Practitioners In Australia Research Articles

Mass Media Social Marketing Campaigns: A Practitioners Perspective

This paper explores mass media social marketing practitioner perspectives of the intersect where the dimensions of religion taxonomy and mass media social marketing campaigns meet. Under an interpretive paradigm (Crotty, 1998), in-depth interviews were conducted with five expert mass media social marketing practitioners in Australia. The data was analysed qualitatively with the data analysis software package NVivo. Five themes emerged from the results: (1) The dimension of religion taxonomy does have application in mass media social marketing campaigns; (2) The use of a ‘patriarch’ in mass media social marketing campaigns and the possible implications; (3) The use of fantasy as a driver for voluntary behaviour change; (4) The assurance of salvation as a driver for voluntary behaviour change and (5) The consideration to use Jung Theory in mass media social marketing campaigns and the possible implications.

Nurse practitioners in Australia: strategic errors and missed opportunities.

Medical Journal of AustraliaVolume 201, Issue 2 p. 85-86 Perspective Nurse practitioners in Australia: strategic errors and missed opportunities Stacy Leidel MSc(Nurs), Corresponding Author Stacy Leidel MSc(Nurs) Lecturer and Nurse Practitioner stacy.leidel@curtin.edu.au School of Nursing and Midwifery, Curtin University, Perth, WA.Correspondence: stacy.leidel@curtin.edu.auSearch for more papers by this author Stacy Leidel MSc(Nurs), Corresponding Author Stacy Leidel MSc(Nurs) Lecturer and Nurse Practitioner stacy.leidel@curtin.edu.au School of Nursing and Midwifery, Curtin University, Perth, WA.Correspondence: stacy.leidel@curtin.edu.auSearch for more papers by this author First published: 21 July 2014 https://doi.org/10.5694/mja14.00125Citations: 10Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume201, Issue2July 2014Pages 85-86 RelatedInformation

Sources of information used to support quality use of medicines: findings from a national survey of nurse practitioners in Australia.

The purpose of this study was to investigate the sources, both print and electronic formats, which Australian nurse practitioners (NPs) currently use to obtain information regarding quality use of medicines (QUM). An additional aim was to document NPs' preferences for continuing education in relation to QUM. A national electronic survey of Australian NPs was conducted in 2007 and again in 2010. Eighty percent of respondents accessed information on QUM from professional literature, which may include scholarly journal articles, reports, and independent publications. There was a decrease in the percentage of respondents who obtained information from drug industry representatives. NPs prefer to receive medicines information in an electronic form, rather than a paper-based version, and over the time period more NPs are utilizing electronic sources rather than paper. These findings provide important insights into medical information products for the developers who may be able to use these results to ensure that their products meet the needs of NP clinicians. Additionally, the finding that NPs prefer to receive their continuing information related to medicines in electronic format, but also highly value conference proceedings, may help to inform future planning of NP education needs in relation to QUM.

The grand challenge - managing end-staged joint osteoarthritis.

Musculoskeletal disease is a common con-dition that affects up to one-quarter of thepopulation over 65years in many devel-oped countries. Over 6 million Australians(1) and 27 million Americans (2) areaffected by some type of musculoskeletaldisorder of which osteoarthritis (OA) isthe most common. Musculoskeletal disor-ders account for one-fifth of all consul-tations with general practitioners (3) inAustralia. The total treatment cost of OAand other musculoskeletal conditions inAustralia was estimated as $55.1 billionin 2012, and the burden of disease costwas estimated to be $34.2 billion, basedon a loss of 182,135 disability adjusted lifeyears (DALYs) (4). In the United States,thepersonal and community cost of muscu-loskeletal diseases including those throughlost wages now approaches $950 billion(5). The 2010 Global Burden of DiseaseStudy demonstrates the worldwide scale ofthis problem, identifying musculoskeletaldisorders as the second largest contrib-utor to life lost through disability afterCancer (6). OA has the highest trajectoryof increasing prevalence across all mus-culoskeletal conditions (4) and in Aus-tralia is forecast to become the leadingcause of disability (7). Total joint replace-ment (TJR), which is not only effective forimproving the quality of life of people withend-stage OA (8), is also a cost-effectivesolution (9).

