Current Projects
Nurse-led follow up phone calls for patients discharged from acute care facilities: A mixed method evaluation of a post-discharge follow-up phone call intervention in a large local health district in NSW Australia
Receiving a follow up phone call (FUPC) within 24hrs of discharge from all Hunter New England (HNE) hospitals has been implemented variously across the Local Health District since 2013 as part of the Patient Care Essentials program within the Excellence: Evidence Based Leadership Framework. This study aims to evaluate FUPCs to better understand current practices and processes and inform intervention refinement across variable contexts within HNELHD. The RE-AIM theoretical framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) will guide a mixed methods evaluation. Quantitative and text data will be obtained from historical service data and via an online survey of key stakeholder groups with responsibility for FUPCs (Nursing and Midwifery managers and clinicians). Qualitative data will be collected via focus groups with purposively recruited inpatient, ward-based nursing and midwifery clinicians and unit managers, and via telephone interviews with patients who have previously responded to FUPCs.
Team Members:
Dr Sophie Dilworth, Assoc Prof Michelle Giles, Dr Gena Lieschke, Dr John Wiggers, Ms Kamana Bantawa, Ms Evelyn Palominos-Letelier, Ms Stacey Simpson, Mr Michael Fahy, Prof Maralyn Foureur
Awards: HNELHD Excellence awards: Patient safety first category (2024)
Improving emergency care outcomes for rural and remote communities: Examining the effectiveness, feasibility and impact of an embedded emergency department Nurse Practitioner model of care
Due to ongoing workforce deficits in the health sector, particularly in rural and remote regions, access to essential healthcare services including emergency care have been compromised. Challenges with attracting and retaining appropriately qualified medical and nursing staff in these areas has resulted in many health care facilities needing to deploy expensive contingency plans, including the commissioning of out-reach medical services. Emergency department nurse practitioners employed to manage patients presenting to emergency departments with non-life threatening conditions have been reported to be effective in providing timely, effective high quality care that is acceptable to patients and feasible for services to adopt. This study seeks to evaluate if a similar model implemented in four rural emergency departments in Hunter New England Local Health District is an effective, feasible, acceptable and cost-effective approach to maintaining emergency services within rural health jurisdictions.
Team Members:
Assoc Prof Michelle Giles, Mr Michael Fahy, Dr Sophie Dilworth, Dr Christopher Oldmeadow, Prof Jennifer May, Mr Mathew Lutze, Ms Josephine Burton, Prof Maralyn Foureur, Assoc Prof Peter Massey, Dr Gena Lieschke
Developing a sustainable model of research capacity leadership and partnership in the HNE Nursing and Midwifery workforce: HNE CNC/CMC Research Internship
The Nursing and Midwifery CNC/CMC Research Internship and Mentorship program aims to support successful applicants in building research skills and literacy through participation in applied clinical research and mentoring. Research interns will develop their skills in researching clinical practice issues, translational research methods and implementation science. There are two key components in the program; 1) CNC/CMC Internship and 2) Research Mentorship.
The Research workshop is for senior nursing and midwifery (NM) clinicians to build skills in research capacity and leadership. A Research mentorship program links trained mentors with each clinician undertaking the research workshop. The HNE Nursing and Midwifery Research Centre (NMRC) supports and facilitates both the research workshops and the mentorships and work closely with partners (UON, UNE and HNE Nursing and Midwifery Services) to develop a sustainable Community of Research Practice for Nurses and Midwives in HNELHD. This program will be run annually and as a result further building a collaborative HNELHD Nursing and Midwifery Research Community of Practice.
Team Members:
Assoc Prof Michelle Giles, Prof Maralyn Foureur, Prof Vicki Parker, Dr Se Ok Ohr
Evaluating and Optimising Nursing and Midwifery Research in Practice
Despite growing understanding of the role of research in ensuring best practice outcomes, knowledge about the engagement and activity of nurses and midwives in research appears to be limited. Growing emphasis on practice based translational research has impacted on the roles and activity of nurses and midwives more broadly. It is timely and essential to understand how nurses and midwives have responded to this change and to look for ways to enhance their participation in research, with the goal of embedding research expertise and processes and normalising research as integral to nursing and midwifery practice.
This HNELHD wide cross-sectional online survey of all nurses and midwives aims to understand the current Nursing and Midwifery research environment, the skills, resources and opportunities available and the role of nurses and midwives as members of research teams.
