Framework In Australia Research Articles

How does the consent model in Australia’s Privacy Act 1988 (Cth) undermine our human right to privacy?

ABSTRACT Cambridge Analytica was a political consulting business that became known for its use of personal data obtained from social media platform Facebook, to drive election campaigns on behalf of its clients. Their most famous client was the winner of the 2016 US Presidential election. When it was realised that Cambridge Analytica had acquired Australian Facebook users’ data, the Australian privacy regulator started litigation against Facebook to enforce the Privacy Act 1988 (Cth). This article examines how the Facebook litigation and subsequent law reform activities shed light on the central, yet fictitious role of the consent model. A historical and cultural analysis reveals how consent to surrender private information is a symptom of social conditions in which we take it for granted that individuals, rather than business, will bear the costs of poor privacy outcomes. Our collective ‘consent realism’ not only constrains the imagination of policy makers but interferes with a person’s autonomy in forming and developing opinions. However, a right to privacy can be more viably re-asserted, at least in response to the Cambridge Analytica incident, within the framework of Australia’s implied freedom of political communication. Consent realism can thus potentially be overcome in favour of human rights principles.

P211 PRESCRIPTION AND DISPENSING DURATION OF MEDICINES FOR CHRONIC CONDITIONS: A REVIEW OF INTERNATIONAL POLICIES AND EVIDENCE TO INFORM THE AUSTRALIAN SETTING

Objective: To summarize the current legislative and regulatory framework in Australia and abroad, as well as evidence on the potential impact that dispensed quantity and prescription durations may have on patient outcomes and costs. Methods: We searched the PubMed database for peer-reviewed articles using the search terms “prescription duration”[title], “*duration prescriptions”[title], “prescription length”[title], “prescription period”[title], “extended prescription”[title], “repeat prescription”[title], “repeat prescribing”[title], and “dispensing duration”[title]. In addition, for a selection of countries, we also searched for and asked national health care authorities or local experts via e-mail regarding dispensing and prescription duration limitations based on legislation, health service guidelines, and subsidy program regulations. To achieve a representative sample, we included the world's 5 most populous countries, as well as the most populous country from each continent. We defined “prescription duration” as the entire period of treatment, based on the quantity of medication, for which a healthcare provider may prescribe a medication, and “dispensing duration” as the period of treatment for which a pharmacist may dispense the medication at a single time point. Results: In 31 countries, the most common limitation for dispensing durations were either 30, 60 or 90 days, and for prescription durations either 3, 6 or 12 months. Evidence on the impact of dispensing and prescription durations is limited in quality, but suggests that longer dispensing durations are less costly to the patient (and funder) and improve adherence compared with shorter dispensing durations. There is not enough evidence to draw any conclusions regarding the effects on medicines supplies or health outcomes. To understand the full effects of different prescription and dispensing durations, and to improve the quality of evidence of what previous studies have thus far suggested, randomized controlled trials are needed. Conclusions: Prescription and dispensing durations vary widely between countries, but the effects of such limitations are largely unknown. More rigorous research is needed to identify the ideal prescription duration by also addressing the impact it has on other aspects such as health outcomes, medicine waste, savings to the health system and loss of working hours.

Unsolicited Sexting and Help-Seeking Behaviours among Australian Adults: A Mixed-Methods Study

