Facilitators and barriers of appropriate and timely initiation of intravenous fluids in patients with sepsis in emergency departments: a consensus development Delphi study.

Background: Sepsis is a life-threatening medical emergency in which appropriate and timely administration of intravenous fluids to patients with features of hypotension is critical to prevent multi-organ failure and subsequent death. However, compliance with recommended fluid administration is reported to be poor. There is a lack of consensus among emergency clinicians on some of the determinant factors influencing fluid administration in sepsis.

Facilitators and barriers of appropriate and timely initial fluid administration in sepsis: A qualitative study.

Background: Sepsis is a medical emergency requiring prompt recognition, and early administration of intravenous fluids and antibiotics. While compliance with appropriate and timely administration of intravenous fluids has been found to be poor, the reasons are not well understood. Therefore, we have explored the experiences and perceptions of emergency nurses and medical officers from four hospitals to identify the associated facilitators and barriers.

Identifying factors associated with intravenous fluid administration in patients with sepsis presenting to the emergency department: a retrospective cohort study.

Background: Appropriate and timely administration of intravenous fluids to patients with sepsis-induced hypotension is one of the mainstays of sepsis management in the emergency department (ED), however, fluid resuscitation remains an ongoing challenge in ED. Our study has been undertaken with two specific aims: firstly, for patients with sepsis, to identify factors associated with receiving intravenous fluids while in the ED; and, secondly to identify determinants associated with the actual time to fluid administration.

Methods: We conducted a retrospective multicentre cohort study of adult ED presentations between October 2018 and May 2019 in four metropolitan hospitals in Western Sydney, Australia.

Early fluid bolus in adults with sepsis in the emergency department: a systematic review, meta-analysis and narrative synthesis.

Background: Early intravenous fluids for patients with sepsis presenting with hypoperfusion or shock in the emergency department remains one of the key recommendations of the Surviving Sepsis Campaign guidelines to reduce mortality. However, compliance with the recommendation remains poor. While several interventions have been implemented to improve early fluid administration as part of sepsis protocols, the extent to which they have improved compliance with fluid resuscitation is unknown.

Association between intravenous fluid resuscitation and outcome among patients with suspected infection and sepsis: A retrospective cohort study.

Objective: To investigate the association between timing and volume of intravenous fluids administered to ED patients with suspected infection and all-cause in-hospital mortality.

Methods: Retrospective cohort study of ED presentations at four metropolitan hospitals in Sydney, Australia, between October 2018 and May 2019. Patients over 16 years of age with suspected infection who received intravenous fluids within 24 h of presentation were included.

Barriers to hepatitis C treatment among secondary needle and syringe program clients and opportunities to intervene.

Background: At least 160,000 Australians are living with hepatitis C (HCV), many of whom are people who inject drugs and access needle and syringe programs (NSP). Secondary NSPs provide injecting equipment via health services that are not dedicated to the provision of services to people who inject drugs; these sites could be a suitable space to increase engagement of people who inject drugs in HCV treatment. Drawing on data from a pilot study exploring the potential of upscaling linkage to HCV care in secondary NSPs, the aim of this research was to explore barriers and enablers to HCV treatment for clients who use these services.

The Effects of Powered Exoskeleton Gait Training on Cardiovascular Function and Gait Performance: A Systematic Review.

Patients with neurological impairments often experience physical deconditioning, resulting in reduced fitness and health. Powered exoskeleton training may be a successful method to combat physical deconditioning and its comorbidities, providing patients with a valuable and novel experience. This systematic review aimed to conduct a search of relevant literature, to examine the effects of powered exoskeleton training on cardiovascular function and gait performance.

The educational benefits of drama in nursing education: A critical literature review.

Background: With the increasing use of technology in nursing, the importance of interpersonal skills can often be forgotten. Patient safety can also be compromised if these skills are not emphasised in nursing education.

Objectives: This review explores how drama in undergraduate and postgraduate nursing education can enhance the development of interpersonal skills such as empathy, emotional intelligence and communication.

Emergency nurses' experiences of the implementation of early goal directed fluid resuscitation therapy in the management of sepsis: a qualitative study.

Background: Severe sepsis can lead to organ failure and death if immediate treatment, such as intravenous fluids and antibiotics, are not commenced within the first hour. Time - critical initiation of intravenous fluids which in other words is early goal directed fluid resuscitation has not always been given its clinical priority. This qualitative study aimed at exploring the experiences of emergency nurses initiating early goal directed fluid resuscitation in patients with sepsis.

Student perceptions, experiences and support within their current Bachelor of Nursing.

Background: This study was developed to assist academics and curriculum designers to understand the perspectives and expectations of students when designing a program of study and inclusive of students as partners. The purpose of this qualitative study was to explore the perceptions and experiences of students enrolled in the Bachelor of Nursing (BN).

Settings, Participants, Methods: The setting is a multi-campus university in Australia.

Effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery: a systematic review.

Review Objective: The objective of this review was to investigate the effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery on patients' health-related quality of life and hospital readmission.

Introduction: Coronary heart disease is a major cause of death and disability worldwide, putting a great strain on healthcare resources. For the past two decades, population-wide primary prevention and individual healthcare approaches have resulted in a dramatic decline in overall cardiac mortality.

The importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice: A systematic review.

Objectives: This systematic review was designed to assess the importance of academic literacy for undergraduate nursing students and its relationship to future professional clinical practice. It aimed to explore the link between academic literacy and writing in an undergraduate nursing degree and the development of critical thinking skills for their future professional clinical practice.

