La Trobe/Alfred Clinical School of Nursing Research
Research at the La Trobe/Alfred Clinical School of Nursing is focussed on:
- Nurse education - in particular problem and work based learning and simulation
- Critical care - with a focus on quality of life for coronary care patients and trauma care for patients in resuscitation
- Gerontic nursing, health assessment, care interventions and dementia
La Trobe/Alfred Clinical School 2008
Nurse Practitioner research
The Nurse Practitioner (NP) research continues to make great progress with three papers published this year in International Emergency Nursing and the Journal of Clinical Nursing. National presentations were undertaken at the Australian Nurse Practitioner Association conference in Melbourne in October 2008 and the 3rd National Conference for Emergency Nurses in Perth in August 2008. The presentations were about expanding the NP role in emergency, the sustainability of the NP role in Victoria and the mentorship program as part of the NP masters program.
A patient satisfaction survey of NP patients and patients seen by ED doctors was undertaken and completed in 2008 and the results have been written up and will shortly be submitted to an international nursing journal for publication.
Alfred clinical school
The Alfred clinical school model was presented at an international conference in Ireland in June 2008 entitled “Building research capacity through a hospital-based clinical school of nursing” at the Nursing in Education/Nurse Education in Practice conference and a paper will be published in Nursing Education Today in 2009.
Diabetes research
Two multidisciplinary studies have commenced for patients with diabetes involving the Department of Endocrinology, Nutrition department and Baker Heart and Diabetes Research Institute. One study was successful in being granted an Alfred small Projects Grant. The study is a randomised controlled study of a pre-operative intervention in patients with diabetes undergoing Cardiac Surgery. The principal investigators are Ms Sue Wyatt, Dr Rachel Stoney, Dr. Karen Walker, Professor Duncan Topliss, Ms Geraldine Lee and Ms Melissa Penrose (a Division of Nursing & Midwifery Honours student). The second study is funded by Medtronic and will examine the service to provide clinic review for patients on continuous subcutaneous insulin infusion therapy (CSII).
Emergency department research
In the emergency department, a study examining the placement of pelvic binder on trauma patients is near completion. The investigators are Nic Santeloudi (ED nurse), Gerry Lee and Mathius Russ (orthopaedic surgeon).
Clinical Masters projects
Several Alfred staff members have undertaken clinical projects as part of their Masters including an evaluation of a protocol for fasting trauma patients by Tarryn McConnell while Julie Barbetti, ICU Liaison Nurse has completed an exploration of percutaneous v. surgical tracheostomy patients.
Awards
Congratulations to Gordon Bingham (current PhD student) on winning the Kathleen AB Smith award for his paper “Bingham G, Koch B, Lee G, Millar I. Ventilator performance under hyperbaric conditions: a study of the Servo 900C ventilator. South Pacific Underwater Medicine Society Journal 2007; 37 (4): 199-203” during Alfred research week.
2008 collaborative papers with Alfred nursing staff
Lee G, Metcalf S. Building research capacity through a hospital-based clinical school of nursing. Nurse Education Today. In press
Kinsman L, Champion R, Lee G, Martin M, Masman K, May E, Mills TM, Taylor M, Thomas P, Williams RJ, Zalstein S. Assessing the impact of streaming in a regional emergency department. Emergency Medicine Australasia 2008; 20: 221-227. Doi: 10.111/j.1742-6723.2008.01077.x
Lee G, Fitzgerald L. A Clinical Internship Model for the Nurse Practitioner Programme. Nursing Education in Practice 2008; 8: 397-404. Doi: 10.1016/j.nepr.2008.03.002
Lee G. “Commentary on The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United Kingdom”. Journal of Clinical Nursing; 2008. Doi: 10.1111/j.1365-2702.2206.01822.
Jennings N, O’Reilly G, Lee G, Cameron P, Free B. Implementing the Emergency Nurse Practitioner into a major inner city trauma centre. A new model of care delivery for patients in the ED setting. Journal of Clinical Nursing 2008; 17: 1044-1050.
Lee G, Smith S, Jennings N. Low acuity abdominal pain: Still a long wait International Emergency Nursing. Doi: 10.1016/j.ienj.2008.01.006
Barbetti J, Lee G. Is there evidence to support the Medical Emergency Team? Nursing in Critical Care 2008; 13 (2): 80-85.
Lee G. Patients reported health related quality of life five years post Coronary Artery Bypass Graft Surgery- a methodological study. European Journal of Cardiovascular Nursing 2008; 7 (1): 67-72.
