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Background: Traumatic life experiences (TLE) are common and can affect a person's physical being and health-related behaviors, including those related to oral health. This scoping review aimed to identify evidence exploring the implementation and provision of trauma-informed care (TIC) in oral health services delivery. Methods: Arksey and O'Malley's framework with enhancements proposed by Levac et al. and Peters et al. was used. Studies were selected based on a preset inclusion and exclusion criteria and the population/concept/context framework. Primary charting of descriptive data was conducted, followed by thematic analysis to identify ideas common within the included literature. Searches were conducted in Medline (via Ovid), APA PsycINFO (via Ovid), Embase (Elsevier), Scopus, CINAHL (via EBSCO), and Cochrane databases. Google Scholar and ProQuest were used to identify grey literature. Results: The search identified 251 records, with fifteen records meeting the inclusion criteria. Limited models, frameworks, and recommendations for trauma-informed practices in oral health services were identified. Recommendations for TIC practices were identified, and clinical practice adjustments for dental practitioners were described to improve service delivery for patients who may have experienced trauma. Avenues for future research were identified. Conclusions: Limited evidence exists to guide trauma-informed practice in oral health service delivery. This scoping review highlights the need for further research into approaches and practices of TIC for oral health services delivery to assess their efficacy and the need to develop evidence-based TIC frameworks to meet the unique needs of oral health service providers and populations. [ABSTRACT FROM AUTHOR]

Objective. Fostering a research culture and enhancing research capacity within the workforce is essential for any health service aiming to provide evidence-based care. This study aims to explore the research culture and capacity in a community health service setting and provide a comparison to previous published research in other health service settings. Methods. Participants were invited to complete a survey consisting of demographics and the Research Capacity and Culture (RCC) tool. Median and interquartile ranges were calculated for each RCC item and compared to three Australian and one international comparison. Results. A total of 73 staff members from Metro North Community and Oral Health service participated. The team-level scores for the RCC were overall the lowest. Comparison to previously published research using the RCC indicated marginally higher scores for individual-level items in our study across all domains. Individual-level items were very weak to weakly correlated with the team and organisation-level RCC items. Strong to very strong correlations were found between a majority of the team and organisation-level items. Conclusions. Team-level scores were substantially lower when compared to individual and organisational levels. The item 'team leaders that support research' was positively correlated with various organisation-level items, indicating that if the respondent perceived the team leader as a low supporter of research the respondent perceived several organisation items also poorly. As an important stakeholder in enabling research in a health service, organisations should investigate the challenges experienced by team leaders in facilitating research and the support or training they may need. [ABSTRACT FROM AUTHOR]

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Introduction Patients with a haematological malignancy may require a lumbar puncture (LP) for either diagnostic purposes or intrathecal delivery of cytotoxic medication. Complications can occur, with postdural puncture headache being the most frequently reported. Objectives/Aims To redesign the LP Diagnostic/Therapeutic Nursing Assessment Tool. Audit data revealed inconsistent tool completion and >66% of surveyed nurses reported it as "not at all user-friendly" or "needing improvement". Description/Methodology The LP tool was redesigned using an iterative co-design approach, including consultation cycles and process mapping with nursing, medical, pharmacy, organisational psychology, and patient safety stakeholders. The LP tool's content, language, logic and flow of information were assessed for ease of use and function. Results/Outcomes The two page LP tool has a clear and structured approach with all critical nursing steps and considerations pre-, during-, and post-LP procedures requiring documentation. The usability analysis demonstrated: (1) clarity, questions are clear and succinct to prevent ambiguity; (2) consistency, information is formatted in the same way to increase efficiency and flow; (3) effort, critical checks are highlighted and rely on recognition (not recall) to reduce workload; (4) order, questions and checks reflect the natural progression of tasks to increase efficiency; (5) flexibility, space is provided to allow for adaptation and change; (6) legibility, information is easily read and presents limited visual noise to reduce workload; and (7) value, only relevant information is presented to support users' tasks. Conclusion The revised LP tool will provide nurses with a usable and fit-for-purpose tool that facilitates patient safety through a structured process of assessment, observation, and escalation. Furthermore, there are anticipated benefits of improved screening, reporting, and management of LP-related complications. A usable and valid assessment tool supports cancer care nurses to confidently identify risk factors, efficiently escalate, and advocate for patients receiving an LP. [ABSTRACT FROM AUTHOR]

