Preliminary Analysis of Fall Concern Among Family Caregivers of Older Adults Discharged From the Hospital: A Psychometric Evaluation of the Carers' Fall Concern Instrument.

PURPOSE: To provide a preliminary descriptive analysis of the change in fall concern among family caregiver-care recipient dyads during hospitalization and after discharge as part of a prospective study exploring the psychometric properties of the Carers' Fall Concern Instrument. METHOD: Using a prospective cohort design, an interviewer-administered survey was completed by dyads at 48 hours before discharge and 1 week and 30 days after discharge. RESULTS: Of family caregivers, 76.9% thought their care recipient was at risk of falling and 61.5% were afraid of them falling. However, only 34.6% of older adults thought that they were at risk of falling and only 42.3% were afraid of falling. Family caregivers reported significantly less concern about falls after their care recipients were discharged. CONCLUSION: This study provided greater insight into caregiver-care recipient dyads' fall concern during their transition from hospital to home that may guide post-discharge fall prevention education on falls. [Journal of Gerontological Nursing, 50(5), 14-18.].

Prevalence of frailty and pain in hospitalised cancer patients: implications for older adult care.

A hospital-wide point prevalence study investigated frailty and pain in patients with a cancer-related admission. Modifiable factors associated with frailty in people with cancer were determined through logistic regression. Forty-eight patients (19%) with cancer-related admissions were 2.65 times more likely to be frail and 2.12 more likely to have moderate pain. Frailty and pain were highly prevalent among cancer-related admissions, reinforcing the need for frailty screening and importance of pain assessment for patients with cancer.

Clinical deterioration as a nurse sensitive indicator in the out-of-hospital context: A scoping review.

AIMS: To explore and summarise the literature on the concept of 'clinical deterioration' as a nurse-sensitive indicator of quality of care in the out-of-hospital context. DESIGN: The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review and the JBI best practice guidelines for scoping reviews. METHODS: Studies focusing on clinical deterioration, errors of omission, nurse sensitive indicators and the quality of nursing and midwifery care for all categories of registered, enrolled, or licensed practice nurses and midwives in the out-of-hospital context were included regardless of methodology. Text and opinion papers were also considered. Study protocols were excluded. DATA SOURCES: Data bases were searched from inception to June 2022 and included CINAHL, PsychINFO, MEDLINE, The Allied and Complementary Medicine Database, EmCare, Maternity and Infant Care Database, Australian Indigenous HealthInfoNet, Informit Health and Society Database, JSTOR, Nursing and Allied Health Database, RURAL, Cochrane Library and Joanna Briggs Institute. RESULTS: Thirty-four studies were included. Workloads, education and training opportunities, access to technology, home visits, clinical assessments and use of screening tools or guidelines impacted the ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting. CONCLUSIONS: Little is known about the work of nurses or midwives in out-of-hospital settings and their recognition, reaction to and relay of information about patient deterioration. The complex and subtle nature of non-acute deterioration creates challenges in defining and subsequently evaluating the role and impact of nurses in these settings. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Further research is needed to clarify outcome measures and nurse contribution to the care of the deteriorating patient in the out-of-hospital setting to reduce the rate of avoidable hospitalisation and articulate the contribution of nurses and midwives to patient care. IMPACT: What Problem Did the Study Address? Factors that impact a nurse's ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting are not examined to date. What Were the Main Findings? A range of factors were identified that impacted a nurse's ability to recognise, relay information and respond to clinical deterioration in the out-of-hospital setting including workloads, education and training opportunities, access to technology, home visits, clinical assessments, use of screening tools or guidelines, and avoidable hospitalisation. Where and on whom will the research have an impact? Nurses and nursing management will benefit from understanding the factors that act as barriers and facilitators for effective recognition of, and responding to, a deteriorating patient in the out-of-hospital setting. This in turn will impact patient survival and satisfaction. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines guided this review. The PRISMA-Scr Checklist (Tricco et al., 2018) is included as (supplementary file 1).Data sharing is not applicable to this article as no new data were created or analysed in this study." NO PATIENT OR PUBLIC CONTRIBUTION: Not required as the Scoping Review used publicly available information.

Factors associated with risk of falling among younger inpatients in a mental health setting-A systematic review.

