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Our Research

 

 

Intensive Care Unit

ICU

Key terms: Extracorporeal Therapies and Mechanical Ventilation; Nutrition; Echocardiography and Ultrasound; Sepsis; Acute Kidney Injury and Renal Replacement Therapy: Sedative Practice and Delirium

Research Goal: To undertake sustainable and translational research that delivers evidence-based care of the critically ill.

Research Overview:

Research interests include sedation, renal replacement therapy, nutrition, echocardiography and ultrasound, extracorporeal techniques, mechanical ventilation and sepsis. The department is a member of the ANZICS Clinical Trials Group (CTG) and has collaborated on numerous multi-centre trials. Collaboration with industry has evaluated methods of oxygen delivery that has been published and presented.  The Department has published in excess of 100 peer reviewed publications and presented extensively both locally and internationally over the last decade.

Staff

Head of Department

Professor John Botha – has been site investigator of numerous CTG trials and was on the Management Committee of the NHMRC funded Nephroprotect Trial.

Director ICU Research

Professor Ravindranath Tiruvoipati – is investigating the role of C02 in mechanically ventilated patients. He has extensive experience in ECMO and was a lead investigator in the CESAR study published in the Lancet.

Intensivists

Dr Kavi Haji – is conducting a PhD on the role of bedside echocardiography and ultrasound on management of the critically ill.

Dr. Ashwin Subramanian – 

Associate Professor Ian Carney

Dr. Sachin Gupta

Unit Managers:

Joanne Stewart, Kirsty Sullivan.

PhD Students:

Professor Ravindranath Tiruvoipati

Dr Kavi Haji

Research Assistants

Mr Cameron Green
ICU Research Co-ordinator Mr Cameron Green has an MSc from the University of Edinburgh for his work on Delirium

Contact Details

Research Coordinator: cgreen@phcn.vic.gov.au

Director of Intensive Care Research: Rtiruvoipati@phcn.vic.gov.au

Current Research

PROTECTIN trial

A randomised controlled trial investigating the use of Aspirin for the treatment of systemic inflammatory response syndrome (SIRS)

PLUS study

A randomised controlled trial comparing Plasma-Lyte 148™ to saline for fluid resuscitation in critically ill patients.

Pressure Injury Prediction in the ICU (PIPICU)

A multicentre study to develop and validate a tool for the identification of patients at risk of developing pressure injuries in ICU.

TARGET Trial

A multi-centre randomised controlled double-blind trial investigating the impact of energy-dense enteral nutrition on the outcomes of critically ill patients, when compared to standard enteral nutrition.

Nebulised Heparin Trial

A multi-centre randomised controlled trial of nebulised heparin for the prevention of lung injury in mechanically ventilated patients.

PRE-DELIRIC

Validation study to investigate the ability of the PRE-DELIRIC instrument to predict patients’ risk of developing delirium in ICU

ANZ-CODE

A multi-centre prospective observational study investigating the characteristics and outcomes of patients experiencing in-hospital cardiac arrests in Australia and New Zealand.

AMINO-III

An international survey of the use of aminoglycosides in critically ill patients

AnchorFast audit

A retrospective audit investigating the incidence of oral pressure injuries before and after the introduction of an endotracheal tube attachment device (the AnchorFast™).

ULTRAWEAN

Evaluation of the ability of respiratory and cardiac ultrasound to predict outcomes of weaning from mechanical ventilation.

Key Publications

  1. Tiruvoipati, R., Pilcher, D., Buscher, H., Botha, J., Bailey, M. (2017). Effects of hypercapnia and hypercapnic acidosis on hospital mortality in mechanically ventilated patients. Jul;45(7):e649-e656. doi: 10.1097/CCM.0000000000002332.
  2. Tiruvoipati, R., Botha, J., Fletcher, J., Gangopadhyay, H., Majumdar, M., Vij, S., Paul, E., Pilcher, and the Australia and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. (2017). Intensive care discharge delay is associated with increased hospital length of stay: a multicentre prospective observational study. PLoS ONE (In press)
  3. Doig, GS., Simpson, F., Bellomo, R., Heighes, PT., Sweetman, EA., Chesher D., Pollock, C., Davies, A., Botha, J., Harrigan, P., & Reade, MC. (2015). Intravenous amino acid therapy for kidney function in critically ill patients: a randomised controlled trial. Intensive Care Medicine, 41 (7), 1197 – 1208
  4. Tiruvoipati, R., Buscher, H., Winearls, J., Breeding, J., Ghosh, D., Chaterjee, S., Braun, G., Paul, E., Fraser, JF., Botha, J. (2016). Early experience of a novel extracorporeal carbon dioxide removal device in management of acute hypercapnic respiratory failure. Critical Care and Resuscitation, 18 (4)
  5. Reade, MC., Eastwood, GM., Bellomo, R., Bailey, M., Bersten, A., Cheung, B., Davies, A., et al. (2016). Effect of Dexmedetomidine added to standard care on ventilator-free time in patients with agitated delirium: a randomised clinical trial. JAMA 315 (14)