Sending unsolicited sexts is increasingly recognised as harmful and, in some countries, constitutes a criminal offence. Recipients of unwanted/unexpected sexts often report compromised mental health, yet it is currently unknown how people deal with these sexting experiences. Using a mixed-methods approach, this study explored help-seeking behaviours following the receipt of unwanted sexts and barriers to reaching out for support in Australia, where the law currently does not recognise unsolicited sexting as a criminal offence. In total, 883 participants, Mage = 22.52 years (SD = 3.09), were recruited comprising 539 (61.2%) women, 325 (36.9%) men, and 17 (1.9%) other/non-binary. Overall, women were more likely to receive unsolicited sexts (389, 81%) than men (66, 26.2%), and ≥97.7% of respondents across genders never sought support in response to these experiences. Template thematic analysis revealed the receipt of unwanted sexts was often regarded “too trivial” to seek support for, which was captured under the theme of it’s just an image. Regarding barriers to help-seeking, three themes were generated: it’s an awkward experience to talk about, I did not realise it was a violation, I didn’t know where to go. Young Australian adults often did not seek support due to feelings of awkwardness and shame associated with receiving unwanted sexts, a lack of understanding of the violating nature of these experiences and young age, and minimal knowledge of supports. This study illustrates that community attitudes and the legal framework in Australia towards unsolicited sexting need to change to recognise this sexting variant as harmful and illegal.

The Queensland geotechnical database

The Queensland Geotechnical Database (QGD; qgd.org.au) was launched in October 2017 with the aim of consolidating primarily tax and toll-payer subsidised geotechnical investigation logs into an open platform. The QGD was influenced by public geotechnical databases in the United Kingdom and New Zealand, and the work of Robert Leggett in Canada as summarised in ‘Cities and Geology’ (1973). As of October 2023, the QGD includes over 3100 geotechnical investigation logs authored by over 10 public and private entities, dating back to 1966. It also includes national geological mapping and links to over 400 technical papers related to sites in Australia. This paper summarises the formation of the QGD, which emerged from the Queensland Chapter of the Australian Geomechanics Society (AGS) and originated from a personal database converted to an open format with hosting support from The Open Data Institute Australia. The QGD was later transferred to The University of Queensland and continues there in support of their Sustainable Infrastructure Research Hub (UQ SIRH). The paper explores the evolution of its formation, the legal framework in Australia regarding investigation log ownership, and the licensing scheme adopted for the database. It outlines the technical features and intended practicality of the database, and its alignment with the objectives of the UQ SIRH. The paper concludes with an outline of opportunities for conversion to a nationalised Australian Geotechnical Database and its usage for educational purposes.

Telecom industry grievance redressal system: a study of ombudsman approach in selected countries

PurposeThis study aims to explore the telecom regulations and telecom reforms of different countries in the context of consumer complaints and grievance handling. The telecom dispute resolution mechanisms of countries such as Australia, the USA, the UK and India are studied. This qualitative research is carried out for the three major telecom markets: Australia, the USA and India.Design/methodology/approachHere, research is conducted in two stages. In the first stage, the telecom policies of the major telecom markets, their ombudsman policies and consumer grievance redressal mechanisms are studied. In the second stage, the qualitative analysis of the three telecom markets, Australia, the USA and India, is conducted through in-depth interviews, the questionnaire method for telecom customers and secondary research.FindingsTelecom customer satisfaction is significantly higher in countries with the telecom ombudsman as a system of telecom governance redressal. This study dedicates significant importance to the distinctiveness of the grievance resolution systems in different countries and suggests recommendations for improving the mechanisms. The recommendations given in the research study emerge as the output of interviewing telecom experts, academicians and researchers and court judges.Research limitations/implicationsThis study has partial limitations as primary research was carried out only in selected countries with limited participants.Practical implicationsThis study is useful for policymakers, regulators and think tanks in the telecommunications sector.Social implicationsThe resolution of individual customer grievances is significant to the telecom industry and all participants. A well-oiled grievance redressal system enhances the trust among the service users and aids in the industry’s growth. Further practical assessment of redressal offered by different telecom operators can be used for benchmarking, and it can create an onus on telecom operators for timely and adequate redressal of consumer complaints. In certain countries with a well-developed alternate dispute resolution (ADR) mechanism, the service offerings of telecom operators and the quality of services are deemed to be better than those without such an ADR. The research aims to bring in the positives of ADR systems from specific telecom markets and suggest the effectiveness of such ADR for countries such as India, which has over 1.17billion active subscribers. This research aims to aid responsive communication with telecom consumers in the overall telecom industry, which can bolster telecom consumers’ confidence and help the industry grow sustainably. Discussing perspectives on telecom dispute resolution in various conferences and discussing use-cases of innovative dispute settlements can act as stimuli in this space. As ADR procedures are conducted in the shadow of the law, a dispute resolution framework must have a buy-in from the government, telecom experts, the judiciary and private telecom stakeholders. This can only help achieve a framework that can reap the benefits of various ADR/ODR processes facilitating better access to justice, including cost-effectiveness, swiftness, a broader reach for dispute resolution and improved efficiency of dispute resolution.Originality/valuePrevious studies have focused on the study of telecom reforms and mechanisms in a particular country and there was a limited comparison with other countries’ mechanisms. Also, there has been minimal research in this area in recent years. This paper contributes to analyzing the effectiveness of the telecom ombudsman framework in Australia, the USA, the UK and India. It also studies the reforms and consumer grievance-handling mechanisms in a few other countries. It also gives well-researched recommendations for improving the consumer grievance resolution system.

