Research capacity building in healthcare works to generate and apply new knowledge to improve health outcomes; it creates new career pathways, improves staff satisfaction, retention and organisational performance. While there are examples of investment and research activity in rural Australia, overall, rural research remains under-reported, undervalued and under-represented in the evidence base. This is particularly so in primary care settings. This lack of contextual knowledge generation and translation perpetuates rural–metropolitan health outcome disparities. Through greater attention to and investment in building research capacity and capability in our regional, rural and remote health services, these issues may be partially addressed. It is proposed that it is time for Australia to systematically invest in rurally focussed, sustainable, embedded research capacity building.
Objective:
Does the provision of a nurse‐based intervention lead to smoking cessation in hospital patients?
Methods: At tertiary teaching hospital in Newcastle, Australia, 4,779 eligible (aged 18–80, admitted for at least 24 hours, and able to provide informed consent) and consenting (73.4%) in‐patients were recruited into a larger cross‐sectional survey. 1,422 (29.7%) smokers (in the last 12 months) were randomly assigned to control (n=711) or intervention group (n=711). The brief nurse‐delivered intervention incorporated: tailored information, assessment of withdrawal, offer of nicotine replacement therapy, booklets, and a discharge letter. Self‐reported cessation at 12 months was validated with CO and salivary cotinine.
Results: There were no significant differences between groups in self‐reported abstinence at three or 12 months post intervention, based on an intention to treat analysis. At three months, self‐reported abstinence was 27.3% (I) and 27.5% (C); at 12 months was 18.5% (I) and 20.6% (C). There were no differences in validation of self‐report between intervention and control groups at 12 months.
Conclusion: This brief nurse‐provided in‐patient intervention did not significantly increase the smoking cessation rates compared with the control group at either three or 12‐month follow‐up.
Implications: A systematic total quality improvement model of accountable outcome‐focused treatment, incorporating assertive physician‐led pharmacotherapy, routine assessment and recording of nicotine dependence (ICD 10 coding), in‐and outpatient services and engagement from multidisciplinary teams of health professionals may be required to improve treatment modalities for this chronic addictive disorder.
Introduction: The cognitive deficits associated with dementia often preclude residents in aged care facilities from being able to communicate their life histories, preferences and needs and staff typically rely on family to provide this information. This project explored the opinions of staff and families of participating together in the process of life storytelling for residents.Methods: Staff and families of residents with dementia in one aged care facility were invited to participate in lifestory telling. Semi structured interviews were then conducted with staff and families to explore their perceptions of working together.Results: Negative aspects reported by staff was the perception that some families expectations of care were too high, while family members reported a lack of communication with staff.
Conclusions:Life story telling for residents provided a positive experience for participants, with reports that the process itself improved their relationships by increasing understanding.
The MMHM project was a successful pilot of a mentoring program in hematological cancers between metropolitan and regional centers that resulted in improved referral links, facilitated better care coordination, updated treatment policies and guidelines and increased clinician satisfaction and knowledge.
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