Julie Considine

Deakin University

Recognising and responding to deteriorating patients is the cornerstone of emergency care. Whilst rapid response systems (RRSs) have been in place on hospital wards for decades, the use of local RRS in emergency departments (EDs) is increasing and the use of both aggregate scoring systems and single-parameter systems has been reported. In this chap...

Background Given the increasing global prevalence of obesity, the International Liaison Committee on Resuscitation (ILCOR) commissioned this scoping review to explore current evidence underpinning treatment and outcomes of obese patients (adult and children) in cardiac arrest. Methods This scoping review, conducted using Arksey and O’Malley’s fram...

Objectives Evidence‐based tools are needed to support aged care nurses in recognising and responding to changes in residents' conditions and clinical deterioration. Systematised emergency nursing frameworks such as HIRAID® ( H istory including I nfection risk, R ed flags, A ssessment, I nterventions, D iagnostics, reassessment and communication) as...

Background The health issues experienced by older people can often be severe and complex, and an increasing number are using residential aged care services to meet their care needs. High-quality nursing care is fundamental to the health and safety of aged care residents and is contingent on nurses’ accurate assessment, informed decision-making, and...

Aim To explore and describe acute care nurses' partnership with patients to recognise and respond to changes in patients' clinical states. Acute care nurses' decisions to partner with patients to recognise deterioration in clinical states and to respond by activating a rapid response system improves patient outcomes. Acutely unwell patients can als...

Hospital discharge is a pivotal point in healthcare delivery, impacting patient outcomes and resource utilisation. Ineffective discharge processes contribute to unplanned hospital readmissions. This study explored hospital discharge process from the perspectives of patients, caregivers, and healthcare staff. Qualitative data were collected through...

Background Gaps in discharge planning are experienced by 41% of hospital patients in Australia. There is an established body of knowledge regarding the features of the discharge process that need to be improved to avoid subsequent hospital readmission and enhance the discharge experience. However, many of these studies have focused solely on factor...

Objective This study aimed to explore patient and nurse perceptions of using a prototype co-designed app to support patient–nurse communication and patient engagement in bedside handover. Methods This qualitative descriptive study evaluated usability of the app with a convenience sample of patient–nurse dyads in a 22-bed medical/oncology ward, duri...

Aim To develop an evidence‐driven, behaviour change focused strategy to maximise implementation and uptake of HIRAID (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) in 30 Australian rural, regional and metropolitan emergency departments. Design An embedded, mixed‐methods study....

Aim To explore and describe acute care nurses’ decisions to recognise and respond to improvement in patients’ clinical states as they occurred in the real‐world clinical environment. Design A descriptive study. Methods Nine medical and eleven surgical nurses in a large Australian metropolitan hospital were individually observed during nurse–patie...

Background Implementing evidence that changes practice in emergency departments (EDs) is notoriously difficult due to well-established barriers including high levels of uncertainty arising from undifferentiated nature of ED patients, resource shortages, workload unpredictability, high staff turnover, and a constantly changing environment. We develo...

Introduction: The Utstein reporting template classifies the etiology of OHCA into “presumed cardiac” and “obvious non-cardiac” or “medical” and “non-medical” categories; however, the accuracy of these classifications is unclear. Ascertaining more accurately the etiology of OHCA is important to tailor advanced life support and identify etiologically...

Objective Transformational leadership benefits both patients and staff. The objective of this scoping review was to explore personal and organisational attributes that support transformational leadership in acute health care. Methods A scoping review was undertaken using Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Me...

Aim(s): To explore the published research related to nurses' documentation and use of vital signs in recognising and responding to deteriorating patients. Design: Scoping review of international, peer-reviewed research studies. Data sources: Cumulative Index to Nursing and Allied Health Literature Complete, Medline Complete, American Psycholog...

Background There is debate whether nurses are active enough stemming from differences in measurement tools, clinical contexts, and nursing tasks. A descriptive case study concerning the use of device-based measures in combination with direct observation is presented to examine the effect of the nursing context and the discrepancies between differen...

The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Sc...

Background At a time when many families were sheltering at home, frontline healthcare workers (FHWs) worldwide continued to work in the community, often under significant stress. While it has been well documented that frontline work during the COVID-19 pandemic has had impacts on healthcare workers’ mental and physical health, the impacts on their...

Background The COVID-19 pandemic changed the face of modern healthcare, with impacts felt by staff and organisations alike. Globally, hospital-based healthcare workers have identified increased stress, anxiety, insomnia, and reduced wellbeing related to their work roles. Hospitals have been plagued by increased demand, poor staff retention and a re...

Background Behavioural and psychological symptoms of dementia are a group of non‐cognitive symptoms such as agitation, physical aggression, depression, sexual disinhibition and psychosis. Therapeutic approaches vary because of the multifactorial and complex symptomology. The researchers of this study aimed to systematically review the nonpharmacolo...

