Christina Narelle Parker, Kim Kaim, Kathleen Joy Finlayson, Julia Hindmarsh, Helen Donovan
Objective
To determine the unique wound management requirements of regional healthcare professionals and to assess the effectiveness of an evidence translation model on practice and confidence in evidence-based wound management.
Design
A pre/post implementation study, including pre/post surveys.
Setting
The project was implemented in two regional areas in Australia.
Participants
Forty-two eligible health professionals completed pre-workshop surveys. Eighteen participants attended a face-to-face workshop while between four and 14 participants attended online workshops each week. Immediately post-workshop, 17 health professionals completed surveys, with 13 able to be directly matched with pre-workshop surveys. Seven participants completed case scenarios as part of the post evaluation within their practices.
Results
This study obtained information on current wound types and treatment strategies in regional areas in Australia. Outcomes of this study found positive trends in the confidence of evidence-based management of wounds in regional areas following the implementation of two formats of an evidence translation model (one face-to-face and one online).
Conclusions
Both formats of the evidence translation model benefited the community in being able to facilitate the implementation of evidence-based wound care in regional areas; therefore potentially leading to improved health outcomes. Pilot information on the prevalence and management of wounds for people in regional areas and supporting information on healthcare professionals' perceptions, knowledge and confidence of wound care in these areas will assist in guiding practice in the future. The outcomes of this project are a starting point for establishing units and/or networks specialised in wound care across regional areas in Australia. The use of innovative evidence translation models ensures sustainability of the use of evidence-based resources and information and in particular understanding that flexible versions of models can and should be used.
{"title":"An Interprofessional Approach to Supporting Evidence-Based Wound Care Practices in Health Care Sectors Outside Major Cities","authors":"Christina Narelle Parker, Kim Kaim, Kathleen Joy Finlayson, Julia Hindmarsh, Helen Donovan","doi":"10.1111/ajr.70120","DOIUrl":"10.1111/ajr.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the unique wound management requirements of regional healthcare professionals and to assess the effectiveness of an evidence translation model on practice and confidence in evidence-based wound management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A pre/post implementation study, including pre/post surveys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The project was implemented in two regional areas in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Forty-two eligible health professionals completed pre-workshop surveys. Eighteen participants attended a face-to-face workshop while between four and 14 participants attended online workshops each week. Immediately post-workshop, 17 health professionals completed surveys, with 13 able to be directly matched with pre-workshop surveys. Seven participants completed case scenarios as part of the post evaluation within their practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study obtained information on current wound types and treatment strategies in regional areas in Australia. Outcomes of this study found positive trends in the confidence of evidence-based management of wounds in regional areas following the implementation of two formats of an evidence translation model (one face-to-face and one online).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both formats of the evidence translation model benefited the community in being able to facilitate the implementation of evidence-based wound care in regional areas; therefore potentially leading to improved health outcomes. Pilot information on the prevalence and management of wounds for people in regional areas and supporting information on healthcare professionals' perceptions, knowledge and confidence of wound care in these areas will assist in guiding practice in the future. The outcomes of this project are a starting point for establishing units and/or networks specialised in wound care across regional areas in Australia. The use of innovative evidence translation models ensures sustainability of the use of evidence-based resources and information and in particular understanding that flexible versions of models can and should be used.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine O'Connell, Steve Woodruffe, Kirsten Middleton, Anthony Bruce Fallon, Floraidh Rolf, Clara Walker
Objective
This pilot study evaluated the feasibility and acceptability of a student-led group falls prevention exercise program delivered to a fixed hub via telehealth to older adults in a remote community.
Design
A convergent parallel mixed-methods design involving pre- and post-participation outcome measures, semi-structured focus groups and interviews explored the experiences and perspectives of participants completing the program and health professional students conducting the sessions.
Setting
Telehealth delivery to a very remote town (Modified Monash Model 7) in southwestern Queensland from a regional city in southeast Queensland.