RFID Implementation in Australian Hospitals

Radio Frequency Identification (RFID) is a mobile technology that was explored in hospitals in the last decade for improving process efficiencies. However, in the Australian context, this technology is still regarded as an innovation that health ICT practitioners and hospitals are reluctant to trial. This technology, although non-intrusive, is perceived as disruptive by hospitals. Information Systems professionals in the ICT sector and Health Informatics practitioners in Australia are exploring best practices for implementation. In this research paper, I report on findings from empirical research that was conducted in Australia, based in two large hospitals1, to better understand the factors involved in the successful implementation of RFID in Australian hospitals. Findings from this study are presented and endorsed by health ICT practitioners and informatics professionals as current implications for the field.

The future of primary healthcare in Australia: Where to from here?

The delivery of care in the community is increasingly seen as vital in terms of patient outcomes, health promotion, and the prevention of illness in society. The primary care practitioner is generally the first point of contact with the healthcare system, and current reforms in primary health care—as well as the dynamic nature of society and social preferences—have seen the roles of general practice and general practitioners in Australia undergo a transformation. Achieving results in health outcomes is going to require the implementation of innovations such as multi-professional primary healthcare teams,1 technological innovations, and procedural reform. The question remains—how are such changes most effectively implemented, and at what stage are we currently in this “reformation”?

Accuracy of general practitioner unassisted detection of depression

Objective:Primary care is an important setting for the treatment of depression. The aim of the study was to describe the accuracy of unassisted general practitioner judgements of patients’ depression compared to a standardised depression-screening tool delivered via touch-screen computer.Method:English-speaking patients, aged 18 or older, completed the Patient Health Questionnaire-9 (PHQ-9) when presenting for care to one of 51 general practitioners in Australia. General practitioners were asked whether they thought the patients were clinically depressed. General practitioner judgements of depression status were compared to PHQ-9 results.Results:A total of 1558 patients participated. Twenty per cent of patients were identified by the PHQ-9 as being depressed. General practitioners estimated a similar prevalence; however, when compared to the PHQ-9, GP judgement had a sensitivity of 51% (95% CI [32%, 66%]) and a specificity of 87% (95% CI [78%, 93%]).Conclusions:General practitioner unassisted judgements of depression in their patients lacked sensitivity when compared to a standardised psychiatric measure used in general practice.

Foreign-born health workers in Australia: an analysis of census data.

BackgroundProvide an up-to-date national picture of the medical, midwifery and nursing workforce distribution in Australia with a focus on overseas immigration and on production sustainability challenges.MethodsUsing 2006 and 2011 Australian census data, analysis was conducted on medical practitioners (doctors) and on midwifery and nursing professionals.ResultsOf the 70,231 medical practitioners in Australia in 2011, 32,919 (47.3%) were Australian-born, with the next largest groups bring born in South Asia and Southeast Asia. In 2006, 51.9% of medical practitioners were born in Australia. Of the 239,924 midwifery and nursing professionals in Australia, 127,911 (66.8%) were born in Australia, with the next largest groups being born in the United Kingdom and Ireland and in Southeast Asia. In 2006, 69.8% of midwifery and nursing professionals were born in Australia. Western Australia has the highest percentage of foreign-born health workers. There is a higher percentage of Australia-born health workers in rural areas than in urban areas (82% of midwifery and nursing professional in rural areas are Australian-born versus 59% in urban areas). Of the 15,168 additional medical practitioners in Australia between the 2006 and 2011 censuses, 10,452 (68.9%) were foreign-born, including large increases from such countries as India, Nepal, Philippines, and Zimbabwe. We estimate that Australia has saved US$1.7 billion in medical education costs through the arrival of foreign-born medical practitioners over the past five years.ConclusionsThe Australian health system is increasingly reliant on foreign-born health workers. This raises questions of medical education sustainability in Australia and on Australia’s recruitment from countries facing critical shortages of health workers.

