Can supervise: YES
© 2019 Australian College of Midwives Background: There has been a rise in induction of labour over recent decades. There is some tension in the literature in relation to when induction is warranted and when not, with variability between guidelines and practice. Given these tensions, the importance of shared decision-making between clinicians and women is increasingly highlighted as paramount, but it remains unclear to what extent this occurs in routine care. Method: Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question "What are the views, preferences and experiences of women and clinicians in relation to induction of labour more broadly, and practices of decision-making specifically?" To identify studies, the databases PubMed, Maternity and Infant Care, CINAHL and EMBASE were searched from 2008 to 2018, and reference lists of included studies were examined. Findings: 20 papers met inclusion criteria, in relation to (a) women's preferences, experiences and satisfaction with IOL; (b) women's experience of shared-decision making in relation to induction; (c) interventions that improve shared decision-making and (d) factors that influence decision-making from the perspective of clinicians. Synthesis of the included studies indicates that decision-making in relation to induction of labour is largely informed by medical considerations. Women are not routinely engaged in the decision making process with expectations and preferences largely unmet. Conclusion: There is a need to develop strategies such as decision aids, the redesign of antenatal classes, and clinician communication training to improve the quality of information available to women and their capacity for informed decision-making.
Frawley, JE, McKenzie, K, Cummins, A, Sinclair, L, Wardle, J & Hall, H 2020, 'Midwives' role in the provision of maternal and childhood immunisation information.', Women and birth : journal of the Australian College of Midwives, vol. 33, no. 2, pp. 145-152.View/Download from: Publisher's site
PROBLEM:Inactivated influenza vaccine and diphtheria-tetanus acellular pertussis vaccine are routinely recommended during pregnancy to protect women and their babies from infection. Additionally, the hepatitis B vaccine is recommended for infants within the first week of life; however, little is known about midwives' experiences of recommending and delivering these immunisations. BACKGROUND:Midwives are a trusted source of vaccine information for parents and the confident provision of information about immunisation during antenatal clinic visits has been found to increase the uptake of antenatal and childhood vaccines. AIM:This study aims to explore midwives' experiences of discussing maternal and childhood immunisation with women and their partners and their confidence in answering parent's questions. METHODS:We conducted 23 semi-structured interviews with registered Australian midwives working in public and private hospital settings, and in private practice. FINDINGS:Midwives find negotiating the requirement to recommend immunisation within a women-centred framework challenging at times. The vast majority of midwives described their education on immunisation as inadequate and workplace issues, such as time pressure, were identified as further barriers to effective communication about immunisation. DISCUSSION/CONCLUSION:The provision of immunisation training within midwifery education and continued professional development is critical. Appropriately resourcing midwives with the necessary infrastructure, education and resources to fully inform parents about immunisation may have a positive impact on vaccine uptake.
Frawley, JE, McKenzie, K, Sinclair, L, Cummins, A, Wardle, J & Hall, H 2020, 'Midwives' knowledge, attitudes and confidence in discussing maternal and childhood immunisation with parents: A national study.', Vaccine, vol. 38, no. 2, pp. 366-371.View/Download from: Publisher's site
INTRODUCTION:Despite the enormous benefits of childhood and maternal immunisation to individual and population health, the uptake of maternal vaccines during pregnancy remains suboptimal. Midwives are a trusted information source for parents and play an important role in the provision of immunisation information. Understanding midwives' attitudes and vaccine knowledge, along with their confidence to discuss maternal and childhood immunisation with parents, is key to reducing parental decisional conflict and achieving immunisation goals. METHODS:An online study was conducted to investigate midwives' knowledge and attitudes towards maternal and childhood vaccination along with their confidence to answer parents' vaccine-related questions. Midwives were recruited by email via the midwifery peek body, the Australian College of Midwives. RESULTS:A total of 359 midwives completed the online survey. The majority of midwives supported maternal (influenza 83%, pertussis 90.5%) and childhood immunisation (85.8%); however, 69.4% of respondents wanted further training about immunisation. Midwives who felt their midwifery education adequately covered immunisation were more confident advising parents about maternal (p = 0.007) and childhood immunisation (p < 0.001). Similarly, Midwives were significantly more likely to confidently advise parents about maternal (p < 0.001) and childhood immunisations (p < 0.001) if they had completed a specific immunisation training course outside of their midwifery course. CONCLUSION:Most midwives working in Australia support vaccination. However, access to contemporary, culturally appropriate education that enables midwives to engage confidently with parents about immunisation is lacking. Education based on a women-centred approach within the pre-registration curriculum along with continuing professional development programs could enable midwives to reduce the evidence to practice gap by increasing vaccine uptake.
