Australian health review : a publication of the Australian Hospital Association
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Objective The aim of this study was to evaluate the prevalence of psychiatric morbidity, alcohol use, burnout and compassion satisfaction among physician trainees in New South Wales, Australia, and examine links between personal, demographic and lifestyle factors. Methods A total of 67 physician trainees were recruited to the study. Fifty-nine completed the online survey (88% response rate). ⋯ What does this paper add? This paper adds to the evidence of psychiatric morbidity, burnout, secondary trauma and increased demographic data on a cohort of junior doctors undertaking speciality training. In addition, it provides reasons for not seeking help and positive and negative coping methods used by these junior doctors. What are the implications for practitioners? The level of distress is high and requires system changes to support both individual health measures and structural change to work and study programs.
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Objective Risk factors and clinical outcomes of non-index hospital readmissions (readmissions to a hospital different from the previous admission) have not been studied in Australia. The present study compared characteristics and clinical outcomes between index and non-index hospital readmissions in the Australian healthcare setting. Methods This retrospective cohort study included medical admissions from 2012 to 2016 across all major public hospitals in South Australia. ⋯ Unlike other studies, the present study found no immediate adverse outcomes for patients readmitted to non-index hospitals, but 30-day outcomes were worse than for patients who had an index hospital readmission. What are the implications for practitioners? Non-index hospital readmissions may not be totally preventable due to factors such as ambulance diversions stemming from emergency department overcrowding and prolonged emergency department waiting times. Patients should be advised to re-present to hospital in case they experience recurrence or relapse of a medical condition, and preferably should be readmitted to the same hospital to prevent discontinuity of care.
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Objective The aim of this study was to describe the experiences of communication for staff providing cardiac care for Aboriginal and Torres Strait Islander patients in hospital and discuss potential improvements. Methods Focus group discussions were performed with 58 multidisciplinary staff who provide care for Aboriginal and Torres Strait Islander cardiac patients in two metropolitan and two regional hospitals in South Australia and Northern Territory. Inductive thematic analysis was undertaken to identify staff perceptions of communication challenges and strategies for improvement. ⋯ What does this paper add? This paper discusses the barriers and potential improvements, as identified by hospital staff providing care to Aboriginal and Torres Strait Islander cardiac patients in both metropolitan and regional settings. What are the implications for practitioners? Practitioners should be trained and supported in providing both clinically and culturally safe care for Aboriginal and Torres Strait Islander patients. This requires adequate time, two-way communication and resources to support and facilitate effective communication.
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Objectives The aims of this study were to determine the costs of hospital-acquired pressure injuries (HAPIs) in one local health district in Australia and compare the costs and consequences of an intervention-based program with current practice to reduce HAPI incidence and prevalence. Methods A retrospective cost-consequence analysis was conducted using HAPI incidence rate per occupied bed days, point prevalence rates, Australian Refined-Diagnosis Related Group (AR-DRG) costs and the costs of the program to reduce the HAPI rate. Data were analysed for two phases: preprogram implementation (1 June 2015-1 June 2016) and postprogram implementation (1 August 2016-31 July 2017). ⋯ This paper reports the economic effect of HAPIs, including hospital episode costs per HAPI and length of stay, on one local health district. What are the implications for practitioners? This cost-consequence analysis has shown that the program to reduce HAPIs resulted in a reduction in expenditure and positive patient outcomes. Such a program is potentially transferable to other healthcare settings.
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Objective The aim of this scoping review was to map the literature on the lived experiences of injured workers in Australia in order to better understand the factors that inhibit the transition back to work and improved health. The ultimate aim of the study was to identify areas for further research into workers' compensation systems and practices that are associated with improved occupational rehabilitation outcomes. Methods PubMed, ProQuest, Embase and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for eligible articles published in English in peer-reviewed journals from 2001 to 2017. ⋯ This review also identified a clear need for future research on workers' compensation systems in order to promote evidence-based approaches to best support the occupational rehabilitation of injured workers. What are the implications for practitioners? Evidence suggests a more holistic, biopsychosocial approach is required by practitioners when facilitating an injured worker's recovery and return to work. This approach is also vital when considering legislative reforms, such as workers' compensation systems, processes and practices.