Amanda J Ullman

Amanda J Ullman
The University of Queensland | UQ · School of Nursing and Midwifery

RN, PhD

About

185
Publications
43,712
Reads
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2,019
Citations
Citations since 2016
152 Research Items
1925 Citations
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Introduction
Dr Amanda Ullman is Professor and Chair in Paediatric Nursing, conjoint between Children’s Health Queensland and the University of Queensland. Supported by the NHMRC, Fulbright Senior Scholarship, Cancer Council Queensland and the Children’s Hospital Foundation, her research focuses on the prevention of complications associated with paediatric hospital admissions, especially those related to central venous access devices.
Additional affiliations
January 2005 - September 2011
Lady Cilento Children’s Hospital
Position
  • Clinical Nurse Researcher

Publications

Publications (185)
Article
Background Peripheral intravenous catheters (PIVCs) are ubiquitous in acute care settings however failure rates are unacceptably high, with around half failing before prescribed treatment is complete. The most effective dressing and securement option to prolong PIVC longevity is unclear. Objectives To determine feasibility of conducting a definiti...
Article
Highlights: Compare effectiveness of chemical disinfectants in reducing S. aureus. Five disinfectants reduced the bacterial load, especially chlorhexidine solutions. Focus on Brazilian clinical practice of needleless connector disinfection. Purpose: This study aimed to gain further knowledge about the comparative effectiveness of chemical disinf...
Article
Background and objectives: Long peripheral catheters (LPCs) are emerging vascular access devices used for short-medium term vascular access needs. Literature in adults suggests LPCs have longer dwell-times than peripheral intravenous catheters (PIVs) and lower rates of serious complications than peripherally inserted central catheters (PICCs). The...
Article
The optimal approach for peripheral intravenous catheter (PIVC) insertion in adult hospitalised patients with difficult intravenous access (DIVA) is unknown. The present study aimed to critically appraise the quality of (i) assessment instruments and (ii) clinical practice guidelines (CPGs) or escalation pathways for identifying and managing patien...
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Background: Pediatric extravasation injuries are significant healthcare-associated injuries, with sometimes significant sequelae. Evidence-based guidance on management is necessary to prevent permanent injury. Purpose: A systematic review of the literature, including aggregated case series, investigating extravasation injury management of hospit...
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Objective: This review will evaluate the effectiveness of checklists in multidisciplinary rounds compared with multidisciplinary rounds without checklists, regarding mortality and patient safety. Introduction: Single studies have demonstrated that checklists can potentially improve communication of care between health professionals, reduce adver...
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Background: Needleless connectors (NCs) are essential devices designed to provide safe, needle-free connection between venous access devices, syringes and infusions. There is a variety of designs, and associated decontamination products and practices; the resulting confusion can cause detrimental patient outcomes. This study aimed to explore nurse...
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Purpose: This study aimed to gain further knowledge about the comparative effectiveness of chemical disinfectants in reducing the bacterial load of NCs inoculated with S. aureus. Methods: Disinfection of needleless connectors was undertaken in vitro against Staphylococcus aureus comparing 70% isopropyl alcohol (IPA), 70% ethanol, 0.5% and 2% chlorh...
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Background Our study aims to explore the experience of having a central venous access device (CVAD) from the perspective of the child and family and how movements within and outside of hospital environments influence this experience. Methods A mixed-methods study was conducted across Children’s Health Queensland (Australia), including inpatient an...
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Background: Paediatric peripheral intravenous catheter (PIVC) insertion using traditional landmark insertion technique can be difficult. Aim: To systematically review the evidence comparing landmark to ultrasound guidance for PIVC insertion in general paediatric patients. Study design: Cochrane methodology to systematically search for randomis...
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Background: Family-centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID-19). Aims: To evaluate...
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Objective To develop and validate a difficult intravenous access risk assessment and escalation pathway, to increase first time intravenous insertion success in paediatrics. Methods Mixed methods underpinned by literature and co-production principles. Iterative development of the instrument was informed through semi-structured interviews and stake...
Article
Background: Central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD complications in children with cancer, preventative strategies are understudied. Objective: The aim of this study was to assess study feasibility, occlusive events, thrombolytic use, adverse events, and direct costs of cat...
Article
Aim: To synthesise evidence related to medical adhesive tapes and supplementary securement products for peripheral intravenous catheters in adults, to prevent complications and device failure. Design: Integrative review informed by Whittemore and Knafl and reported in accordance with the PRISMA 2020 statement. Data sources: The Cochrane Centra...
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Background Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited. Methods A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the ope...
Article
Introduction Peripheral venous catheters (PVCs) are used to administer antimicrobials, but many fail prior to completion of therapy. While some antimicrobials are known to increase PVC failure, risk profiles for many are unclear. Objective To synthesise data from prospective PVC studies conducted between 2013–2019, to determine associations betwee...
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Introduction Peripheral intravenous catheters (PIVCs) frequently fail during therapy administration, resulting in infusates pooling in the surrounding tissue. These extravasation injuries can cause significant pain, tissue destruction and scarring. ivWatch is a biosensor that uses visible and near-infrared light to measure tissue changes surroundin...