Moving Towards Inclusive Education: Secondary School Teacher Attitudes Towards Universal Design for Learning in Australia

AbstractAchieving Sustainable Development Goal 4 is underpinned by the provision of quality inclusive education for all young persons, including persons with disabilities. The universal design for learning (UDL) framework provides the basis for establishing an inclusive pedagogical learning environment in classrooms. However, implementing such an inclusive pedagogical framework continues to be profoundly challenging across all countries, including Australia. Teacher attitude is the most important construct in efforts to create inclusive educational contexts. The aim of this study was to examine secondary school teachers’ attitudes towards the UDL framework in Australia. One hundred and twenty mainstream secondary classroom teachers in Sydney completed an online survey. The mean values and standard deviations of a self-designed UDL framework were calculated to examine teacher attitudes. Correlations and multiple regressions were conducted to verify the relationship between teachers’ attitudes and their background variables. The main results indicated that Australian secondary school teacher attitudes towards the UDL framework were generally positive, although they still had some practical concerns, such as having inflexible ideas about how to provide instructions. The findings provide useful insights for developing professional teacher training to promote inclusive education, where the UDL framework is a lens for interpreting inclusive education.

Multicultural quality of life predictive effects on wellbeing: a cross-sectional study of a Muslim community in South Australia

ABSTRACT Muslim women (n = 39) and men (n = 59) in Adelaide, South Australia were surveyed using the ONS-UK Personal Wellbeing questions (PWB) and Multicultural Quality of Life Index (MQLI). Pearson product-moment correlational analysis, multiple regression analyses, and Hayes’s PROCESS modeling showed spiritual fulfillment-MQLI as the strongest predictor of life satisfaction-PWB, and of PWB overall. Physical wellbeing-MQLI was the greatest predictor of worthiness-PWB. For Muslim women, low spiritual fulfillment-MQLI was positively correlated with high anxiety-PWB. Muslim religiosity is not often integrated into policy and practice frameworks in Australia, which has implications for social work practice with Muslim minority communities, more so with Muslim women.

Starting with us: Imagining relational, co-designed policy approaches to improve healthcare access for rural people with disability.

Access to healthcare for rural Australians is a wicked problem, particularly for rural people with disability. Contemporary healthcare access frameworks in Australia tend to overlook geography, use a 'one-size-fits-all approach', and disregard the valuable relationships between key rural healthcare stakeholders, including rural people with disability, rural health services and health professionals. The United Nation's Convention on the Rights of Persons with Disabilities requires the Australian Government to engage people with disability in the design of policies that will shape their day-to-day lives, including their access to healthcare. However, the nature and extent to which rural people with disability, rural health professionals and other key rural stakeholders are involved in the design of Australian policies impacting the health of rural people with disability are unknown. This paper examines approaches taken to engage rural people with disability and health professionals in the design of Australian disability policy impacting healthcare access, and reimagines future processes which can improve healthcare access for rural people with disability. Co-design and ethics of care lenses are applied to policy design approaches in this paper. We approach this work as rural disability and health academics, rural health professionals, and as rural people with disability, neurodivergence and family members of people with disability. We argue future co-designed policy approaches could focus on driving change towards equity in healthcare access for rural people with disability by harnessing the relational nature of rural healthcare.

