Randomized Control Trial Of A Cancer Shared Care Model
Funder
National Health and Medical Research Council
Funding Amount
$242,400.00
Summary
Cancer care in Australia remains fragmented. Shared care has been seen as a potentially more effective way to manage patients with chronic and subacute diseases, by overcoming many of the difficulties which beset the traditional hospital-based model. These difficulties include poor communication between hospital-based and community-based carers, the high costs of hospital-based care and the loss of involvement of the primary care health professional in ongoing care. This project is a trial of a ....Cancer care in Australia remains fragmented. Shared care has been seen as a potentially more effective way to manage patients with chronic and subacute diseases, by overcoming many of the difficulties which beset the traditional hospital-based model. These difficulties include poor communication between hospital-based and community-based carers, the high costs of hospital-based care and the loss of involvement of the primary care health professional in ongoing care. This project is a trial of a Shared Care Model (SCM) with cancer patients in a hospital in Western Australia. The project is designed to improve the emotional well-being and feelings of empowerment of the patients as well as reduce the number of unplanned admissions these patients need to make during their cancer treatment. The SCM intervention includes: -A patient-held record (PHR) comprising chemotherapy road map, treatment intention, medication list and communication pages for health workers; - Earlier and timely direct communication between specialist and general practitioner; -A Shared Care coordinator to assist with patient care and information; and - General practitioner educational and resource packages with tailored side effects table detailing anticipated side effects and actions to be taken. - For rural patients, the model can be expanded to include general practitioner administration of selected chemotherapeutic agents on alternate cycles. - Protocols for general practitioners administration of selected chemotherapeutic agents.Read moreRead less
A Population Based Study Of The Use Of Acute Hospital Services By Elderly People Living In Residential Care.
Funder
National Health and Medical Research Council
Funding Amount
$127,000.00
Summary
This project will be the first population based Australian study to describe the pattern of utilisation of acute hospital services by elderly people living in residential care. It will provide much needed information on which to base health policy decisions relating to the acute care needs of the most frail elderly members of our community. Within a context of an ageing demographic profile of the Australian population, it is essential that the dynamic interplay between acute care services and th ....This project will be the first population based Australian study to describe the pattern of utilisation of acute hospital services by elderly people living in residential care. It will provide much needed information on which to base health policy decisions relating to the acute care needs of the most frail elderly members of our community. Within a context of an ageing demographic profile of the Australian population, it is essential that the dynamic interplay between acute care services and the residential aged-care sector be elucidated, both for current service provision and for better prediction of future service requirements. This study will make use of existing linked health data sources in WA to achieve the following aims: 1. To provide health service planners with information about the rates, patterns, causes, outcomes and costs of acute emergency department and in-patient hospital services for elderly persons living in residential care in Perth, Western Australia. 2. To develop a population model to determine future acute hospital requirements for elderly persons living in residential care. 3. To estimate the potential impact of alternate modes of integration of acute and long-term care on the utilisation of acute hospital services by hostel and nursing home residents.Read moreRead less
Nurses, Older People And Hospitals: Meeting New Challenges.
Funder
National Health and Medical Research Council
Funding Amount
$462,500.00
Summary
This project addresses an area of pressing international concern- how to improve health care provision in acute care hospitals to a growing group of patients, people aged 85 years and over. It is known that people 85 years and over have complex health needs. It is also known that older people typically do not do well in hospital. In fact, there is often a decline in their health following hospitalisation. The need to cope with older and often sicker patients will continue to place, substantial p ....This project addresses an area of pressing international concern- how to improve health care provision in acute care hospitals to a growing group of patients, people aged 85 years and over. It is known that people 85 years and over have complex health needs. It is also known that older people typically do not do well in hospital. In fact, there is often a decline in their health following hospitalisation. The need to cope with older and often sicker patients will continue to place, substantial pressure on the acute hospital system and those who work in it. The Registered Nurse [RN], as a part of the health care team, has a pivotal role in providing and coordinating the care that people 85 and over require while in hospital. Yet, little is known about the problems that RNs face in providing care to people 85 and over in hospital. The aim of this project is to identify the problems that impact upon RNs in the provision of care to people 85 years and over and find innovative solutions to those problems. In so doing, the final project recommendations will address ways to assist RNs to enhance the care of people 85 and over in hospital, and at the same time enhance the professional working life of RNs. These recommendations will feed into health and aged care policy development, and the educational preparation of nurses, and thus will have relevance at an individual, organisational, and policy level.Read moreRead less
A Randomised Trial Of Core Cooling Versus Surface Cooling In Comatose Survivors Of Prehospital Cardiac Arrest
Funder
National Health and Medical Research Council
Funding Amount
$309,000.00
Summary
Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to ho ....Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to hospital for further care. Despite this approach and recent improvements such as decreased ambulance response times, outcome remains poor and there are very few survivors who make a good recovery. This proposal is for funding to conduct a randomised, controlled trial, which compares two different techniques of induction of hypothermia in patients who are resuscitated from pre-hospital sudden cardiac arrest. Recently available data suggests that the outcome from SCA is significantly improved if moderate hypothermia is used as a treatment of neurological injury. However, the technique of induction of hypothermia requires further research. This study compares core-cooling using large-volume ice-cold intravenous fluid with the current technique of using ice packs for surface cooling, initiated in the field by ambulance paramedics and continued in hospital for a total of 12 hours. This study has the potential to demonstrate a significant improvement in outcome in a common clinical condition, which currently carries a very high mortality rate. This will be the first trial internationally which assess core versus surface cooling initiated pre-hospital, in SCA patients. It is highly likely that with the successful results from this trial that induced hypothermia in SCA patients will become standard care. The use of induced hypothermia could lead to over 500 lives saved per year accross Australia.Read moreRead less
PREVENTION OF HOSPITAL ACQUIRED PRESSURE ULCERS: A RANDOMISED CONTROLLED TRIAL.
