Nursing & Health

Most healthcare-associated urinary tract infections (HAUTIs) including catheter associated urinary tract infections (CAUTIs) are potentially preventable through implementation of effective strategies. To provide the foundation for a national point prevalence study of HAUTIs including CAUTIs, a three phase project was developed. This study reports the findings of Phase II which aimed to (1) pilot an online process including online database for conducting point prevalence survey of HAUTIs and CAUTIs and (2) determine the point prevalence of HAUTIs and CAUTIs in acute and aged care facilities

Background: The Tasmanian Infection Prevention and Control Unit (TIPCU) reviewed methods of evaluating environmental cleanliness in healthcare in July 2012. At a subsequent State wide multidisciplinary forum, there was consensus for the TIPCU to develop a standardised method of assessing environmental cleanliness within Tasmanian healthcare using a combination of both visual and ultraviolet (UV) gel applicator assessments.

Methods: The TIPCU developed a protocol outlining methodology for performing both visual and UV gel cleanliness assessments. An on-line tool was used to develop secure web based data collection and reporting. We developed a training program which could be used for face to face or web based education and provided training of key personnel across the Tasmanian Health Organisations (THOs) in the use of the environmental cleaning assessment tools and accompanying data collection and reporting tools. The sites were provided with IPads for data entry, UV sensitive gel and UV lights for a 6 week trial and consultation period. We sought feedback from participants via an on-line survey.

Results: A trial period to test the programs functionality was held in the four Tasmanian larger acute public hospitals during April and May 2013. Over 80% of respondents were positive about the protocol, on-line tools and training. On qualitative feedback, the major themes that emerged were around the number of UV gel sites and the limitations in using the UV gel in some specialist areas. We have addressed each of these in the revised protocol.

Conclusion: The consultation phase of this project highlighted a number of modifications that were required in the protocol and on-line tools and was an important phase that allowed us to evaluate aspects of the program prior to finalisation of the protocol and tools.

Introduction: In 2012 the Tasmanian Infection Prevention and Control Unit (TIPCU) implemented an Infection Control Assessment (ICA) program in rural hospitals and non-acute settings (RHANAS). The three main aims of the ICA program are:

1. Build clinician capacity in RHANAS
2. Have the ability to assess and manage infection control risks
3. Foster local ownership of infection prevention and control by individual service providers and clinicians.

The project implementation and evaluation is ongoing.

Methods: The ICA consists of a range of location and process specific audits, designed specifically for RHANS. Each rural hospital in Tasmania participated in the ICA program during 2012. The program was undertaken collaboratively by a TIPCU CNC, regional infection prevention and control clinical nurse educator and either the DON of the hospital or a designated representative. The majority of the assessments were done on site at each rural hospital in conjunction with a short education program which was tailored on requests from each facility.

Results: Consistent themes emerged from the results of each rural hospital ICA. These included the following set of challenges relating to infection prevention and control:

• No management plan including no regular or structured auditing program
• No consistent orientation messages
• Limited direction for site portfolio holders
• Limited or no healthcare associated infection surveillance programs
• No ongoing education for staff
• Outdated policies and procedures

Conclusion: The TIPCU in conjunction with the regional Tasmanian Health Organisations (THO) are working collaboratively to address the challenges identified by the ICA program. The TIPCU have produced a template for an infection prevention and control management plan, a portfolio position description and tools for undertaking surveillance in RHANS. The additional challenges identified by the ICA are being addressed at the local THO level.

Presented at the ASID Gram Negative 'Superbugs' Meeting, 2-3 Aug. 2013.

The mental health and wellbeing of health care workers has been uniquely challenged by the COVID-19 pandemic. Health care organizations may support the mental health of their members by offering tailored, evidence-based interventions and initiatives. METHODS: The American College of Lifestyle Medicine offered its members an online, 10-week, multicomponent mental health and well-being program (The Lift Project) for free, and extended the invitation to members from sister organizations associated with the Lifestyle Medicine Global Alliance. Individuals (n=1785) representing 39 countries registered for the program. Website meta-data was used to explore participant’ engagement with the program. One hundred forty-five participants responded to a post-program questionnaire that included Likert items and open-ended questions. RESULTS: The website hosting the program recorded 9,815 total visits over 10 weeks. Ninety-one percent of the respondents agreed or strongly agreed that the program supported their mental wellbeing, and there was a significant increase (X2=80.8, p< 0.01) in the proportion of respondents who rated their wellbeing higher after the program compared to at the start of the program. Ninety percent of respondents indicated that the program would have a long-term positive influence on their mental wellbeing, and 94% indicated they would recommend the program to a friend. Dominant themes from the open-ended questions in the post-program evaluation included: the participants liked the style of the video presentations, the structure of the program, content covered and the practical application of the content; the participants would have liked more time to engage with the program and would have enjoyed the provision of group meetings. CONCLUSION: Health care organizations may play an important role in supporting their members’ mental health and wellbeing by offering large-scale, evidence-based interventions. To optimize efficacy, the interventions should be well-designed, engaging, and potentially provide the opportunity for group connection and interaction.

