Marie Gerdtz

• La Trobe University

Aim To evaluate a community‐based psychological health and well‐being programme for nurses and midwives. Design Mixed methods programme evaluation. Methods Four studies were included: observational descriptive study (cross‐sectional survey) of the health, well‐being and experiences of previous programme participants (Study 1); observational explo...

Globally, emergency medical services (EMSs) report that their demand is dominated by non-emergency (such as urgent and primary care) requests. Appropriately managing these is a major challenge for EMSs, with one mechanism employed being specialist community paramedics. This review guides policy by evaluating the economic impact of specialist commun...

Objective In 2023, Australian government emergency medical services (EMS) responded to over 4 million consumers, of which over 56% were not classified as an ‘emergency’, at the cost of AU$5.5 billion. We explored the viewpoints of politicians, policymakers, clinicians and consumers on how these non-emergency requests should be managed. Design A re...

Safewards is a multi‐intervention mental health nursing model of practice improvement aimed at preventing and reducing conflict and containment. The use of Safewards has now extended beyond mental health settings. Implementation of Safewards has been reported to be challenging and therefore requires an evidence‐informed and structured approach. Thi...

Nursing graduates require competence in the use of digital health technologies. The Department of Nursing at the University of Melbourne has integrated an Electronic Medical Record (EMR) training platform into the entry-to-practice curriculum to enhance students’ digital literacy. The Case Based Learning (CBL) software, developed by CSIRO and the U...

Pressure injuries affect 1 to 46% of residents in aged care (long term) facilities and cause a substantial economic burden on health care systems. Remote expert wound nurse consultation has the potential to improve pressure injury outcomes; however, the clinical and cost effectiveness of this intervention for healing of pressure injuries in residen...

Background Cognitive and implicit biases negatively impact clinicians’ decision-making capacity and can have devastating consequences for safe, effective, and equitable healthcare provision. Internationally, health care clinicians play a critical role in identifying and overcoming these biases. To be workforce ready, it is important that educators...

Pressure injuries affect 13.1% to 45.5% of patients in the intensive care unit and lead to pain and discomfort for patients, burden on healthcare providers, and unnecessary cost to the health system. Turning and positioning systems offer improvements on usual care devices, however the evidence of the effectiveness of such systems is still emerging....

Background: Families who perceive themselves as prepared for an impending death experience reduced psychological burden during bereavement. Understanding which interventions promote death preparedness in families during end-of-life care in intensive care will inform future intervention development and may help limit the burden of psychological sym...

Background Whilst there is a sense of holism existing within palliative care practice, what is not clear is the extent to which holism, as applied in recent palliative care practice, has been adequately researched. Currently, no reviews on this topic were identified through systematic and scoping review registries. Aim To identify and describe the...

Background Anecdotal reports suggest that during emergence from anaesthesia, some post–cardiac surgery patients exhibit signs of agitation with concerning clinical features, including hypoxaemia, ventilation dysynchrony, and haemodynamic instability. This clinical phenomenon has not been described in the published literature. Objective We aimed to...

Aim: To determine prevalence, predictors and change over time of nurses' and student nurses' mental health and well-being, and explore nurses' perceptions, barriers and enablers of well-being. Design: Longitudinal mixed-methods survey. Methods: Forty-nine students and registered nurses participated from Victoria, Australia. Data were collected...

Background Increasing demand and limited supply of clinical placements in nursing underscore the need to better understand the role of clinical placements in students' learning. Identifying pedagogically rich activities that support work place learning alongside factors that influence educational outcomes has the potential to optimise professional...

Background The need to mitigate the volume of unplanned emergency department (ED) presentations is a priority for health systems globally. Current evidence on the incidence and risk factors associated with unplanned ED presentations is unclear because of substantial heterogeneity in methods reporting on this issue. The aim of this review was to exa...

Safewards is an internationally adopted framework that provides interventions to reduce conflict and containment in healthcare settings. This systematic review evaluated the effect of Safewards on conflict and containment events in inpatient units and the perceptions of staff and consumers. Quantitative, qualitative, and mixed‐methods studies were...

Aim To describe the common elements of Graduate Entry Master of Nursing curricula and identify a set of standards and quality indicators for benchmarking purposes within and across jurisdictions. Background Internationally, there has been an increase in universities offering Graduate Entry Masters programs in Nursing. Such programs specify a bache...

Background Safety is a priority for organizations that provide maternity care, however, preventable harm and errors in maternity care remain. Maternity care is considered a high risk and high litigation area of health care. To mitigate risk and litigation, organizations have implemented strategies to optimize women's safety. Our objectives were to...

