Social and Behavioral Sciences Commons^™

The Development Of Professional Practice Standards For Australian General Practice Nurses, Elizabeth J. Halcomb, Moira Stephens, Julianne Bryce, Elizabeth Foley, Christine Ashley

Faculty of Science, Medicine and Health - Papers: part A

Aims The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses.

Background Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting.

Design …

Patients' Attitudes Towards Chaperone Use For Intimate Physical Examinations In General Practice, Lucie C. Stanford, Andrew D. Bonney, Rowena G. Ivers, Judy Mullan, Warren C. Rich, Bridget R. Dijkmans-Hadley

Faculty of Science, Medicine and Health - Papers: part A

BACKGROUND: The objective of this article is to investigate patients' attitudes to the use of chaperones for intimate physical examinations (IPEs) in a sample of Australian general practices. METHODS: A cross-sectional survey of adult patients from 13 randomly selected general practices in regional New South Wales was conducted between September and November 2012. Generalised linear mixed models were used for analysis. RESULTS: Of 780 surveys distributed, 687 (88%) were returned; the age range was 18-91 years and 356 (52%) were from female patients. Most women had never had a chaperone present for a Papanicolaou (Pap) smear (82.6%). Between 23% and …

Many People In Scotland Now Benefit From Anticipatory Care Before They Die: An After Death Analysis And Interviews With General Practitioners, Julia Tapsfield, Charlie Hall, Carey Lunan, Hazel Mccutcheon, Peter Mcloughlin, Joel J. Rhee, Alfonso Leiva, Juliet Spiller, Anne Finucane, Scott Murray

Faculty of Science, Medicine and Health - Papers: part A

Background Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care. Aims We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs' views on using KIS. Methods We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which …

Evaluating Women's Knowledge Of The Combined Oral Contraceptive Pill In An Australian Rural General Practice Setting, Sharna Kulhavy, Teresa M. Treweek

Faculty of Science, Medicine and Health - Papers: part A

Background: In addition to the contraceptive action of the combined oral contraceptive pill (COCP), there are a number of other benefits to its use such as menstrual cycle regulation. However, COCP use is also associated with a higher risk of thromboembolism. Despite the prevalence of COCP use, studies have indicated that overall women have poor knowledge of the COCP.

Aim: To evaluate women's knowledge of the COCP in a rural general practice setting. The extent of knowledge was assessed in several domains including: COCP use and effectiveness, mechanism of action, and the risks and benefits of COCP use. …

Culturally And Linguistically Diverse General Practitioners' Utilisation Of Practice Nurses, Elizabeth J. Halcomb, Yenna Salamonson, Melissa Cooper, Jennifer L. Clauson, Lien Lombardo

Faculty of Science, Medicine and Health - Papers: part A

Background Practice nurses are primarily employed by general practitioners, however little is known about the barriers to practice nurse employment from the perspective of general practitioners (GPs). Aim This paper seeks to explore solo, culturally and linguistically diverse (CALD) general practitioners' perceptions of the practice nurse role, and to identify the barriers and facilitators of these doctors employing nurses within their practice. Methods A descriptive study, using semi-structured interviews, was conducted from July to August 2010. Participants were CALD GPs working as solo practitioners who were members of a Division of General Practice in South Western Sydney. Quantitative data were …

Connectgpr: Implementing A Virtual Community Of Practice For General Practice Training, Stephen Barnett

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper the presented at the 2013 Medicine 2.0: World Congress on Social Media, Mobile Apps, Internet/Web 2.0, 25 September, London.

A Qualitative Evaluation Of New Zealand Consumers Perceptions Of General Practice Nurses, Elizabeth J. Halcomb, Kath Peters, Deborah Davies

Faculty of Science, Medicine and Health - Papers: part A

Background An important consideration in health service delivery is ensuring that services meet consumer needs and that consumers are satisfied with service delivery. Patient satisfaction can impact on compliance with suggested treatments and therefore impact on health outcomes. Comparatively few studies have explored consumer satisfaction with nurses in general practice. Methods A sub-group of 18 consumers from a larger quantitative evaluation of consumer satisfaction with New Zealand general practice nurses participated in semi-structured telephone interviews. Interview data was analysed using thematic analysis. Results Four major themes emerged from the data. These themes highlighted that, despite confusion experienced by some consumers …

Australian General Practitioner Perceptions Of The Detection And Screening Of At-Risk Drinking, And The Role Of The Audit-C: A Qualitative Study, Chun Wah Michael Tam, Nicholas Arnold Zwar, Roslyn Markham

Faculty of Science, Medicine and Health - Papers: part A

Background: At-risk drinking is common in Australia. Validated screening tools such as the AUDIT-C have been promoted to general practitioners (GPs), but appear rarely used and detection of at-risk drinking in primary care remains low. We sought to describe Australian GP perceptions of the detection and screening of at-risk drinking; to understand their low uptake of alcohol screening questionnaires, and in particular, their attitude to the adoption of the AUDIT-C. Methods. Semi-structured focus group interviews of four groups of GPs and GP trainees were conducted in metropolitan Sydney between August and October 2011. Audio recordings were transcribed and analysed using …