Participants
Over 2022 and 2023, 17 community participants completed the program. Seven final year students, six studying exercise physiology and one studying physiotherapy, completed a clinical placement in a regional health and wellness clinic and implemented the telehealth program during their placement.
Results
Community participants demonstrated significant improvements in mobility and function following program participation, with higher BOOMER scores (M = 13.12, 95% CI 11.94–14.29) and faster 10-m walk times (M = 8.56 s, 95% CI 7.31–9.81) compared to baseline (M = 10.94, 95% CI 9.04–12.84; and M = 10.31 s, 95% CI 8.32–12.31, respectively). Clinically meaningful gains on the 10-m walk test were achieved by 64.7% of participants. Beyond physical outcomes, the program fostered valuable social connections. Health professional students reported increased awareness of effective telehealth strategies and growth in clinical skills as additional benefits.
Conclusions
Telehealth delivery of a group-based exercise program to a fixed hub appears to be a feasible and well-accepted model of rural health service delivery for both older adults and health students. Wider implementation of this approach to a broader range of health services could improve access to high-value care for rural and remote communities.
目的：本初步研究评估了学生领导的团体预防跌倒运动项目的可行性和可接受性，该项目通过远程医疗向偏远社区的老年人提供固定中心。设计：采用融合平行混合方法设计，包括参与前和参与后的结果测量、半结构化焦点小组和访谈，探讨了完成项目的参与者和主持会议的卫生专业学生的经验和观点。环境：从昆士兰州东南部的一个区域城市向昆士兰州西南部一个非常偏远的城镇（改进的莫纳什7型）提供远程医疗服务。参与者：在2022年和2023年期间，17名社区参与者完成了该计划。七名最后一年级的学生，六名学习运动生理学，一名学习物理疗法，在一个区域健康诊所完成了临床实习，并在实习期间实施了远程医疗方案。结果：社区参与者在活动和功能方面表现出显著的改善，与基线（M = 10.94, 95% CI 9.04-12.84; M = 10.31 s, 95% CI 8.32-12.31）相比，他们的BOOMER评分更高（M = 13.12, 95% CI 11.94-14.29）， 10米步行时间更快（M = 8.56 s, 95% CI 7.31-9.81）。64.7%的参与者在10米步行测试中获得了临床意义上的获益。除了身体上的收获，这个项目还培养了宝贵的社会关系。卫生专业学生报告说，作为额外的好处，他们对有效远程保健战略的认识有所提高，临床技能有所提高。结论：对老年人和卫生系学生来说，向固定中心提供以团体为基础的锻炼计划似乎是一种可行且被广泛接受的农村卫生服务提供模式。在更广泛的保健服务范围内更广泛地实施这种做法，可以改善农村和偏远社区获得高价值保健的机会。
{"title":"A Student-Led Telehealth Group Falls Prevention Exercise Program for Older Adults in a Rural Community: A Pilot Study","authors":"Christine O'Connell, Steve Woodruffe, Kirsten Middleton, Anthony Bruce Fallon, Floraidh Rolf, Clara Walker","doi":"10.1111/ajr.70109","DOIUrl":"10.1111/ajr.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This pilot study evaluated the feasibility and acceptability of a student-led group falls prevention exercise program delivered to a fixed hub via telehealth to older adults in a remote community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A convergent parallel mixed-methods design involving pre- and post-participation outcome measures, semi-structured focus groups and interviews explored the experiences and perspectives of participants completing the program and health professional students conducting the sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Telehealth delivery to a very remote town (Modified Monash Model 7) in southwestern Queensland from a regional city in southeast Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Over 2022 and 2023, 17 community participants completed the program. Seven final year students, six studying exercise physiology and one studying physiotherapy, completed a clinical placement in a regional health and wellness clinic and implemented the telehealth program during their placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Community participants demonstrated significant improvements in mobility and function following program participation, with higher BOOMER scores (<i>M</i> = 13.12, 95% CI 11.94–14.29) and faster 10-m walk times (<i>M</i> = 8.56 s, 95% CI 7.31–9.81) compared to baseline (<i>M</i> = 10.94, 95% CI 9.04–12.84; and <i>M</i> = 10.31 s, 95% CI 8.32–12.31, respectively). Clinically meaningful gains on the 10-m walk test were achieved by 64.7% of participants. Beyond physical outcomes, the program fostered valuable social connections. Health professional students reported increased awareness of effective telehealth strategies and growth in clinical skills as additional benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Telehealth delivery of a group-based exercise program to a fixed hub appears to be a feasible and well-accepted model of rural health service delivery for both older adults and health students. Wider implementation of this approach to a broader range of health services could improve access to high-value care for rural and remote communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary Health Care and Continuous Quality Improvement. An Evidence-Based GuideBy A. Laycock, L. O'Donoghue, and R. Bailie, Sydney: Sydney University Press, 2025. 392 pp. $80.00 (paperback). ISBN: 978-1-74-332926-9","authors":"Amy-Louise Byrne","doi":"10.1111/ajr.70121","DOIUrl":"https://doi.org/10.1111/ajr.70121","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michele Conlin, Dorothy McLaren, Sean MacDermott, Evelien Spelten