Article
Objective The objective of this study was to audit current patient blood management practice in children throughout cardiac surgery and paediatric intensive care unit (PICU) admission. Design This was a prospective observational cohort study. Setting This was a single-centre study in the cardiac operating room (OR) and PICU in a major tertiary ch...
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Objectives The aim of this study was to examine patient perceptions regarding vascular access quality measurement.MethodsA web-based, cross-sectional survey was performed using a convenience sample of healthcare consumers with vascular access experience, recruited from September 2019 to June 2020. Survey respondents were asked to rate the perceived...
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Objectives Endotracheal suction is an invasive airway clearance technique used in mechanically ventilated children. This article outlines the methods used to develop appropriate use criteria for endotracheal suction interventions in mechanically ventilated paediatric patients. Methods The RAND Corporation and University of California, Los Angeles...
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Background/objective Endotracheal suction is an invasive and potentially harmful technique used for airway clearance in mechanically ventilated children. Choice of suction intervention remains a complex and variable process. We sought to develop appropriate use criteria for endotracheal suction interventions used in paediatric populations. Methods...
Article
The use of the RAND/UCLA appropriateness method is an innovative way to provide practical, evidence based clinical guidance to infection preventionist (IP) in the absence of clinical trial data. This brief primer aims to introduce the IP to the methodology, including a short case study demonstrating the utilisation of the method in the arena of inf...
Article
Objective: Insertion and function of pediatric peripheral intravenous catheters (PIVCs) present challenges. We systematically reviewed techniques and technologies to improve PIVC outcomes (first-time insertion success, overall insertion success, time to insertion, dwell time, failure, and complications). Data sources: Cochrane Central Register o...
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Background Childbirth is a normal, physiological process, yet intervention is common. Arguably the most common intervention is the insertion of a peripheral intravenous catheter; however, there are few studies guiding best practice. This study aimed to describe current intravenous catheter insertion practice, explore clinician decision-making durin...
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Objective To determine the incidence of adverse events (AEs) associated with umbilical catheters in the neonatal population. Study design Systematic review and meta-analysis of observational studies and randomized controlled trials published between 2010 and 2020. Results In total 14,226 umbilical venous catheters (UVCs) and 4228 umbilical arteri...
Article
Background Family-centered care (FCC) has been successfully incorporated into daily practice in many neonatal intensive care units (NICUs) worldwide. However, the implementation of FCC in lower-resourced settings, such as Thailand, can be challenging and needs to be further explored. Aims and objectives To identify parents' and interdisciplinary p...
Article
Background Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Objectives Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve...
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Background Central venous catheters are prone to infectious complications, affecting morbidity, mortality and healthcare costs. Polyhexamethylene biguanide-impregnated discs at the catheter insertion site may prevent local and bloodstream infection; however, efficacy has not been established in a critical care setting. Objective The objective of t...
Article
Introduction Adverse events associated with umbilical catheters include malposition, bloodstream infections, thrombosis, tip migration, and extravasation, resulting in loss of vascular access and increased risk of morbidity and mortality. There is a need for greater understanding of risk factors associated with adverse events to inform safe practic...
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Background: The optimal intravenous device for antibiotic administration for children with respiratory disease is uncertain. We assessed the feasibility of a randomized controlled trial (RCT) comparing midline catheters with peripherally inserted central catheters (PICCs). Methods: Prospective, 2-arm, feasibility RCT in an Australian tertiary, p...
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Objective: To examine the effectiveness of antimicrobial and antithrombogenic materials incorporated into peripherally inserted central catheters (PICCs) to prevent bloodstream infection, thrombosis, and catheter occlusion. Methods: Prospective cohort study involving 52 hospitals participating in the Michigan Hospital Medicine Safety Consortium....
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Introduction Peripherally inserted central catheters (PICCs) are vital for the delivery of medical therapies, but up to 30% of PICCs are associated with complications such as deep vein thrombosis or infection. The integration of antimicrobial and hydrophobic catheter materials, and pressure-activated valves, into polyurethane PICCs are innovations...
Article
Background The approach to vascular access in children with CHD is a complex decision-making process that may have long-term implications. To date, evidence-based recommendations have not been established to inform this process. Methods The RAND/UCLA Appropriateness Method was used to develop miniMAGIC, including sequential phases: definition of s...
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Objective: to construct a mobile application in the mobile-learning format that favors learning, offering support to the nurse's clinical reasoning and decision-making in the prevention of adverse events related to the peripherally inserted central catheter in pediatrics. Method: the construction of the mobile-learning technological production took...
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Background Sepsis is a leading cause of death and disability in adults and children. Evidence suggests that early recognition and management can significantly improve patient outcomes, therefore education of healthcare workers around sepsis is critical. Little is known about the preparation of final year nursing students regarding recognition and r...
