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Pressure injuries affect 13.1% to 45.5% of patients in the intensive care unit and lead to pain and discomfort for patients, burden on healthcare providers, and unnecessary cost to the health system. Turning and positioning systems offer improvements on usual care devices, however the evidence of the effectiveness of such systems is still emerging. We conducted an investigator initiated, prospective, single centre, two group, non-blinded, randomised controlled trial to determine the effectiveness of a system for turning and positioning intensive care unit patients, when compared to usual care turning and positioning devices, for preventing PIs. The trial was prematurely discontinued after enrolment of 78 participants due to COVID-19 pandemic related challenges and lower than expected enrolment rate. The study groups were comparable on baseline characteristics and adherence to the interventions was high. Four participants developed a PI (in the sacral, ischial tuberosity or buttock region), n = 2 each in the intervention and control group. Each participant developed one PI. As the trial is underpowered, these findings do not provide an indication of the clinical effectiveness of the interventions. There was no participant drop-out or withdrawal and there were no adverse events, device deficiencies, or adverse device effects identified or reported. The results of our study (in particular those pertaining to enrolment, intervention adherence and safety) provide considerations for future trials that seek to investigate how to prevent PIs among ICU patients.

Objective: This systematic review will aim to evaluate and synthesise the evidence on the impact of primary care paramedics within emergency medical services on healthcare system resource use. Introduction: Non-emergency requests to emergency medical services in Australia are estimated to make up 60% of patients of the $4.4 billion AUD services. Several programs to reduce this have been introduced, including paramedics specialising in primary care. No research currently exists synthesising the impact of these roles within emergency medical services on overall healthcare system resource use. Inclusion criteria: The study will include both analytical and observational study designs that discuss healthcare system resource use from incorporation of paramedics specialising in primary care within the emergency medical service. Methods: A systematic search will be performed using JBI methods, including a peer review of electronic search strategies. Six databases will be systematically searched: the Cochrane CENTRAL Register, PubMed, Embase, MEDLINE Complete, CINAHL, and Google Scholar. Identified studies will be independently assessed for inclusion and quality by two independent investigators using JBI critical appraisal tools. Data will be extracted for narrative and tabular synthesis. If heterogeneity permits pooling, meta-analysis to compare means will be performed using the random effects model.

Additional file 2: Supplementary Table 1. Exclude Articles.

Additional file 1. Search Strategy used for OVID Medline.

Objective: The objective of this scoping review is to identify what metrics, methods and instruments are used to evaluate the impact of nurse practitioner roles. Introduction: There is much literature evaluating the impact of the nurse practitioner (NP) roles on processes and outcomes of care. Most of this literature evaluates highly specialised areas of NP practice rather than focusing on core elements of these roles. There is a critical need to clearly demonstrate the contribution of NP roles to the healthcare system and to the health of the population. To evaluate NP impact common to all roles, it is important to scope the available evidence to identify current metrics, methods, and instruments. By undertaking this review, we expect to establish an evidence base for the development of a core set of indicators sensitive to all NP models. Inclusion criteria: Articles exploring any form of NP service process outcomes will be included. Articles that report on outcomes of advanced practice nursing roles will be included if it is possible to extrapolate NP specific outcomes. Any healthcare service and area of specialty nurse practitioner practice will also be included. Methods: The proposed scoping review will be guided by the JBI methodology for scoping reviews. Peer review of quantitative, qualitative and mix method research articles in English will be performed. Medline, Cumulative Index to Nursing and Allied Health, Embase, and Scopus electronic databases will be searched. Screening of identified citations will be reviewed by a single reviewer following intra-rater reliability of 10% of citations at each stage. Data extraction will be performed using two reviewers. Results: The results of the search will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram, and a narrative summary to explain how the results relate to the review questions and objectives. Implications: Key findings from this review will be used to develop research questions and inform evaluations of the impact of NP roles on health systems and health outcomes. The results will be disseminated though peer-reviewed publication and conference presentations.