AIM: To synthesise evidence related to risk factors of falls among younger mental health inpatients age ≤65 years old. BACKGROUND: Hospitalised patients with mental illness are at increased risk of falling. Specific risk factors for falls for younger inpatients are poorly understood. DESIGN: Systematic review. METHODS: Medline, CINAHL, APA PsycINFO, Scopus and Web of Science were searched for studies published in English till December 2022. The review followed the 2020 PRISMA checklist. Odds ratios and P values of significant risk fall factors and the frequency of factors related to circumstances of falls were extracted. RESULTS: Nine studies were included and 95 risk factors, across seven categories were extracted. These categories included socio-demographic, fall-related factors, functional status, health and mental status, psychiatric diagnosis and assessment, medication, and staff related factors. Factors related to medication, health and mental status are most reported. Majority of the patients sustained minor or no injury from the fall and circumstances of fall vary across studies. CONCLUSION: Factors strongly associated with risk of falls were dizziness, use of psychotropics and antihypertensive drugs. A meta-analysis of risk factors was not possible due to different dependent variables studied, controlled confounding variables and control groups used. RELEVANCE TO CLINICAL PRACTICE: Fall prevention is relevant to all patients in mental health settings. Approaches to fall risk assessment and management need to be better tailored to younger mental health patients in the psychiatric setting. PATIENT AND PUBLIC CONTRIBUTION: Patient or public contribution was not possible because of the study design.

Frailty knowledge, training and barriers to frailty management: A national cross-sectional survey of health professionals in Australia.

OBJECTIVE(S): To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice. METHODS: A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training. Responses were analysed using descriptive statistics. RESULTS: The survey was taken by 736 health professionals. Less than half of respondents (44%, 321/733) reported receiving any training on frailty, with 14% (105/733) receiving training specifically focussed on frailty. Most respondents (78%, 556/712) reported 'good' or 'fair' understanding of frailty. The majority (64%, 448/694) reported being 'fairly' or 'somewhat' confident with identifying frailty. Almost all respondents (>90%) recognised frailty as having an important impact on outcomes and believed that there are beneficial interventions for frailty. Commonly reported barriers to frailty assessment in practice included 'lack of defined protocol for managing frailty' and 'lack of consensus about which frailty assessment tool to use'. Most respondents (88%, 521/595) were interested in receiving further education on frailty, with a high preference for online training. CONCLUSIONS: The findings suggest frailty is important to health professionals in Australia, and there is a need for and interest in further frailty education.

Staff perceptions of the effectiveness of managerial communication during the COVID-19 pandemic: A cross-sectional study.

AIMS: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID-19 pandemic and (2) the impact of organizational communication on staff well-being and ability to progress their work and patient care. BACKGROUND: Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID-19 pandemic is not well understood. DESIGN: An exploratory cross-sectional research design was used. A 33-item survey tool was created for the study. METHODS: The study was conducted at a tertiary teaching hospital in Western Australia. Convenience sampling was used to recruit participants from nursing, medical, allied health services, administrative and clerical, and personal support services (N = 325). Data were collected between December 2020 and May 2021. RESULTS: Overall, all occupational groups found working during the COVID-19 pandemic stressful, and all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. CONCLUSIONS: The use of occupational group-relevant strategies and COVID-19 protocols, as well as the on-going use of email, face-to-face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles.

Frailty and pain in an acute private hospital: an observational point prevalence study.

Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assist health care professionals to target interventions and develop resources to improve patient outcomes. This study reports the point prevalence concurrence of frailty and pain in adult patients in an acute hospital. A point prevalence, observational study of frailty and pain was conducted. All adult inpatients (excluding high dependency units) at an acute, private, 860-bed metropolitan hospital were eligible to participate. Frailty was assessed using the self-report modified Reported Edmonton Frail Scale. Current pain and worst pain in the last 24 h were self-reported using the standard 0-10 numeric rating scale. Pain scores were categorised by severity (none, mild, moderate, severe). Demographic and clinical information including admitting services (medical, mental health, rehabilitation, surgical) were collected. The STROBE checklist was followed. Data were collected from 251 participants (54.9% of eligible). The prevalence of frailty was 26.7%, prevalence of current pain was 68.1% and prevalence of pain in the last 24 h was 81.3%. After adjusting for age, sex, admitting service and pain severity, admitting services medical (AOR: 13.5 95% CI 5.7-32.8), mental health (AOR: 6.3, 95% CI 1. 9-20.9) and rehabilitation (AOR: 8.1, 95% CI 2.4-37.1) and moderate pain (AOR: 3.9, 95% CI 1. 6-9.8) were associated with increased frailty. The number of older patients identified in this study who were frail has implications for managing this group in a hospital setting. This indicates a need to focus on developing strategies including frailty assessment on admission, and the development of interventions to meet the care needs of these patients. The findings also highlight the need for increased pain assessment, particularly in those who are frail, for more effective pain management.Trial registration: The study was prospectively registered (ACTRN12620000904976; 14th September 2020).

