Methamphetamine-related presenters are more aggressive and agitated and more likely to be brought in by police. There is a need for policy development and staff training around these issues and further research in this area using stronger study designs.
Aims and objectives
To explore the quantitative and qualitative literature on the impact of nurse‐led postdischarge telephone follow‐up (TFU) call interventions on patient outcomes.
Background
Adverse patient outcomes such as postdischarge problems, premature contact with health systems, inability to self‐manage conditions and hospital readmissions all have an impact on the health and well‐being, and satisfaction of patients as well as a financial impact on healthcare systems.
Design
A mixed‐study systematic review.
Review methods
A systematic search of CINAHL, Ebsco, PubMed, Quest and Cinch‐Health databases was undertaken using the key terms “nurs*,” “nurse‐led,” “nurse initiated,” “discharge,” “hospital,” “telephone,” “follow‐up” and “telephone follow‐up” to identify relevant original peer‐reviewed studies published between 2010–2016. Ten articles were selected for inclusion. The selected papers were critically appraised. A sequential explanatory approach with a convergent synthesis was used to report findings following PRISMA guidelines.
Results
The findings demonstrate that nurse‐led TFU interventions have the potential to improve patient outcomes. The studies suggest patient satisfaction with TFU is one of the strongest positive outcomes from the interventions. However, the results do not support improvement in patient readmission or mortality.
Conclusions
Of the 10 studies reviewed, only two were methodologically strong limiting the conclusions that can be drawn from the current research on this topic. Telephone follow‐up interventions improve patient satisfaction and have the potential to meet patient information and communication needs, improve self‐management and follow‐up appointment attendance and reduce postdischarge problems. Further research is required to explore patients’ perceptions of the most useful content of TFU calls, the efficacy of TFU calls and nurses’ perceptions and experiences of conducting TFU interventions.
Relevance to clinical practice
When conducted by a nurse, these interventions have the potential to enhance postdischarge care to patients and meet care needs. Patients perceive TFU as acceptable and are satisfied with this form of postdischarge care.
This study explores the patterns and features of methamphetamine-related presentations to emergency departments (EDs) in Queensland. Despite an overall decrease in the use of methamphetamine in Australian, an increase in the use of the crystalized form of methamphetamine has been noted over recent years. A descriptive observational study was utilized to analyse emergency department (ED) injury surveillance data sourced from Queensland Injury Surveillance Unit (QISU) from 2005 to 2017. Data were analysed for presentations related to stimulants (n = 564) with methamphetamine (n = 250) included as a subcategory. Descriptive statistics were used to identify patterns and features of presentations related to methamphetamines. The relationship between demographic variables, service type variables, and drug type was assessed using chi-square and z-tests. Results included the following: 84.4% of methamphetamine-related presentations were allocated a triage score of 1, 2, or 3; 14.8% of all methamphetamine-related presentations required police involvement; 18% were brought in by ambulance; and 15.6% exhibited behaviour that was either, agitated, aggressive, or violent in nature. Methamphetamine-related presentations more frequently required police or ambulance services and more often included aggression or agitation. Methamphetamine-related presentations to ED have a high acuity and often require other emergency resources (police and ambulance). There is a need to develop policy for managing aggressive and agitated people presenting to EDs as a result of methamphetamine use and to further explore the experience of personnel (police and ambulance) managing persons under the influence of methamphetamine.
Providing care to methamphetamine-related callout events in the prehospital environment is often complex and resource-intensive, requiring staff to manage agitation and violence-related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined.The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine-related events. A qualitative descriptive phenomenology design was employed using semi-structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis.Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/ family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use.
Genetic parameters were obtained for iron content inm. longissimus dorsi(2255 records) and haemoglobin levels recorded at 5 (4974 records) and 21 (2405 records) weeks of age in two sire lines from September 2009 until January 2011. The measure of iron in pork was the mean of two replicates. Genetic associations of haematological traits with meat quality traits (2255 records), as well as growth rate and backfat (close to 60 000 records), were estimated. Analyses were based on an animal model using residual maximum likelihood procedures. Iron content in pork was moderately heritable (0.34 ± 0.07) and genetic correlations with haemoglobin measures ranged from 0.39 ± 0.24 to 0.58 ± 0.13, indicating their potential use as selection criteria for increasing iron levels in pork. However, heritabilities for haemoglobin levels were low, ranging from 0.04 ± 0.2 to 0.18 ± 0.04. Procedures to measure haemoglobin on farm may require refinement. Redness of pork, quantified bya* value, had high genetic correlations with iron content (0.90 ± 0.04 to 0.94 ± 0.03) and moderate genetic correlations with haemoglobin levels (0.31 ± 0.22 to 0.55 ± 0.15). Iron content had significant genetic associations withL* measures (−0.61 ± 0.14 to −0.54 ± 0.23),b* value (0.60 ± 0.14 for dorsalb* measure, 0.50 ± 0.15 for average of dorsal and ventral b* measures) and pH at 45 minpost mortem(−0.42 ± 0.14). These high genetic correlations between colour measurements and iron content in pork provide further avenues for selection strategies to improve iron content in pork. Current selection practices are not expected to affect iron content in pork, as no significant genetic correlations between performance and haematological traits were found.
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