Can supervise: YES
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: UTS OPUS or Publisher's site
Objective To decrease the incidence of bloodstream infection (BSI) for neonates <29weeks 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 <29weeks 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 <29weeks gestation who survived >48h, for a total of 33933 bed days and 14447 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.
Spence, K, Sinclair, L, Morritt, ML & Laing, S 2016, 'Knowledge and learning in speciality practice', Journal of Neonatal Nursing, vol. 22, no. 6, pp. 263-276.View/Download from: UTS OPUS or Publisher's site
Foster, J.P., Buckmaster, A., Sinclair, L., Lees, S. & Guaran, R. 2015, 'Nasal continuous positive airway pressure (nCPAP) for term neonates with respiratory distress.', Cochrane Database of Systematic Reviews, no. 11.
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: UTS OPUS or 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 H0; 6 cm H0)
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: UTS OPUS or 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, Gerbach, 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
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.View/Download from: UTS OPUS
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.View/Download from: UTS OPUS
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.