Tompkins, JW, Mequanint, S, Barre, DE, Fournie, M, Green, ME, Hanley, AJ, Hayward, MN, Zwarenstein, M, Harris, SB, Barre, E, Bhattacharyya, O, Dannenbaum, D, Dawson, K, Dyck, R, Episkenew, JA, Lavallee, B, Macaulay, A, McComber, A, McDonald, H, Parry, M, Reichert, S, Salsberg, J, Tehiwi, B, Thind, A, Tobe, S, Toth, E, Walsh, A, Wortman, J, Wylie, L, Bailie, R, Collins, K, De Oliveira, C, Hindmarsh, M, Rac, V, Lewis, J, Bowers, R, Chetty, S, Parent, B, Pathammavong, R, Houle, L, Houle, A, Malcolm, MJ, Racette, P, Houle, S, Montour-Lazare, D, Emond, J, Jacobs, J, Audi, A, Peterson, R, Littlechild, R, Graham, B, Littlechild, T, Ekomiak, I, Guy, D, Onespot, C, Redmond, D, Plume-Kahnapace, KB, McComb, IK, Dufour, E, Jolly, V, Diamond, C, Jacob, M, Hester, S, Jones, J, Hadden, D, Deyaeger, A, O'Keefe, T, Benoit, C, Organ, M, Keesickquayash, P, Panacheese, D, Ishabid, E, Skunk, H, Skunk, E, Jebb, M, Constant, C, Wilson, C, Kirkness, S, Deleary, A, Nawash, R, Sinclair, L, Tabobondung, L, Gregory, M, Jacobs, T, Nickel, B, Bobb, P, George, K, Esler, J, McLellan, J, Miller, K, Tyler, M, Webster-Bogaert, S & Zaran, H 2018, 'National Survey of Indigenous primary healthcare capacity and delivery models in Canada: The TransFORmation of IndiGEnous PrimAry HEAlthcare delivery (FORGE AHEAD) community profile survey 11 Medical and Health Sciences 1117 Public Health and Health Services', BMC Health Services Research, vol. 18, no. 1.View/Download from: UTS OPUS or Publisher's site
© 2018 The Author(s). Background: There is a significant deficiency of national health information for Indigenous peoples in Canada. This manuscript describes the Community Profile Survey (CPS), a community-based, national-level survey designed to identify and describe existing healthcare delivery, funding models, and diabetes specific infrastructure and programs in Indigenous communities. Methods: The CPS was developed collaboratively through FORGE AHEAD and the First Nations and Inuit Health Branch of Health Canada. Regional and federal engagement and partnerships were built with Indigenous organizations to establish regionally-tailored distribution of the 8-page CPS to 440 First Nations communities. Results were collected (one survey per community) and reported in strata by region, with descriptive analyses performed on all variables. Results were shared with participating communities and regional/federal partners through tailored reports. Results: A total of 84 communities completed the survey (19% response rate). The majority of communities had a health centre/office to provide service to their patients with diabetes, with limited on-reserve hospitals for ambulatory or case-sensitive conditions. Few healthcare specialists were located on-site, with patients frequently travelling off-site (> 40 km) for diabetes-related complications. The majority of healthcare professionals on-site were Health Directors, Community Health Nurses, and Home Care Nurses. Many communities had a diabetes registry but few reported a diabetes surveillance system. Regional variation in healthcare services, diabetes programs, and funding models were noted, with most communities engaging in some type of innovative strategy to improve care for patients with diabetes. Conclusions: The CPS is the first community-based, national-level survey of its kind in Canada. Although the response rate was low, the CPS was distributed and successfully administered across a broad range of First Nations ...