Preventive Evidence Into Practice (Pep) Study: Implementation Of Guidelines To Prevent Primary Vascular Disease In General Practice Protocol For A Cluster Randomised Controlled Trial, Mark Fort Harris, Jane Lloyd, John Litt, Mieke Van Driel, Danielle Mazza, Grant Russell, Jane Smith, Chris Del Mar, Elizabeth Denney-Wilson, Sharon M. Parker, Yordanka Krastev, Upali W. Jayasinghe, Richard J. Taylor, Nicholas Zwar, Jinty Wilson, Helen Bolger-Harris, Justine Waters

Faculty of Science, Medicine and Health - Papers: part A

Background: There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.Methods: We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20%) and increased adherence to guideline recommendations for: the …

Clinical Placements In General Practice: Relationships Between Practice Nurses And Tertiary Institutions, Kath Peters, Elizabeth J. Halcomb, Susan Mcinnes

Faculty of Science, Medicine and Health - Papers: part A

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and …

Adapting General Practice Training To Meet The Evolving Health Care Needs Of Our Communities, Andrew Bonney, Simon Morgan, Parker Magin

Faculty of Science, Medicine and Health - Papers: part A

Abstract of workshop held at General Practice Education and Training Convention 2013, 11-12 September 2013, Perth.

Practice Nurses Experiences Of Mentoring Undergraduate Nursing Students In Australian General Practice, Elizabeth J. Halcomb, Kathleen Peters, Susan Mcinnes

Faculty of Science, Medicine and Health - Papers: part A

Internationally, the delivery of health services has shifted from secondary to primary care, necessitating an exponential growth of the nursing workforce and expansion of the nursing role in general practice. This growth, and the subsequent need to develop this workforce, has created a need to expose undergraduate nurses to general practice nursing as a viable career option. Concurrently, universities are struggling to find sufficient clinical places for their undergraduate students to gain clinical experience. It is logical, therefore, to increase the number of undergraduate nursing student placements in general practice. Through qualitative research methods, this paper seeks to explore the …

Access To Same Day, Next Day And After-Hours Appointments: The Views Of Australian General Practitioners, Mark Fort Harris, Patrick Davies, Mahnaz Fanaian, Nicholas Zwar, Siaw-Teng Liaw

Faculty of Science, Medicine and Health - Papers: part A

Objective. To evaluate factors associated with the availability of same or next day appointments and after-hours access reported by Australian general practitioners (GPs). Methods. Secondary analysis of a survey of primary care practitioners conducted by the Commonwealth Fund in 2009 in 11 countries. Analysis of factors likely to be associated with reported availability of same or next day appointments and after-hours access. Findings. Of 1016 Australian GPs, 78.8% reported that most patients in their practice had access to an appointment on the same or next day and 50% that their practice had arrangements for after-hours access. Access to same or …

How Generalisable Are Results Of Studies Conducted In Practicebased Research Networks? A Cross-Sectional Study Of General Practitioner Demographics In Two New South Wales Networks, Parker Magin, Melanie Marshall, Susan Goode, Georgina Cotter, C Dimity Pond, Nicholas Zwar

Faculty of Science, Medicine and Health - Papers: part A

Objective: To compare the demographics of general practitioners in two practice-based research networks (PBRNs) and to explore the generalisability of research findings from these PBRNs. Design, setting and participants: Cross-sectional questionnaire-based study of two geographically-based PBRNs - Hunter New England Central Coast Network of Research General Practices (NRGP) and Primary Healthcare Research Network-General Practice (PHReNet-GP) - during August-September 2010. All 183 GP members of both PBRNs were invited to participate; of these, 140 (77%) participated. Main outcome measures: GPs' demographics, use of languages other than English in consultations, and previous participation in research. Practices' use of practice nurses. Socioeconomic status …

Quit In General Practice: A Cluster Randomised Trial Of Enhanced In-Practice Support For Smoking Cessation, Nicholas Arnold Zwar, Robyn Richmond, Elizabeth Halcomb, John Furler, Julie Smith, Oshana Hermiz, Irene Blackberry, Ron Borland

Faculty of Science, Medicine and Health - Papers: part A

Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN) and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1) Quit with Practice Nurse 2) Quitline referral 3) GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and …

Development Of A Clinician-Led Research Agenda For General Practice Nurses, Elizabeth J. Halcomb, Louise Hickman

Faculty of Science, Medicine and Health - Papers: part A

Objective: This study sought to identify and prioritise research issues as perceived by Australian general practice nurses. In this context, a research priority refers to the most pressing research problems that necessitate exploration to improve clinical practice. Design: This paper reports the findings of a two-round Delphi study. Initially, focus groups identified research issues. Subsequently, an online survey facilitated ranking of these issues on a 5-point Likert scale. Setting: Australian general practices. Subjects: Twenty-five practice nurses participated in the focus groups and 145 practice nurses responded to an online survey. Main outcome measure(s): The main outcome measure was the prioritisation …

