Introduction: Fifty percent of Australian women enter pregnancy overweight or obese. Unfortunately, few women receive weight management advice from health professionals during pregnancy. The aim of this study was to investigate current midwifery curricula from Australian universities to identify strengths and deficits in the teaching of preconception and antenatal weight management. Methods: Midwifery courses from 20 universities were identified. Of the 568 units taught at these universities, 252 course outlines were obtained. Data were coded using the qualitative analysis technique of Framework Analysis for the following main themes: 1) the effect of weight, diet and physical activity on health outcomes for women who are pregnant or planning a pregnancy; 2) weight management advice in any population; and 3) health behaviour change techniques in any context. Results: Analysis revealed a variety of teaching methods and skills training that emphasised the importance of clinical judgement and autonomous clinical practice, in conjunction with critical enquiry and sourcing reputable evidence. There was little evidence, however, that weight management advice was taught explicitly to midwifery students in the curricula. Discussion: A greater emphasis on skilling midwifery students to address weight gain during pregnancy, and behavioural techniques to achieve this, is required.
This study aimed to examine reported medication error trends in an Australian paediatric hospital over a 5‐year period and to determine the effects of person‐related, environment‐related and communication‐related factors on the severity of medication outcomes. In particular, the focus was on the influence of changes to a hospital site and structure on the severity of medication errors.
OBJECTIVE:Children are particularly vulnerable to experiencing medication incidents in hospitals. Making sound medication decisions is therefore of paramount importance. Prior research has principally described pharmacists' role in reducing medication errors. There is a dearth of information about pharmacists' interactions with pediatric hospital staff across disciplines in resolving medication issues. The aim of this study was to examine interdisciplinary medication decision making by pharmacists in pediatric hospital settings. DESIGN:An ethnographic design was undertaken comprising observations, semi-structured interviews and focus groups. Audio-recorded data were analyzed thematically. SETTING:The study was conducted in three wards of an Australian pediatric tertiary teaching hospital, comprising general surgical, gastroenterology, endocrinology, neurology, adolescent and rehabilitation settings. PARTICIPANTS:Pharmacists, registered nurses and doctors were recruited from diverse clinical wards following information sessions. RESULTS:Pharmacists were central to complex pediatric medication decision making, intervening about dosage, administration, drug interactions and authorities. Pharmacists proactively contacted doctors and nurses about prescribing issues; conversely, staff routinely approached pharmacists for medication advice. Pharmacists were perceived as medication experts, their extensive knowledge valued in resolving complex issues: when off-label medications were prescribed, when protocols were absent or ambiguous, where tension existed between protocol adherence and patient safety, and where patients on multiple medications were at risk of medication error. Pharmacists had strong relationships with doctors and nurses, which had a bearing on pharmacists' input in interventions. Furthermore, pharmacists identified prescribing errors through strategies, such as case note review and medication reconciliation, although the lack of emergency department pharmacists and limited after-hours staffing posed challenges to both strategies. CONCLUSIONS:Pharmacists made a substantial and highly valued contribution to pediatric inter-professional medication decision making. These results provide new knowledge that informs theoretical developments of pharmacists' role in decision making.
Objectives: The importance of accurate paediatric patient assessment is well established but under-utilised in managing postoperative medication regimens. Methods: Data for this case report were collected through observations of clinical practice, conduct of interviews, and retrieval of information from the medical record. This case report involving a hospitalised 1-year-old boy demonstrates the difficulties associated with assessing and managing postoperative distress, including pain and other clinical conditions related to the surgical procedure. Results: Postoperatively, there were difficulties in managing pain and an episode of over-sedation, occasioning opiate reversal with naloxone. In addition, he had decreasing oxygen saturation and increased work of breathing. X-ray showed changes consistent with either atelectasis or aspiration, and he was commenced on antibiotics. The patient experienced respiratory distress and required intervention from the medical emergency team. Conclusion: This case demonstrated the importance of comprehensive assessment and careful consideration of alternative causes of an infant’s distress using the results of assessment tools to aid decision-making. Communication moderates effective patient care, and more favourable outcomes could be achieved by optimising interdisciplinary information-sharing.
Public attitudes towards sex offenders are believed to play a key role in the development of legislation and public policy designed to manage the risks posed by known sex offenders who live in the community. There have, however, been few previous attempts to validate methods by which public attitudes can be measured. The current study aims to address this issue by establishing the factor structure of the Community Attitudes Towards Sex Offenders (CATSO) scale with an Australian community sample and examine the extent to which demographic variables and support for sex offender management policies influence these attitudes. A sample of 552 participants recruited through online social media sites completed the CATSO as well as a number of items developed by the researchers designed to assess individuals' support for specific sex offender policies. Results of an exploratory factor analysis suggested the presence of four distinct factors which were labelled 'social tendencies', 'treatment and punishment', 'crime characteristics' and 'sexual behaviour'. Individuals with higher levels of educational attainment rated sex offenders less negatively than those with lower educational attainment, while those who reported being supportive of community notification reported more negative attitudes towards sex offenders.