This study will collect information from the records of 3000 children from 30 hospitals presenting after a head injury in 2016 and will interview staff to look at different factors influencing the care provided. APHIRST-Gap is expected to provided crucial information on scan rates and inform strategies, including national guideline development to standardise and improve the care of children with head injury across Australia and New Zealand.
Head injury is a common reason children present to Emergency Departments in Australia and New Zealand. While most are minor the important issue for emergency clinicians is to determine whether a particular child is at risk of a serious head injury such as a bleed on the brain. A computerised tomography(CT) scan is the investigation of choice to look for these injuries. Its use is not without risks though, including those of sedation, and radiation induced cancer.
Several “rules” have been designed to guide doctors in the decision between risk of injury and risk of scan. The recently published Australasian APHIRST study examined three of these rules in our context. It found that all three rules performed well, clinicians made good judgements on who to scan, and the overall rate of CT scan use was low(10%). APHIRST was limited to 10 large metropolitan, and predominately children specific hospitals. Most children in Australia are not seen in these hospitals. Further research is required to determine whether there is a large variation in scan use between different hospitals and how best to apply these findings to a broader range of hospitals.
This trial is being run by the PREDICT network and the Principal Investigator is A/Prof Franz Babl.READ MORE
Domestic and family violence (DFV) against women is the number one cause of hospitalisations in Australian girls and women aged 15-54 years. It is also the number one cause of death and disability in women aged 15 to 44. Although most victims of fatal DFV access health services in the 24 months prior to their deaths, many victims living with DFV go unnoticed in the community. Health care providers are well placed to identify DFV victims and refer them to appropriate services. The ED has been described as a good place to undertake identification of DFV victims in several published research papers. Yet, how to do this remains controversial, and there are no standard protocols in place in our EDs. In this project, we aim to describe the current DFV health practice culture in five Queensland EDs. Knowledge, beliefs, and attitudes, as well as what’s actually happening to detect cases of DFV, will be assessed among our front-line ED social workers, nurses, and doctors. We aim to determine how many presentations to ED are identified and referred to social worker services for DFV. Ultimately, this research will both raise awareness about the potential of the ED to detect DFV, and will help pave the way forward to a well-informed and structured ED DFV screening program for Queensland, with applicability internationally.READ MORE
Fractures of the metacarpal bones are the most common hand injuries. Fractures through the neck of the 5th metacarpal (little finger hand bone) account for the majority of these. They are known as Boxer’s Fractures, as they are often sustained during a punch. Boxer’s fractures are traditionally managed in plaster, but in recent years there has been some suggestion that to simply ‘tape’ the little and ring fingers together will allow similar recovery with the advantage of full mobilisation. Currently there is not enough evidence to recommend one treatment over another. Potential benefits of buddy taping include: earlier return to work, less time spent in emergency, simple community follow up at the patient’s discretion. There is an economic benefit for the patient (they don’t miss work through being in a cast) and for the hospital (less time in ED and no need for orthopaedic follow up).
Our study is randomised and prospective. We enrol patients in the EDs of Robina and Gold Coast University Hospitals and randomise the patient to either receive a cast or buddy strapping. The patients are followed up in the orthopaedic fracture clinic at 1, 3 and 6 weeks, with phone follow up at 12 weeks. We are measuring hand function (using the quickDASH score of function), pain, satisfaction, economic analysis of return to work and sports, as well as objective strength and movement in the affected hand.
The study will improve the way that we manage a common injury. Patients who previously had to attend multiple busy outpatient clinics will potentially follow up with their GP at their discretion. Where patients would previously have spent 4 weeks in a cast, if buddy taping is effective, they can return to work immediately. This will result in time and resources saved in both the ED (assessment and application of plaster) as well as in orthopaedic outpatients (fewer follow up appointments and no need to replace plasters). Our aim is to optimise the care of our patients in a busy and time-pressured environment, and if the functional outcome is the same in both arms, we can choose the arm that most benefits the long-term economic, and social outcomes.READ MORE
Applying for a grant? Make use of our application guidelines, SmartyGrants guide, application templates and other resources to help make the process easier.
There are also slides available from our Research 102 workshop.Researcher support tools
Find out more about our robust and transparent grant process.Grant process