Introduction Australasian emergency departments (ED) routinely test patient alcohol levels following major trauma, but assessment for illicit drugs is uncommon. Methods A prospective cross-sectional study of major motor-vehicle-related trauma patients attending both adult major trauma centres in Victoria, Australia. All eligible patients had point...

Background The contribution of work to positive mental health is increasingly apparent. Transition into the workplace causes a range of stressors for new graduate nurses who experience both psychological wellbeing and illbeing in their first year of practice. Objective To determine published prevalence, predictors, barriers and enablers of new gra...

Background The wellbeing of individuals influences organisational outcomes. Insight into nurses’ wellbeing is crucial to a sustaining a high-quality workforce. Aim To describe nurses’ perceptions and experiences of wellbeing, work wellbeing, and mental health. Method Using a qualitative descriptive design, semi-structured interviews were conducte...

Objective Undergraduate nursing students may experience high levels of stress, anxiety or depression. This can not only influence their personal wellbeing and academic performance, but also communication with patients during clinical placement and the quality and safety of the healthcare delivered. The objective of the review was to identify interv...

Aim To synthesize Registered Nurses’ self‐reported perceptions and experiences of psychological well‐being and ill‐being during their first year of practice. Design Qualitative meta‐synthesis. Data sources Databases included Cumulative Index of Nursing and Allied Health Literature, Excerpta Medica database, Medical Literature Analysis and Retriev...

Introduction Safewards is an organisational approach to delivering inpatient mental health services. The aim of Safewards is to minimise the number of situations in which conflict arises between healthcare workers and patients that lead to the use of coercive interventions (restriction and/or containment). The Safewards Model has been developed, im...

Behavioural assessment units (BAU) have been established in emergency departments (EDs) to provide short-term observation, treatment, and care to people experiencing acute behavioural disturbance. A prospective observational study was conducted in a cohort of adult patients admitted to one BAU located within an ED (July-December 2017) to compare cl...

• Objective Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and criticall...

Amphetamine‐type stimulant use, including methamphetamine, amphetamine, and 3,4‐methylenedioxymethamphetamine, is associated with a range of behavioural symptoms. Screening for amphetamine‐type stimulant use among people presenting to the emergency department with behavioural disturbance and referral to treatment has not been evaluated. The objecti...

Objective: To determine the prevalence of illicit substance use among patients presenting to one ED with acute behavioural disturbance using point-of-care saliva testing. Methods: A prospective observational study was conducted. Acute behavioural disturbance was defined as any episode requiring a security response for unarmed threat (Code Grey)....

This exciting new book is the first of its kind to offer an analysis of Service Navigation and provide a framework for understanding the role and its application across a range of fields of practice. With an emphasis on the participation of individuals in their own care, it directly addresses the recent changes in policy and service development in...

Objective: To determine current clinical practices for managing behavioural emergencies within Victorian public hospital EDs. Methods: A multi-centre retrospective study involving all patients who attended ED in 2016 at the Alfred, Ballarat, Dandenong, Geelong and Royal Melbourne Hospitals. The primary outcome was the rate of patient presentatio...

Abstract Background Emergency department (ED) presentations made by patients having cancer treatment are associated with worse outcomes. This study aimed to explore the socio-demographic and disease related characteristics associated with ED presentation, frequent ED presentations, and place of discharge for cancer patients receiving systemic cance...

Objective: To evaluate the use of management plans for people who frequently attend the emergency department (ED). Background: Management plans are used to decrease ED utilisation by people who frequently attend. There is limited evidence regarding the use management plans for this population and the perspectives of staff who use them has previo...

The aim of the study was to evaluate the maintenance of the 30° side‐lying lateral tilt position among aged care residents at the risk of developing pressure injuries when using the standard care pillow and a purpose‐designed positioning device. An observational study was conducted. Participants were monitored during positioning under two condition...

Pressure injuries are prevalent in highly dependent aged care residents. This study investigated the clinical effectiveness of the application of the Mepilex Border Sacrum and Mepilex Heel dressings to prevent the development of facility‐acquired pressure injuries. A total of 288 recently admitted residents were enrolled from 40 Australian nursing...

Background: The number of natural disasters occurring worldwide has increased, including Indonesia, a country that continues to experience natural disasters of varying level of severity. Despite this evidence, limited information is available about nurses’ disaster preparedness in Indonesia particularly in community settings. This study aims to ide...

Objective: We aimed to assess the impact of a new model of care for patients presenting to the ED with acute behavioural disturbance. Methods: This pre-/post-intervention study involved creating a dedicated, highly resourced six bed unit, the behavioural assessment unit (BAU). Co-located with the ED at the Royal Melbourne Hospital, the unit was...

