Towards the idea of 'clinical capital': A longitudinal study exploring nurses' dispositions and workplace manifestations in an Australian intensive care unit.

Objective: To explore the concept of 'capital' through the study of successive interventions and outcomes (patient and staff) in a quaternity intensive care unit (ICU) across a 5-year time frame.

Design: A longitudinal intrinsic single site, a survey study was designed. The concept of 'capital' was explored through an adopted interpretive approach that involved understanding meanings from different sources, for example, discussions at compassion cafés, follow-up from staff-initiated activities, informal responses to organizational imperatives external to the unit (i.

Accuracy of reporting of Aboriginality on administrative health data collections using linked data in NSW, Australia.

Background: Aboriginal people are under-reported on administrative health data in Australia. Various approaches have been used or proposed to improve reporting of Aboriginal people using linked records. This cross-sectional study used self-reported Aboriginality from the NSW Patient Survey Program (PSP) as a reference standard to assess the accuracy of reporting of Aboriginal people on NSW Admitted Patient (APDC) and Emergency Department Data Collections (EDDC), and compare the accuracy of selected approaches to enhance reporting Aboriginality using linked data.

Cardiac procedures in ST-segment-elevation myocardial infarction - the influence of age, geography and Aboriginality.

Background: Timely restoration of bloodflow acute ST-segment elevation myocardial infarction (STEMI) reduces myocardial damage and improves prognosis. The objective of this study was describe the association of demographic factors with hospitalisation rates for STEMI and time to angiography, Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) in New South Wales (NSW) and the Australian Capital Territory (ACT), Australia.

Methods: This was an observational cohort study using linked population health data.

Factors associated with non-beneficial treatments in end of life hospital admissions: a multicentre retrospective cohort study in Australia.

Objective: To quantitatively assess the factors associated with non-beneficial treatments (NBTs) in hospital admissions at the end of life.

Design: Retrospective multicentre cohort study.

Setting: Three large, metropolitan tertiary hospitals in Australia.

Doctors' perceptions of how resource limitations relate to futility in end-of-life decision making: a qualitative analysis.

Objective: To increase knowledge of how doctors perceive futile treatments and scarcity of resources at the end of life. In particular, their perceptions about whether and how resource limitations influence end-of-life decision making. This study builds on previous work that found some doctors include resource limitations in their understanding of the concept of futility.

Better cardiac care: health professional's perspectives of the barriers and enablers of health communication and education with patients of Aboriginal and Torres Strait Islander descent.

Background: A body of knowledge continues to grow regarding Aboriginal perspectives on current challenges and barriers to health literacy and access to health services. However, less is known from the perspectives of health professionals who work in cardiac care. Given their role in delivering patient education, health practitioners could provide useful insights into potential solutions to improve patient-practitioner communication.

Home to health care to hospital: Evaluation of a cancer care team based in Australian Aboriginal primary care.

Objective: To evaluate the acceptability of a cancer care team based at an Australian Aboriginal medical service in supporting patients' cancer journeys and to assess improvements in access to cancer care.

Design: The cancer care team consisted of an Australian Aboriginal health worker, counsellor and enrolled nurse employed for 2 days a week, supported by a general practitioner. The cancer care team supported patients from prediagnosis while investigations were being undertaken, at diagnosis and through treatment, such as surgery, chemotherapy and radiotherapy, and follow-up, including to palliative care and grief support where these were required.

The Role of the Nurse Educator in Sustaining Compassion in the Workplace: A Case Study From an Intensive Care Unit.

Intensive care unit (ICU) nurses are frequently exposed to emotional and stressful situations in the workplace, which has changed little over the decades. Compassion fatigue is caused by sustained exposure to situations that conflict with one's values and beliefs in the ICU, eroding clinical team relationships and ultimately the quality and safety of patient care. Continuing education in the intensive care setting is a priority, as ICU nurses need to remain abreast of the rapid developments in high-acuity care delivery; however, attention also needs to be directed to nurses' emotional well-being.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

Objective: The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines.

Methods: International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017.

Building compassion literacy: Enabling care in primary health care nursing.

This paper introduces the concept of compassion literacy and discusses its place in nursing within the general practice setting. Compassion literacy is a valuable competency for sustaining the delivery of high quality care. Being compassion literate enables practice nurses to provide compassionate care to their patients and to recognise factors that may constrain this.

Incidence, duration and cost of futile treatment in end-of-life hospital admissions to three Australian public-sector tertiary hospitals: a retrospective multicentre cohort study.

