older person within an acute-care setting. Methods: A multidisciplinary team was recruited to conduct the project. The pain team with the other six TOPIC 7 teams was facilitated by a coordinating team. The project was divided into four phases. Phase one was designated as Describing, where the clinical issue was identified and focused to priority areas. It was decided to focus on the elderly who were unable to verbally communicate their pain management needs. Standards of practice relevant to the area of practice were sourced to guide practice improvement. Phase two was Measuring activity where clinical audits were used to measure current practice and compare this with the appropriate standards. Phase three was Taking action where a range of practice improvement activities were implemented including the introduction of the Abbey Pain Scale. The final phase was designated as Review and share where the impact of the project activities was measured with a follow-up audit and the results were disseminated. Results: Initial results showed a need for increased awareness of the difficulties in the pain assessment and management of older persons who cannot verbally communicate their needs. Seventy-eight per cent of patients had a documented pain assessment in the previous 24 h on audit. However, 83% of these assessments were only a general comment in the patient records. No tools were available for completing a systematic assessment that was reliable and reproducible. Sixty-two per cent of patients did not have analgesia administered 1 h before mobilising or having a significant dressing completed. Reaudit, posteducation sessions, showed an increase in the awareness in the complexities involved in caring for this group of patients. An alternate, specific tool (Abbey Pain Scale) was utilised well by staff and acted as a prompt in reminding staff to assess the pain levels of their elderly patients. Conclusions: Globally, pain in the older person is poorly managed. Pain in older persons who are unable to communicate or who have difficulty in communicating their needs is even more poorly managed. However, the availability of an appropriate tool and an increased awareness of this issue can have a significant and real impact on the pain management of this group of patients.Paul McLiesh, Davina Mungall and Rick Wiechul

The value of nursing

EditorialPaul McLiesh, Rebecca Jester, Julie Santy-Tomlinso

Building multidisciplinary health workforce capacity to support the implementation of integrated, people-centred models of care for musculoskeletal health

To address the burden of musculoskeletal (MSK) conditions, a competent health workforce is required to support the implementation of MSK models of care. Funding is required to create employment positions with resources for service delivery and training a fit-for-purpose workforce. Training should be aligned to define "entrustable professional activities", and include collaborative skills appropriate to integrated and people-centred care and supported by shared education resources. Greater emphasis on educating MSK healthcare workers as effective trainers of peers, students and patients is required. For quality, efficiency and sustainability of service delivery, education and research capabilities must be integrated across disciplines and within the workforce, with funding models developed based on measured performance indicators from all three domains. Greater awareness of the societal and economic burden of MSK conditions is required to ensure that solutions are prioritised and integrated within healthcare policies from local to regional to international levels. These healthcare policies require consumer engagement and alignment to social, economic, educational and infrastructure policies to optimise effectiveness and efficiency of implementation.M.J. Chehade, T.K. Gill, D. Kopansky-Giles, L. Schuwirth, J. Karnon, P. McLiesh, J. Alleyne, A.D. Wool