Acute Medicine Unit (AMU)
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Research outputs from the Acute Medicine department at the RD&E.
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Item Suspected acute rheumatic fever in a young man in England(BMJ, 2021-11-09) Wilson, Z. M.; Craster, K.A 24-year-old fit and well Caucasian man was referred to acute hospital via his General Practitioner with chest pain, palpitations, shortness of breath and an antecedent sore throat. Investigations revealed pericardial and pleural effusions, pericardial thickening on MRI, mild mitral regurgitation on echocardiogram and a raised Antistreptolysin O (ASO) titre.He was treated as acute rheumatic fever (ARF) with a prolonged course of penicillin, supportive therapy with bisoprolol and colchicine with lansoprazole cover. The patient made a full recovery and subsequent cardiac MRI showed resolution of all changes.Item Healthcare professional views on barriers to implementation of evidence-based practice in prevention of ventilator-associated events: A qualitative descriptive study(Elsevier, 2021-10-27) Madhuvu, A.; Endacott, R.; Plummer, V.; Morphet, J.OBJECTIVE: To explore health professional views of barriers to the use of evidence-based practice to prevent ventilator-associated events in intensive care units. DESIGN: A qualitative descriptive study was conducted with nurses and doctors with more than six months experience caring for mechanically ventilated patients. SETTING: The study was conducted in two intensive care units, in large metropolitan health services in Victoria, Australia. METHODS: Individual semi-structured interviews were undertaken with 20 participants (16 nurses and 4 doctors) in 2019. Purposive sampling method was used until data saturation was reached. The interviews were held at the hospital in a private room away from their place of employment. The interview data were analysed using thematic analysis. FINDINGS: Four major themes were inductively identified from nine subthemes: i) prioritising specific situations, ii) inadequate use of evidence to underpin practice, iii) perception of inadequate staffing and equipment and, iv) inadequate training and knowledge of evidence-based guidelines. CONCLUSIONS: These themes helped to explain previously reported deficits in nurses' knowledge of and adherence to evidence-based practice in intensive care. Findings suggest the need for a well-established policy to underpin practice. The barriers faced by nurses and doctors in preventing ventilator associated events need to be addressed to optimise quality of patient care in intensive care units.Item POSU: A pilot study looking into the feasibility, safety and efficacy of a post-operative surgical unit for high-risk patients(Sage, 2019-12) Baldwin, Matthew; McCormick, Bruce; Foale, Mark; Belete, Martha; Chen, Connie; Williams, Helen; Stark, David; Matthews, EdIn this ambitious quality improvement project, we investigated the possibility of using operating theatre post-operative recovery ward to care for high-risk patients overnight.Item Barriers to undertaking technical skills(Wiley, 2020-04) Garwood, JamesItem The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: The VIP2 Study(Springer, 2020-01) Boulanger, CarolePremorbid conditions affect prognosis of acutely-ill aged patients. Several lines of evidence suggest geriatric syndromes need to be assessed but little is known on their relative effect on the 30-day survival after ICU admission. The primary aim of this study was to describe the prevalence of frailty, cognition decline and activity of daily life in addition to the presence of comorbidity and polypharmacy and to assess their influence on 30-day survival.