Posters
Grummisch M, Chou K, Lowe G, Jennings N, Thompson J, Keating S, Smith D, Lee G. Emergency Nurse Practitioners in the emergency and trauma centre-defining the nurse practitioner scope of practice. Australian Nurse Practitioner Association conference. Melbourne, 26-28th October 2008.
Lee G, Jennings N. "Nurse practitioner research: a collaborative approach". Australian Nurse Practitioner Association conference. Melbourne, 26-28th October 2008.
Lee G, Jennings N. "Nurse practitioner research: a collaborative approach". Alfred Hospital Research Week. Melbourne, 20-24th October 2008.
Lee G, Opie S. “Diabetes and cardiac surgery: An audit in a metropolitan hospital" Alfred Hospital Research Week. Melbourne, 20-24th October 2008.
Lee G, Jennings N, Lowe G, Bushell J, Samers J. “Who doesn’t have a General Practitioner? A snapshot from one emergency department”. Alfred Hospital Research Week. Melbourne, 20-24th October 2008.
Lee G, Opie S. “Diabetes and cardiac surgery: An audit in a metropolitan hospital" Cardiac Society for Australia and New Zealand Annual Scientific Meeting, August 2008.
Lee G, Jennings N, Lowe G, Bushell J, Samers J. “Who doesn’t have a General Practitioner? A snapshot from one emergency department”. College of Emergency Nurses Australia. Perth, August 2008.
Lee G, Kuhn L. “I have my diploma in Emergency Nursing, now what and so what? A discussion”. College of Emergency Nurses Australia. Perth, August 2008.
La Trobe/Alfred Clinical School 2006
In January 2006, Associate Professor Susan Koch was seconded from the School of Nursing and Midwifery to the La Trobe Alfred Clinical School Alfred. Her appointment as Director of Nursing Research within the clinical School provides academic and research leadership to clinical and academic staff and students of The Alfred and La Trobe University.
The focus of the research undertaken by members of the La Trobe Alfred Clinical School is on clinical practice improvement and the translation of evidence into practice.
In 2006 fourteen students commenced their Masters of Nursing (Nurse Practitioner program) at the Alfred clinical school with many Alfred staff from several disciplines including radiology, pathology and cardiology providing lectures and practicals. The first student enrolled into the Nurse Practitioner Masters completed her course in 2006 (Ms Belinda Free, Alfred Emergency Department).
Research Outcomes
Trauma Reception and ResuscitationThe Victorian Trauma Foundation funded “From reception to resuscitation” project in the Emergency Department continues with successful development of the algorithms and installation of the software. Several nursing perspective projects are planned to examine the issues around clinical decision making and the use of technology.
Streaming: An innovative model for emergency care in a regional hospital
The La Trobe Faculty Collaborative grant received by Ms Geraldine Lee and Mr. Leigh Kinsman (Bendigo) in association with the maths department at La Trobe University Bendigo, has successfully demonstrated application of a mathematical model in predicting queuing in emergency departments. It is expected that this model can be applied to other emergency departments and assist in reducing waiting times for patients.
Ventilating patients under hyperbaric conditions
Gordon Bingham investigated the functioning of the Servo 900C ventilator in the hyperbaric chamber at pressure. He found that correction of the Servo 900C ventilator for the reduction in minute volume caused by raised atmospheric pressure is possible at the lower minute volume of 1 Lt/min, but could not be achieved at the higher minute volumes of 10 and 15 Lt/min. This has implications for the ventilation of adult patients who concurrently require hyperbaric oxygen therapy.
Nursing Awards
The Janet Secatore Nursing Research Award was presented to Geraldine Lee (La Trobe/Alfred Clinical School) for best overall poster “Patients who did not wait for treatment in the Emergency Department: a follow-up survey” during Alfred research week. The research was in collaboration with the nursing staff in the Emergency Department.
The Nursing Research & Access Committee Award for early researchers was presented to Lauren McTier (Alfred/Deakin Centre for Nursing Research) for her poster “Endotracheal suction with or without daily changes of closed system suction catheters: effect on ventilator associated pneumonia”.
The Kathleen AB Smith Memorial Prize in Nursing for best publication went to Gabrielle Burdeu, Ruth Crawford, Melita van de Vreede and Joanne McCann for their publication “Taking aim at infusion confusion. Journal of Nursing Care Quality, 2006 21(2), 151-9.
Current Projects
- Clinical practice improvement program: unmet needs and behaviours in acute care.
- Nursing administration of medications via enteral tubes.
- Sustaining quality functional outcomes of older patients in acute care.