Changes in professional human care work: The case of nurse practitioners in Australia

Recently, the Australian Government has provided significant support for the expansion of Nurse Practitioner services in the community. As a result, the emerging role and ongoing retention of these professionals is an area for policy investigation. However, there is also a broader significance in the Nurse Practitioner role for which sociological perspectives can provide insight. Sociologists identify two key characteristics of late-modernism as the rise in service work and the emphasis on service worker knowledge as a commodity. This paper argues that the Nurse Practitioner role is an embodiment of these trends. Specifically, the paper considers the expanding Nurse Practitioner role as an example of the shifting boundaries between human care professionals. The paper argues that these changes point to a need for renewed consideration of identity, interaction, negotiation and emotion in relation to professional human care work. It concludes by considering conceptual resources that could support new sociological understandings of the Nurse Practitioner role in the future.

Adapting lung cancer symptom investigation and referral guidelines for general practitioners in Australia: Reflections on the utility of the ADAPTE framework

The ADAPTE framework was established to enhance efficiency in guideline development and to facilitate adaptation of high-quality clinical practice guidelines for a local context. It offers guideline developers a systematic methodology for guideline adaptation; however, the feasibility and usability of the process has not been widely evaluated. A pragmatic approach was undertaken throughout the evaluation of the ADATPE process throughout the development of a guide for general practitioners in Australia regarding the initial investigation of symptoms of lung cancer. At each step of the framework all members of the project team leading the development process reflected on the steps outlined in the ADAPTE. The reflections were collated into a lesson-learned log and analysed following completion of the project. Several opportunities for improvement were identified to improve usability and practicability of the ADAPTE framework. These items were both specific, in response to using steps and tools, and general issues concerned with the overall ADAPTE framework. Key challenges to using ADAPTE, highlighted in this study, were the lack of clarity about efficiency of the guideline adaptation process, level of assumed knowledge and expertise, and requirement of resources. In response to these challenges, modifications to the ADAPTE have been recommended. The ADAPTE framework offers an attractive alternative to de novo guideline synthesis in circumstances where high-quality, compatible guidelines already exist. Pending further evaluation, the modifications identified in this study may be applied to future versions of ADAPTE to improve usability and feasibility of the framework.

Integrative medical practitioners and the use of evidence

IntroductionIncreasing numbers of general medical practitioners in Australia define themselves as integrative practitioners, incorporating both allopathic and complementary and alternative medicine (CAM) in an environment where evidence-based medicine is the hallmark of best practice in medicine. Methodology and approachWe conducted semi-structured qualitative interviews with 23 self-identified integrative medical practitioners in two states of Australia. Participants were recruited from publicly available lists of self-identified integrative medical practitioners – the local telephone listing and the website of their professional organisation. Interviews explored how doctors define and use evidence in their practice. We undertook a thematic analysis of the interview transcripts with particular exploration of the key ideas that emerged about their use of evidence. ResultsThese practitioners are sceptical about the dominance of the evidence-based medicine movement, and push to reclaim their autonomy based on the indeterminancy of individual cases. They acknowledge that an understanding of clinical benefit may not be scientifically evidenced and utilise discourses of experience and safety in discussing their clinical practice. ConclusionsOur findings provide further insights into how medical practitioners work within their own profession, their relationships with other care providers (specifically CAM practitioners), their views about their non-integrative medical peers and their resistance to prescribed ways of clinical practice.

Producing the “Problem” of Addiction in Drug Treatment

In this article, we argue that the "problem" of addiction emerges as an effect of treatment policy and practice as well as a precursor to it. We draw on the work of Marrati to analyze interviews with policy makers and practitioners in Australia. The interviews suggest that the episode-of-care system governing service activity, outcomes, and funding relies on certain notions of addiction and treatment that compel service providers to designate service users as addicts to receive funding. This has a range of effects, not least that in acquiring the label of "addict," service users enter into bureaucratic and epidemiological systems aimed at quantifying addiction. Rather than treating pre-existing addicts, the system produces "addicts" as an effect of policy imperatives. Because addiction comes to be produced by the very system designed to treat it, the scale of the problem appears to be growing rather than shrinking.