Introduction Monoclonal antibody drugs are widely used anti-cancer therapies in the oncology outpatient setting. Increasing demand for outpatient cancer care necessitates exploration of improvements in efficiency. Limited literature has investigated the impacts of bolusing intravenous administration sets with monoclonal antibodies on chair time and associated cost. We hypothesised that bolusing IV administration sets with monoclonal antibodies would be a safe and efficient method to reduce chair time and associated cost in the oncology outpatient setting. Objectives/Aims Primary objective: To evaluate the impact on chair time and associated cost of bolusing intravenous administration sets with prescribed monoclonal antibodies, compared to a compatible fluid. A secondary objective was to assess the incidence of hypersensitivity reactions associated with this practice. Description/Methodology A randomised controlled trial (n=128), with a two-arm design (monoclonal antibody bolus versus priming with a compatible fluid i.e., 0.9% sodium chloride) at a major, quaternary hospital in metropolitan Brisbane, Australia. Included monoclonal antibodies were daratumumab, obinutuzumab, pembrolizumab and nivolumab. Cost per minute of chair time were calculated from the National Efficient Price Determination 2023 for 'chemotherapy -- treatment'. Results/Outcomes From July 2021 to January 2022, 52 patients were recruited, representing 128 episodes of care. There was a statistically significant reduction in chair time for obinutuzumab (16-minute reduction; P=0.032), pembrolizumab (7-minute reduction; P=<0.001) and nivolumab (7-minute reduction; P=<0.001) compared to priming with a compatible fluid. This led to a cost saving of $46.40, $20.30, and $20.30 (AUD) per infusion respectively, for these three monoclonal antibodies. There was no statistically significant difference in frequency of hypersensitivity reactions between study arms. Conclusion Findings suggest that bolusing IV administration sets with a prescribed monoclonal antibody drug could reduce chair time and cost in busy oncology outpatient settings. A powered study to assess the incidence of hypersensitivity reactions related to this practice is recommended. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate COVID-19 vaccine hesitancy, acceptance, and unmet informational needs in a cancer population during the first phase of the coronavirus disease 2019 (COVID-19) vaccination rollout in Australia. Methods: A cross-sectional survey was conducted in a large tertiary hospital in Queensland, Australia, between 10 May and 31 July 2021. The survey assessed health beliefs, experiences of the COVID-19 pandemic, COVID-19 vaccine hesitancy and informational needs. Results: COVID-19 was perceived to be a significant threat to both physical and mental health. While 57.9% (n = 110) of respondents believed the COVID-19 vaccines were safe and 64.2% (n = 122) believed they were effective, more than half (52.6%; n = 100) agreed that they worried about vaccine side effects. Most respondents (84.2%; n = 160) planned to receive the COVID-19 vaccine; however, feelings of hesitancy remained. There was a statistically significant association between those aged under 60 years (P = 0.003), those with previous vaccine hesitancy (P = 0.000), those who felt they had not received adequate information (P = 0.000) and vaccine hesitancy. Requested information pertained to interactions with cancer treatments, those with a history of blood clotting and information for those undergoing bone marrow transplantation. Conclusions: There is a need for tailored COVID-19 vaccine communication that is responsive to the concerns of people with cancer. This will be beneficial during current and future vaccination rollouts. What is known about topic? People with cancer are a COVID-19 vaccine priority group, as they are at increased risk of morbidity and mortality from this disease. There is currently a dearth of information regarding COVID-19 vaccine hesitancy, acceptance, or informational needs for this population. What does this paper add? This paper has shown that although vaccine refusal rates were low in this population, feelings of hesitancy remained. Women, those in younger age categories, those with previous vaccine hesitancy and those who felt they had not received adequate information had stronger vaccine hesitancy and higher refusal rates. What are the implications for practitioners? There is a need for tailored information and open communication regarding COVID-19 vaccines and people with cancer. There is an opportunity to build upon established relationships of trust between cancer patients and their clinicians. [ABSTRACT FROM AUTHOR]