Purpose: To pilot a community-based, localised lifestyle medicine intervention for improving residents' mental health, wellbeing and resilience.

Background: Mental health is deteriorating globally, exacerbated by the COVID-19 pandemic and its residual effects. There is an urgent need to provide large-scale interventions that equip the general population with knowledge and skills to improve their mental health, wellbeing and resilience. Disseminating lifestyle medicine interventions through local governing authorities may provide an efficient model for achieving community-wide impact.

Methods: Avondale University and Lake Macquarie City Council (LMCC), located in Australia, partnered to offer a free, online, seven-week, lifestyle-based mental health promotion program to all residents of the LMCC during a COVID-19 lockdown. LMCC promoted the program through established networks and 2390 households registered—4041 participants. In a mixed-methods design, 138 participants responded to a post-program survey that included questions and statements (using Likert scales) about: their perceived mental wellbeing before and after the program; the program's effect on self-efficacy for managing mental health; and program satisfaction. Qualitative questions probed participants' likes and dislikes and were analysed thematically.

Results: The majority (89%) of respondents reported that participating in the program improved their mental health, and 99% indicated they would recommend the program to a friend. While 37% rated themselves as having either 'poor' or 'fair' mental health at the beginning of the intervention, only 6% reported being in that range on completion. Most respondents (94%) believed they gained skills to help them manage their wellbeing, and 91% perceived the learnings would continue to impact their mental health positively. Themes generated from the qualitative data showed that most participants liked the video content and delivery style, community camaraderie, growth in personal empowerment, and accessibility. Some participants did not find accessibility easy, disliked the delivery style, and experienced technical difficulties.

Conclusions: The community-based, online, localised lifestyle medicine intervention improved residents' perceived mental health and skills for future mental health management. Overall, participants were satisfied with the intervention and valued the content, community togetherness and emphasis on self-empowerment.

Objective. In a previous study, we found mediating variables (resilience, self-efficacy, hope, social support) were strongly associated with both positive and negative psychological outcomes among family caregivers of people with traumatic brain injury (TBI). Building on these results, the comparability of the model between caregivers for relatives with TBI and family caregivers of individuals with Spinal Cord Injury (SCI) was tested.

Methods. Structural equation modelling with multigroup analysis was conducted in a cross-sectional sample to test a hypothesised model of resilience. A total of 181 family members were recruited (131 TBI, 50 SCI) from 6 specialist rehabilitation services in New South Wales and Queensland, Australia. Assessments comprised the Connor-Davidson Resilience Scale, Eysenck Personality Questionnaire, Ways of Coping Questionnaire, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey; and four measures of psychological adjustment including: Caregiver Burden Scale, Medical Outcomes Survey, General Health Questionnaire, and Positive and Negative Affect Scale.

Results. The model for the aggregated sample demonstrated a very good model fit (χ2 = 47.42, df = 39, ρ = 0.167, NFI = .962, IFI = .993, TLI = .985, CFI = .993, RMSEA = .035). The model accounted for 59% of the variance in resilience. Resilience was directly associated with caregiver positive affect and also played a protective role in relation to caregiver burden, as mediated through social support. Multi-group analysis showed neuroticism was significantly more influential on burden in family members supporting relatives with TBI than family members of individuals with SCI. Further, problem-focused coping was statistically more influential on positive affect in family members of individuals with TBI when compared to family members of individuals with SCI.

Conclusions. This is the first study to show neurological disability specific pathways underlying resilience and psychological adjustment in family caregivers of individuals with TBI or SCI. This study makes a contribution to better targeting strength based family support interventions.