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en Aims The aim of this systematic review and meta‐analysis was to summarize and quantify peripheral intravenous catheter‐related complications. Design This systematic review is reported by means of the Cochrane process for randomized controlled trials and the Meta‐analysis of Observation Studies in Epidemiology for cohort studies. Data sources...
Article
Introduction Peripheral intravenous catheters (PIVCs) are widely used, but failure is unacceptably common with up to 69% failing before treatment is complete. PIVC securement reduces failure, but the optimal way to achieve this is unclear. Tapes and supplementary securement products are widely used, however rigorous testing of these to reduce PIVC...
Article
Background Transfusion of red blood cell (RBC) concentrates is a common procedure to restore blood volume and tissue oxygen delivery in patients with trauma. Although RBC warmers may prevent hypothermia, some warming or infusion equipment may lead to haemolysis and patient injury. Objectives The aim of this study was to test the effect of (i) RBC...
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Background: Data regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset. Methods: A modified Delphi study with three rounds (two electronic s...
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Background: To evaluate the feasibility of an efficacy trial comparing a hydrophobic polyurethane peripherally inserted central catheter (PICC) with a standard polyurethane PICC. Methods: This pilot randomised controlled trial (RCT) was conducted between May 2017 and February 2018. Adult participants (n = 111) were assigned to hydrophobic polyur...
Article
Background The peripheral intravenous catheter (PIVC) is the most frequently used invasive medical device. PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, delays in treatment, increased health care costs and even death. Undergraduate nurses assess and manage PIVCs as part of the...
Article
Aim Central venous access devices (CVADs) are vital medical devices to support the treatment of paediatric cancer; however, device occlusion is common, which disrupts treatment. This study aimed to improve the identification and management of CVAD occlusions in children with cancer, as well as to identify the demographic, clinical and device charac...
Article
Highlights: There is a wide variance in neonatal and pediatric vascular access workforce models, training, and competency assessments. Pain control during procedures is critical for children, yet it is not consistently used. Procedural support has shown improved patient outcomes, yet is not standardly used for every distressful procedure. Core sta...
Article
Background Peripherally inserted central catheter tip placement at the cavoatrial junction is associated with reduced catheter-related deep vein thrombosis . Electrocardiographic tip confirmation purportedly improves accuracy of tip placement, but whether this approach can reduce deep vein thrombosis is unknown. Methods Prospectively collected dat...
Article
Background Critically ill patients in an intensive care setting often require arterial catheters for blood pressure monitoring and arterial blood collection. Arterial catheter failure, which manifests in both mechanical and infective forms, remains common. Dressing and securement inadequacies may impact this failure; however, the best method for dr...
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Full-text available
Pilot randomized controlled trial (180 patients) of needleless connector decontamination. Central line-associated bloodstream infection occurred in 2% (1/61) of 70% isopropyl alcohol (IPA) wipe, 2% (1/59) of 70% IPA cap, and zero (0/58) infections in 2% chlorhexidine gluconate in 70% IPA wipe patients. Larger definitive trials are feasible and need...
Article
Background: Peripherally inserted central catheters are susceptible to microbial colonisation and subsequent biofilm formation, leading to central line-associated bloodstream infection, a serious peripherally inserted central catheter-related complication. Next-generation peripherally inserted central catheter biomaterials, such as hydrophobic mat...
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Objective: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). Data sources: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. Study selection: C...
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Objectives: To describe the methodology undertaken to provide guidance on the appropriateness, as well as inappropriateness, of vascular access device selection, characteristics, and insertion technique for pediatric patients. Methods: The RAND Corporation-University of California, Los Angeles Appropriateness Method was used. After definition of...
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Objectives: Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device char...
Article
Background: Despite evidence to support best practice in neonatal and pediatric venipuncture delivery and procedural support, there are inconsistencies in practice. To inform future research, education, and workforce innovation, the Association for Vascular Access Pediatric Special Interest Group (PediSIG) developed and undertook a survey to descri...
Article
Aim Evaluate the feasibility of an efficacy randomised control trial (RCT) of paediatric peripheral intravenous catheter (PIVC) securement to prevent failure without resultant skin damage. Methods A 3-arm, pilot RCT in an XX paediatric hospital. Random assignment of 330 children to receive (i) bordered polyurethane dressing (BPU) + non-sterile foa...
Article
Background Interventions to support psychological recovery after critical illness, including information provision via an intensive care unit (ICU) diary or discharge summary, have been widely adopted in some regions, albeit without strong empirical evidence. Objective The objective of this study was to examine the feasibility and acceptability, f...
Article
Introduction: Central venous access devices (CVADs) are a vital medical device for intensive care (ICU) patients; however, complications and failure are common, yet potentially prevented through effective dressings and securement. Objectives/aims: The objective of this study was to test the feasibility of a randomised controlled trial (RCT) comp...
Article
Background High-quality paediatric nursing research is needed to inform and advance nursing practice. To date there has not been a systematic description of the current state of Australian paediatric nursing research. Aim The aim of this study was to identify and describe demographic, professional, and research characteristics of Australian nurses...