Introduction Brachytherapy is a targeted form of radiation treatment that requires specialist, multidisciplinary management. Despite this, there is currently no standardised clinical pathway for the management of gynaecological and prostate brachytherapy. Aims/Objectives The aim of this study was to develop a comprehensive, standardised clinical pathway for the management of brachytherapy patients that can be utilised by multidisciplinary staff to improve patient safety. Methodology A multi-phase, iterative process was undertaken. Phase 1 involved a clinical review of incidents and adverse events over a five year period. Phase 2 encompassed a representative survey of nursing staff from the radiation oncology, medical oncology, and haematology units where the brachytherapy beds are located. The survey assessed the staff's current level of knowledge and confidence in the management of brachytherapy. Phase 3 utilised the findings of the previous phases to develop a clinical pathway. Results Phase 1 identified forty (n=40) brachytherapy incidents reported between 2018-2023. The most common incidents were clinical process error (40%), medication error (30%), skin integrity (13%) and miscommunication (8%). Thirty-five (n=35/114) nurses from inpatient and outpatient settings completed the Phase 2 survey, representing 31% of the cancer nursing workforce of a large, tertiary hospital. Findings displayed that 57% of participants lacked confidence in managing patient controlled analgesia and 54% lacked confidence in epidural removal. Less than 50% were aware of the brachytherapy repositioning time frames and over 50% identified the incorrect escalation pathway for non-urgent care. 100% of participants agreed that a clinical pathway be beneficial. This led to the development of a multidisciplinary clinical pathway, which incorporated pre-, peri- and post- assessment instructions and prompts related to identified common clinical incidents. Conclusions Results display that there is a critical need for a standardised clinical pathway for the management of brachytherapy. The next steps will be to implement and evaluate this pathway. [ABSTRACT FROM AUTHOR]

Introduction Vascular access devices (VADs), both peripheral intravenous cannulas (PIVCs) and central venous access devices (CVADs) are fundamental in the diagnosis, assessment and treatment of patients with cancer. Standardised, evidence-based management is essential to minimise complications and premature removal. Vessel health and preservation, a relatively new topic in the literature, is about appropriate device selection for the individual patient and their prescribed therapy, and identification and appropriate management of difficult intravenous access. Objectives/Aims To summarise the current literature and detail graded, evidenced-based recommendations to guide clinical management of CVADs with the aim of preserving vein health for current and future use. Methods The CNSA VAD Specialist Practice Network used a systematic review methodology to establish clinically relevant PICO questions, perform an extensive database search, extract a priori data into Covidence and analyse data from the eligible studies. Findings from the data analysis were summarised into clinically-focused recommendations for practice, graded using the Infusion Nurses Society grading scale. Results/Outcomes A final 378 records were included from the 7936 records screened and 692 eligible records. Most studies were from Europe (n=132), followed by the USA (n=116), Australia (n=24) and China (n=20). The number of studies in this an emerging subject is steadily increasing with notable increases around the times of two key publications by Moureau and colleagues in 2012 and Hallam and colleagues in 2016. Recommendations detailing these three subjects were established and published on the CNSA website. Conclusion This systematic review provides a summary of current evidence and valuable evidence-based, graded recommendations to inform clinical practice. [ABSTRACT FROM AUTHOR]

Introduction Clinicians find little utility in research, guidelines, position statements and recommendations for patient management unless they can be seamlessly and efficiently incorporated into clinical practice. The Cancer Nurses Society of Australia (CNSA) Occlusion Prevention and Management Guidelines align with the revised, evidenced-based eviQ and eviQ Education central venous access device procedures, education, and resources launched in July 2021. All documents use a common language and provide an evidencebased, peer-reviewed, and standardised approach located on open-source webpages. Objectives/Aims This projct reviewed and evaluated the impact of the CNSA Occlusion Prevention and Management Guidelines and recommendations. Methods Website analytics -- webpages accesses by unique users -- from 1 July 2021 to 30 January 2024 were requested from eviQ. CNSA Sosido questions and CNSA Congress 2022 and 2023 abstracts pertaining to vascular access devices were collated and analysed descriptively. Results/Outcomes The CNSA Guidelines have been accessed 1857 times and the Patency Algorithm 6553 times via the eviQ web-based platform. The top three Sosido questions were: (i) preventing and managing occlusion; (ii) implementing and sharing guidelines; and (iii) annual competency. Two CNSA abstracts presented the implementation of the Guidelines into clinical practice. Conclusion This project highlights the Guidelines are informing clinical practice and generating professional conversations to inform patient safety. [ABSTRACT FROM AUTHOR]