Bowen, JR, Callander, I, Richards, R, Lindrea, KB, Chaudari, T, Carmo, K, Spence, K, Wake, C, Kinross, D, Callander, I, Richards, R, Shein, D, Jolley, B, Shingde, V, Bradenburg, U, Lindrea, KB, Boisetti, S, Cameron, D, Bowen, J, Bowers, S, Gordon, A, Bredemeyer, S, Polverino, J, Morritt, ML, Marceau, J, Rochefort, M, Tracy, M, Bajuk, B, Sedgley, S, Leckie, M & Sinclair, L 2017, 'Decreasing infection in neonatal intensive care units through quality improvement', Archives of Disease in Childhood. Fetal and Neonatal Edition, vol. 102, no. 1, pp. F51-F57.View/Download from: Publisher's site
Objective To decrease the incidence of bloodstream infection (BSI) for neonates <29 weeks gestation through quality improvement.
Design Commencing in September 2011, eight neonatal intensive care units (NICUs) in New South Wales and Australian Capital Territory, Australia participated in the Sepsis Prevention in NICUs Group project, a multicentre quality improvement initiative to reduce neonatal infection through implementation of potentially better practices and development of teaching resources. Data were collected for neonates <29 weeks gestation from D3 to 35, using point of care data entry, for BSI, central line-associated BSI (CLABSI) and antibiotic use. Exponentially weighted moving average data trend lines for rates of BSI, CLABSI and antibiotic use for each NICU were automatically generated and composite charts were provided each month to participating NICUs.
Results Between January 2012 and December 2014, data were collected from D3 to 35 for 1075 neonates <29 weeks gestation who survived >48 h, for a total of 33 933 bed days and 14 447 central line days. There was a significant decrease from 2012 to 2014 in BSI/1000 bed days (7.8±3.0 vs 3.8±1.1, p=0.000), CLABSI/1000 bed days (4.6±2.1 vs 2.1±0.8, p=0.003), CLABSI/1000 central line days (9.9±4.3 vs 5.4±1.7, p=0.012) and antibiotic days/100 bed days (31.1±4.3 vs 25.5±4.2, p=0.046).
Conclusions This study demonstrates a >50% reduction in BSI in extremely premature neonates from D3 to 35 following a collaborative quality improvement project to reduce neonatal infection across an NICU network, supported by timely provision of data.
© 2016 Purpose To describe the working knowledge (knowledge-in-action) of nurses in the speciality of neonatal nursing and understand how they acquire this knowledge to inform strategies for orientation, mentorship, in-service programs and curricula of speciality neonatal programs. A questionnaire consisting of three parts; demographics, questions about outcomes of care and the NICU-BKAT4 knowledge questionnaire. Was distributed to all neonatal nurses in Neonatal Intensive Care Units (NICU) and Newborn Emergency Transport Service (NETS) in New South Wales Australia. Results Nurses with less than one year speciality experience typically had the lowest NICU-BKAT4 scores and 'critical' knowledge essential for safe practice (p's < .001). Patterns of learning emerged, with the majority (97%) of novice nurses showing a preference for experiential 'on-the-job' learning. Conclusion This research adds to the understanding of nurses' learning preferences, has implications for speciality nursing education and practice and suggests a review of current educational strategies.
Foster, JP, Buckmaster, A, Sinclair, L, Lees, S & Guaran, R 2015, 'Nasal continuous positive airway pressure (nCPAP) for term neonates with respiratory distress [Intervention Protocol]', Cochrane Database of Systematic Reviews, no. 11, pp. 1-11.View/Download from: Publisher's site
This is the protocol for a review and there is no abstract. The objectives are as follows:
To determine whether nCPAP as the primary modality of treatment is effective and safe for treating respiratory distress in the term neonate (≥ 37 weeks gestation).
