Fenella J Gill

• RN, PhD, BN, MN, Paed Cert, Grad Cert Tertiary Teaching, FACCCN
• Professor (Associate) at Perth Children'sHospital & Curtin University, Perth, Australia

Family centred care is a shared belief that a child's emotional and developmental needs are best met when the health system involves the family in planning, delivery and evaluation of care. The important role that families contribute to health care outcomes is emphasised throughout the National Safety and Quality Healthcare Service (NSQHS) Standard...

Background: Rapid response systems incorporate concepts of early recognition of patient deterioration, prompt reporting, and response which result in escalation of patient care. The ability to initiate escalation of care is now being extended to families of hospitalized patients. Research aims: To identify the impact of implementation of family-...

Aim: To explore critical care patients and families experiences and seek their input into nurses' postgraduate educational preparation and practice. Background: There is an inconsistency in the expected standard of practice to ‘qualify’ Australian critical care nurses. There has also been a lack of health consumer input in the development of postgr...

Promptly recognising changes in an acutely unwell child’s condition is fundamental to prevent tragic outcomes. Western Australian (WA) healthcare facilities used inconsistent and varied paediatric early warning systems. To improve care consistency, a standardised ESCALATION system, inclusive of family involvement and sepsis recognition, was develop...

Background The ESCALATION system is a novel paediatric Early Warning System that incorporates family involvement and sepsis recognition. This study aimed to assess the feasibility and iteratively refine the ESCALATION system in a variety of hospital settings in preparation for full-service implementation. Methods A series of four multi-methods stu...

Aim The aim of the study was to assess the suitability of an online education package to prepare health professionals to use a new paediatric early warning system. Design Quasi‐experimental mixed methods using co‐production. Methods Participants completed the Package and participated in up to four clinical scenarios. Data were collected using sel...

Background Infants with life-limiting conditions are a heterogeneous population. Palliative care for infants is delivered in a diverse range of healthcare settings and by interdisciplinary primary healthcare teams, which may not involve specialist palliative care service consultation. Objective To synthesise the literature for how palliative care...

Background: Determining research priorities for health services is recommended to better understand health service needs, direct resources, and support translational research. This traditionally involved clinicians, whilst consumer perspectives have been overlooked. Priority-setting partnerships bring together consumers and clinicians to identify r...

Aim: To explore the factors influencing the use of high-flow nasal cannula (HFNC) therapy for infants with bronchiolitis. Design: Qualitative approach using semi-structured interviews. Methods: The semi-structured interviews (face-to-face or virtual) were conducted between September 2020 and February 2021. Deductive content analysis was used t...

Background: Aboriginal children hospitalised with acute lower respiratory infections (ALRIs) are at-risk of developing bronchiectasis, which can progress from untreated protracted bacterial bronchitis, often evidenced by a chronic (>4 weeks) wet cough following discharge. We aimed to facilitate follow-up for Aboriginal children hospitalised with A...

Background: Patient-centred care is widely recognised as a core aspect of quality health care and has been integrated into policy internationally. There remains a disconnect between policy and practice, with organisations and researchers continuing to offer definitions and frameworks to suit the operational context. It is unclear if and how patien...

Background The impact of hospital building design on patients, families and nurses related to nursing care interactions is not well understood. This study reports a pre–post intervention study to understand the effects of the move to a new children’s hospital in Perth, Australia, on nurse workflow activities and on patient, family, and nurse experi...

Purpose To characterise the care management trajectories of infants with life-limiting conditions, who died before 12 months, including clinical decision-making processes, identification of triggers that led to changes in care management from cure-orientated to palliative care and specialist palliative care team involvement. Design and methods Ret...

Aim: The aims of the study were to investigate family and hospital staff views about the use of spring-infusor devices for administration of intravenous antibiotic medications, to examine if the device is acceptable and feasible and to map a process for implementation. Design: A qualitative study with a pragmatist approach, within a larger, mixe...

Aim: To determine the prevalence of high flow nasal cannula (HFNC) therapy in infants presenting to hospital in Australia and New Zealand with bronchiolitis over four bronchiolitis seasons. Secondary aims were to determine temporal trends in HFNC use, and associations between HFNC, hospital length of stay (LOS) and intensive care unit (ICU) admiss...

Background First Nations children hospitalised with acute lower respiratory infections (ALRIs) are at increased risk of future bronchiectasis (up to 15–19%) within 24-months post-hospitalisation. An identified predictive factor is persistent wet cough a month after hospitalisation and this is likely related to protracted bacterial bronchitis which...

Purpose Priority settings are important to plan and direct future research. The aim of this study was to identify the top ten pediatric and child health nursing research priorities from the perspectives of consumers, community, and healthcare professionals in Western Australia. Design and methods This study used an adapted James Lind Alliance Prio...

Aims: This feasibility study aimed to systematically identify and address the support needs of parents of children with life-limiting illnesses and to assess whether the systematic approach was acceptable and relevant to parents. Methods: The CSNAT (Paediatric) intervention consisted of two assessment visits with the paediatric palliative care t...