Team Members:
Assoc Prof Michelle Giles, Prof Vicki Parker, Dr Se Ok Ohr, Dr Gena Lieschke, Prof Maralyn Foureur, Ms Evelyn Palominos-Letelier, Ms Jean Ball, Ms Kamana Bantawa
Funding: HMRI’s Clinical Research Design, Information Technology and Statistical Support (CReDITSS): $7,500
Publications:
Towards translational research participation for nurses and midwives: a mixed method study, Feb 2022
Partnerships in Aged-Care Emergency services using Interactive Telehealth (PACE-IT) incorporating telehealth visual assessment, information sharing and decision making for people living in residential aged-care facilities (RACF)
This project aims to reduce unnecessary RACF resident presentations to Emergency Department and hospital admissions, strengthen partnerships and decision making between EDs and RACFs, improve communication and increase the skill and confidence of RACF staff and ensure care is delivered by the right person in the right place, and in a timely manner.
The project builds on the pilot project completed at John Hunter Hospital in 2018.
Team Members:
Ms Carla Sunner, Assoc Prof Michelle Giles, Prof Maralyn Foureur, Dr Carolyn Hullick, Ms Roslyn Barker, Ms Jenny Rutherford, Prof Vicki Parker, Dr Rod Ling, Dr Christopher Oldmeadow, Ms Kathryn Cain, Ms Melissa Jolliffe, Ms Miriam Eaton, Dr Se Ok Ohr, Ms Jean Ball, Ms Sophie Dilworth, Ms Kamana Bantawa
Funding: NSW Health Translational Research Grant Scheme (TRGS) ​$751,000.​
Awards: HNE Health Excellence Awards (2021)
Publications:
Implementation and evaluation of a nurse-led intervention to augment an existing residential aged care facility outreach service with a visual telehealth consultation: stepped-wedge cluster randomised controlled trial, December 2023
Does telehealth influence the decision to transfer residents of residential aged care facilities to emergency departments? A scoping review, Nov 2022
Experiences of nurses working in RACFs and EDs utilising visual telehealth consultation to assess the need for RACF resident transfer to ED: A qualitative descriptive study, September 2022
COVID-19 preparedness in aged care: A qualitative study exploring residential aged care facility managers experiences planning for a pandemic, June 2021
PACE-IT study protocol: a stepped wedge cluster randomised controlled trial evaluating the implementation of telehealth visual assessment in emergency care for people living in residential agedcare facilities, July 2020
The HealthTracker Project
Tracking surgical site infection post caesarean section through post hospital discharge surveillance.
This project aims to more accurately identify post Caesarean Section surgical site infection (CS SSI) with improved access to data, establishing a baseline and ongoing monitoring across HNELHD. This in turn will stimulate action from health services aimed at preventing post CS SSI. The proposed "Healthtracker" surveillance system facilitates active patient-reported SSI identification through an automated SMS linking women to an individualised online SSI survey.
Team members:
Assoc Prof Michelle Giles, Dr Se Ok Ohr, Ms Sally Munnoch, Ms Mandy Hunter, Mr Jeff Deane, Prof Maralyn Foureur, Assoc Prof John Ferguson, Mr Patrick Cashman, Dr Andrew Woods, Dr Christopher Oldmeadow
Funding: HNELHD Improvement Project Grant $26,378; HMRI Statistical support grant $7,500
Awards: HNE Health Excellence Awards (2021)
Publications:
Effectiveness of HealthTracker for post-caesarean section surgical site infection surveillance: An intervention study, March 2024
What gets measured gets noticed. Tracking surgical site infection post caesarean section through community surveillance: A post intervention study protocol, May 2021
NMRC Research Internship Projects
What are the mentoring needs of Nurse Practitioners (MNoNP) in a large health district in NSW: A mixed methods approach
Pressure on NSW health care services arising from increasing demand and diminished workforce has been a driving factor behind the increasing numbers of Nurse Practitioners (NP) employed across various health care contexts. Central to these roles' original development and deployment has been the requirement for supportive networks and active mentorship. However, there are no mentorship programs, and no understanding of the NP mentoring needs, nor has there been an assessment of available supporting networks across the range of services and sites.
This study aims to identify NP and TNP mentoring needs across the continuum of experience stages and develop a mentoring needs assessment tool. The assessment tool will inform individualised mentoring needs to design a mentoring program for NP and TNP unique requirements.