Objective
To explore how mobile interviewing can be utilised to better inform rural health promotion efforts, as well as the type and breadth of data generated. Mobile methods are defined by the researcher and participant being in motion in a specific setting, collaborating in the data collection process.
Setting
A rural health service catchment in Victoria, Australia.
Participants
Members of local Progress Associations, Town Advisory Committee and service clubs within the catchment.
Design
The study employed an exploratory qualitative design. Mobile interviewing was used in the form of unstructured guided tours, led by participants. The theme provided was ‘What in your town helps or hinders community health?’. Content and thematic qualitative analysis were applied, and a socioecological model was adopted to structure the findings.
Results
Six guided tours involving seven participants were conducted. Local drivers of health were identified across all five levels of the applied model (intrapersonal, interpersonal, institutional, community, public policy). Institutional-level factors figured most prominently during the guided tour discussions (e.g., relating to the agricultural sector or not-for-profit community organisations). Community factors (e.g., intentional support between local organisations) were also highlighted. Public policy factors were the least discussed out of the five levels of the socioecological model. The study found that perceptions of community health drivers varied substantially, even among geographically close and demographically similar towns.
Conclusion
The study highlights how mobile interviewing can generate rich, contextual data. The findings suggest that guided tours can serve as a valuable tool for rural health promotion practitioners, providing a holistic understanding of local drivers of health and informing more tailored interventions.
{"title":"Guided Tours to Better Understand Rural Community Contexts for Health Promotion","authors":"Michele Conlin, Dorothy McLaren, Sean MacDermott, Evelien Spelten","doi":"10.1111/ajr.70119","DOIUrl":"10.1111/ajr.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore how mobile interviewing can be utilised to better inform rural health promotion efforts, as well as the type and breadth of data generated. Mobile methods are defined by the researcher and participant being in motion in a specific setting, collaborating in the data collection process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A rural health service catchment in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Members of local Progress Associations, Town Advisory Committee and service clubs within the catchment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The study employed an exploratory qualitative design. Mobile interviewing was used in the form of unstructured guided tours, led by participants. The theme provided was ‘What in your town helps or hinders community health?’. Content and thematic qualitative analysis were applied, and a socioecological model was adopted to structure the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six guided tours involving seven participants were conducted. Local drivers of health were identified across all five levels of the applied model (intrapersonal, interpersonal, institutional, community, public policy). Institutional-level factors figured most prominently during the guided tour discussions (e.g., relating to the agricultural sector or not-for-profit community organisations). Community factors (e.g., intentional support between local organisations) were also highlighted. Public policy factors were the least discussed out of the five levels of the socioecological model. The study found that perceptions of community health drivers varied substantially, even among geographically close and demographically similar towns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights how mobile interviewing can generate rich, contextual data. The findings suggest that guided tours can serve as a valuable tool for rural health promotion practitioners, providing a holistic understanding of local drivers of health and informing more tailored interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the perceptions of rural Australian clinicians towards antenatal point-of-care ultrasound (APoCUS) training and accreditation, investigating barriers and enablers to continuing professional development (CPD).
