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Objectives: Arterial catheters (ACs) are critical for haemodynamic monitoring and blood sampling but are prone to complications. We investigated the incidence and risk factors of AC failure. Methods: Secondary analysis of a multi-centre randomised controlled trial (ACTRN 12610000505000). Analysis included a subset of adult intensive care unit patients with an AC. The primary outcome was all-cause device failure. Secondary outcomes were catheter associated bloodstream infection (CABSI), suspected CABSI, occlusion, thrombosis, accidental removal, pain, and line fracture. Risk factors associated with AC failure were investigated using Cox proportional hazards and competing-risk models. Results: Of 664 patients, 173 (26%) experienced AC failure (incidence rate [IR] 37/1000 catheter days). Suspected CABSI was the most common failure type (11%; IR 15.3/1000 catheter days), followed by occlusion (8%; IR 11.9/1,000 catheter days), and accidental removal (4%; IR 5.5/1000 catheter days). CABSI occurred in 16 (2%) patients. All-cause failure and occlusion were reduced with ultrasound-assisted insertion (failure: adjusted hazard ratio [HR] 0.43, 95% CI 0.25, 0.76; occlusion: sub-HR 0.11, 95% CI 0.03, 0.43). Increased age was associated with less AC failure (60–74 years HR 0.63, 95% CI 0.44 to 0.89; 75 + years HR 0.36, 95% CI 0.20, 0.64; referent 15–59 years). Females experienced more occlusion (adjusted sub-HR 2.53, 95% CI 1.49, 4.29), while patients with diabetes had less (SHR 0.15, 95% CI 0.04, 0.63). Suspected CABSI was associated with an abnormal insertion site appearance (SHR 2.71, 95% CI 1.48, 4.99). Conclusions: AC failure is common with ultrasound-guided insertion associated with lower failure rates. Trial registration Australian New Zealand Clinical Trial Registry (ACTRN 12610000505000); date registered: 18 June 2010. [ABSTRACT FROM AUTHOR]

Studies of doctors' life satisfaction (subjective well-being) have largely overlooked the specific experiences of international or overseas trained doctors. This study explores any difference in life satisfaction and its determinants between international and domestic medical graduates (i.e. IMGs vs. DMGs), in Australia (a major destination country). We pooled eight waves of data from the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey of Australian doctors (2009–2016). Life satisfaction was measured on a standard 10-point scale. We applied Oaxaca and Ransom's linear decomposition method to evaluate factors associated with any observed difference in satisfaction between the two groups of doctors. IMGs were more likely to report lower life satisfaction than DMGs (mean 7.37 vs 7.48, p-value < 0.001). The well-being gap (of 0.11) was largely attributable to the groups' differences in observable characteristics such as psychosocial and demographic factors. Most notably, the IMG group was worse off with respect to self-reported financial security, exposure to work-related psychosocial risk factors, and community integration. Our study highlights the importance of the workplace and community context in understanding the life satisfaction difference between IMGs and DMGs. The study results may have important implications for policies and programs that seek to promote the integration and retention of IMGs. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of the COVID‐19 pandemic on clinical supervision practices of health care workers in health care settings in one Australian state. Method: A bespoke survey was developed and administered online using Qualtrics™. The survey consisted of Likert scale and closed questions, with options for free text comments. Numerical data were analysed descriptively and using Chi‐Square tests. Textual data were analysed through content analysis. Results: Of the 178 survey respondents, 42% were from allied health disciplines, 39% from nursing and midwifery, and 19% from medicine. The type and mode (i.e., face‐to‐face, telesupervision) of clinical supervision prior to the pandemic and at the time of survey completion (i.e., July–August 2021) were similar. Eighteen percent of respondents had a change in supervision arrangements but only 5% had a change in supervisor. For the 37% who changed roles due to COVID‐19, 81% felt their current supervisor was still able to support them, 69% were still having their supervisory needs met. Analyses of textual data resulted in the development of two categories: Supervision deteriorating, and some clinical supervision functions (i.e., formative and restorative) being more impacted than others (i.e., normative). Conclusion: There were substantial disruptions to several parameters of clinical supervision due to COVID‐19, that may pose a threat to high quality supervision. Health care workers reported pandemic‐induced stress and mental health challenges that were not always addressed by effective restorative supervision practices. [ABSTRACT FROM AUTHOR]

Background: To better target rural background and rurally interested applicants during medical school admission, it is increasingly common for rural medical programs to include multiple mini-interview (MMI) scenarios designed to screen for rural interest. It remains unclear whether the inclusion of regionally/rurally focused MMI scenarios positively impacts the selection of rural background applicants and evidence is limited regarding why rural background applicants may perform worse on the MMI. Therefore, this study explored how rural and metropolitan applicants prepare for and perceive the MMI for admission to a regional medical pathway. Methods: A mixed-methods survey was sent to provisional entry regional pathway medical school applicants who had completed an MMI. The survey was distributed before any offers of admission had been released. Results: Rural applicants spent less time and money preparing for the MMI and felt less prepared (P < 0.05). However, time and money spent, and resources used to prepare were not associated with feeling more prepared (all P > 0.05). Respondents mostly felt that the MMI process aligned with their expectations (83%), is fair (64%), and helps a rural program select the most suitable applicants (61%). Rural applicants generally felt that they had an advantage over other applicants (61%) while most metropolitan applicants did not (23%; P = 0.002). Discussion: Applicants to a regional medical pathway are generally supportive of the MMI process. It appears valuable for applicants to prepare for the MMI by understanding the format and requirements; however, investing substantial time and money does not underpin feeling better prepared. MMI scenarios which include a regional focus are perceived to advantage rural applicants. [ABSTRACT FROM AUTHOR]