The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less
Cognitive Behaviour Therapy For Posttraumatic Stress Disorder In Police Officers
Funder
National Health and Medical Research Council
Funding Amount
$190,255.00
Summary
Posttraumatic stress disorder (PTSD) is a significant anxiety disorder that affects many serving police officers. Although cognitive behaviour therapy (CBT) is the treatment of choice to treat PTSD, it has never been validated in police offcers. This project represents the first controlled trial of applying CBT to reduce PTSD in police officers.
Australia has limited systems in place to identify, then reduce or withdraw (disinvest) ineffective or inappropriate health care practices. Such practices result in sub-optimal care and inefficient use of scarce resources. Disinvestment models are few and have not been tested in Australia. We will develop a novel, systematic policy framework by linking policy, clinical, patient and community members as partners in the decision process for disinvesting (or not) selected health care practices.
The Diamond Cohort Study- Examining Depressive Symptoms In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$570,886.00
Summary
Depression is the single largest cause of disability for people in Australia. It is mainly managed in general practice-primary care, yet many people experiencing depression go unrecognised by their family doctor or general practitioner (GP). Some people, even when given treatment, remain depressed. Guides on how to manage depression have been mainly based upon people attending psychiatrists and hospitals. In addition, there have been a number of large studies overseas testing new ways of helping ....Depression is the single largest cause of disability for people in Australia. It is mainly managed in general practice-primary care, yet many people experiencing depression go unrecognised by their family doctor or general practitioner (GP). Some people, even when given treatment, remain depressed. Guides on how to manage depression have been mainly based upon people attending psychiatrists and hospitals. In addition, there have been a number of large studies overseas testing new ways of helping people with depression. Unfortunately, they do not seem any better than usual care by a GP. We are currently funded by the NHMRC for diamond 1 to follow 800 people to investigate the factors from the patient's and doctor's point of view that are likely to aid recovery from depression, and to detail the way in which people are cared for in the primary health care system. There is increasing research showing that depression is a chronic and relapsing condition and that a one-year follow-up, whilst longer than most previous studies, will capture only a small glimpse of the health service use and relapse patterns of the patients enrolled in our study. In this application, we request funding to continue to follow participants. diamond 2 aims to explore the patient characteristics and health service use patterns of patients who experience persistent major depression with patients who experience a single episode of depression within a 3-year period. We will use the data gathered to develop models that predict recovery-relapse-persistence of depression. Such models will enable us to develop guidelines and design interventions that better target those at risk of continuing and disabling illness. This work will be of international significance and has the potential to influence the entire primary mental health care system and contribute to substantial system change.Read moreRead less
Randomised Trial Of Continuity Of Nursing Care In Vascular Surgery
Funder
National Health and Medical Research Council
Funding Amount
$190,648.00
Summary
Both overseas (Bruni, Hoosier-Paty and Hoffman 1996) and in Australia (Norman, Semmens, Laurence-Brown and Holman, under review), surgeons have become increasingly aware of the need to improve outcomes for patients undergoing arterial surgery for the lower limb. Unlike other areas of health care reform such as cardiac surgery or breast cancer, there is little confidence that the current links between acute facilities, community-based health services and general practice, work optimally together. ....Both overseas (Bruni, Hoosier-Paty and Hoffman 1996) and in Australia (Norman, Semmens, Laurence-Brown and Holman, under review), surgeons have become increasingly aware of the need to improve outcomes for patients undergoing arterial surgery for the lower limb. Unlike other areas of health care reform such as cardiac surgery or breast cancer, there is little confidence that the current links between acute facilities, community-based health services and general practice, work optimally together. Peripheral vascular disease is rarely studied. In NSW, there are about 4200 inpatient episodes for arterial surgery for ischaemia of the lower limb each year (AN-DRG 228 - 232), the majority involving older men. This study brings together a multi-disciplinary team of CIs comprising an academic nurse, two vascular surgeons and an expert in outcomes evaluation to conduct a randomised trial (n-586) of continuity of nursing care for patients admitted for arterial surgery of the lower limb. The intervention is comprised of a 'Patient Stay' Flowchart, continuing postoperative in-patient nursing assessment and staff consultation, Patient Education Discharge Booklet, Patient - Family Care Plan; proactive and reactive telephone follow-up and extensive GP liaison. Blinded outcome evaluation at six and twelve months will compare its differential effectiveness against usual care to which only the Patient Stay' Flowchart has been added. We will generate Level 2 evidence for the effectiveness of continuity of nursing care in improving outcomes for patients undergoing arterial surgery for ischaemia of the lower limb. To our knowledge, this would be the first Australian efficacy trial of its type.Read moreRead less