An exploration of the perceptions of Emergency Physicians and Trainees, towards Emergency Nurse Practitioners in Australia

To explore Emergency Physicians perceptions towards the Emergency Nurse Practitioner role, specifically, examining their support, its perceived benefits, difficulties, impact in the clinical environment and proposed scope of practice. A survey was distributed to all members of the Australasian College of Emergency Medicine via Survey Monkey between August and November 2009. Statistical analysis of the data was performed using the SPSS package. A total of 50.8% (n = 315) responded positively to supporting the Emergency Nurse Practitioner role whilst 20% (n = 124) responded negatively. When comparing those who have worked with Emergency Nurse Practitioners vs those who have not, 59.8% (n = 307) of those who have worked with Emergency Nurse Practitioners were positively identified as supporting the role, compared to 7.5% (n = 8) of those who had not. In those who had not worked with Emergency Nurse Practitioners 53.3% (n = 57) neither agreed nor disagreed in supporting the role. With respect to the benefits and the proposed scope of practice, a response trend of greater significance was found in those who had previously worked with Emergency Nurse Practitioners. Emergency healthcare is evolving in line with increasing demands. Worldwide, the Emergency Nurse Practitioner role has been researched and critiqued at length. This paper provides evidence of Emergency Physicians positive perceptions and recognition of benefits of the Emergency Nurse Practitioner role within Australia. This was especially apparent amongst clinicians that have previously worked alongside them. Despite this, concerns were expressed with regard on-going medical training, medico-legal implications and training of Emergency Nurse Practitioners.

Nurse practitioner prescribing practices: the most frequently prescribed medications

To explore which medications Australian nurse practitioners most frequently prescribe. Although nurse practitioners in Australia have prescriptive authority, little is known about which specific medications nurse practitioners are prescribing and how frequently they do so. Descriptive electronic survey. A total of 209 nurse practitioners reported current prescribing practices. Medications reported were categorised according to the Australian Medicines Handbook major drug classifications and frequencies presented. Seventy-eight per cent of respondents reported prescribing medications as part of their Nurse Practitioner practice. In total, participants reported prescribing 234 separate medications from most Australian Medicines Handbook major drug classifications. Medications from the classification anti-infective drugs were most frequently prescribed followed by medications from analgesic, psychotropic, cardiovascular, musculoskeletal, genitourinary and gastrointestinal classifications. The majority of nurse practitioners in Australia prescribe medications in their clinical practice, although the proportion of nurse practitioners prescribing has not changed significantly in the past four years. The medications prescribed are comparable with those most frequently prescribed by all prescribers in Australia and highlight the diversity in scope of practice among nurse practitioners. Findings highlight the importance of Nurse Practitioner's a capacity to prescribe wide variety of medications, especially in practice areas such acute, primary and emergency care. The unique role nurse practitioners in relation to management of patients with infective processes and patients requiring pain relief is highlighted. Insight into current Nurse Practitioner prescribing trends informs future Nurse Practitioner curricular and future continuing education programmes. Findings give unique insight for future service planning, especially service providers considering introducing nurse practitioners to their service. The finding that nurse practitioners prescribing patterns are similar to other non-nurse practitioner prescribers in Australia highlights the potential for service providers to introduce new models of care that are Nurse Practitioner lead.

Aged care nurse practitioners in Australia: evidence for the development of their role

To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners' care in aged care settings. If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required.

Empty space or sacred place? Place and belief in social work training

This paper highlights common errors in social work students’ approaches to faith/spirituality and place whilst on field education placement. It briefly investigates the Christian conception of sacredness and space which often underpins such errors.The issue is exemplified by contrasts between Aboriginal Australian conceptions of place and spirituality and the mutually exclusive conceptions of these spaces, held by many non-Aboriginal welfare practitioners in Australia. This paper suggests some ways in which social workers, including social work students, could engage with spirituality, inclusive of geo-socio-political materiality, in their work, where appropriate, with Indigenous, migrant, refugee or colonial settler populations.The paper engages critically with literature on cultural competence in relation to issues of land, and the identity one gains from connection to land, and spirituality. This paper concludes by identifying key questions for placement students and educators seeking to respond appropriately when interfacing sacred spaces of the ‘other’.