Nurses' perceptions of using volunteer support in health care settings: A systematic scoping review.

AIMS: To understand nurses' perceptions of volunteer support in health care settings. BACKGROUND: Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses' perceptions of volunteer support. METHODS: A scoping review was conducted following the PRISMA-ScR checklist. A mixed-methods convergent integrative approach was taken guided by the JBI framework. Quantitative data were transformed into qualitative data for synthesis and descriptive thematic analysis. Six databases were searched (CINHAL+, EMBASE, PubMed, Scopus, PsycInfo, ProQuest Health and Medical Collection) on 24 January 2022 using terms related to nurses, perceptions, volunteers and care settings, followed by a manual search. The search was limited to English language articles published during 2000-2022. Studies were included if they reported nurses' perceptions of volunteers supporting care within any health care setting. RESULTS: Of the 943 records identified, 12 met the inclusion criteria. All 12 were included in the review following critical appraisal. Five themes were identified: perceived benefits for patients, volunteers providing support for nursing staff, nurses' valuing volunteer support, nurses' understanding of the volunteer role and nurses' understanding of recruitment and training of volunteers. CONCLUSION: Nurses generally viewed volunteer support positively and perceived that it benefitted patients and assisted nurses. Some nurses raised concerns about the burden of additional supervision of volunteers and lacked knowledge of the volunteer role, recruitment and training. Emerging innovative models of nurse-led volunteer support can maximise the contribution of volunteers and help overcome barriers to volunteer acceptance. IMPLICATIONS: These findings will inform volunteer policies and provide guidance in developing volunteer support programs.

Effectiveness of nurse-led volunteer support and technology-driven pain assessment in improving the outcomes of hospitalised older adults: protocol for a cluster randomised controlled trial.

INTRODUCTION: Hospitalised older adults are prone to functional deterioration, which is more evident in frail older patients and can be further exacerbated by pain. Two interventions that have the potential to prevent progression of frailty and improve patient outcomes in hospitalised older adults but have yet to be subject to clinical trials are nurse-led volunteer support and technology-driven assessment of pain. METHODS AND ANALYSIS: This single-centre, prospective, non-blinded, cluster randomised controlled trial will compare the efficacy of nurse-led volunteer support, technology-driven pain assessment and the combination of the two interventions to usual care for hospitalised older adults. Prior to commencing recruitment, the intervention and control conditions will be randomised across four wards. Recruitment will continue for 12 months. Data will be collected on admission, at discharge and at 30 days post discharge, with additional data collected during hospitalisation comprising records of pain assessment and volunteer support activity. The primary outcome of this study will be the change in frailty between both admission and discharge, and admission and 30 days, and secondary outcomes include length of stay, adverse events, discharge destination, quality of life, depression, cognitive function, functional independence, pain scores, pain management intervention (type and frequency) and unplanned 30-day readmissions. Stakeholder evaluation and an economic analysis of the interventions will also be conducted. ETHICS AND DISSEMINATION: Ethical approval has been granted by Human Research Ethics Committees at Ramsay Health Care WA|SA (number: 2057) and Edith Cowan University (number: 2021-02210-SAUNDERS). The findings will be disseminated through conference presentations, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER: ACTRN12620001173987.

Light acupuncture and five-element music therapy for nurses' mental health and well-being during and post-COVID-19: protocol for a randomised cross-over feasibility study.

INTRODUCTION: Australian nurses have experienced higher levels of anxiety during the COVID-19 pandemic compared with the prepandemic. This may have affected their long-term mental health and intention to stay in the profession resulting in a workforce shortage, which further impacts the health of the public. Management is urgently required to improve nurses' well-being. However, there is limited evidence available. The proposed clinical trial aims to evaluate the feasibility and therapeutic effects of using a combination of light acupuncture and five-element music therapy to improve nurses' mental health and well-being during and post-COVID-19. METHODS AND ANALYSIS: This randomised, single blinding, two-arm cross-over feasibility study involves a 1-week run-in period, 2-week intervention and 1-week run-in period in between interventions. Thirty-six eligible nurses will be recruited from the community and randomised into either a combination of light acupuncture treatment and five-element music therapy group or no treatment group for 2 weeks. After a 1-week run in period, they will be swapped to the different group. The primary outcome of this study is to evaluate the feasibility of a combination of light acupuncture treatment and five-element music therapy to improve nurses' mental health and well-being. The secondary outcomes will include anxiety and depression, work productivity and activity, and quality of life assessments. Participants will be asked to complete a set of online questionnaires throughout the trial period. All analyses will be performed in R Studio V.1.1.463. ETHICS AND DISSEMINATION: Ethical approval was attained from Edith Cowan University's Human Research Ethics Committee (No. 2021-02728-WANG). Research findings will be shared with hospitals and in various forms to engage broader audiences, including national and international conferences, presentations, open-access peer-reviewed journal publications, and local community workshop dissemination with healthcare professionals. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry: ACTRN12621000957897p https://www.anzctr.org.au/ACTRN12621000957897p.aspx.