Design: A systematic review of qualitative studies and expert opinion publications.

A review of inpatient ward location and the relationship to Medical Emergency Team calls.

Objective: To identify the relationship between in-hospital location and patient outcomes as measured by Medical Emergency Team calls.

Study Design: A narrative systematic review of the literature.

Data Sources: A systematic search of the literature was conducted in October 2014 using the electronic databases: Embase, Cochrane, Medline, CINAHL, Science Direct and Google Scholar for the most recent literature from 1997 to 2014.

Hemin Preconditioning Upregulates Heme Oxygenase-1 in Deceased Donor Renal Transplant Recipients: A Randomized, Controlled, Phase IIB Trial.

Background: The enzyme heme oxygenase-1 (HO-1) degrades heme and protects against ischemia-reperfusion injury. Monocytes/macrophages are the major source of HO-1 and higher levels improve renal transplant outcomes. Heme arginate (HA) safely induces HO-1 in humans.

Measuring final-year nursing students' satisfaction with the viva assessment.

This paper reports a study conducted to develop and test the psychometric properties of a brief 5-item Satisfaction with the Oral Viva Assessment Scale. The viva has been increasingly used to gauge students' learning, beyond the traditional written assessments. This assessment approach may pose additional challenges to various student groups.

Analgesia after open abdominal surgery in the setting of enhanced recovery surgery: a systematic review and meta-analysis.

Importance: The optimal analgesic technique following open abdominal surgery within an enhanced recovery protocol remains controversial. Thoracic epidural is often recommended; however, its role is increasingly being challenged and alternative techniques are being suggested as suitable replacements.

Objective: To determine by meta-analysis whether epidurals are superior to alternative analgesic techniques following open abdominal surgery within an enhanced recovery setting in terms of postoperative morbidity and other markers of recovery.

Attitudes of patients and care providers to enhanced recovery after surgery programs after major abdominal surgery.

Background: Enhanced recovery after surgery (ERAS) is a well-established pathway of perioperative care in surgery in an increasing number of specialties. To implement protocols and maintain high levels of compliance, continued support from care providers and patients is vital. This survey aimed to assess the perceptions of care providers and patients of the relevance and importance of the ERAS targets and strategies.

Enhanced recovery following liver surgery: a systematic review and meta-analysis.

Background: Enhanced recovery after surgery (ERAS) programmes aim to improve postoperative outcomes. They are being utilized increasingly in hepatic surgery. This review aims to evaluate the impact of ERAS programmes on outcomes following liver surgery.

Challenges in managing patients in Australia with chronic hepatitis B: the General Practitioners' perspective.

Objective: General Practitioners (GPs) are essential to reducing the impact of chronic hepatitis B (CHB) given their clinical management role where only 56% of people with the infection in Australia have been diagnosed. This qualitative study aimed to identify the challenges GPs face in effectively responding to CHB.

Methods: Semi-structured interviews were conducted with 26 GPs self-identifying as having a 'high caseload' of patients and/or a particular interest in CHB.

Management of chronic hepatitis B in the Torres Strait Islands: an identified need for a comprehensive public health approach to chronic hepatitis B in remote Australian Indigenous communities.

We aimed to document how health service providers in the Torres Strait Island region of northern Australia respond to chronic hepatitis B, and to identify priorities for the effective clinical management of the infection. Semi-structured qualitative interviews with 61 health service providers were conducted in 2011 in the Torres Strait and north Queensland region to explore issues affecting chronic hepatitis B management. Two critical issues were identified affecting the health service response to chronic hepatitis B: (i) the absence of a systems-based approach to clinically managing the infection; and (ii) variable knowledge about the infection by the health workforce.

Teaching NeuroImages: hemorrhagic cavernoma with secondary development of hypertrophic olivary degeneration.

Hypertrophic olivary degeneration (HOD) is secondary degeneration of the inferior olivary nucleus (ION) due to a primary lesion in the dento-rubro-olivary pathway. This pathway is known as the Guillain and Mollert triangle, containing the dentate nucleus and the contralateral red and inferior olivary nuclei (figure e-1 on the Neurology® Web site at www.neurology.

Managing chronic hepatitis B - the role of the GP.

Background: General practitioners are critical to reducing the impact of chronic hepatitis B in the community. This study explored how GPs understand their role in chronic hepatitis B management.

Methods: Semi-structured interviews were held with 26 GPs from five Australian jurisdictions.

The ongoing impacts of hepatitis c--a systematic narrative review of the literature.

Background: Many countries have developed, or are developing, national strategies aimed at reducing the harms associated with hepatitis C infection. Making these strategies relevant to the vast majority of those affected by hepatitis C requires a more complete understanding of the short and longer term impacts of infection. We used a systematic approach to scope the literature to determine what is currently known about the health and psychosocial impacts of hepatitis C along the trajectory from exposure to ongoing chronic infection, and to identify what knowledge gaps remain.

Challenges to the effective delivery of health care to people with chronic hepatitis B in Australia.

Background: The complexity of the hepatitis B natural history and its prevalence in specific populations in Australia challenges the capacity of the health system to deliver health care effectively to affected people. This study explores the challenges in delivering health care to people with chronic hepatitis B (CHB) in Australia.

Methods: We conducted a grounded theory based qualitative study in which data were gathered from 70 in-depth interviews with government program officers, clinicians and health and community workers across Australia, and four focus group discussions with 40 health and community workers from the communities most at risk of CHB.