Monash Health is the largest public health service in the state of Victoria, providing care to one-quarter of the population of Melbourne. Services are provided across the lifespan, from prenatal to end-of-life care, and are delivered at 40 locations in the south-east of Melbourne, including six hospitals, five residential homes, community and mental health facilities. More than 18,000 employees work across these locations, including more than 8800 nurses and midwives. Annually at Monash Health, more than 3.2 million episodes of care are provided to members of the community, including more than 258,000 people admitted to hospital and the delivery of more than 10,000 babies.
Care of older people/ Healthy aging
- Nurse empowerment and engagement in residential aged mental health and dementia care: Examining the factors to support safe, respectful and quality care
- Barriers and enablers to the implementation of the diabetes guidelines in residential aged care services
- Improving care for older people through innovative, nurse-led, patient-centred workforce models
- Nurses and direct staff familiarisation with technology in residential aged care
Chronic and complex conditions
- How to fix a broken heart: a guide for Transcatheter Aortic Valve Implantation (TAVI) patients
- Perception and action: How the cognitive constructs of health and illness shape the model of care for co-morbid chronic disease in the hospital setting
Communicating for safety
- Communication processes when commencing a new medication in patients with a chronic illness
- Development and evaluation of a triage tool in a public tertiary referral clinical genetics department
Perceptions of family-centred care during critical illness and at the end of life in the context of COVID-19 enhanced infection prevention and control measures
Lead researcher: Associate Professor Melissa Bloomer
The COVID-19 pandemic is challenging health care systems worldwide. Epidemics have often contributed to the most significant events and challenges in human history, with COVID-19 described as an extraordinary public health emergency. Stringent Infection Prevention and Control (IPC) measures that minimise and manage any community spread and in-hospital cross transmission of COVID-19 are essential. A key element of in-hospital IPC measures is the restriction or limiting of visitors for all patients, not just those with suspected or diagnosed COVID-19. While these constraints are understandable and justified, restrictions of visitors can create significant tensions between the provision of family-centred care, particularly for families of critically ill and dying patients, and their family members. The Australian Commission on Safety and Quality in Health Care highlights the need for clinicians to demonstrate family inclusion and family involvement, in the provision of patient care. Nurses are key to supporting family members, communicating with sensitivity, and providing practical, grief and bereavement support. Whilst COVID-19 enhanced IPC measures are essential to the COVID-19 response, 16 the extent of the impact on family-centred care and the family experience during critical illness and at the end of life is unknown.
The aim is to explore nurses’ and families’ perceptions of family-centred care and partnering with families of critically ill or dying patients during COVID-19 enhanced Infection Prevention and Control (IPC) measures. Interviews will be undertaken with bereaved family members and nurses impacted by the restricted visitation, via Zoom.
Aligning closely with Monash Health’s strategic priorities to consistently provide safe, high quality and timely care, to work with respect, kindness and compassion, and to orientate care towards the community, optimising access, independence and wellbeing, the findings of this study will contribute to improving family-centred care, and partnering with families.
Health Literacy of Caregivers (HELICS): Development of a novel intervention to optimize caregiver health literacy in clinical cancer settings
Lead researcher: Dr Eva Yuen
Informal caregivers frequently provide vital day-to-day care and support for people with cancer, often with little guidance or help. Their skills to find, understand, appraise, and apply information to make health decisions (i.e., health literacy) significantly impacts their capacity to provide care, and consequent health outcomes for the patient and themselves.
The proposed Health Literacy of Caregivers (HELICS) study will be the first internationally to: (a) comprehensively examine the impact of caregiver health literacy and caregiver activation on both patient and caregiver health outcomes (survey data from 190 patient-caregiver dyads), (b) identify strategies to improve caregiver health literacy and caregiver activation from the caregiver perspective (interviews with up to 30 caregivers), and (c) synthesize the strategies for inclusion in a novel caregiver health literacy intervention (engagement with ~20 stakeholders).
The two-year, mixed-methods, participatory-based study funded by an Executive Dean’s Health Research Fellowship will be conducted in collaboration with clinical staff and researchers at Monash Health and Austin Health’s Olivia Newton-John Cancer, Wellness and Research Centre. Together, the findings will enable us to achieve our overall goal of the study: to develop an innovative caregiver psycho-educational intervention to improve caregiver health literacy and caregiver activation, and the consequent health of both the patient and caregiver.
- Midwifery/Maternity Care
- Health workforce – support and development
Nurse and Midwife Compassion
Lead researcher: Alfred Deakin Professor Alison Hutchinson
Following a rapid literature review in early 2020, a systematic literature search was conducted that explored: a) psychometric properties of compassion instruments for healthcare professionals; b) compassion/ compassion satisfaction in work versus compassion fatigue and burnout; c) risk factors and consequences of developing compassion fatigue; d) preventative strategies/ interventions to address compassion fatigue; e) patient perspectives of compassion; f) compassion in nursing/midwifery students; and g) organisational compassion. This exploratory work informed components of two studies that are currently underway.
Nurse and midwife compassion and the quality of nursing and midwifery care at Monash Health.