Systematic review of perception of barriers and facilitators to chronic disease self-management among older adults: Implications for evidence-based practice.

BACKGROUND: An aging population has contributed to an increased prevalence in chronic disease. To empower patients, healthcare systems are shifting toward chronic disease self-management. However, no review on how older adults self-manage chronic disease and the barriers and facilitators they experience has been published. AIMS: To explore barriers and facilitators perceived by older adults during the process of self-managing chronic disease. METHODS: A systematic review of qualitative literature was performed using the Joanna Briggs Institute methodology. The literature search was conducted using Ovid databases (MEDLINE, CINAHL with full text, and PsycINFO) for the period of 1988-2020. All records were screened using predetermined eligibility criteria. The critical appraisal instrument QARI (Qualitative Assessment and Review Instrument) was employed to assess the quality of the included studies. Data from the included papers were extracted using the QARI data extraction tool. Extracted data were then synthesized to produce final sets of themes and sub-themes relating to the review question. RESULTS: A total of 267 abstracts were screened, and 13 studies reporting barriers and facilitators perceived by older adults during the process of managing chronic diseases were included in the review. Physical and cognitive decline, low-health literacy, culture, and relationships with healthcare professionals were described as barriers. Facilitators were described as resources that supported disease self-management and included family, social networks, healthcare professionals, and religious beliefs. LINKING EVIDENCE TO ACTION: This study highlights the importance of understanding the patients' perspectives of the barriers and enablers of self-management of chronic illness for health professionals across settings. Understanding barriers and facilitators to chronic disease self-management will support health professionals to identify strength-based approaches to self-management that meet the needs of individual older adults.

The use of theory in qualitative research: Challenges, development of a framework and exemplar.

BACKGROUND: Whilst theoretical grounding is considered important for sound research methodology, consensus on the application of theory in qualitative research remains elusive. Novice researchers may experience challenges in applying theory in qualitative research and these may contribute to the under-use, over-reliance or inappropriate application of theory. Practical guidance on how theory can inform and guide the conduct of qualitative research is needed. PURPOSE: The purpose of this paper was to propose a framework for the application of theory in qualitative research and provide an exemplar. METHODS: The Theoretical Application Framework for Qualitative Studies (TAF-QS) was developed from the synthesis of existing literature and the authors' own experience of the application of theory. RESULTS: The TAF-QS encourages researchers to articulate which theoretical framework or conceptional framework they are drawing on and how this will be applied by reflecting on the purpose and the context of the study. CONCLUSION: The TAF-QS provides support for researchers to explore how theory can be applied and how to achieve this in qualitative research. TWEETABLE ABSTRACT: The use of theory in qualitative research.

My hip journey: A qualitative study of patients' experiences of an eHealth program for patient preparation and recovery from hip replacement surgery.

AIM AND OBJECTIVE: To explore patient experiences, perceived benefits and suggestions of an eHealth program for pre- and post-operative education for total hip arthroplasty. BACKGROUND: eHealth programs for surgical patients can facilitate the delivery of information, provide individualised rehabilitation plans and enable communication with health professionals to promote overall patient recovery. DESIGN: A qualitative descriptive study was conducted following the COREQ guidelines. A convenience sample of nine patients who had total hip arthroplasty and used the My Hip Journey eHealth program were recruited and participated in individual semi-structured telephone interviews. Interviews were audio recorded, transcribed verbatim and analysed using inductive thematic analysis. RESULTS: The participant group were aged between 53 and 70 years. The results are described in three overarching themes and sub-themes: (1) Supported surgical journey-how the My Hip Journey eHealth program supported them in their preparation and recovery from their surgery, and how the program provided information and encouraged engagement; (2) Motivated recovery-how patients found the program motivational, facilitated their self-management and enabled communication with the healthcare team if they had any concern; and (3) Functionality-how the program related to ease of use, its interactivity with the patient and suggestions for future use. CONCLUSIONS: The patients reported that using the eHealth program for pre- and post-operative education was helpful to their overall surgical experience and recovery. It was found to engage patients in their care, enabled self-management, encouraged communication with health professionals and motivated them with their recovery. These findings identify the potential for eHealth programs to support patients in the preparation and post-operative stages, and in their post-discharge self-care for other surgical and orthopaedic journeys. RELEVANCE TO CLINICAL PRACTICE: Patient experiences of eHealth education can inform nurses of the benefits of eHealth and the development of future eHealth education programs.

