Gender difference in the use of coronary interventions for patients with acute coronary syndrome: Experience from a major metropolitan hospital in Melbourne, Australia.

Background: Literature suggests an ongoing gender disparity in the use of coronary angiography and subsequent interventions among patients with acute coronary syndrome (ACS).

Objectives: The study aimed to examine gender differences in the use of coronary interventions amongst patients with acute coronary syndrome (ACS) admitted to a major metropolitan hospital in Melbourne during the period 2009-2012.

Methods: We undertook a retrospective analysis of a hospital database of 2096 ACS patients.

Exploring Aboriginal patients' experiences of cardiac care at a major metropolitan hospital in Melbourne.

Objectives The aim of the present study was to explore Aboriginal patients' lived experiences of cardiac care at a major metropolitan hospital in Melbourne. Methods The study was a qualitative study involving in-depth interviews with a purposive sample of 10 Aboriginal patients who had been treated in the cardiology unit at the study hospital during 2012-13. A phenomenological approach was used to analyse the data.

Assessment of an established dialysis nurse practitioner model of care using mixed methods research.

Aims And Objectives: To assess a dialysis nurse practitioner (NP) model of care by examining satisfaction, quality of life (QOL) and clinical outcomes of haemodialysis patients and explore experiences of dialysis nurses.

Design: Mixed methods.

Methods: Database analyses of dialysis indices amongst a sample (n = 45) of haemodialysis patients; a survey (n = 27) examining patient experience, satisfaction and QOL; and in-depth interviews with a sample (n = 10) of nurses.

Gender Differences in Presentation, Coronary Intervention, and Outcomes of 28,985 Acute Coronary Syndrome Patients in Victoria, Australia.

Background: Differences in demographics, presenting characteristics, and treatment of heart disease in women may contribute to adverse outcomes. The purpose of this paper was to describe gender differences in the epidemiology, treatment, and outcomes of all admissions for acute coronary syndrome (ACS) in Victoria that occurred between June 2007 and July 2009.

Methods: We undertook a retrospective cohort study of all patients admitted to Victorian hospitals with a first time diagnosis of ACS.

Systematic Review and Meta-analyses Investigating Whether Risk Stratification Explains Lower Rates of Coronary Angiography Among Women With Non-ST-Segment Elevation Acute Coronary Syndrome.

Background: Guidelines recommend that all non-ST-segment elevation acute coronary syndrome (NSTEACS) patients with high-risk features receive a coronary angiogram. We hypothesised that the widely reported gender disparity in the use of angiography might be the result of women more frequently being stratified into the lower-risk category.

Objectives: The aim of the study was to review studies reporting risk stratification of NSTEACS patients by gender, compare risk profiles, and assess impact on use of coronary angiography.

Is There any Gender Difference for Smoking Persistence or Relapse Following Diagnosis or Hospitalization for Coronary Heart Disease? Evidence From a Systematic Review and Meta-Analysis.

Introduction: Persistent smoking in patients diagnosed with coronary heart disease (CHD) has a significant effect on morbidity and mortality. Although there has been considerable debate around gender differences in smoking cessation, conclusive evidence on how gender impacts rates of smoking cessation and/or relapse following CHD diagnosis is lacking.

Aims And Methods: Our aim was to test the hypothesis that female smokers with CHD were more likely to persist in smoking or relapse post-diagnosis or hospitalization than male smokers.

Impact of comorbidities and gender on the use of coronary interventions in patients with high-risk non-ST-segment elevation acute coronary syndrome.

Objectives: To determine the impact of gender and comorbidity on use of coronary interventions in patients diagnosed with high-risk non-ST-segment acute coronary syndrome (NSTEACS).

Background: Guidelines recommend the use of coronary angiography for all patients diagnosed with NSTEACS with high-risk features, except in the presence of severe comorbidities. However, little is understood about the relationship between gender, comorbidity, and the use of coronary interventions.

Depression screening and referral in cardiac wards: A 12-month patient trajectory.

Background: Depression is common among patients with coronary heart disease (CHD) and has a major impact on their quality of life, morbidity and mortality.

Aim: The aim of this study was to map the 12-month psychosocial outcomes of patients with CHD who were screened positive for depression in an acute cardiac ward.

Methods: A prospective cohort study was conducted of the psychosocial trajectory (depression, anxiety, wellbeing, social support, mental health service access) of 212 patients with CHD who were screened for depression after being admitted to acute cardiac wards of a major metropolitan hospital.

E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis.

Background: E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation.

Objectives: To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation.

Data Sources: A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases.

Gender difference in treatment and mortality of patients with ST-segment elevation myocardial infarction admitted to Victorian public hospitals: a retrospective database study.

Background: Death from acute coronary syndrome (ACS) is avoidable with early reperfusion therapy, however, evidence suggests inequity in women's ACS treatment within a number of international healthcare systems, when compared to men's. Research indicates mortality rates are higher in some age groups of women when compared to men for the sub-group of ACS known as ST-segment elevation myocardial infarction (STEMI).

Objective: To determine whether patient sex was associated with patterns of reperfusion treatment variation or increased inhospital mortality in patients with STEMI.

Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne.

A review of sedation scales for the cardiac catheterization laboratory.

Purpose: Sedation scales have the potential to facilitate effective procedural sedation and analgesia in the cardiac catheterization laboratory (CCL). For this potential to become realized, a scale that is suitable for use in the CCL either needs to be identified or developed.