Team Members:
Mr Anthony Sokolowski, Dr Sophie Dilworth, Prof Vicki Parker, Mr Michael Fahy
Exploration of the experience of ‘personal recovery’ for consumers discharged from long stay mental health rehabilitation
After a period of long stay mental health rehabilitation in hospital, many people with serious mental illness moved to live in the community under the Pathways to Community Living Initiative (PCLI). It is expected that each person has their own experience of community living. Through interviews with at least eight people, their experience of transitioning into the community will be explored and recorded. The data will be analysed and will potentially provide rich narrative and lessons learned from the transition process. It may provide an opportunity for the consumer to tell their story and describe the quality of their life in the community from their individual personal experience. This project has the potential to inform future research and create further opportunity for ongoing organisational enhancement to improve clinical practice for consumers transitioned under the PCLI program.
Team Members:
Ms Tanya Nelson, Dr Se Ok Ohr, Mr Antony Mullen, Assoc Prof Peter Massey, Mr Arun Sen
Pre - term neonatal Surgical wounds: Current and best practice
Infants born prematurely have a higher risk of morbidity and mortality and more susceptible to a variety of complication in comparison to those infants born at full term. Pre-term neonates may require surgical intervention therefore surgical wound management within the Neonatal Intensive Care Unit (NICU) is critical. Appropriate surgical wound management is imperative in decreasing the risk of any further complications associated from surgical wounds. At present there is no pre-term neonatal surgical wound management guidelines or current practice consensus in John Hunter Children’s Hospital NICU. Project Pre - term neonatal Surgical wounds: Current practice is a study that will ask NICU Clinical Nurse Consultants (CNC), Nurse Practitioners, Paediatric Surgeons and Neonatal Intensivists who are seen and considered content experts within this field for their expert opinions regarding surgical wound management of pre- term neonates. Findings of the study will inform to develop a Practice Guideline within the Pre-term surgical wound management within the NICU. Development of this guideline will ensure better surgical NICU standards of wound management care, less risk for health care workers and an overall consensus in practice.
Team Members:
Ms Ilana Haseltine, Ms Krischelle York, Ms Justine Parsons, Mr Antony Mullen, Dr Se Ok Ohr, Assoc Prof Peter Massey
The Contraceptive Choice Study in Birra-Li Community
In order to respect and appreciate the capacity of our First Australians to determine their own health needs and to implement processes to address these needs, this project aims to engage with the local Aboriginal community which is served by the Birra Li Aboriginal Maternal and Infant Health Service (AMIHS), to explore the issue of an immediate postnatal contraceptive option to be provided prior to discharge from hospital.
Guided by a Cultural and Clinical advisory team and in partnership with a project co-lead from the community, members of the community will be invited to participate in one or more yarning groups to explore “what are your thoughts about contraception in the immediate postnatal period and while the mother and baby are still in hospital?”
Team Members:
Ms Gwen McKenzie, Dr Gena Lieschke, Ms Kelly Drury, Ms Sarah Corrigan
Understanding baRriers and Enablers to Delirium scREening and diagnoSiS in the adult intensive care unit
This research study aims to understand the barriers and enablers to delirium screening and diagnosis as perceived by clinical staff of the ICU, in order to inform recommendations for how to embed the delirium screening tools into routine clinical practice within the John Hunter Hospital adult ICU.
Team Members:
Ms Amber Poulter, Mr Kelvin Smith, Assoc Prof Michelle Giles, Dr. Gena Lieschke, Dr. Gary Crowfoot, Dr. Rebecca Tee, Ms Sarah Dalton
The evaluation of new outpatient models of care for pregnant women experiencing Hyperemesis Gravidarum in HNELHD
The study aims to evaluate the model of care program by measuring uptake of the program, emergency department re-presentations and management of symptom severity for women experiencing hyperemesis gravidarum. The study will collect qualitative and quantitative data using interviews and clinical data audit. Data will be analysed using thematic analysis and descriptive statistical analysis. The findings of the study will contribute to the review of the program and improvement of care options for women experiencing hyperemesis gravidarum in HNELHD and NSW.
Team Members:
Ms Rachel Upton, Assoc Michelle Giles, Prof Maralyn Foureur, Dr Ginger Chu
Evaluating opportunities to target delirium prevention, in the older surgical patient: A Retrospective cohort study
The study aims to identify the incidence of, and risk factors associated with the development of delirium, in older people with a traumatic isolated hip fracture at John Hunter Hospital, NSW Australia.
Team Members:
Ms Remia Bruce, Assoc Prof Michelle Giles, Dr Gena Lieschke, Dr Garry Crowfoot, Ms Leanne Pike