Administrative justice theory and benchmarks in mandatory immigration detention: principled tensions or power imbalance?

ABSTRACT The controversial mandatory immigration detention framework in Australia restricts individual freedoms in the most fundamental way and warrants close scrutiny. This article takes a pre-formulated theory of administrative justice as a lens to consider law-making and decision-making in mandatory detention cases where people sought asylum in Australia without a valid visa. In so doing, the article takes novel steps beyond defining the concept of administrative justice to applying a comprehensive administrative justice theory to this particular Australian setting. It provides a basis for analysing the limitations of the mandatory detention framework from a normative legal perspective and highlights areas of concern that are ripe for reform in the delivery of administrative justice. The article proposes a set of normative benchmarks that are founded on four administrative justice themes: the proper exercise of power, equal treatment, due process, and accessibility. These immigration detention-specific benchmarks are drawn from domestic law and policy, international law and literature in public administration and human rights. The article then analyses overseer recommendations, law reform reports and scholarly material to reveal the extent to which immigration detention practices meet normative administrative justice values. The article analyses how power imbalances destabilise the principled tensions that should exist between administrative justice properties and the subsequent effect that such imbalances have on those subject to mandatory immigration detention. This article proves that administrative justice theory provides a suitable lens for normative analysis of a public law system and emphasises the need for principled tensions between administrative justice properties.

Maintaining Asepsis in Paramedicine: A Delphi Study: Asepsis in Paramedicine

Background The body's natural defences are breached during invasive procedures conducted during paramedic clinical care. Despite the complexity of these procedures, asepsis is a clinical goal for all invasive procedures. In doing so, it is critical that ‘key-parts’ and ‘key-sites’ are protected to decrease the risk of transmitting healthcare-associated infections (HAIs). Although a national framework in Australia for the prevention of HAIs exists, this advice needs adapting to the field of paramedicine to account for variation in practice setting and clinical practice. This project aimed to reach consensus among experts regarding how to maintain asepsis in paramedic practice. Method A modified Delphi process was used with four iterative online rounds. Participants were sought nationally using a snowball (bias) technique and included professionals within healthcare who met the inclusion criteria of extensive experience in one or more of three areas: paramedicine, infection prevention and control, and evidence-based policy development. Results Eleven experts in the field of IPC and paramedicine contributed to a consensus project regarding how to maintain asepsis in paramedic practice. Conclusion This project provides a consensus statement that will allow operational procedures to be reviewed, techniques specific to paramedic practice to be developed and implemented, and scientific research to be conducted.

Preparing preservice early childhood educators to use music in Australian settings: An audit of programmes

Music is ever-present in early childhood but does not feature strongly in the national curriculum framework – The Early Years Learning Framework in Australia or in the intentional practice of educators in early childhood education and care settings. This is mainly due to a lack of knowledge and confidence or self-efficacy to engage musically with the children. Preservice educator training plays a critical role in the development of effective pedagogical skills, knowledge and understanding. This article explored the music education preparation that preservice educators receive in initial training. A content analysis approach was used to review course content of all approved preservice educator programmes in Australia by the Australian Children’s Education & Care Quality Authority. Interviews with tertiary teachers explored content taught. The findings offer rich insight into the extent of music education provided for preservice early childhood educators and implications for the development for future programmes.