Objective To explore clinicians' use and perceptions of interdisciplinary communication pathways for escalating care within the pre-medical emergency team (pre-MET) tier of rapid response systems.MethodA sequential mixed-methods study was conducted using observations and interviews. Participants were clinicians (nurses, allied health, doctors) cari...

Aim: The study aim was to evaluate the feasibility and efficacy of a digital App developed to enhance patient communication with nurses during bedside nursing handover at shift change. Methods: Six nurses and 11 patient actors/volunteers participated in 12 simulated nursing handovers across six simulation workshops. Over half the patients were a...

Aim(s): To explore vital sign assessment (both complete and incomplete sets of vital signs), and escalation of care per policy and nursing interventions in response to clinical deterioration. Design: This cohort study is a secondary analysis of data from the Prioritising Responses of Nurses To deteriorating patient Observations cluster randomise...

Bed and chair alarms have been included in many multifaceted falls prevention interventions. None of the randomised trials of falls alarms as sole interventions have showed significant effect on falls or falls with injury. Further, use of bed and chair alarms did not change patients’ fear of falling, length of hospital stay, functional status, disc...

Introduction Emergency department (ED) overcrowding is a global problem and a threat to the quality and safety of emergency care. Providing timely and safe emergency care therein is challenging. To address this in New South Wales (NSW), Australia, the Emergency nurse Protocol Initiating Care—Sydney Triage to Admission Risk Tool (EPIC-START) was dev...

Aim: To determine the impact implementation of Emergency Department Clinical Emergency Response System (EDCERS) on inpatient deterioration events and identify contributing causal factors. Methods: EDCERS was implemented in an Australian regional hospital, integrating a single parameter track and trigger criteria for escalation of care, and emerg...

Objective: International standards of end-of-life care (EOLC) intend to guide the delivery of safe and high-quality EOLC. Adequately documented care is conducive to higher quality of care, but the extent to which EOLC standards are documented in hospital medical records is unknown. Assessing which EOLC standards are documented in patients' medical...

Objective We aim to examine the activities undertaken by medical and surgical ward nurses at a major health service in Victoria, Australia, to inform nursing and midwifery strategic workforce planning.Methods This descriptive, exploratory study was conducted on 17 wards from three acute care hospitals in one of Victoria's largest health services. T...

Objective: Intensive care nurses care for critically ill patients in a complex, fast paced environment. Management of noradrenaline (norepinephrine) is core business for intensive care nurses and nurse decision-making on noradrenaline is poorly understood. The study objective was to investigate decision-making processes nurses use when caring for...

Background: The pre-medical emergency team (pre-MET) tier of rapid response systems facilitates early recognition and treatment of deteriorating ward patients using ward-based clinicians before a MET review is needed. However, there is growing concern that the pre-MET tier is inconsistently used. Objective: This study aimed to explore clinicians...

Introduction Poor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red fl...

Aim To understand how the COVID‐19 pandemic impacted nurse educators' and novice nurses' experience with the perioperative transition to specialty practice program. Design A qualitative descriptive study. Methods Semi‐structured interviews were conducted with five perioperative nurse educators and five perioperative transition to specialty practi...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

This is the sixth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. This summary addresses the most recently published resuscitation evidence reviewed by International Liaison Committee on Resuscita...

Background: Nurses working in intensive care units make autonomous decisions to manage high-risk vasoactive medications in critically ill patients. Noradrenaline (norepinephrine) is a vasoactive medication commonly administered to patients in intensive care units. The influence of unit culture and environment on nurse-decision-making on noradrenal...

Objective To evaluate complaints from patients, their families, and caregivers concerning nursing and midwifery care using the Healthcare Complaints Analysis Tool.MethodsA prospective cross-sectional study with data coded against the domains and categories outlined in the Healthcare Complaints Analysis Tool. Complaints were received between June an...

Aim ****** Objective To conduct a systematic review of the published evidence related to family presence during adult resuscitation from cardiac arrest. Methods This review, registered with PROSPERO (CRD42021242384) and reported according to PRISMA guidelines, included studies of adult cardiac arrest with family presence during resuscitation that...

Objectives: To develop and validate a prediction model to estimate the risk of Medical Emergency Team (MET) review, within 48 hours of an emergency admission, using information routinely available at the time of hospital admission. Design: Development and validation of a multivariable risk model using prospectively collected data. Transparent Re...

Background Medical emergency team (MET) afferent limb failure is the presence of MET triggers and the absence of a documented MET call. Objectives The aim of this study was to measure and understand the frequency and nature of MET afferent limb failure in patients with documented vital sign abnormalities in an Australian major teaching hospital....

Introduction : Blunt chest injury in older adults, aged 65 years and older, leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes in older adults with blunt chest injury. Methods : ChIP comprised multidimensional i...