Introduction: Internationally and independent of clinical area. Patient and visitor Aggression (PVA) is a threat to the physical and psychological health and wellbeing of healthcare professionals, to patient safety and quality of care. Moreover, PVA incurs substantial financial cost. Increasing numbers of patients with secondary psychiatric diagnos...

Objectives: Behavioral emergencies are commonly seen in emergency departments. Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and staff. While the experience of staff caring for this population has been reported, patients' experiences wit...

Alcohol and Other Drug (AOD) education amongst hospital staff is often inadequate. This leads to suboptimal care of patients and is a missed opportunity for early identification and treatment. This integrative review evaluates the core features of current education for hospital-based doctors and nurses in AOD, including country of origin, content,...

Aims and objectives: This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Background: Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a dir...

Rationale, aims and objectives: As patients move across transition points, effective medication management is critical for patient safety. The aims of this study were to examine how health professionals, patients and family members communicate about managing medications as patients moved across transition points of care and to identify possible so...

Objective: Critically ill patients are at high risk of developing pressure ulcers (PU), with the sacrum and heels being highly susceptible to pressure injuries. The objective of our study was to evaluate the clinical effectiveness of a new multi-layer, self-adhesive soft silicone foam heel dressing to prevent PU development in trauma and criticall...

Aims and objectivesTo examine the challenges and opportunities of undertaking a video ethnographic study on medication communication among nurses, doctors, pharmacists and patients.Background Video ethnography has proved to be a dynamic and useful method to explore clinical communication activities. This approach involves filming actual behaviours...

Background There is no clear treatment pathway for people presenting to Australian emergency departments with deliberate self-harm. PurposeTo explore variations in mental health nurses' disposition decisions for patients following risk assessment for deliberate self-harm. Design and MethodA survey was distributed to mental health nurses. This surve...

Aims and objectivesTo explore how health professionals, patients and family members communicate about managing medicines across transition points of care in two Australian public hospitals.Background Medicines errors are common at transition points of care. Little qualitative work has targeted communicating about medicines management across patient...

Background: Research on patient aggression in hospital emergency departments supports the development of a systematic process for identifying individuals at risk of becoming violent. The feasibility and community acceptance of this approach is unknown. In this study, we determine the feasibility and explore the need for a violence risk screening p...

Emergency department mental health triage is a complex clinical task for which the evidence base is minimal. Research in the past decade has consistently identified issues associated with the accuracy and consistency of mental health triage assessment. In this study, we investigated the predictive validity of the clinical descriptors in the Victori...

Physical environments of clinical settings play an important role in health communication processes. Effective medication management requires seamless communication among health professionals of different disciplines. This paper explores how physical environments affect communication processes for managing medications and patient safety in acute ca...

Triage systems provide a centralised safety mechanism where all patients are assessed for clinical urgency at point of entry to the ED. The present study aims to evaluate the effect of a multifaceted intervention on triage documentation rates and guideline adherence. A before-and-after design was used. The intervention involved restructuring the co...

Little is known about the cost-benefit of soft silicone foam dressings in pressure ulcer (PU) prevention among critically ill patients in the emergency department (ED) and intensive care unit (ICU). A randomised controlled trial to assess the efficacy of soft silicone foam dressings in preventing sacral and heel PUs was undertaken among 440 critica...

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a met...

The prevention of hospital acquired pressure ulcers in critically ill patients remains a significant clinical challenge. The aim of this trial was to investigate the effectiveness of multi-layered soft silicone foam dressings in preventing intensive care unit (ICU) pressure ulcers when applied in the emergency department to 440 trauma and criticall...

The participation of service users in all aspects of mental health service delivery including policy development, service planning and evaluation is increasingly an expectation of contemporary mental health care. Although there are a growing number of publications reporting service-user perspectives in the evaluation of mental health services, litt...

Background Mental health related presentations are common in Australian Emergency Departments (EDs). We sought to better understand ED staff knowledge and levels of confidence in treating people with mental health related problems using qualitative methods. Methods This was a qualitative learning needs analysis of Australian emergency doctors and...

To explore ED staff perceptions of the factors that influence accuracy of triage for people with mental health problems. This qualitative learning needs analysis used a descriptive exploratory design. Participants were Australian emergency nurses and doctors. We used a criterion-based sampling approach. Recruitment was facilitated by the College of...

Mental health clinicians working in emergency crisis assessment teams or mental health triage roles are required to make rapid and accurate risk assessments. The assessment of violence risk at triage is particularly pertinent to the early identification and prevention of patient violence, and to enhancing the safety of clinical staff and the genera...

b>Aims and objectives. The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Background. Recent global trends indicate an increased reliance on tele...