Aims and objectives To explore the perspectives of family members of Aboriginal children about a) their involvement in recognising clinical deterioration in a hospital setting and b) the effectiveness of a poster designed to promote family involvement. Background To assist in the early recognition and response to clinical deterioration for hospita...

Background Among Aboriginal children, the burden of acute respiratory tract infections (ALRIs) with consequent bronchiectasis post-hospitalisation is high. Clinical practice guidelines recommend medical follow-up one-month following discharge, which provides an opportunity to screen and manage persistent symptoms and may prevent bronchiectasis. Med...

Aim The aim of this study was to develop an evidence-based paediatric early warning system for infants and children that takes into consideration a variety of paediatric healthcare contexts and addresses barriers to escalation of care. Methods A three-stage intervention development framework consisted of Stage 1: evidence review, benchmarking, sta...

The impact of child health research can be far reaching; affecting children’s immediate health, their adult health, the health of future generations and the economic wellbeing of countries. Consumer and community involvement is increasingly recognised as key to successful research recruitment. Systematic approaches to research recruitment include r...

Background The optimal duration of infusion set use to prevent life-threatening catheter-related bloodstream infection (CRBSI) is unclear. We aimed to compare the effectiveness and costs of 7-day (intervention) versus 4-day (control) infusion set replacement to prevent CRBSI in patients with central venous access devices (tunnelled cuffed, non-tunn...

The impact of child health research can be far reaching; affecting children’s immediate health, their adult health, the health of future generations and the economic wellbeing of countries. Consumer and community involvement is increasingly recognised as key to successful research recruitment. Systematic approaches to research recruitment include r...

Background Provision of paediatric palliative care is complex and optimally covers meeting the individual needs of a heterogenous population of children and their parent caregivers throughout a life-limiting illness. It is unclear whether existing approaches comprehensively address parent caregivers’ needs. Aim To examine support needs of parents...

Background Parents of children with life-limiting illnesses experience considerable burden and distress, yet few interventions have targeted their well-being. Objectives Evaluate the use and feasibility of the Paediatric Carer Support Needs Assessment Tool (pCSNAT) in assessing and addressing parents’ needs caring for cancer and non-cancer conditi...

Objective: The objective of the review was to identify, critically appraise and synthesize evidence on the impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency. Introduction: A key strategy to facilitate effective communication between limited-English-profici...

Aim Linguistic diversity is increasing nationally; patients with limited English proficiency require provision of professional interpreters. We reviewed hospital‐wide use of interpreters for low English proficiency in a tertiary hospital across emergency (ED), outpatient and inpatient presentations. Methods Two cohorts with low English proficiency...

Problem: Priority setting for pediatric nursing is important to plan, coordinate and direct future research. The aim of this scoping review was to systematically identify and synthesise the nature, range and extent of published pediatric nursing research priorities. Eligibility criteria: English language full text publications focusing generic n...

Objective To evaluate the implementation of an intervention for parents to escalate care if concerned about their child's clinical condition. Design Mixed‐methods health‐care improvement approach guided by the Theoretical Domains Framework. Methods Implementation of the ‘Calling for Help’ (C4H) intervention was informed by previously identified b...

The cover image is based on the Original Research Paper Barriers and facilitators to implementing a process to enable parent escalation of care for the deteriorating child in hospital, by Fenella J. Gill PhD, RN, FACCCN et al., DOI 10.1111/hex.12806.

Abstract Objectives: To review and synthesise international literature to reveal the contemporary structures, processes and outcomes of critical care nurse (CCN) education. Method: An integrative review on specialist critical care education was guided by Whittemore and Knafl’s integrative review steps: problem-identification; literature search; and...

Position statements are used by large organisations such as the Australian College of Critical Care Nurses to publically present an official philosophy or beliefs and to propose recommendations. Position statements are increasingly used by health departments and healthcare facilities to allocate resources and to guide and audit nursing practice, ye...

Objective To identify barriers and facilitators to implementing a parent escalation of care process: Calling for Help (C4H). Design Audits, semi‐structured interviews and focus groups guided by the Theoretical Domains Framework. Setting Australian paediatric hospital where a parent escalation of care process was introduced in the previous 6 month...

Aim To identify neonatal nurses’ self-reported practices, knowledge and attitudes toward premature infant pain assessment and management. Method An exploratory cross sectional mixed methods survey. Findings Of the 127 surveys distributed, 86 were returned (68% response rate). Those with postgraduate education had higher knowledge and reported mor...

Aim: A discussion of the findings from a nationwide study of workplace and well-being issues of Australian nurses and midwives. Background: Current discourse only provides a fragmented understanding of a multifaceted nature of working conditions and well-being, necessitating a more holistic investigation to identify critical workplace issues wit...

Background: Bronchiolitis is the commonest respiratory infection in children less than 12 months and cause of hospitalisation in infants under 6 months of age in Australasia. Unfortunately there is substantial variation in management, despite high levels of supporting evidence. This paper reports on the process, strengths and challenges of the hyb...

Objectives: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. Design: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) valida...