Pubmed Links

Professor John Botha

Associate Professor Ian Carney

Dr Kavi Haji

Professor Ravindranath Tiruvoipati  

Dr Sachin Gupta

Dr Ashwin Subramaniam  

Associate Professor Andrew Davies

 

 

Allied and Community Health

 Allied-Health

Key terms: models of care, gait, chronic disease

Allied health, health services research, community health,

Research Overview

Research undertaken in Allied Health and Community Health is a mix of investigator initiated projects and contribution to large multi-centred trials. Research projects span across the community we work with, our professions and the services we provide.

Our unit has and number of active and emerging researchers. Our clinician researchers are leaders in paediatric foot and lower leg research, and also conduct studies in musculoskeletal conditions and chronic diseases (such as diabetes) that reduce quality of life and participation. We are in partnership with other Victorian public health services and universities to contribute to research into models of care and service delivery by allied health.

The research unit currently supports over 30 staff research projects that are either discipline specific or have inter-professional research teams. There are a range of projects including some in intensive care, Parkinson’s disease, and diabetes related foot disease. An emerging focus is in the sphere of ageing and rehabilitation. We supervise eight postgraduate (PhD students and MPhil) students. The unit also supports Monash University allied health student honours projects.

Staff

Allied Health Research Lead

Cylie Williams

Cylie is the Allied Health Research Lead at Peninsula Health. She is the recipient of a NHMRC Early Career Health Professional Research Fellowship. She is a Senior Research Fellow at Monash University and has ~ $1.5m in grant funding and over 40 publications.

Cylie’s research interests are diverse. She leads paediatric foot and gait related research, and coordinates projects relating to older adult foot complications relating to diabetes, health services research into the impact of system change, low back pain research and research into workforce change. She currently supervises nine PhD and MPhil students and six honours students.

Management

Allied Health Director

Kirsten Caspers 

Kirsten is the Allied Health Director of Peninsula Health. She is chair of the Allied Health and Community Health Research Steering committee and committed to supporting allied health professionals at Peninsula Health to contribute to, lead and use research in every day practice.

Email: kcaspers@phcn.vic.gov.au

Community Health General Manager (Acting)

Iain Edwards

Iain is the General Manager of Peninsula Health Community Health services. He has been the primary investigator of a large telehealth partnership project with CSIRO. Iain is an active member of the Allied Health and Community Health Research Steering committee and champion for research support in Community Health.

Email: iedwards@phcn.vic.gov.au

PhD Students

Lucia Michailidis: lucia.michailidis@monashhealth.org.au

Antoni Caserta: antoni.caserta@monash.edu

Freya Coker: fcoker@phcn.vic.gov.au

Research Assistants

Anna Couch: acouch@phcn.vic.gov.au

Contact Details

cyliewilliams@phcn.vic.gov.au

Current Research

Allied Health IMPACT study:

Investigating Models of Practice for Allied health Care and functional Trajectory for subacute patients

This research is funded by the Department of Health and Human Services of Victoria. It aims to evaluate the difference models of allied health services in rehabilitation services across Peninsula Health, Monash Health and Eastern Health.

Understanding and measuring idiopathic toe walking gait

This research seeks to explore any differences between lower limb muscle length, muscle activity and muscle strength in children with idiopathic toe walking gait. It also seeks to understand how clinicians can better measure treatment outcomes and what treatment outcomes are important to parents and children.

Prevention and treatment of foot wounds in older adults.

People with diabetes related foot wounds commonly receive podiatry-based education to prevent further complications. Part of this research seeks to understand this education delivery and if it changes behaviours. Additionally, there are many ways that foot wounds are treated. Another component of this body of research seeks to determine the effectiveness and cost effectiveness of common treatment methods.

Key Publications

  1. Kaplonyi J, Bowles KA, Nestel D, Kiegaldie D, Maloney S, Haines T, Williams C, Understanding the impact of simulated patients on health care learners communication skill: A systematic review, Medical Education, (IN PRESS)
  2. Michailidis L, Kotsanas, D, Orr E, Coombes G, Bergin S, Haines T, Williams C, Does the new low-frequency ultrasonic debridement technology pose an infection control risk for clinicians, patients, and the clinic environment? 2017 American journal of infection control 44 (12), 1656-1659
  3. Williams CM, Skinner EH, James AM, Cook JL, McPhail SM, Haines TP, Comparative effectiveness research for the clinician researcher: a framework for making a methodological design choice, 2016, Trials 17 (1), 406
  4. Bright SJ, Williams CM, Development of Australia’s first older adult‐specific early intervention for alcohol‐related harm: Feasibility and proof of concept, 2017, Australasian journal on ageing 36 (1), 52-55

 

Nursing and Midwifery

About our Research

Key terms: nursing, midwifery, mental health, interprofessional, education, research, quality, innovation

Research Goal:  To generate high quality evidence leading to clinical translation in areas relevant to nursing and midwifery.