Policy solutions to facilitate restoration in coastal marine environments

Restoration of coastal and marine ecosystems is essential to meet both national and global conservation targets and to counteract declines in coastal marine ecosystems. However, despite its status as a world leader in marine protection, Australia is lagging behind other countries in the implementation of coastal and marine restoration. Effective legislative frameworks that support the implementation of coastal and marine restoration as a management tool remains a key barrier to large-scale implementation of coastal and marine restoration in Australia and many other regions. We analyzed restoration projects and their policy frameworks in Australia, North America and Europe to identify the range of policy approaches for marine and coastal restoration. We then evaluated the legislative frameworks for coastal and marine restoration in two states in Australia (Queensland and New South Wales), to assess the current restoration permitting process and identify how different legislative and policy approaches could facilitate coastal and marine restoration projects. We identified two specific areas where improvements could be made to facilitate marine coastal restoration in Australia: increased transparency and better integration into coastal policy. Coastal and marine restoration in Australia is undertaken without appropriate and effective policy at the local, regional and national levels, which likely impedes its broader use as a management strategy. The policy and legislative changes and amendments outlined in this article can streamline the coastal and marine restoration process and thereby improve uptake of marine and coastal restoration in Australia.

How do health services engage culturally and linguistically diverse consumers? An analysis of consumer engagement frameworks in Australia.

ABSTRACTBackgroundEngagement frameworks provide the conceptual structure for consumer engagement in healthcare decision making, but the level to which these frameworks support culturally and linguistically diverse (CALD) consumer engagement is not known.ObjectiveThis study aimed to investigate how consumer engagement is conceptualised and operationalized and to determine the implications of current consumer engagement frameworks for engagement with CALD consumers.MethodAltheide's document analysis approach was used to guide a systematic search, selection and analytic process. Australian Government health department websites were searched for eligible publicly available engagement frameworks. A narrative synthesis was conducted.ResultsEleven engagement frameworks published between 2007 and 2019 were identified and analysed. Only four frameworks discussed engagement with CALD consumers distinctly. Organisational prerequisites to enhance engagement opportunities and approaches to enable activities of engagement were highlighted to improve CALD consumers' active participation in decision making; however, these largely focused on language, with limited exploration of culturally sensitive services.ConclusionThere is limited discussion of what culturally sensitive services look like and what resources are needed to enhance CALD consumer engagement in high‐level decision making. Health services and policy makers can enhance opportunities for engagement with CALD consumers by being flexible in their approach, implementing policies for reimbursement for participation and evaluating and adapting the activities of engagement in collaboration with CALD consumers.Patient/Public ContributionThis study is part of a wider ‘CanEngage’ project, which includes a consumer investigator, and is supported by a consumer advisory group. The study was conceived with inputs from the consumer advisory group, which continued to meet regularly with the project team to discuss the methodology and emerging findings.

A Preliminary Study of Students With Disabilities in ‘Flexi’ Education Settings

Abstract Flexible learning programs (FLPs) provide a place for students who have disengaged and disconnected from mainstream schools. Despite the legislative framework in Australia supporting the participation of students with disability in their local mainstream schools wherever possible, very little research focusing on whether students with disability are being excluded from, or dropping out of, mainstream schools into these FLPs has been conducted. In this paper, we report on the findings of an online cross-sectional survey of FLP leaders about their student populations, with a focus on the 10 most prevalent disabilities among Australian children. Data from the 22 participants who completed all items of the survey were analysed. The participants’ (n = 22) schools represented a total enrolment of 2,383 students in FLPs across Australia: Tasmania (n = 3), Victoria (n = 5), New South Wales (n = 5), Queensland (n = 4), Western Australia (n = 3), and South Australia (n = 2). We found that while there was an apparent overrepresentation of students with certain types of disabilities in FLPs, others were not overrepresented at all. The findings of this preliminary study are discussed, with an exploration of issues relating to why students with some disabilities may be more likely to disengage, or be excluded, from mainstream schooling while others are not, as well as recommendations for future research.