Funded by the Nurses Board Victoria Legacy Limited, $99K. For this study, a mixed-methods approach will use concurrent cross-sectional surveys of nurses and midwives and their care recipients (including family members), to examine their perceptions of compassion and care quality. We will then use this information to work with nurses/midwives and consumers in a series of human-centred co-design workshops developed specifically to iterate on solution development. Data will be captured across a wide range of care recipient, and nursing and midwifery care settings and contexts.
A survey study of paediatric nurse compassion and perceived quality of care.
The aim of this study is to explore the relationship among paediatric nurses’ self-reported compassion levels, practice environment, and perceptions about the quality of care delivery. Registered paediatric nurses employed by Monash Children’s Hospital at Monash Medical Centre Clayton, Dandenong Hospital and Casey Hospital will be invited to complete an online cross-sectional survey. The survey comprises validated tools to examine compassion, the work environment, and quality of care along with demographic items.
It is anticipated that the findings of both studies will provide insights into the association between quality of care and compassion across diverse clinical settings and inform the development of targeted strategies to minimise compassion fatigue and support the quality improvement of compassionate nursing and midwifery care at Monash Health.
- Evaluation of Nursing and Midwifery Digital Health educational modules
- Perceptions and experiences of graduate nurses and midwives in the context of the COVID-19 pandemic
Victorian residential aged care staff awareness of, and participation in, dementia-specific support, education, and training
Preventing hospital-acquired harm
Preventing harm to older people in acute hospitals: supporting quality in complex nursing work
Lead research: Associate Professor Bernice Redley
Funded by the National Health and Medical Research Council (NHMRC) of Australia under the Translating Research Into Practice (TRIP) Fellowship scheme (2019-21), and the Nurses Board of Victoria Legacy Limited Mona Menzies Research Grant (2019), this research addresses the gap between the recommended evidence and nursing practices to prevent harms commonly experienced by older people (>65 years) in hospital. Hospital strategies for comprehensive nursing care to prevent harm to older people in hospital are complex and poorly defined, and health information technology solutions have a poor history of efficiently and effectively supporting complex nursing work.
The research aims were to develop and test an integrated harm prevention model and codesign a suitable technology solution to support nurses’ decision-making and care to prevent harm to older people in hospital. The research uses a framework of eight-factors sensitive the quality of nursing care factors that contribute to patient harm in hospital.[2-4]
The 3-stage design included participatory co-design methods to collaborate with researchers, decision-makers, nurse and patient end-users to develop an innovative solution. Stage 1 examined existing practices and synthesised best evidence; Stage 2 codesigned a novel harm prevention model; and Stage 3 examined the feasibility and usability of the solution prototype technology for clinician use.
The outcomes included:
- An understanding of strengths and gaps on harm prevention practices by nurses
- A synthesis of recommend bundles or groupings of practical strategies for common combinations of factors contributing to patient risk (e.g. delirium, incontinence and falls) that are readily integrated into local practice contexts.[5-6]
- A model for comprehensive harm prevention by nurses.
- A technology prototype to assist nurses use the model in clinical practice when admitting a new patient to hospital.
- Topaz M, Ronquillo C, Peltonen LM, et al. Nurse Informaticians Report Low Satisfaction and Multi-level Concerns with Electronic Health Records: Results from an International Survey. AMIA Annu Symp Proc2016;2016:2016-25.
- Redley B, Baker T. Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. J Clin Nurs2019;28(3-4):560-74. doi: 10.1111/jocn.14650
- Redley B, Raggatt M. Use of standard risk screening and assessment forms to prevent harm to older people in Australian hospitals: a mixed methods study. BMJ Qual Saf2017;26(9):704-13. doi: 10.1136/bmjqs-2016-005867
- McGrath M, Botti M, Redley B. Clinicians’ perceptions and recognition of practice improvement strategies to prevent harms to older people in acute care hospitals. J Clin Nurs2017;26(23-24):4936-44. doi: 10.1111/jocn.13978
- Resar R, Griffin FA, Haraden C, et al. Using Care Bundles to Improve Health Care Quality. IHI Innovation Series white paper. Cambridge, Massachusetts: 2012. Available from: http://www.ihi.org/resources/Pages/IHIWhitePapers/UsingCareBundles.aspx.
- Saunders H. Translating knowledge into best practice care bundles: a pragmatic strategy for EBP implementation via moving postprocedural pain management nursing guidelines into clinical practice. J Clin Nurs 2015;24(13-14):2035-51. doi: 10.1111/jocn.12812
- Reviewing the Nursing and Midwifery Foundations of Care at Monash Health
- Reducing Harm, in the Acute Hospital Setting, to People Displaying Symptoms Associated with a Neurocognitive Disorder
- Supporting Antimicrobial Stewardship Activities in Specialised Paediatric Settings
- Partnering with Patients in Medication Administration
- Prescribing practices and clinical outcomes after acute hospitalisation
Translation of evidence into policy and practice
- Maternity service organisational interventions that aim to reduce caesarean section: a systematic review and meta-analyses
Technologies (EMR, telehealth, AI)
- Measuring nurse motivation, engagement and well-being in the implementation of an electronic medical record