Respiratory follow-up to improve outcomes for Aboriginal children: twelve key steps

Laird, Pamela; Walker, Roz; Gill, Fenella J.; Whitby, Jack; Chang, Anne B.; Schultz, André

doi:10.1016/j.lanwpc.2021.100239

Cited by 4 publications

(7 citation statements)

References 21 publications

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“…Similar complexities within the hospital system were reported in a recent Australian study, which identified 12-key steps required to facilitate successful medical follow-up for Aboriginal children hospitalized with acute chest infections (Laird et al, 2021). Mapping and then following the 12-steps was important in ensuring this vulnerable group of patients received timely medical follow-up to prevent serious long-term morbidity.…”

Section: Discussionmentioning

confidence: 65%

Spring‐infusors: How a simple and small solution can create king‐sized complexity

et al. 2022

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Aim The aims of the study were to investigate family and hospital staff views about the use of spring‐infusor devices for administration of intravenous antibiotic medications, to examine if the device is acceptable and feasible and to map a process for implementation. Design A qualitative study with a pragmatist approach, within a larger, mixed methods knowledge translation study. Methods Data were collected by semi‐structured interviews with patients who have cystic fibrosis and their parents and focus groups and interviews with hospital staff. Interviews were concluded when no new themes were identified. Thematic analysis and process mapping was undertaken. Results Six parents, nine children and 30 staff were interviewed. Families preferred spring‐infusors. Staff knowledge, experience and attitudes toward spring‐infusor use was varied. All staff acknowledged that their role is to support patient‐centred care. Spring‐infusors are preferred by families and clinicians above other IV administration devices but misconceptions about spring‐infusor use and numerous procedural challenges reduced their use.

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Section: Discussionmentioning

confidence: 65%

Spring‐infusors: How a simple and small solution can create king‐sized complexity

et al. 2022

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“…Such follow-up could prevent chronic disease but is not simple to arrange. 14 Our study had limitations. The retrospective nature of the study did not allow the study of causation.…”

Section: Discussionmentioning

confidence: 90%

“…Importantly, all efforts should be made to facilitate appropriate medical follow‐up for children post‐hospitalization. Such follow‐up could prevent chronic disease but is not simple to arrange 14 …”

Section: Discussionmentioning

confidence: 99%

Lung abscess: 14 years of experience in a tertiary paediatric hospital

Fernando

Bhatt

Saiganesh

et al. 2022

ANZ Journal of Surgery

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Background Lung abscess is a rare condition in paediatrics with a paucity of literature. Intravenous antibiotics is the main therapy; however interventional radiological approaches have led to the use of percutaneous drainage. Surgery is reserved for the management of complications. The aim of this study was to describe lung abscess in a cohort of paediatric patients' and determine associations between factors at presentation and outcomes. Methods A 14‐year retrospective cohort study was conducted including all children who presented to a tertiary paediatric hospital in Western Australia with lung abscess. Clinical characteristics, laboratory and radiologic findings, management options and clinical outcomes were examined. Results Sixty‐eight patients (median age 3.6 (0.08–17.6) years; 44.1% female) were identified to have a lung abscess, with 81% being primary lung abscess. Staphylococcus aureus (including MRSA) and Streptococcus pneumoniae were the most common organisms identified, with S. aureus being most common in Aboriginal patients (80%). A total of 25 antibiotics were prescribed on initiation of treatment in over 20 combinations. 44.9% of patients had complications and hospitalization was prolonged. Patients with S. aureus had longer hospitalization (20.5 days (3–67) than those without (median 13 days (3–52), p = 0.04). There were no associations between factors at presentation and subsequent outcomes. Factors at presentation were not associated with outcomes. Conclusion There is unwarranted variation in management of paediatric lung abscess and high complication rates. There is a need for collaboration and clinical practice guidelines to standardize care for lung abscess in children.

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“…The medical follow-up strategy (henceforth termed ‘strategy’) was informed by our previous research [ 13 , 14 ] and methodological approaches [ 15 ], and is consistent with Australian [ 16 ] and International [ 17 ] guidelines for children at high risk of developing bronchiectasis. Implementation of the strategy core components will be adapted to the unique context of each study site; the core components are outlined in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…The medical follow-up strategy was developed in a study at Perth Children’s Hospital [ 14 ]. Delivery of the strategy’s core components (Table 1 ) will be adapted to the workflows and structure of sites using a combined decolonising research approach [ 15 ], which includes Participatory Action Research (PAR) [ 14 ] and the Consolidated Framework for Implementation Research (CFIR). The CFIR provides a structure for identifying a range of factors that can facilitate or hinder the implementation of evidence-informed interventions.…”

Section: Methodsmentioning

confidence: 99%

Implementation of a strategy to facilitate effective medical follow-up for Australian First Nations children hospitalised with lower respiratory tract infections: study protocol

et al. 2022

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Background First Nations children hospitalised with acute lower respiratory infections (ALRIs) are at increased risk of future bronchiectasis (up to 15–19%) within 24-months post-hospitalisation. An identified predictive factor is persistent wet cough a month after hospitalisation and this is likely related to protracted bacterial bronchitis which can progress to bronchiectasis, if untreated. Thus, screening for, and optimally managing, persistent wet cough one-month post-hospitalisation potentially prevents bronchiectasis in First Nations’ children. Our study aims to improve the post-hospitalisation medical follow-up for First Nations children hospitalised with ALRIs and thus lead to improved respiratory health. We hypothesize that implementation of a strategy, conducted in a culturally secure manner, that is informed by barriers and facilitators identified by both parents and health care providers, will improve medical follow-up and management of First Nations children hospitalized with ALRIs. Methods Our trial is a multi-centre, pseudo-randomized stepped wedge design where the implementation of the strategy is tailored for each study site through a combined Participatory Action Research and implementation science approach informed by the Consolidated Framework of Implementation Research. Outcome measures will consist of three categories related to (i) health, (ii) economics and (iii) implementation. The primary outcome measure will be Cough-specific Quality of Life (PC-QoL). Outcomes will be measures at each study site/cluster in three different stages i.e., (i) nil-intervention control group, (ii) health information only control group and (iii) post-intervention group. Discussion If our hypothesis is correct, our study findings will translate to improved health outcomes (cough related quality of life) in children who have persistent wet cough a month after hospitalization for an ALRI. Trial registration ACTRN12622000224729, prospectively registered 8 February 2022, URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382886&isReview=true.

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Respiratory follow-up to improve outcomes for Aboriginal children: twelve key steps

Cited by 4 publications

References 21 publications

Spring‐infusors: How a simple and small solution can create king‐sized complexity

Spring‐infusors: How a simple and small solution can create king‐sized complexity

Lung abscess: 14 years of experience in a tertiary paediatric hospital

Implementation of a strategy to facilitate effective medical follow-up for Australian First Nations children hospitalised with lower respiratory tract infections: study protocol

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