Objectives: To estimate the incidence, duration and cost of futile treatment for end-of-life hospital admissions.

Design: Retrospective multicentre cohort study involving a clinical audit of hospital admissions.

Setting: Three Australian public-sector tertiary hospitals.

Enhancing the get healthy information and coaching service for Aboriginal adults: evaluation of the process and impact of the program.

Background: Non-communicable chronic diseases in Australia contribute to approximately 85% of the total burden of disease; this proportion is greater for Aboriginal communities. The Get Healthy Service (GHS) is effective at reducing lifestyle-based chronic disease risk factors among adults and was enhanced to facilitate accessibility and ensure Aboriginal cultural appropriateness. The purpose of this study is to detail how formative research with Aboriginal communities was applied to guide the development and refinement of the GHS and referral pathways; and to assess the reach and impact of the GHS (and the Aboriginal specific program) on the lifestyle risk factors of Aboriginal participants.

The reach and flow of health information in two Aboriginal communities: a social network analysis.

The aim of the present paper was to explore how social networks enable dissemination of health information within two Aboriginal communities in New South Wales. The study design was modelled on a social network analysis socio-centric model. Data collection was conducted primarily by Aboriginal community members who were trained as community researchers.

Delivering compassionate care in intensive care units: nurses' perceptions of enablers and barriers.

Background: Compassion is core to nursing practice. Nurses' expression of compassion is a complex interaction informed by the nurse, the patient and the practice environment.

Aim: The aim of this study was to identify personal, professional and organizational factors, intensive care nurses, in a major metropolitan facility in Australia, identified as enabling or disabling them to be compassionate.

Reasons doctors provide futile treatment at the end of life: a qualitative study.

Objective: Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient's life.

Design: Semistructured in-depth interviews.

What does "futility" mean? An empirical study of doctors' perceptions.

Objective: To investigate how doctors define and use the terms "futility" and "futile treatment" in end-of-life care.

Design, Setting, Participants: A qualitative study using semi-structured interviews with 96 doctors from a range of specialties which treat adults at the end of life. Doctors were recruited from three large Brisbane teaching hospitals and were interviewed between May and July 2013.

Recognizing the dialectic of compassionate care in the workplace: feedback from nurse educators.

Compassionate care and compassion fatigue affects managers, clinicians, and patients and is gaining international recognition. Using the café methodology as a structure and nurse educators as participants, a compassion dialectic between the psychological intent of the nurse to be compassionate and a system designed on maximizing throughput, with the least inputs possible is identified. Our findings indicate that the café in itself is not sufficient to enable experienced educators to take responsibility for compassionate care, but the café methodology opens the space for the important steps of naming the problem, recognizing its dialectical nature, deflecting blame for compassion fatigue away from individuals, and balancing the responsibility for compassion across the spectrum of elements that enable care to take place.

Understanding compassion literacy in nursing through a clinical compassion cafe.

This article presents a method of reconnecting and reaffirming with nurses the importance of compassion in health care by using a clinical compassion cafe, which describes nine steps that provide a forum to reaffirm clinicians' core values. This process has the potential to engage clinical staff in a different modality removed from the usual didactic approaches.

Intermittent LHRH therapy in the management of castrate-resistant prostate cancer (CRPCa): results of a multi-institutional randomized prospective clinical trial.

Background: Patients who develop castration-resistant prostate cancer (CRPCa) typically continue on androgen deprivation therapy (ADT). Whether these patients need to remain on ADT has not been well studied. We conducted a multicenter randomized trial to compare an intermittent versus continuous approach to ADT in CRPCa patients.

Autonomy versus futility? Barriers to good clinical practice in end-of-life care: a Queensland case.

Findings from a Queensland coronial inquest highlight the complex clinical, ethical and legal issues that arise in end-of-life care when clinicians and family members disagree about a diagnosis of clinical futility. The tension between the law and best medical practice is highlighted in this case, as doctors are compelled to seek family consent to not commence a futile intervention. Good communication between doctors and families, as well as community and professional education, is essential to resolve tensions that can arise when there is disagreement about treatment at the end of life.

Emergency medicine and futile care: Taking the road less travelled.

Debate around medical futility has produced a vast literature that continues to grow. Largely absent from the broader literature is the role of emergency medicine in either starting measures that prove to be futile, withholding treatment or starting the end of life communication process with patients and families. In this discussion we review the status of the futility debate in general, identify some of the perceived barriers in managing futile care in the ED including the ethical and legal issues, and establish the contribution of emergency medicine in this important debate.