Improving pharmacy practice in relation to complementary medicines: a qualitative study evaluating the acceptability and feasibility of a new ethical framework in Australia

BackgroundThere is a need for clearer guidance for pharmacists regarding their responsibilities when selling complementary medicines. A recently published ethical framework provides guidance regarding the specific responsibilities that pharmacists need to meet in order to fulfil their professional obligations and make a positive contribution to health outcomes when selling complementary medicines.ObjectiveEvaluate the acceptability and feasibility of a new ethical framework for the sale of complementary medicines in community pharmacy.MethodsAustralian community pharmacists were invited to participate in online focus groups and interviews. Participants were recruited via multiple methods, including social media and the professional networks of pharmacy groups. Participants were provided the ethical framework prior to the discussion. Discussions were transcribed verbatim and analysed using thematic analysis.ResultsSeventeen community pharmacists participated in the study (11 in 4 focus groups and 6 in individual interviews). There was good representation among participants in terms of gender, years of practice, pharmacy location and script volume. Participants differed in how proactive they were in relation to selling and providing advice on complementary medicines, how they interpreted evidence in relation to complementary medicines, and how they navigated their practice within the retail environment of community pharmacy. The majority of participants found the framework was acceptable for practice and was feasible for implementation with targeted support. Participants identified two important areas for targeted support in implementing the framework: improved access to evidence-based information resources on complementary medicines and independent evidence-based education and training on complementary medicine for pharmacists and pharmacy support staff.ConclusionThe ethical framework addresses an important gap in providing specific professional guidance to pharmacists when selling complementary medicines. The results of the study suggest that the framework may be acceptable to community pharmacists and be feasible to implement with targeted support.

Judicial reliance on the executive: tensions, discrepancies and recommendations for court interpreter service delivery models across Australian jurisdictions

ABSTRACT In the past decade, there has been noticeable improvement in judicial attention and attitudes towards court interpreters, reflected in the implementation of various court interpreter protocols and the Recommended National Standards for Interpreters in Courts and Tribunals. However, this article identifies a number of discrepancies and gaps that still exist in the court interpreting framework in Australia. There are discrepancies across jurisdictions in the types of matters for which the court takes responsibility for engaging and paying for interpreters, and significantly different service delivery models for the funding, recruitment, training and coordination of interpreters. This study found a correlation between jurisdictions with centralised interpreting agencies and streamlined funding with courts who are more generous in their provision of interpreters and willingness to engage in innovative approaches such as the Northern Territory duty interpreter system. The article identifies service delivery frameworks which are more likely to enhance consistency and competence in court interpreters, concluding that centralised and government-funded agencies are more appropriate than small private for-profit agencies. The issues identified in relation to service delivery models illustrate judicial reliance on the executive branch of government to ensure a fair trial through the provision of interpreters. There are, however, immediate steps available to the judiciary such as a collection of data and implementation of small-scale duty interpreting, which are likely to precipitate more appropriate executive government policy responses to legal interpreting.

A Measure of Happiness—The Use of Live Animals in Contemporary Art Installations

The deployment of living creatures for the purposes of contemporary art installations can be controversial. The debate centres on the unsettling convergence of freedom of artistic expression and the rights of other non-human animals—two moral principles that have high social value. This paper examines the legislative and formalised frameworks in Australia that relate to the use and welfare of live animals on display in contemporary art presentations, with a particular focus on the display of live birds and a case study of the contemporary art installation, Céleste Boursier-Mougenot, from here to ear (vol. 13) 2010. Examples of recent contemporary art installations and presentations that use live animals and the subsequent public reactions and host organisation responses are used to illustrate this controversial artform. The paper contends that there is an imperative for host organisations to build defensible positions on the use of live animals in art, via ethical frameworks supported by research and due diligence, to ensure good animal welfare and care. This process also helps to clarify what could be considered justifiable use of live animals, demonstrating the ethics and moral value of artistic endeavours.