Funder
National Health and Medical Research Council
Funding Amount
$195,652.00
Summary
Pressure ulcers are frequently encountered in hospitalised patients. Several factors such as immobility, poor circulation, malnutrition and aging skin and tissue, along with pressure, moisture and friction (shear) from hospital bedding, contribute to their development. Pressure ulcers usually occur over bony prominences. Here, internal tissue pressures are most intense where the skin contacts the supporting surface. The principles for efficient prevention of pressure ulcers are to reduce pressur ....Pressure ulcers are frequently encountered in hospitalised patients. Several factors such as immobility, poor circulation, malnutrition and aging skin and tissue, along with pressure, moisture and friction (shear) from hospital bedding, contribute to their development. Pressure ulcers usually occur over bony prominences. Here, internal tissue pressures are most intense where the skin contacts the supporting surface. The principles for efficient prevention of pressure ulcers are to reduce pressure on the classic ulcer sites, interrupt the pressure frequently, keep the stressed area dry, and provide a low friction cushioning interface between the patient and bed. Sheepskins have been claimed to be of value in the prevention of pressure ulcers. The therapeutic value is believed to be due to the pressure relieving properties of the dense woolpile, the moisture absorbing properties of the wool and the low friction at the wool-tip surface. The CSIRO Leather Research Centre has facilitated the development of an Australian Standard for Medical Sheepskins. In his address at the launch of this Standard (July 1997), Dr Michael Wooldridge, Federal Minister for Health, stated that pressure ulcers would cost the Australian health system over $350M in that year. To unequivocally establish the efficacy of sheepskins in preventing the onset of pressure ulcers, and to meet the present requirements for evidence based medicine, a rigorous Randomised Controlled Trial is essential. CSIRO, in conjunction with the Royal Melbourne Hospital, The University of Melbourne School of Postgraduate Nursing, Deakin University and Fremantle Hospital, plan to undertake a study into the prevention of hospital acquired pressure ulcers comparing the efficacy of two mattress covers: sheepskin overlays and the standard hospital sheet and mattress with or without other low technological constant pressure supports.Read moreRead less
Does Inpatient Weight Restoration Prior To Outpatient Family Therapy Improve Outcomes In Adolescent Anorexia Nervosa?
Funder
National Health and Medical Research Council
Funding Amount
$552,283.00
Summary
This study examines the effect of length of hospital admission for refeeding, prior to manualised outpatient family therapy on outcomes for patients with anorexia nervosa. Subjects will include sixty children and adolescents aged 10 to 18 years admitted to the Children's Hospital at Westmead for medical management of anorexia nervosa. This study aims to randomly allocate and compare outcomes between adolescents with anorexia nervosa admitted for medical stabilisation followed by outpatient famil ....This study examines the effect of length of hospital admission for refeeding, prior to manualised outpatient family therapy on outcomes for patients with anorexia nervosa. Subjects will include sixty children and adolescents aged 10 to 18 years admitted to the Children's Hospital at Westmead for medical management of anorexia nervosa. This study aims to randomly allocate and compare outcomes between adolescents with anorexia nervosa admitted for medical stabilisation followed by outpatient family therapy versus adolescents admitted for full weight restoration followed by outpatient family therapy. Physical and psychological outcomes will be measured at admission to hospital, at the end of the hospital treatment and at the completion of outpatient family therapy and 6 and 12 months after the completion of treatment.Read moreRead less