We will explore potential sources of clinical heterogeneity through the following a priori subgroup analysis:
Age of infant at randomisation (< 6 hours, 6 to 12 hours, > 12 hours to 24 hours)
Setting (neonatal intensive care unit; non-tertiary special care nursery)
Level of continuing distending pressure used (≤ 5 cm H₂0; ≥ 6 cm H₂0)
Types of nCPAP (via continuous flow e.g. bubble nCPAP; variable flow nCPAP e.g. Infant Flow Driver)
Delivery system (nasal cannulae (short); nasal cannulae (long); nasal mask)
Method of oxygen delivery (ambient oxygen (crib, headbox); low-flow nasal cannulae; high-flow nasal cannulae)
Method of birth (caesarean section; vaginal delivery)
Reason for respiratory distress (e.g. hyaline membrane disease; transient tachypnoea of the newborn; bacterial pneumonia; meconium aspiration syndrome; persistent pulmonary hypertension).
Sinclair, L, Crisp, J & Sinn, J 2009, 'Variability in incubator humidity practices in the management of preterm infants', Journal of Paediatrics and Child Health, vol. 45, no. 9, pp. 535-540.View/Download from: Publisher's site
To determine current practice and opinion in relation to incubator humidity use in the management of preterm infants in neonatal intensive care units (NICU's) within the Australian and New Zealand Neonatal Network (ANZNN). Methods: A survey was conducted in 26 NICU's in the ANZNN. A senior clinical nurse in each perinatal centre participated in a telephone survey that focused on local humidification practices and on the clinicians' views and experiences of humidity use. Results: All centres routinely used supplemental humidity in the management of preterm infants. The majority of centres (77%) had written protocols to guide practice. Eighty-eight per cent commenced humidity at a high level (relative humidity ? 80%). There was wide practice variation in the gestational age parameters determining humidification use (all gestational ages up to 37 weeks), duration of use (3-77 days), timing of initiation (admission to 72 h after birth) and weaning practices. Perceived benefits of humidification included improved thermoregulation, skin integrity, and fluid and electrolyte balance and reduced transepidermal water loss. Perceived risks included sepsis and hyperthermia. Conclusions: Our study confirmed that incubator humidity is used routinely in the management of preterm infants in the ANZNN. Wide variation in humidification practices across NICUs reflects the paucity of research evidence. Perceived benefits and risks of humidity use were consistent with available literature. To optimise the care environment and provide an evidence base for practice further research is warranted.
Ferguson, L, Calvert, J, Davie, M, Fallon, M, Fred, N, Gersbach, V & Sinclair, L 2007, 'Clinical leadership: using observations of care to focus risk management and quality improvement activities in the clinical setting.', Contemporary nurse, vol. 24, no. 2, pp. 212-224.View/Download from: Publisher's site
In an era when patient safety and quality of care are a daily concern for health care professionals, it is important for nurse managers and other clinical leaders to have a repertoire of skills and interventions that can be used to motivate and engage clinical teams in risk assessment and continuous quality improvement at the level of patient care delivery. This paper describes how a cohort of clinical leaders who were undertaking a leadership development program used a relatively simple, patient-focused intervention called the 'observation of care' to help focus the clinical team's attention on areas for improvement within the clinical setting. The main quality and safety themes arising out of the observations that were undertaken by the Clinical Leaders (CLs) were related to the environment, occupational health and safety, communication and team function, clinical practice and patient care. The observations of care also provided the CLs with many opportunities to acknowledge and celebrate exemplary practice as it was observed as a means of enhancing the development of a quality and safety culture within the clinical setting. The 'observation of care' intervention can be used by Clinical Leader's to engage and motivate clinical teams to focus on continuously improving the safety and quality of their own work environment and the care delivered to patients within that environment.