Valuing ecosystem services of urban forests and open spaces: application of the SEEA framework in Australia*

Around two‐thirds of the global population will live in cities by 2050 requiring large urban infrastructure development. Decision‐makers and planners usually rely on standard economic accounting methods for urban planning and investments on infrastructure assets. However, standard methods fail to account for the ecosystem services benefits that living infrastructure (e.g. urban forests, open spaces) provides to city dwellers. This could generate socially inefficient configurations of urban spaces and compromise the achievement of long‐term urban sustainability targets. In this analysis, we applied a stochastic whole‐of‐life benefit–cost analysis following the System of Environmental‐Economic Accounting (SEEA) framework to compare alternative long‐term management strategies for living infrastructure in Canberra, Australia. Spatially explicit data, i‐Tree Eco and benefit transfer methods were used to estimate the stocks and flows ecosystem services benefits of urban forests and irrigated open spaces from 2018 to 2070. Our analysis suggests that a ’30 per cent canopy cover expansion’ scenario has the highest benefit–cost ratio, while the business as usual scenario, where a net loss of 400 trees is expected per year, offers the lowest benefit–cost ratio. Scenarios of expanding versus not expanding irrigated open spaces in the future both result in a benefit–cost ratio of approximately two.

What is needed for Trauma Informed Mental Health Services in Australia? Perspectives of clinicians and managers.

Trauma Informed Care is an approach to the delivery of mental health care that requires sensitivity to the prevalence and effects of trauma in the lives of people accessing services. While TIC is increasingly emphasized in mental health policy and frameworks in Australia, people working in mental health settings have reportedly struggled to translate the values and principles into their everyday practice. This qualitative study used an experience-based co-design methodology to explore the potential for implementation of Trauma Informed Care into mental health services in Australia. The experiences of consumers, carers, clinicians, and managers were gathered. This paper presents the perspectives of clinicians (n=64) and senior managers (n=9) from across three Local Health Districts in New South Wales in Australia. All data were analysed thematically to address the research question: What is needed for Trauma Informed Mental Health Services in Australia? To be trauma-informed, managers required: leadership at all levels, access to resource, relevant and accessible training, support for staff, resolution of wider systems issues, and clarification of the concept and actions of TIC. Clinicians identified that to be trauma-informed they required services to: be aware of staff well-being, support different ways of working, address workplace cultures and provide increased resources. The findings have implications for any service, team or individual seeking to implement TIC within mental health settings.

A critical care pandemic staffing framework in Australia

BackgroundPandemics and the large-scale outbreak of infectious disease can significantly impact morbidity and mortality worldwide. The impact on intensive care resources can be significant and often require modification of service delivery, a key element which includes rapid expansion of the critical care workforce. Pandemics are also unpredictable, which necessitates rapid decision-making and action which, in the lack of experience and guidance, may be extremely challenging. Recognising the potential strain on intensive care units (ICUs), particularly on staffing, a working group was formed for the purpose of developing recommendations to support decision-making during rapid service expansion. MethodsThe Critical Care Pandemic Staffing Working Party (n = 21), representing nursing, allied health, and medical disciplines, has used a modified consensus approach to provide recommendations to inform multidisciplinary workforce capacity expansion planning in critical care. ResultsA total of 60 recommendations have been proposed which reflect general recommendations as well as those specific to maintaining the critical care workforce, expanding the critical care workforce, rostering and allocation of the critical care workforce, nurse-specific recommendations for staffing the ICU, education support and training during ICU surge situations, workforce support, models of care, and de-escalation. ConclusionThese recommendations are provided with the intent that they be used to guide interdisciplinary decision-making, and we suggest that careful consideration is given to the local context to determine which recommendations are most appropriate to implement and how they are prioritised. Ongoing evaluation of recommendation implementation and impact will be necessary, particularly in rapidly changing clinical contexts.