Future considerations for Australian nurses and their disaster educational preparedness: A discussion.

Australian nurses have been active participants in disaster assistance both within the in-hospital and out-of-hospital environment. This paper discusses the current disaster education opportunities and challenges for nurses. Additionally, various educational strategies for different cohorts of nurses are discussed highlighting the need for education to be targeted at the right cohort of nurses, at the right time, using the right strategy. To enhance the educational preparedness of Australian nurses and subsequently their willingness to assist in a disaster it is suggested that the education should replicate the realities of 'what it is like' to assist in a disaster. Additionally, education should be positioned within a national framework for disaster health education.Full Tex

A comparison of open access in exercise science journals: 2010 to 2012

he aim of this study was to complete an audit on the number of open access journals within the discipline of Exercise Science. Publishing in open access journals results in wide dissemination of material in a very short period of time compared with the more traditional way of publishing in a subscription journal. The 2010 ERA journal list, category Human Movement and Sport Science, was initially utilised and then compared with the openness of the same journals in 2012. In this study journals were audited for their degree of open access, open licensing and open format. Open access relates to the free online availability of research results and hence research publications and in the discipline of exercise science relates to the concept of an idealised level playing field. Open licensing relates to the ability of the consumers to replicate and share those publications freely whilst open format relates to the use of open and transferrable format types. Open access increased (p=0.014) as did our measurement of open licensing (p=0.000) and open formats (p=0.021) between the 2010 and 2012 reviews of the journals in 1106 For code. This study reveals an increase in the number of Exercise Science journals that have full or partial open access over the two year period and suggests that authors are increasingly adopting peer reviewed open access journal publications. It is evident from this study that the impact of open access journals be assessed and further research into the feasibility of such a rating is imperative.Full Tex

Disaster content in Australian tertiary postgraduate emergency nursing courses: a survey

Background Emergency nurses play a pivotal role in disaster relief during the response to, and recovery of both in-hospital and out-of-hospital disasters. Postgraduate education is important in preparing and enhancing emergency nurses' preparation for disaster nursing practice. The disaster nursing content of Australian tertiary postgraduate emergency nursing courses has not been compared across courses and the level of agreement about suitable content is not known. Aim To explore and describe the disaster content in Australian tertiary postgraduate emergency nursing courses. Method A retrospective, exploratory and descriptive study of the disaster content of Australian tertiary postgraduate emergency nursing courses conducted in 2009. Course convenors from 12 universities were invited to participate in a single structured telephone survey. Data was analysed using descriptive statistics. Results Ten of the twelve course convenors from Australian tertiary postgraduate emergency nursing courses participated in this study. The content related to disasters was varied, both in terms of the topics covered and duration of disaster content. Seven of these courses included some content relating to disaster health, including types of disasters, hospital response, nurses' roles in disasters and triage. The management of the dead and dying, and practical application of disaster response skills featured in only one course. Three courses had learning objectives specific to disasters. Conclusion The majority of courses had some disaster content but there were considerable differences in the content chosen for inclusion across courses. The incorporation of core competencies such as those from the International Council of Nurses and the World Health Organisation, may enhance content consistency in curriculum. Additionally, this content could be embedded within a proposed national education framework for disaster health.No Full Tex

The epidemiology of dying within 48 hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand

BACKGROUND: Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people.OBJECTIVES: To estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere.METHODS: We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48 hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression.RESULTS: From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31-6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65-74 years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation.CONCLUSIONS: Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens.</p

Importance of immediate electronic-based feedback to enhance feedback for first-time cpr trainees