Aged care staff perceptions of an online training program for responsive behaviours of residents with dementia.

OBJECTIVE: To explore residential aged care staff perceptions of an online training program on the management of antipsychotic medications for responsive behaviour in residential aged care. METHODS: A qualitative process evaluation was undertaken in four residential aged care facilities of one organisation in Australia. Five focus group interviews were conducted with 25 participants including nurses, care workers, occupational therapists and assistants. RESULTS: Direct care staff found that the training program increased their awareness and knowledge of responsive behaviours associated with dementia. Inductive thematic analysis identified three themes: (1) impact of online learning for dementia care; (2) applying online learning in dementia practice; and (3) realising the benefits and challenges of online learning. CONCLUSIONS: From the perspective of the participants, the online training program had a positive effect on their knowledge, communication and practice of caring for residents with dementia with responsive behaviours.

Reflecting on experiences of care: an exploratory qualitative descriptive study of the perspectives of stroke survivors, families and staff.

OBJECTIVE: The aim of this study was to identify barriers and enablers from the perspectives of stroke survivors, carers and staff to understand the experiences of care. DESIGN: The study used a qualitative descriptive methodology and employed semistructured interview technique. SETTING: A metropolitan stroke rehabilitation unit in Western Australia providing rehabilitation services for inpatients and outpatients. PARTICIPANTS: Overall, 10 participants (four staff, four stroke survivors and two primary carers) were interviewed. Transcripts were analysed using thematic analysis. RESULTS: Experiences of care focused on lack of time, urgency to regain mobility, postshock recovery, uncertainty about the future and the importance of accepting help once home. There was a degree of mismatch between staff experiences of the reality of what can be provided and the experiences and expectations of stroke survivors and families. However, the benefits of a specialised rehabilitation unit were found to contribute to a positive patient experience overall. The specialised unit demonstrated that services must optimise staff time with patients and carers in the poststroke rehabilitation journey to ensure benefits for the long-term well-being for both. CONCLUSION: Seeking patient, family and staff experiences of care can provide valuable insights into facilitating better patient, family and staff engagement for preparation for home-based rehabilitation for stroke survivors and their caregivers. Further research with a larger sample across diverse hospital settings would provide even greater insight into strategies to best address the reality of rehabilitation care and readiness of patients when returning home to the community.

Clinical staff perceptions on the quality of end-of-life care in an Australian acute private hospital: a cross-sectional survey.

Objective To explore the perceptions of clinical staff on the quality of end-of-life care in an acute private hospital. Methods A descriptive cross-sectional study with a convenience sample of clinical staff in an acute private hospital were surveyed using a validated end-of-life survey. Data from the surveys were analysed using descriptive statistics for quantitative responses and inductive content analysis for the open-ended responses. Results Overall, 133 staff completed the survey. Of these, 107 had cared for a dying patient in the hospital. In total, 87.6% of participants felt confident in their ability to recognise a dying patient and 66.7% felt confident in their ability to talk to the patient and family. Almost one-third had not received specific training in the area. Conclusions Hospitals need to take the lead in ensuring end-of-life care processes are embedded across clinical areas. This includes providing staff with end-of-life care education and support in the delivery of end-of-life care. These strategies will facilitate safe and quality end-of-life care, including better collaboration between patients, families and staff. What is known about the topic? Key to providing quality end-of-life care in hospitals are strategic guidelines that support good clinical governance and adequately trained staff to deliver the care. What does the paper add? This study highlights the importance of clinical staff in all areas having skills and confidence in providing care to dying patients and their families. What are the implications for practitioners? It is important that all health practitioners implement strategies to overcome gaps in staff education and support, to ensure all patients and families receive quality end-of-life care.

Improving the safety and quality of end-of-life in an Australian private hospital setting: An audit of documented end-of-life care.