Objective: The objective of this scoping review is to summarise the evidence regarding the prevention of pulmonary complications in patients receiving mechanical ventilation in the ED Background: Mechanical ventilation is a commonly applied therapeutic intervention for critically unwell patients in the Emergency Department (ED). Ventilator associated pneumonia, acute respiratory distress syndrome and ventilator associated lung injury are some of the significant risks of receiving mechanical ventilation. Early implementation of clinical strategies can prevent or mitigate the development of pulmonary complications Method: The scoping review process will be adapted from the Joanna Briggs Institute Methodology for Scoping Reviews. Five clinical databases have been chosen for a formal literature search. A three-part grey literature search has been designed to identify clinical practice guidelines relating to ventilatory settings care of the mechanically ventilated patient in the ED published in the digital domain. Interrater reliability will be measured using percentage agreement prior to single reviewer screening of citations. Data extraction will be performed using two reviewers. Results: The results of the search and the study inclusion process will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram. The results of the scoping review will be presented using a tabular format with accompanying narrative summary that will describe the results in the context of the review objective and questions Implications: A summation of the evidence regarding the prevention of pulmonary complications in patients receiving mechanical ventilation in the ED will strengthen knowledge around this topic. The clinical translation of this work may result in the reduction of preventable harms and improving quality of care for the entirety of the patient journey. Keywords: mechanical ventilation, emergency, lung protective ventilation, clinical practice guideline

Objective: To identify and characterise interventions that help prepare families for the possibility of death in the adult intensive care unit, barriers to the implementation of these interventions, outcome variables and instruments used. Introduction: Providing end-of-life care that prepares families for the possibility of death when a patient is identified at risk of dying in the intensive care unit can reduce the burden of psychological symptoms associated with bereavement. Characterising interventions that prepare families for the possibility of death, mapping barriers to their implementation and instruments used to measure outcome variables is an essential step to inform the development of a future intervention to address the preparedness of families for a death in the intensive care unit. Inclusion criteria: This review will consider randomised controlled trials evaluating interventions that foster death preparedness in family members. Any outcome variables used to measure the impact of the intervention on family member psychosocial wellbeing or quality of life will be considered. Studies will be excluded if the intervention relates to organ donation. Methods: This scoping review will be conducted using Joanna Briggs Institute methodology. Six databases will be systematically searched from Jan 2007 to March 2022. Citations will be screened against the inclusion criteria and extracted by two reviewers independently. Data analysis will be performed by the primary reviewer. This protocol is guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and will be registered with Open Science Framework.

Objective: To describe the teaching strategies employed in health education settings to reduce the influence of cognitive and implicit bias in health professional students’ clinical decision-making. Introduction: Cognitive and implicit biases negatively impact clinicians’ decision-making capacity and can have devastating consequences for the provision of safe, effective, equitable healthcare. There is some evidence that clinicians can be taught strategies to recognise or mitigate cognitive biases, so it is important that educators proactively prepare pre-registration healthcare students to be workforce ready by incorporating self-awareness about cognitive and implicit biases and strategies to mitigate these into curricula. Notwithstanding commentary on the nature and potential impacts of cognitive and implicit bias, the specific pedagogical techniques used to enhance clinical decision making of learners are relatively unknown. Inclusion criteria: All articles exploring pedagogical approaches and/or educational techniques, strategies, teaching tools to reduce cognitive and implicit biases/errors (concept), delivered in tertiary healthcare education settings (context) to preregistration students in any healthcare discipline (population) will be included. Methods: The proposed scoping review will be guided by the Joanna Briggs Institute methodology for scoping reviews. Peer review of qualitative and quantitative research employing any research design, in English, will be performed. Medical Literature Analysis and Retrieval System Online (MEDLINE), the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Joanna Briggs Institute (JBI), Embase and Education Resources Information Center (ERIC) will be searched. Grey literature will be identified by searching OpenDissertations and Google Scholar. Conference abstracts, editorials and opinion papers will be excluded. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data extraction will be performed using two reviewers. Results: Results will be reported via the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram, accompanied by a narrative summary to explain how the results relate to the review questions and objectives. Implications: Key findings from this review will be used to develop research questions that will inform curriculum development and teaching strategies aimed at mitigating cognitive and implicit biases. The results will be disseminated though peer-reviewed publication and conference presentations