COVID-19 has impacted healthcare provision in Australian emergency departments (EDs). Infection control precautions, including isolation of patients with respiratory symptoms and methodical use of Personal Protective Equipment (PPE), are of paramount importance to reduce the risk of transmission within the healthcare setting.
Patients presenting to Australian EDs with epidemiological or clinical features suggesting risk of COVID-19 illness are isolated into a physically separate, high risk-zone (HRZ) within the ED. Entry into HRZ is restricted to essential staff wearing appropriate personal PPE. Consequently, interactions between patients and clinicians, particularly allied health, are limited.
Mobile robotic telepresence (MRT) has the potential to maintain quality of care while facilitating contactless communication between patients and staff in the HRZ and the external multidisciplinary team. MRT is a wifi-enabled wheeled devices with audio-video capabilities controlled remotely by a clinician. This study aims to determine the feasibility of using MRT to support clinical care in the HRZ of the ED.READ MORE
Health workers are at increased risk of exposure and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). The implications of healthcare worker infection are wide-reaching and impact not only the worker, but also have implications for nosocomial spread in the pre-symptomatic phase and depletion of the skilled workforce required to manage an increased volume of presentations.
Front-line health care workers represent a unique cohort to follow for trends in SARS-CoV-2 infection, immune response and antibody production as well as monitoring for re-infection. Understanding the implications of staff infection on the potential for long-lasting immunity is of key significance to staff and leaders of EDs. Equally, understanding of asymptomatic staff infection can inform policy regarding routine screening of staff to minimise the risk of nosocomial spread to other staff and patients.READ MORE
Since COVID-19 was declared a pandemic by the World Health Organization (WHO), the elderly population globally have been identified as a vulnerable group, yet there is limited literature exploring the effect of pandemics on Emergency Department (ED) presentations in this cohort.
Healthcare systems have rapidly adapted and made changes to prepare for a potential healthcare crisis that has largely targeted our frail older population. The impact of the pandemic and changes in health care delivery need to be evaluated, to ensure the measures taken did not have unforeseen negative consequences and subsequent positive consequences.
This research aims to describe the clinical profiles, patterns of presentations and factors associated with outcomes of patients, aged 60 years and over, presenting to Queensland EDs before, during and after the COVID-19 pandemic. The results of this study will assist clinicians and policymakers to better respond to the challenges of acute care provision for this complex population during future pandemics.READ MORE
COVID-19 is an infectious respiratory pathogen with significant capacity to spread within the healthcare environment which has been highlighted by the number of healthcare staff internationally that have died or suffered significant morbidity through transmission while caring for patients. Guidelines recommend distancing between healthcare staff and patients and the need for personal protective equipment (PPE).
The majority of hospitalised and unwell patients with COVID-19 will receive some type of respiratory support, however very little is known in regard to how differing devices mitigate or exacerbate spread of respiratory droplets during coughing. Inadequate information has led to restrictions on certain types of therapies being offered to patients at risk for COVID-19. This study aims to clarify the extent of environmental contamination from droplet spread during coughing and the effect of different types of standard respiratory support on this.READ MORE
Reports worldwide indicate there has been a change in the cohort of patients seen within hospital emergency departments (EDs) during COVID-19, with fewer presentations for non-COVID symptoms, such as chest pain.
This study will evaluate the impact of COVID-19 on Queensland EDs by reviewing the number and nature of patient presentations, and generate a comprehensive statewide evidence-base to understand and manage patients who require emergency care during a global pandemic. It is expected that results will inform future management strategies and guiding documents generated in the event of a ‘second wave’, or other large scale disaster.READ MORE
Paediatric peripheral intravenous cannula (PIVC) insertion is a frequently performed procedure in the emergency department (ED), which can result in significant distress for both the child and caregiver, particularly when there are multiple attempts. Children with difficult intravenous access (DIVA) are generally poorly recognised but several studies have developed prediction tools. Furthermore, the use of ultrasound (US) has been demonstrated to improve the success rate of paediatric DIVA patients when used as an adjunct.