Communication plays a crucial role in the management of medications. Ward rounds are sites where health professionals from different disciplines and patients come together to exchange medication information and make treatment decisions. This article examines power relations and spatial practices surrounding medication communication between patients...

Communication is central to safe medication management. Handover is a routine communication forum where nurses provide details about how patients' medications are managed. Previous studies have investigated handover processes as general communication forums without specific focus on medication information exchange. The effects of social, environmen...

To prospectively evaluate the accuracy of a predictive model to identify homeless people at risk of representation to an emergency department. A prospective cohort analysis utilised one month of data from a Principal Referral Hospital in Melbourne, Australia. All visits involving people classified as homeless were included, excluding those who died...

Violence and aggression remain a significant issue for nursing staff in emergency departments. Although there is literature on the increasing number of incidents, impact on nursing staff and the need for prevention, there is no model for violence risk screening at point of entry. Violence risk screening is a prevention strategy that aims to identif...

S32 not to screen is the subject of considerable international debate. Semi-structured interviews, supplemented with the Composite Abuse Scale (CAS) were conducted with 30 women, 12 weeks after an ED visit. These formed three groups: group A had screened positive for DV, group B had screened negative and group C had not been screened. The CAS indic...

LIU W, MANIAS E and GERDTZ M. Nursing Inquiry 2011; 18 : 290–302 Understanding medication safety in healthcare settings: a critical review of conceptual models Communication can impact on the way in which medications are managed across healthcare settings. Organisational cultures and the environmental context provide an added complexity to how comm...

The study aimed to describe: (i) the perceived barriers faced by emergency clinicians in the assessment and management of patients presenting with a mental health complaint to Australian hospital EDs; and (ii) perceived strategies to optimize care of the mentally unwell in the ED. Semistructured interviews with open and closed question formats were...

To identify the mental health-related learning needs of doctors and nurses working in Australian EDs. A purpose-designed survey was developed, and face validity was verified by 12 doctors and nurses. A cross-sectional survey of a national sample of nurses and senior doctors (registrars and consultants) working in EDs across Australia was then under...

Homeless people face many challenges in accessing and utilising health services to obtain psychosocial supports offered in hospital and community settings. The complex nature of health issues is compounded by lack of accessibility to services and lack of appropriate and safe housing. To examine the perceptions and experiences of homeless people in...

Mental health literacy (MHL) is the term used to describe people's knowledge and beliefs about mental disorders which aid in the recognition, management or the prevention of illness. Health professionals' levels of MHL will shape the therapeutic relationship in which they work in partnership with patients. Studies have been conducted in Australia a...

This study aimed to describe the perceived barriers faced by emergency clinicians in utilising mental health legislation in Australian hospital emergency departments. A semi-structured interview methodology was used to assess what barriers emergency department doctors and nurses perceive in the operation of mental health legislation. Key findings f...

To describe patterns of service use and to predict risk factors for re-presentation to a metropolitan emergency department (ED) among people who are homeless. A retrospective cohort analysis was undertaken over a 24-month period from a principal referral hospital in Melbourne, Australia. All ED visits relating to people classified as homeless were...

Objective. We explored perspectives of emergency department users (patients and visitors) regarding the management of acute behavioural disturbances in the emergency department and whether these disturbances influenced their levels of anxiety. Methods. Emergency department patients and visitors were surveyed using the State-Trait Anxiety Inventory,...

Introduction. We aimed to describe perceptions of Australian emergency clinicians of differences in management of mental health patients in rural and remote Australia compared with metropolitan hospitals, and what could be improved. Methods. Descriptive exploratory study using semi-structured telephone interviews of doctors and nurses in Australian...

Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countr...

Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countr...

As patients move across transition points of care, medication discrepancies are likely to occur. In the emergency department (ED), patients are vulnerable to medication discrepancies because they are in an environment in which rapid decisions need to be made under high levels of stress. To identify the patient-, environment-, and medication-related...

To examine the influence of the nurse, the type of patient presentation and the level of hospital service on consistency of triage using the Australasian Triage Scale. A secondary analysis of survey data was conducted. The main study was undertaken to measure the reliability of 237 scenarios for inclusion in a national training programme. Nurses we...

To measure levels of anxiety among people accompanying consumers to the emergency department and to explore how anxiety influences satisfaction with care. When people seek treatment in an emergency department they are often accompanied by a next-of-kin, family member or friend. While the accompanying person plays a vital role in providing psycho-so...