Spence, K, Foster, J, Wright, I, Badawi, N, Lees, S, Buckmaster, A, Taylor, C, Sinclair, L, Morris, S & Peters, K 2017, 'Tube Feeding and Feed Transition Practice in Special Care Nurseries (SCNs): A Need for a Consistent Approach', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand Annual Congress, Blackwell Publishing Inc., Canberra, pp. 94-95.
Gorman, E, Guaran, R, Sinclair, L, Boubeta, C, Xafis, V, Pussell, K, Challis, D & Tarnow-Mordi, W 2016, 'Improving parents understanding of extremely Preterm infants Outcomes Data (POD Study)', Journal of Paediatrics and Child Health, Blackwell Publishing Inc., pp. 37-37.
Kinross, D, Spence, K, Sinclair, L, NSW Clinical Nurse Consultants Network & NSW Neonatal Intensive Care Units (NICUS) Study Group 2016, 'Breastfeeding outcomes and support across NICUs in NSW', Journal of Paediatrics and Child Health, Blackwell Publishing Inc., pp. 105-105.
Sinclair, L, McPhillips, J & Berry, A 2013, 'The 'Good Egg Pack': An innovative approach to neonatal emergencies in rural NSW, Australia', Australian Critical Care, ANZICS/ACCCN Annual Scientific Meeting, Cambridge Media, Hobart, Tasmania, pp. 63-63.
Sinclair, L, Spence, K, Morritt, ML, Bredemeyer, S, Bowers, S, Richards, R, Kinross, D, Lindrea, KB & Jolley, B 2012, 'NURSING KNOWLEDGE AND OUTCOMES OF NEONATAL CARE: A TWO-PHASE MULTICENTRE STUDY', Journal of Paediatrics and Child Health, 17th Congress of the Federation of Asian and Oceania Perinatal Societies (FAOPS) and the 16th Annual Congress of the Perinatal Society of Australia and New Zealand (PSANZ), Blackwell Publishing Inc., Sydney, pp. 75-75.
Sinclair, LS, Luig, M & Hallman, P 2011, 'THERAPEUTIC HYPOTHERMIA FOR NEWBORN INFANTS WITH HYPOXIC ISCHAEMIC ENCEPHALOPATHY BORN IN NON-TERTIARY CENTRES IN NSW, AUSTRALIA', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand, Blackwell Publishing Inc., Hobart, Tasmania, pp. 39-39.
Sinclair, LS, Luig, M & Hallman, P 2011, 'Therapeutic hypothermia for newborn infants with hypoxic-ischaemic encephalopathy born in non-tertiary centres in NSW, Australia', Pediatric Critcial Care Medicine, World Congress on Paediatric Critical Care, Sydney.
Sinclair, LS, McPhillips, J & Berry, A 2011, 'THE 'GOOD EGG PACK': AN INNOVATIVE APPROACH TO NEONATAL EMERGENCIES IN RURAL NSW, AUSTRALIA', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand, Blackwell Publishing Inc., Hobart, Tasmania, pp. 107-107.
Wall, M, Sinclair, L & Berry, A 2011, 'DEVELOPING AN AUSTRALASIAN MINIMUM DATA SET FOR NEONATAL TRANSPORT', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand, Blackwell Publishing Inc., Hobart, Tasmania, pp. 15-15.
Jorgensen, C, Sinclair, L & Crisp, J 2010, 'The rhetoric and reality of evidence based practice and clinical practice guideline use within the NICU; A qualitative descriptive study', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand, Blackwell Publishing Inc., Wellington, New Zealand, pp. 29-29.
Sinclair, L & Sinn, J 2008, 'A SYSTEMATIC REVIEW OF HIGHER VERSUS LOWERHUMIDITY FOR THE PREVENTION OF MORBIDITY ANDMORTALITY IN PRETERM INFANTS IN INCUBATORS', Journal of Paediatrics and Child Health, Perinatal Society of Australia and New Zealand Annual Congress, Blackwell Publishing Inc., Gold Coast, pp. A73-A73.