Background Most hospitals use physiological signs to trigger an urgent clinical review. We investigated whether facilitation could improve nurses’ vital sign measurement, interpretation, treatment and escalation of care for deteriorating patients. Methods In a pragmatic cluster randomised controlled trial, we randomised 36 inpatient wards at four...

Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and thei...

Background: Patient isolation is widely used as a strategy for prevention and control of infection but may have unintended consequences for patients. Early recognition and response to acute deterioration is an essential component of safe, quality patient care and has not been explored for patients in isolation. Primary aims of this study were to:...

Aims The aim of this study was to explore clinician–patient engagement during, and patient experience of, medical emergency team (MET) reviews. Design This study involved a convergent mixed-methods design. Methods This three-phase study was conducted at two hospitals of one Australian health service. Reviews by the MET were observed for clinician...

Objective The aim of this study was to describe the epidemiology of pre-medical emergency team (pre-MET) reviews, including patient characteristics, the frequency and nature of triggers and interventions and in-hospital outcomes.Methods An exploratory retrospective cohort study was performed using a medical record audit. Fifty orthopaedic and gener...

Background Patients are at risk of deterioration on discharge from an emergency department (ED) to a ward, particularly in the first 72 h. The implementation of a structured emergency nursing framework (HIRAID) in regional New South Wales (NSW), Australia, resulted in a 50% reduction of clinical deterioration related to emergency nursing care. To d...

Background Assessing and managing the risk of clinical deterioration is a cornerstone of emergency care, commencing at triage and continuing throughout the emergency department (ED) care. The aim of this scoping review was to assess the extent, range and nature of published research related to formal systems for recognising and responding to clinic...

Aim To perform a systematic review of cardiopulmonary resuscitation (CPR) and/or defibrillation in the prone position compared to turning the patient supine prior to starting CPR and/or defibrillation. Methods The search included PubMed, Embase, Web of Science, Cochrane, CINAHL Plus, and medRxiv on December 9, 2020. The population included adults...

Aims and Objectives To determine if the use of an emergency nursing framework improves the accuracy of clinical documentation. Background Accurate clinical documentation is a nursing professional responsibility essential for high-quality and safe patient care. The use of the emergency nursing framework “HIRAID” (History, Identify Red flags, Assess...

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Tre...

The International Liaison Committee on Resuscitation initiated a continuous review of new, peer-reviewed published cardiopulmonary resuscitation science. This is the fifth annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Tre...

Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury—respiratory support, analgesia and complication prevent...

Background Most investigations of nurses’ and midwives’ psychological wellbeing during the COVID-19 pandemic have been conducted in a single setting. Aim To assess and compare the psychological wellbeing of nurses and midwives in Australia and Denmark during the COVID-19 pandemic. Methods Nurses and midwives employed at four metropolitan health s...

Background : The COVID-19 pandemic significantly disrupted health services and their staff, including nursing and midwifery educators. Nursing and midwifery educators were tasked with meeting nurses’ and midwives’ rapidly-changing educational requirements, and supporting the nursing and midwifery workforce through the pandemic. Thus, nursing and mi...

Background Vasoactive medications are high-risk drugs commonly used in intensive care units (ICUs), which have wide variations in clinical management. Objectives The aim of this study was to describe the patient population, treatment, and clinical characteristics of patients who did and did not receive vasoactive medications while in the ICU and t...

Background Isolation is effective in preventing transmission of infectious disease. However, it has been shown to have negative effects including increased anxiety and poor physical outcomes. Objectives To summarize the effects of interventions to improve safety and outcomes for patients in isolation Design Systematic review (PROSPERO protocol re...

Topic Patients with acute coronary syndrome undergoing primary percutaneous coronary intervention are at risk of clinical deterioration that results in similar general signs and symptoms regardless of its cause. However, specific causes and forms of clinical deterioration are associated with key differences in assessment findings. Focused clinical...

Aims and objectives: To explore: i) the frequency and nature of patient participation in nursing handover and ii) patients' and nurses' perceived strategies to enhance patient involvement in nursing handover. Background: Patient participation in nursing handover is important for patient-centred care, shared decision-making, patient safety and a...

Background: Team-based learning (TBL) is an evidence-based, highly structured teaching strategy. Purpose: The purpose of this review was to explore the specific TBL structure and process design elements reported in nursing education studies. Methods: A scoping review was undertaken according to Preferred Reporting Items for Systematic Reviews...

AimsThis study aimed to quantify the health economic treatment costs of clinical deterioration of patients within 72 hours of admission via the emergency department. Methods This study was conducted between March 2018 and February 2019 in two hospitals in regionl New South Wales, Australia. All patients admitted via the emergency department were s...

Background Patients are at risk of deterioration on discharge from an emergency department (ED) to a ward, particularly in the first 72 hours. The implementation of a structured emergency nursing framework (HIRAID) in regional New South Wales (NSW), Australia, resulted in a 50% reduction of clinical deterioration related to emergency nursing care....