Transnational Education: A Case Study of One Professional Doctorate

This case study of a Doctor of Education program in a transnational setting is contextualized in Australian national policies for international higher education and influences of regionalization and globalization. The doctorate was designed to meet aspirations of professional practitioners in Australia and South East Asia where the School had productive partnerships. The longitudinal case study discusses factors influencing revision of the program in response to federal government policies, student feedback over two reviews and considerations of quality delivery in the transnational setting. Finally, it presents an analysis of the perceived current success of the program and threats to its future viability.

Prescribing Data in General Practice Demonstration (PDGPD) project--a cluster randomised controlled trial of a quality improvement intervention to achieve better prescribing for chronic heart failure and hypertension.

BackgroundResearch literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chronic heart failure (CHF). The objectives of this study were to improve general practitioner’s drug treatment management of these patients through feedback on their own prescribing and small group discussions with peers and a trained group facilitator. The impact evaluation includes quantitative assessment of prescribing changes at 6, 9, 12 and 18 months after the intervention.MethodsA pragmatic multi site cluster RCT began recruiting practices in October 2009 to evaluate the effects of a multi-faceted quality improvement (QI) intervention on prescribing practice among Australian general practitioners (GP) in relation to patients with CHF and HT. General practices were recruited nationally through General Practice Networks across Australia. Participating practices were randomly allocated to one of three groups: two groups received the QI intervention (the prescribing indicator feedback reports and small group discussion) with each group undertaking the clinical topics (CHF and HT) in reverse order to the other. The third group was waitlisted to receive the intervention 6 months later and acted as a “control” for the other two groups.De-identified data on practice, doctor and patient characteristics and their treatment for CHF and HT are extracted at six-monthly intervals before and after the intervention. Post-test comparisons will be conducted between the intervention and control arms using intention to treat analysis and models that account for clustering of practices in a Network and clustering of patients within practices and GPs.DiscussionThis paper describes the study protocol for a project that will contribute to the development of acceptable and sustainable methods to promote QI activities within routine general practice, enhance prescribing practices and improve patient outcomes in the context of CHF and HT. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), Trial # 320870.

The use of botulinum toxin type A in the management of adult‐onset focal spasticity: A survey of Australian allied health professionals

Recently, the European Journal of Neurology published international consensus statements for the assessment, treatment and aftercare associated with the use of botulinum neurotoxin type A. This survey examined current allied health practice in relation to botulinum neurotoxin type A use in Australia in the light of these guidelines. An electronic questionnaire was distributed to members of neurology groups of the Australian Physiotherapy Association and Occupational Therapy Australia. The questionnaire explored assessment processes used, familiarity with pharmaceutical benefits scheme indications for botulinum neurotoxin type A use, goal setting and outcome measurement, follow-up therapy and access to spasticity management services. The 123 survey respondents (81 from the Australian Physiotherapy Association - response rate 16.2%, 42 from Occupational Therapy Australia - response rate 6.4%) reported that focal spasticity was a major problem for which botulinum neurotoxin type A was a primary intervention. The Tardieu scale was more frequently used than the modified Ashworth scale (82% vs. 48%). Most therapists (76.3%) reported being confident diagnosing spasticity and its functional implications (84.2%), but fewer were confident discussing referral for botulinum neurotoxin type A with doctors (56.1%). Goals were set in conjunction with the client (93.6%). Barriers to injection and adjunctive therapy (motor training etc.) included waiting times for botulinum neurotoxin type A injection, access to specialist adjunctive therapists and referral for treatment. Allied health practitioners in Australia report clinical practice to be closely aligned with international guidelines for the use of botulinum neurotoxin type A in adult spasticity. Therapist confidence in advocating for botulinum neurotoxin type A injection, consistent use of objective measures of spasticity and treatment outcomes and barriers to providing adjunctive therapy need to be addressed.

The critical issues facing business intelligence practitioners

This paper presents the top 20 critical issues currently faced by Business Intelligence (BI) practitioners in Australia. The results were obtained from a series of nominal group technique-based meetings with BI practitioners designed to elicit the most important of the challenges that they face. Developing BI systems for mobile devices is the most important issue facing practitioners at the current time. The list of issues identified are important as they provide an insight into the work performed by BI practitioners that can be used to define a research agenda that is relevant to their needs.