This research will shine a spotlight on current practice in the largest mixed ED in Queensland, which aims to determine factors contributing to paediatric DIVA patients and attitudes towards the use of US to assist first pass success. Furthermore, this background data will lay the foundation to inform an interventional trial using US to improve PIVC practices for children in the ED. Novice researchers in this project will be well supported by a research team with a strong track record of completing projects that can impact patient careREAD MORE
People with type 1 diabetes (T1D) require ongoing insulin administration. Insufficient administration results in hyperglycaemia and then diabetic ketoacidosis (DKA) which, if not treated urgently, can lead to death. It is vital that all people with T1D have timely access to acute care advice and service delivery.
Across Australia, DKA is the cause of a significant and increasing number of hospitalisations, especially when considering socioeconomic disadvantage. This project will explore current outcomes for people with T1D presenting to the Caboolture Hospital ED with DKA, explore factors associated with poor outcomes, and describe current barriers and enablers; to inform intervention development. Local diabetes support is provided through a diabetes education service which does not provide after-hours telephone support to provide timely assistance and determine the requirement for (and potentially preventing if unnecessary) hospital presentations.READ MORE
Mental health is a nationally recognised priority area and significantly contributes to the burden of illness in the Australian community, with almost 50% of people aged over 16 experiencing a mental illness at some point in their life. Coordinating treatment and support for people with mental illness is a key priority area in the Fifth National Mental Health and Suicide Prevention Plan and is a key priority indicator.
Over the last decade several models of mental health service delivery have evolved in response to the need for specialised mental health assessment and care in EDs as client numbers and acuity increases. Research has shown that these models are effective at supporting staff and increasing consumer satisfaction. However, little is known about how well the services integrate into ED service delivery and the way in which these MH services augment ED care and processes or their cost. Nor is there any research that summarises the salient features of the various models in a way that health services may integrate them to improve service delivery.
This research project is in two parts. The first phase aims to describe and explore the structures and processes required to sustain an ED physician championed. By understanding the structure and process required and through identifying its salient features, it may allow health services to implement the model or redesign, or adapt, current practice to improve the care received by patients presenting to EDs with a mental illness. The second phase will involve three quantitative studies that will examine the performance of the model.READ MORE
Australia is five years behind the US’ opioid epidemic (>15,000 US deaths/year). General Practitioners and EDs frequently prescribe opioids for isolated musculoskeletal pain (e.g. “whiplash”) from RTCs, but this potentially inappropriate opioid prescribing likely leads to unnecessary opioid exposures. In the last decade, opioid overdoses in Australia have more than doubled. 75% of opioid overdose deaths involve prescription opioids; annual death rates exceed road traffic deaths.
Emergency Departments (EDs) commonly prescribe opioids on discharge for patients with non-serious road traffic crash (RTC) injury. This potentially compromises recovery and contributes to continued opioid use and potential misuse in the community.
The project will address the gap on whether, or for how long, short courses of opioids are continued following acute non-serious RTC injury, and to what extent this causes subsequent problems, by measuring patterns of use, impacts, and costs of opioid use in EDs and following discharge over a 12-month period.
The project will provide the first Australian data on opioid prescribing in ED for acute minor RTC injuries and link ED data to community data to explore longitudinal prescribing patterns post RTC.READ MORE
Aboriginal and Torres Strait Islander people die from heart attacks at younger ages than non-indigenous Australians. The factors that increase risk of death from heart attack in young Aboriginal and Torres Strait Islander people are unknown.
Most patients who present to an Emergency Department (ED) with chest pain do not have a heart problem but all are assessed for their risk of having a life-threatening cause, such as heart attack. The level of risk determines which tests are performed so that a final diagnosis can be obtained as quickly as possible. Due to the lack of knowledge about risk factors in the Aboriginal and Torres Strait Islander population there is uncertainty about how best to use chest pain risk assessments in indigenous patients.
In this study, we will determine the rate of coronary artery disease (a hardening of arteries and the underlying cause of heart attacks) in Aboriginal and Torres Strait Islander people who present to the ED with chest pain. We will also compare the characteristics of patients who do and do not have heart attacks to identify potential risk factors for heart attack in this population.
The findings from this study will: 1) allow ED doctors to determine a baseline level of risk of heart attack for the Aboriginal and Torres Strait Islander patient population, and 2) provide preliminary information necessary for the design of large-scale research studies with the goal of determining specific risk factors for heart attack in Aboriginal and Torres Strait Islander people.READ MORE