Sudden cardiac arrest is one of the leading causes of death globally. The recommended clinical management in out-of-hospital cardiac arrest cases is the immediate initiation of high-qual-ity cardiopulmonary resuscitation (CPR). Training mannequins should be combined with technology that provides students with detailed immediate feedback on the quality of CPR performance. This study aimed to verify the impacts of the type of feedback (basic or detailed) the responders receive from the device while learning CPR and how it influences the quality of their performance and the motivation to improve their skills. The study was conducted at the Medical University of Lublin among 694 multi-professional health students during first aid classes on basic life support (BLS). The students first practiced on an adult mannequin with a basic control panel; afterward, the same mannequin was connected to a laptop, ensuring a detailed record of the performed activities through a projector. Next, the participants expressed their subjective opinion on how the feedback provided during the classes, basic vs. detailed, motivated them to improve the quality of their CPR performance. Additionally, during the classes, the instructor conducted an extended observation of students’ work and behavior. In the students’ opinion, the CPR training with detailed feedback devices provided motivation for learning and improving CPR proficiency than that with a basic control panel. Furthermore, the comments given from devices seemed to be more acceptable to the students, who did not see any bias in the device’s evaluation compared to that of the instructor. Detailed device feedback motivates student health practitioners to learn and improve the overall quality of CPR. The use of mannequins that provide detailed feedback during BLS courses can improve survival in out-of-hospital cardiac arrest

Australasian emergency nurses\u27 willingness to attend work in a disaster: a survey

Abstract not availablePaul Arbon, Jamie Ranse, Lynette Cusack, Julie Considine, Ramon Z. Shaban, Richard J. Woodman, Laura Bahnisch, Mayumi Kako, Karen Hammad, Belinda Mitchel

Impact of a pilot pathway for the management of gastroenteritis-like symptoms in an emergency department: A case study following a Salmonella outbreak

Objective: This research aims to describe the effect of standard care (control) versus a clinical management pathway (intervention) on patient length of stay and admission rates during a public health emergency at one Australian ED. Methods: A retrospective audit of hospital records for patients who presented in May 2013 with gastroenteritis-like symptoms was undertaken following a surge in patient presentations from a Salmonella outbreak. Patients who presented with gastroenteritis-like symptoms between 15 and 19 May 2013 received care according to a clinical management pathway (intervention). The focus of the intervention was based on symptom management, including a standardised approach to analgesia, anti-emetics and rehydration. Patient characteristics, such as age and gender are described using descriptive statistics. A Mann–Whitney test was used to compare continuous data, and a Fisher's exact test was used to compare categorical data, between the two groups. Results: Over an 8 day period, 110 patients presented with gastroenteritis-like symptoms. The median length of stay was statistically different between the two groups (P < 0.001). More patients were admitted to hospital from the control group (n = 5) when compared with the intervention group (n = 0); however, given the small number of patients in these groups, inferential statistical analysis was not a reasonable consideration. Conclusion: The length of stay for patients between the two groups was statistically different, suggesting that the implementation of a clinical management pathway for patients with gastroenteritis-like symptoms reduced the ED length of stay. This finding is useful in future planning for similar public health emergency responses and/or for use when patients present with gastroenteritis-like symptoms on a daily basis.No Full Tex

End-of-life care in postgraduate critical care nurse curricula: An evaluation of current content informing practice

Despite the frequency with which critical care nurses’ engage in end-of-life care, preparation and support of nurses for this work through professional development opportunities or postgraduate education is reportedly limited

Minimum data set for mass-gathering health research and evaluation: A discussion paper

This paper discusses the need for consistency in mass-gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world, and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factors within the environmental, psychosocial and biomedical domains influence the usage of health services at mass gatherings. The biomedical domain includes the categorization of presenting injury or illness, and rates such as patient presentation rate, transferred to hospital rate and referred to hospital rate. These rates provide insight into the usage of onsite health services, prehospital ambulance services. and hospital emergency department services. Within the literature, these rates are reported in a manner that is varied, haphazard and author dependent. This paper proposes moving away from an author-dependent practice of collection and reporting of data. An expert consensus approach is proposed as a means of further developing mass-gathering theory and moving beyond the current situation of reporting on individual case studies. To achieve this, a minimum data set with a data dictionary is proposed in an effort to generate conversation about a possible agreed minimum amount and type of information that should be collected consistently for research and evaluation at mass gatherings. Finally, this paper outlines future opportunities that will emerge from the consistent collection and reporting of mass-gathering data, including the possibility for meta-analysis, comparison of events across societies and modeling of various rates to inform health services.No Full Tex