OBJECTIVE: This study reviewed the audit outcomes of the documented end-of-life care in a private hospital against the Australian Commission on Safety and Quality in Health Care's five recommended processes of care (Essential Elements (EE) 1-5). METHODS: A retrospective database review of deaths over a three-year period was undertaken. This was followed by a sequential medical record audit (n = 100) to evaluate the end-of-life care documented in the three days preceding death. RESULTS: There were 997 deaths from 2015 to 2017. The audit found communication to family the patient was dying (91%) and to the patient (36%) (EE1); evidence of specialist referral (68%) (EE2); assessment of the ability to eat/drink in the last 72 hours (86%) (EE3); advance care directives (13%) and hospital resuscitation plans (92%) (EE4); and response to patient or family concerns (100%) (EE5). CONCLUSIONS: Components of the processes of care of the Essential Elements need to be addressed to improve patient-centred communication and shared decision-making.

Prevalence of frailty and pain in hospitalised adult patients in an acute hospital: a protocol for a point prevalence observational study.

INTRODUCTION: Frailty and pain are associated with adverse patient clinical outcomes and healthcare system costs. Frailty and pain can interact, such that symptoms of frailty can make pain assessment difficult and pain can exacerbate the progression of frailty. The prevalence of frailty and pain and their concurrence in hospital settings are not well understood, and patients with cognitive impairment are often excluded from pain prevalence studies due to difficulties assessing their pain. The aim of this study is to determine the prevalence of frailty and pain in adult inpatients, including those with cognitive impairment, in an acute care private metropolitan hospital in Western Australia. METHODS AND ANALYSIS: A prospective, observational, single-day point prevalence, cross-sectional study of frailty and pain intensity of all inpatients (excluding day surgery and critical care units) will be undertaken. Frailty will be assessed using the modified Reported Edmonton Frail Scale. Current pain intensity will be assessed using the PainChek smart-device application enabling pain assessment in people unable to report pain due to cognitive impairment. Participants will also provide a numerical rating of the intensity of current pain and the worst pain experienced in the previous 24 hours. Demographic and clinical information will be collected from patient files. The overall response rate of the survey will be reported, as well as the percentage prevalence of frailty and of pain in the sample (separately for PainChek scores and numerical ratings). Additional statistical modelling will be conducted comparing frailty scores with pain scores, adjusting for covariates including age, gender, ward type and reason for admission. ETHICS AND DISSEMINATION: Ethical approval has been granted by Ramsay Health Care Human Research Ethics Committee WA/SA (reference: 2038) and Edith Cowan University Human Research Ethics Committee (reference: 2020-02008-SAUNDERS). Findings will be widely disseminated through conference presentations, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER: ACTRN12620000904976.

Comparing an eHealth Program (My Hip Journey) With Standard Care for Total Hip Arthroplasty: Randomized Controlled Trial.

BACKGROUND: The role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. OBJECTIVE: The aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. METHODS: A prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. RESULTS: A total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. CONCLUSIONS: This study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry ACTRN12617001433392; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657.

Nursing and Allied Health Staff Perceptions and Experiences of a Volunteer Stroke Peer Support Program: A Qualitative Study.

PURPOSE: Stroke brings about physical, cognitive, and psychosocial changes and, consequently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital staff caring for stroke patients, by providing experiential knowledge that staff are not able to provide. AIM: This study explored the perceptions and experiences of nursing and allied health staff of a volunteer peer support program for stroke inpatients. METHODS: This study utilised a qualitative, evaluative case study design. This study was conducted at a public metropolitan hospital in Western Australia that had developed a stroke peer support program (SPSP) on a rehabilitation ward. A purposeful sample of nurses (n = 5) and multidisciplinary allied health staff (n = 5) were recruited from the ward where the SPSP was provided for stroke inpatients. Semi-structured, face-to-face interviews were conducted with staff participants. Verbatim transcripts from audio-recorded interviews were analysed using inductive thematic analysis. RESULTS: Nursing and allied health staff perceived the SPSP as valuable to stroke patients' rehabilitation and beneficial to families, volunteer peers and staff. Four themes encapsulated the findings: awareness of and involvement in the program; recognising the benefits of the program; perceived enablers and barriers of the program and suggestions for the future of the program. CONCLUSION: Nursing and allied health staff within multidisciplinary teams are cognisant of the psycho-emotional needs of stroke patients which staff are not fully able to meet. The study findings confirm volunteer peer support can provide valuable and fundamental adjunct support to address stroke patients' unmet needs, as well as supporting staff to enhance stroke patient care.