Aim: This paper compares two qualitative approaches used to thematically analyse data obtained from focus groups conducted with critical care nurses from Australia. Background: Focus groups are an effective mechanism to generate understanding and gain insight into the research participants' world. Traditional verbatim transcription of participan...

Review question/objective The overall objective is to identify, critically appraise and synthesize evidence on the impact of professional interpreters on outcomes for hospitalized children (aged 0–18 years) from migrant and refugee families with low English proficiency. More specifically, does the intervention of the use of a professional interpret...

Background: Observational work to develop the ACCCN Competency Standards was undertaken more than 20 years ago. Since then the landscape of critical care nursing as a specialty has changed and it is not known if the Competency Standards reflected contemporary practice. Objectives: To revise the ACCCN Competency Standards for Specialist Critical...

Aims and objectivesTo investigate medical and nursing staff's perceptions of and self-confidence in facilitating family presence during resuscitation in a paediatric hospital setting. Background Family presence during resuscitation is the attendance of family members in a location that affords visual or physical contact with the patient during resu...

Mitchell, M* and Gill, F* and Grealy, B* and McCutcheon, C* and Greenwood, M and Tramm, R*, “ACCCN Position Statement - Partnering with Families in Critical Care”, ACCCN Position Statement - Partnering with Families in Critical Care, Australian College of Critical Care Nurses Ltd, Australia, pp. 1-7.

The 2nd edition of the ACCCN Competency Standards was published in 2002. It is almost 20 years since data collection was undertaken for the 1st edition. In 2013-2015 a second revision was undertaken. Nurses from the critical care community were invited to participate in the Standards Revision Project that was conducted in two phases. For phase on...

This poster explains the knowledge translation project on the implementation of a parent activated Medical Emergency Team

Poster explaining the development of the SPECT

Background: Nurses working in critical care often undertake specialty education. There are no uniform practice outcomes for critical care programs, and consumer input to practice standards has been lacking. Methods: A structured multiphase project was undertaken to develop practice standards and an assessment tool informed by critical care nursi...

Aims and objectivesTo develop critical care nurse education practice standards.Background Critical care specialist education for registered nurses in Australia is provided at graduate level. Considerable variation exists across courses with no framework to guide practice outcomes or evidence supporting the level of qualification.DesignAn eDelphi te...

Aim: This paper is a report of the comparison of perceptions of family-centred care by hospital staff (nurses, doctors and allied health staff) and parents of hospitalised children in 2 Australian tertiary paediatric hospitals. Background: Family-centred care is an accepted approach to caring for children and their families in hospital. Previous pu...

Background Preparation of specialist critical care nurses in Australia is at graduate level, although there remains considerable variation in courses offered in relation to qualification, content, assessment and outcomes. As higher education providers must now comply with the Australian Qualifications Framework (AQF) a study was conducted to examin...

Aim The purpose of this project was to explore the existing attitudes and level of understanding of nurses and midwives towards co-bedding multiples (twins and higher order multiples) in a large Australian, tertiary level, Neonatal Unit. Method A purposefully designed anonymous survey was first piloted and then distributed to nurses and midwives w...

This study examined nurses' reported compliance with the medication administration protocol and explored reasons for noncompliance. A mixed-methods design incorporated a questionnaire (n= 72) and focus groups (n= 24). Differences were found between the level of experience and protocol compliance. Noncompliance was widespread in the checking of iden...

Unlabelled: The aim of this paper is to review the differences and similarities in critical care nursing staffing, education and practice standards in the US, Canada, UK, New Zealand and Australia. Search methods: A university library discovery catalogue, Science Direct, Scopus databases and professional websites were searched. Key terms used in...

Purpose. This study examined nurses’ reported compliance with the medication administration protocol and explored reasons for noncompli- ance. Design and Method. A mixed-methods design incorporated a question- naire (n = 72) and focus groups (n = 24). Results. Differences were found between the level of experience and protocol compliance. Noncompli...

There is a lack of evidence to direct and support nursing practice in the specialty of paediatric intensive care (PIC). The development of national PIC nursing research priorities may facilitate the process of undertaking clinical research and translating evidence into practice. To (a) identify research priorities for the care of patients and their...

A Perth metropolitan hospital group standardized changes to nasogastric tube placement, including removal of the "whoosh test" and litmus paper, and introduction of pH testing. Two audits were conducted: bedside data collection at a pediatric hospital and a point-prevalence audit across seven hospitals. Aspirate was obtained for 97% of all tests an...

Internationally, the assessment of nursing clinical performance has remained a challenge at undergraduate and postgraduate level. The clinical performance assessment tool (CPAT) was developed to measure paediatric intensive care (PIC) and adult critical care (ACC) postgraduate nursing students' developing clinical performance. The CPAT was based up...

In October 1998, the Australian College of Critical Care Nurses (ACCCN) launched a model to credential specialist level critical care nurses. This model was ‘road tested’ during a pilot study, when experienced critical care nurses were invited to apply to become the first Australian credentialled critical care nurses. The pilot study was designed t...