"I didn't feel like I could trust her and that felt really risky": a phenomenographic exploration of how Australian Midwives describe intrapartum risk.

Objective: Concepts of intrapartum risk are not well explored in the Australian context. In response to an increasing focus on risk in maternity care, we sought to obtain insight into what Australian midwives conceptualised as intrapartum risk.

Design: The research was conducted using a phenomenographic approach.

Hospital presentations with diabetic ketoacidosis: A retrospective review.

Background: Diabetic ketoacidosis (DKA) is a significant source of preventable episodes of care and cost. This study aimed to describe the demographic and clinical characteristics of people with type 1 diabetes (T1D) presenting to the Emergency Department (ED) with DKA in an area of socio-economic deprivation in metropolitan Queensland, Australia, and to describe factors associated with hospital admission and re-presentation in this population.

Methods: This was a retrospective descriptive analysis of routine healthcare record data for January 2015-December 2019.

The enigma: Decision-making to transfer residents to the emergency department; communication and care delivery between emergency department staff and residential aged care facilities' nurses.

Objective: To investigate the experience of nurses involved in decision-making to transfer residents from a residential aged care facility (RACF) to their local hospital emergency department. This paper reports on the findings of the second phase of a two-phase study.

Methods: Qualitative semi-structured interviews with 19 aged care nurses were conducted.

Involuntary Patient Assessment in Australia: A Mental Health or Public Health Response?

Involuntary assessment relates to detaining and transporting a person at risk of harming themselves or others, and without their consent, to hospital for examination and treatment. State and Territory statutory authorities generally allow police, paramedics and/or health practitioners to initiate involuntary assessment. Because of the stigma attached to mental illness, and to protect people from harming themselves or others in broader circumstances than mental illness alone, the Queensland government changed involuntary assessment powers.

Optimising emergency department and acute care for people experiencing mental health problems: a nominal group study.

Objective The aim of this study was to identify potential model of care approaches and systems processes for people presenting to acute healthcare settings with mental health problems, including mental illnesses. Methods Five (consensus) nominal group technique sessions were conducted in 2019 with a purposive sample of stakeholders from health, police, ambulance and consumer agencies (n  = 21). Sessions were recorded, transcribed and analysed for thematic content.

Diabetic ketoacidosis presentations in a low socio-economic area: are services suitable?

Background: Diabetic ketoacidosis causes a significant number of hospitalisations worldwide, with rates tending to increase with remoteness and socioeconomic disadvantage. Our study aimed to explore healthcare professionals' perceptions of factors affecting presentation of people with type 1 diabetes in a low socioeconomic area of Queensland, Australia.

Methods: This was a qualitative study.

Understanding nurses perspectives of acuity in the process of emergency mental health triage: a qualitative study.

Post deinstitutionalisation, mental health mainstreaming has led to substantial increases in presentations to Emergency Departments (EDs). The assessment process requires the ED triage nurse to undertake a rapid client assessment, assign a clinically appropriate triage score, and then refer the client to a mental health clinician. The initial assessment is important, and a number of factors influence the process of triage, referral and response including an understanding of mental health presentation acuity.

A structure and process evaluation of the Geriatric Emergency Department Intervention model.

Background: The positive effect of the Geriatric Emergency Department Intervention (GEDI) model, on the outcomes of frail older adults, is established. This study aimed to describe and evaluate the structures and processes required for the effective delivery of the GEDI model to assist in its potential translation into emergency departments in Australia and overseas.

Methods: This was a descriptive qualitative study.

The development of a modified comprehensive geriatric assessment for use in the emergency department using a RAND/UCLA appropriateness method.

Background: The universal screening and comprehensive assessment of older persons presenting to the emergency department is considered useful, yet is difficult to embed. A number of assessment instruments exist however they are not widely used and there is a lack of agreement between clinicians as to which tools are best suited to the emergency department. The aim of this study was to develop a modified comprehensive geriatric assessment using consensus methodology for use by the multidisciplinary team in the emergency department.

Understanding registered nurse decision-making, communication and care delivery between emergency departments and residential aged care facilities: A research protocol.