Research Overview

Our program is informed by innovative evidence-based inquiry centred on quality and safety.

At the forefront of understanding how to provide the best nursing and midwifery care in hospital and in the community, researchers are working with a range of local and international partners to improve health issues in fields such as healthcare management and education, emergency and critical care, informatics, mental health nursing, women’s and children’s health, cancer services, acute, sub-acute and aged care.  From exploring the consumer view of care and causes of pressure injuries, to understanding the outcomes of care of newborns with respiratory conditions, falls prevention, living with metastatic breast cancer and the effectiveness of nursing interventions for clinical aggression, the range of studies is diverse.  Further studies have explored the existing evidence on perioperative nurses’ attitudes to organ procurement and nurses’ management of clinical alarms and another developed a screening tool for depression for those with stroke and aphasia. Nursing and midwifery research translates knowledge to policy and practice, to answer clinical questions and demonstrate benefit.

Staff

Group Leader/Head

Associate Professor V. Plummer

PhD Students

Dr David Langton

W. Gao

Contact Details

+61 3 99044064

virginia.plummer@monash.edu

Current Research

Implementing Safewards in Acute Health Care

This study aims to assess the effectiveness of a evidence based conceptual model which is underpinned by a training program in building participants’ knowledge and confidence in using the Safewards model to manage clinical aggression on an acute medical ward for the first time. The aim is to reduce the use of restrictive interventions and make the ward calmer and a safer place to recover, visit and work.

Does removing the FRAT risk status impact falls prevention: A stepped wedge cluster randomised control trial.

The risk factors for patient falls are multifactorial and include intrinsic and extrinsic risk factors.  Falls risk screening tools (such as FRAT) have been promoted for use in inpatient settings, to identify patients at risk of falls.  Numerous falls risk assessment tools have been developed, with varying degrees of sensitivity and specificity. In this study a trial is being conducted across 19 wards to determine if using clinical judgement in addition to a screening questions results in a more comprehensive risk assessment and plan.

Identification & management of the deteriorating patient-(Adult) Emergency Dept

This quality improvement project contributes at a state-wide level to evidence-based care to reduce variation in clinical practice and improve patient care. The aim is to identify indicators of deterioration, increase knowledge of management of escalation and decrease mortality.  The work contributes to the Emergency Clinical Care Network in building sustainable improvements in the delivery of emergency care in Victorian Emergency Departments

Impact of endotracheal tube fastening devices on the incidence of oral pressure injuries in a metropolitan Australian Intensive Care

Nursing handover involving clients in acute mental health

This study explores the mental health nursing staff handover where patients are active participants in decision-making processes for transfer of care. It aims to identify solutions and recommendations to improve practices in mental health inpatient units with a focus on collaborative relationships, establishing a shared care culture locally and developing established processes that promote structured meaningful communication.

Key Publications

Lowe, G, Plummer, V, Boyd, L. (2018) Nurse Practitioner integration: qualitative experiences of the change management process”. Journal of Nursing Management. 2018 Apr 30. doi: 10.1111/jonm.12624

Dredge, A, Oates, L, Gregory, H, King, S. (2017) Effective change management within an Australian community palliative care service. British Journal of Community Nursing.  November 2017 Vol 22, No.11.

Hampson, J, Green, C, Stewart, J, Armistead, L, Degan, G, Aubrey, A, Eldho, P and Tiruvoipati. (2018) Impact of the introduction of an endotracheal tube attachment device on the incidence and severity of oral pressure injuries in the intensive care unit: a retrospective observational study. BMC Nursing https://doi.org/10.1186/s12912-018-0274-2  ©   8 February 2018. See also research page of Intensive Care Unit.

Innes, K., Elliott, D, Plummer, V. Jackson, D. (2018). Emergency department waiting room nurses in practice: an observational study”. Journal of Clinical Nursing. April 27 EPub. DOI: 10.1111/jocn.14240

Grover EPorter JEMorphet, J.        
An exploration of emergency nurses’ perceptions, attitudes and experience of teamwork in the emergency department. Australas Emerg Nurs J. 2017 May;20(2):92-97. doi: 10.1016/j.aenj.2017.01.003. Epub 2017 Feb 11.