Design: A structured review strategy was applied.

Factors associated with post-intensive care unit adverse events: a clinical validation study.

Background: Many patients discharged from intensive care units (ICU) have complex care needs, placing them at risk of an adverse event in a ward environment. Currently, there is limited understanding of factors associated with these events in the post-intensive care population. A recent study explored intensive care liaison nurses' opinions on factors associated with these events; 25 factors were identified, highlighting the multifaceted nature of post-intensive care adverse events.

Smoking behavior among patients and staff: a snapshot from a major metropolitan hospital in Melbourne, Australia.

Background: A cross-sectional study was conducted to provide a snapshot of smoking behavior among staff and patients at a major metropolitan hospital in Melbourne.

Methods: Patients and staff were surveyed using a questionnaire exploring demographics, nicotine dependence (Fagerstrom test), readiness to quit, and preference for smoking cessation options.

Results: A total of 1496 people were screened within 2 hours; 1,301 participated (1,100 staff, 199 patients).

Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues.

Background: Electronic cigarettes (e-cigarettes) are battery-powered devices that vaporize a liquid solution to deliver a dose of inhaled nicotine to the user. There is ongoing debate regarding their regulation.

Objectives: This comprehensive narrative review aimed to discuss key issues including usage patterns, health effects, efficacy in smoking cessation and regulatory concerns with a view to informing future regulation and research agendas.

Intensive care readmission: a contemporary review of the literature.

ICU readmissions are a commonly used quality measure but despite decades of research, these adverse events continue to occur. Of particular concern is that readmitted patients have much worse prognoses than those not readmitted. In recent years new clinical service roles have evolved to assist ward staff with the care of acutely ill patients, such as those discharged from ICU.

The process and utility of classification and regression tree methodology in nursing research.

Aim: This paper presents a discussion of classification and regression tree analysis and its utility in nursing research.

Background: Classification and regression tree analysis is an exploratory research method used to illustrate associations between variables not suited to traditional regression analysis. Complex interactions are demonstrated between covariates and variables of interest in inverted tree diagrams.

Factors associated with delayed treatment onset for acute myocardial infarction in Victorian emergency departments: a regression tree analysis.

Background: Minimising time to treatment onset for acute myocardial infarction (AMI) in the emergency department (ED) is essential, yet little is understood about the interactions between variables affecting it. The aim of this study was to develop a regression tree model explicating the influence of patient and non-patient factors on the time taken to commence treatment for patients with AMI in Victorian EDs.

Methods: A regression tree model for variables impacting time to treatment was developed on retrospective data for patients aged 18-85 years with AMI treated in Victorian EDs from 2005 to 2010 (n=21,080).

Examining adverse events after intensive care unit discharge: outcomes from a pilot questionnaire.

Adverse events are common in acute clinical settings but little is known about these events occurring after Intensive Care discharge. This study aimed to develop a reliable and valid tool for exploring clinicians' opinions of factors associated with post-Intensive Care adverse events. A convenience sample of Australian Intensive Care Liaison Nurses was invited to complete and appraise a questionnaire using structured guidelines.

Effect of patient sex on triage for ischaemic heart disease and treatment onset times: A retrospective analysis of Australian emergency department data.

Unlabelled: Time between emergency department (ED) presentation and treatment onset is an important, but little-researched phase within the revascularization process for ischaemic heart disease (IHD).

Objective: To determine if sex influences triage score allocation and treatment onset for patients with IHD in the ED.

Methods: Retrospective data for patients 18-85 years presenting to EDs from 2005 to 2010 for acute myocardial infarction (AMI), unstable and stable angina, and chest pain were analysed collectively and separately for AMI.

Complexity of management and health outcomes in a prospective cohort study of 573 heart failure patients in Australia: does more equal less?

Aims And Objectives: To compare the efficacy of chronic heart failure management programmes (CHF-MPs) according to a scoring algorithm used to quantify the level of applied interventions-the Heart Failure Intervention Score (HF-IS).

Background: The overall efficacy of heart failure programmes has been proven in several meta-analyses. However, the debate continues as to which components are essential in a heart failure programme to improve patient outcomes.

Reason's accident causation model: application to adverse events in acute care.

Adverse events are unintended harm to a patient caused by the health care provided; more than half of all these events have been deemed avoidable. Adverse events are a common problem in acute care and represent a breach in care quality and safety. They are generally not caused by a single mistake or error and although safety barriers exist in health care, patients today are still harmed.

Assessing risk post intervention for an acute coronary syndrome: a review of the risk assessment tools and their development.

Considerable variability in survival rate after an acute myocardial infarction exists and accurate risk stratification is of significant importance. The American College of Cardiology and the American Heart Association has recommended early risk stratification using several clinical risk scoring instruments to identify high risk patients. The aim of this paper is to identify secondary cardiovascular risk scoring instruments that could be utilized at the time of intervention for acute coronary syndromes and compare their psychometric properties as they were developed.

Factors contributing to adverse events after ICU discharge: a survey of liaison nurses.

Background: A significant number of patients experience an adverse event when discharged from intensive care to a ward. More than half of these events may be preventable with better standards of care.

Aim: To explore the opinions of an expert group of clinicians around factors contributing to adverse events in patients discharged from ICU.