Development And Early Experience From An Intervention To Facilitate Teamwork Between General Practices And Allied Health Providers: The Team-Link Study, Mark Fort Harris, Bibiana Chan, Christopher Daniel, Qing Wan, Nicholas Zwar, Gawaine Powell Davies

Faculty of Science, Medicine and Health - Papers: part A

Abstract. Background. This paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers. Methods. A review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation. Results. Facilitating teamwork across organizational boundaries was very challenging. The quality of the relationship between professionals was of key importance. This was enabled …

Cardiovascular Absolute Risk Assessment And Management Engagement And Outcomes In General Practice Patients, Qing Wan, Nicholas Zwar, Sanjyot Vagholkar, Terry Campbell, Mark Fort Harris

Faculty of Science, Medicine and Health - Papers: part A

Despite a decline in recent decades, cardiovascular disease (CVD) remains the major cause of death and disability in Australia.1,2 To improve primary prevention of CVD, many clinical guidelines recommend using cardiovascular absolute risk (CVAR) assessment to guide risk factor management.3-6 Cardiovascular absolute risk assessment predicts the overall risk of a cardiovascular event over a given time period (usually 5 or 10 years). However, use of CVAR is limited and has not been incorporated well in routine general practice.7-9 There has been little research on CVAR implementation and an effective implementation strategy has been lacking.10

Uptake Of Medicare Chronic Disease Items In Australia By General Practice Nurses And Aboriginal Health Workers, Elizabeth J. Halcomb, Patricia M. Davidson, Nicola Brown

Faculty of Science, Medicine and Health - Papers: part A

The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and …

The Burden Of The Rheumatic Diseases In The General Adult Population Of Greece: The Esordig Study, A A. Andrianakos, Spyridon Miyakis, P Trontzas, G Kaziolas, F Christoyannis, D Karamitsos, G Karanikolas, P Dantis

Faculty of Science, Medicine and Health - Papers: part A

OBJECTIVE: To estimate the burden of rheumatic diseases in terms of disability and health-care utilization in the Greek general adult population. METHODS: The study was conducted on the total adult population of seven communities (8547 subjects), as well as on 2100 out of 5686 randomly selected subjects in an additional two communities. Rheumatologists visited the participants at their homes to assess the prevalence of six morbidity indicators concerning disability and health-care utilization associated with rheumatic diseases or other major disease groups. RESULTS: The participation rate in the study was 82.1%. The prevalence of chronic health problems, long-term disability, short-term disability, …

Minimum Energy As The General Form Of Critical Flow And Maximum Flow Efficiency And For Explaining Variations In River Channel Pattern, He Qing Huang, Howard H. Chang, Gerald Nanson

Faculty of Science, Medicine and Health - Papers: part A

Although the Bélanger-Böss theorem of critical flow has been widely applied in open channel hydraulics, it was derived from the laws governing ideal frictionless flow. This study explores a more general expression of this theorem and examines its applicability to flow with friction and sediment transport. It demonstrates that the theorem can be more generally presented as the principle of minimum energy (PME), with maximum efficiency of energy use and minimum friction or minimum energy dissipation as its equivalents. Critical flow depth under frictionless conditions, the best hydraulic section where friction is introduced, and the most efficient alluvial channel geometry …

The Nature And Prevalence Of Psychological Problems In New Zealand Primary Healthcare: A Report On Mental Health And General Practice Investigation ( Magpie), John Bushnell, Deborah Mcleod, A D. Dowell, C Salmond, S Ramage, S Collings, P Ellis, Marjan Kljakovic, L Mcbain

Faculty of Science, Medicine and Health - Papers: part A

Aims This paper describes the methods used in a study of the prevalence and types of common mental disorders among patients attending New Zealand general practices, and reports some key findings from the first phase of the study. The study also aimed to determine the degree of associated disability and other factors influencing recognition, management, course and outcome of these disorders, and subsequent papers will address these issues. Methods General practitioners (GPs) were selected randomly. In the first phase of the study, all adult attenders at each practice on selected days were administered a short questionnaire, the General Health Questionnaire …

Psychological Problems In New Zealand Primary Health Care: A Report On The Pilot Phase Of The Mental Health And General Practice Investigation (Magpie), John Bushnell, Deborah Mcleod, A D. Dowell, C Salmond, S Ramage, S Collings, University Of Otago, Marjan Kljakovic, L Mcbain

Faculty of Science, Medicine and Health - Papers: part A

Aim. To carry out a pilot study in two regions in order to investigate prevalence of psychological problems in primary care in New Zealand. Method. General Practitioners (GPs) within two geographic regions were randomly selected. All adult attenders at their practice on selected days were administered a short questionnaire, the GHQ-12, which assesses the presence of psychological symptoms. The GP recorded the reasons for each consultation, and was interviewed at the end of each day about selected patients, to determine their opinion about the type of psychological problems experienced. Results. Three-quarters of selected GPs (76%) agreed to participate. 96% of …