Objectives: Nursing staff in residential aged care facilities (RACF)s often make decisions about the transfer of residents to the emergency department (ED). This paper describes the protocol of a study that aims to understand decision-making process utilised by RACF registered nurses (RNs) and to explore the perceptions of RNs about the decision and communication process between RACF and ED.

Methods: The proposed mixed-method study will survey and interview RACF RNs to understand their decision to transfer a resident and collect information about older people referred to the ED.

Effect of the Geriatric Emergency Department Intervention on outcomes of care for residents of aged care facilities: A non-randomised trial.

Objective: As the population of Australia ages, EDs will experience an increasing frequency of presentations of older adults from residential aged care facilities (RACFs). These presentations are often complex and time consuming in the chaotic and potentially hazardous ED environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to optimise the care of frail older adults, especially RACF residents, in the ED.

Mental health presentations to the emergency department: A perspective on the involvement of social support networks.

The involvement of families, carers and significant others (i.e. social support networks) has a positive corollary for a person experiencing mental health problems.

Review article: Interventions for people presenting to emergency departments with a mental health problem: A systematic scoping review.

The number of people presenting to EDs with mental health problems is increasing. To enhance and promote the delivery of safe and efficient healthcare to this group, there is a need to identify evidence-based, best-practice models of care. This scoping review aims to identify and evaluate current research on interventions commenced or delivered in the ED for people presenting with a mental health problem.

The predictive validity of the interRAI ED screener for predicting re-presentation within 28 days for older adults at a regional hospital emergency department.

Background: The rapid screening of older adults in the Emergency Department (ED) at risk of adverse events is considered useful. The aim of this study was to evaluate the predictive validity of the interRAI ED screener for re-presentation to the ED within 28 days.

Method: A prospective cohort study with convenience sampling of 687 adults aged 70 years or older, and eligible for discharge, was conducted.

The Geriatric Emergency Department Intervention model of care: a pragmatic trial.

Background: To evaluate a Geriatric Emergency Department Intervention (GEDI) model of service delivery for adults aged 70 years and older.

Methods: A pragmatic trial of the GEDI model using a pre-post design. GEDI is a nurse-led, physician-championed, Emergency Department (ED) intervention; developed to improve the care of frail older adults in the ED.

Nurse-led multidisciplinary initiatives to improve outcomes and reduce hospital admissions for older adults: The Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration project.

Objectives: This article describes the Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project.

Methods: CEDRiC is designed to improve the health outcomes for older people with an acute illness. It attempts this via enhanced primary care in residential aged care facilities, focused and streamlined care in the emergency department and enhanced intersectoral communication and referral.

The use of functional and cognitive assessment in the emergency department to inform decision making: A scoping review.

Background: The use of functional and/or cognitive assessment in the emergency department (ED) to inform decision making in the complex older adult is considered important, yet not routinely administered.

Method: Electronic databases were searched to identify eligible published research studies: older adults >65 years; the administration of a functional and/or cognition assessment instrument whilst the older adult is in any part of the ED; interventions resulting from the administration of the instrument; and a measured outcome post ED visit. A revised scoping review methodology was applied to chart study data and to identify key differences.

A structure, process and outcome evaluation of the Geriatric Emergency Department Intervention model of care: a study protocol.

Background: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed.

Midwives and the Computerization of Perinatal Data Entry: The Theory of Beneficial Engagement.

Theory building in nursing and midwifery both to explain and inform practice is important to advance these professions via provision of a theoretical foundation. This research explored the process of perinatal data entry undertaken by midwives to explore the impact of the movement from paper to computer collection of data. Use of grounded theory methodology enabled theory building, leading to a theoretical understanding of the phenomenon and development of the Theory of Beneficial Engagement grounded in the data.

Providing support to nursing students in the clinical environment: a nursing standard requirement.

Aim: This discussion paper poses the question 'What enables or deters Registered Nurses to take up their professional responsibility to support undergraduate nursing students through the provision of clinical education?'.

Background: Embedded within many nursing standards are expectations that Registered Nurses provide support and professional development to undergraduate nursing students undertaking clinical placements. Expectations within nursing standards that Registered Nurses provide support and professional development to nursing students are important because nursing students depend on Registered Nurses to help them to become competent practitioners.