Methods
A prospective cross-sectional online survey of rural Australian clinicians (doctors, nurses, midwives) was undertaken in 2023, using non-probability sampling with self-selection/voluntary response. The survey targeted rural clinicians caring for pregnant patients. Thematic and descriptive analyses were performed with response frequencies grouped by role, work sector, APoCUS use and previous training experience. Fisher's exact test was used for association.
Results
Fifty-seven responses were analysed (41 midwives/nurses, 16 physicians/doctors). Two-thirds were performing APoCUS, half reported formal or on-the-job training, and none were accredited. Midwives/nurses had a poorer understanding of their scope of practice (eligibility to learn/perform APoCUS) and accreditation requirements. Interest in accreditation was high, particularly for the midwife/nurse cohort. The perceived benefits of accreditation surrounded improved patient care and services, scanning capability and professional satisfaction. The main barriers to pursuing accreditation were supervision for scanning and assessments, cost, time commitment and workforce shortages. Half of the respondents had access to employer-provided CPD funds, and most reported having to self-fund to meet professional registration requirements.
Conclusion
Australian rural clinicians are driven to upskill and provide high-quality care to patients but face significant barriers to CPD and attaining accreditation, evidenced by low accreditation rates. Future efforts should focus on simplifying accreditation processes, improving access to qualified supervisors/mentors and raising awareness of training and accreditation opportunities while providing support and incentives for rural clinicians to facilitate access.
{"title":"Antenatal Point-of-Care Ultrasound Training and Accreditation: A Cross-Sectional Survey of Australian Rural Clinicians","authors":"Amber Bidner, Eva Bezak, Nayana Parange","doi":"10.1111/ajr.70111","DOIUrl":"10.1111/ajr.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the perceptions of rural Australian clinicians towards antenatal point-of-care ultrasound (APoCUS) training and accreditation, investigating barriers and enablers to continuing professional development (CPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cross-sectional online survey of rural Australian clinicians (doctors, nurses, midwives) was undertaken in 2023, using non-probability sampling with self-selection/voluntary response. The survey targeted rural clinicians caring for pregnant patients. Thematic and descriptive analyses were performed with response frequencies grouped by role, work sector, APoCUS use and previous training experience. Fisher's exact test was used for association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-seven responses were analysed (41 midwives/nurses, 16 physicians/doctors). Two-thirds were performing APoCUS, half reported formal or on-the-job training, and none were accredited. Midwives/nurses had a poorer understanding of their scope of practice (eligibility to learn/perform APoCUS) and accreditation requirements. Interest in accreditation was high, particularly for the midwife/nurse cohort. The perceived benefits of accreditation surrounded improved patient care and services, scanning capability and professional satisfaction. The main barriers to pursuing accreditation were supervision for scanning and assessments, cost, time commitment and workforce shortages. Half of the respondents had access to employer-provided CPD funds, and most reported having to self-fund to meet professional registration requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Australian rural clinicians are driven to upskill and provide high-quality care to patients but face significant barriers to CPD and attaining accreditation, evidenced by low accreditation rates. Future efforts should focus on simplifying accreditation processes, improving access to qualified supervisors/mentors and raising awareness of training and accreditation opportunities while providing support and incentives for rural clinicians to facilitate access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the place of origin and placement locations as predictors of non-metropolitan practice among domestic pharmacy graduates from the University of Tasmania (UTAS).
Methods
The 2023 principal place of practice (PPP) for all domestic UTAS pharmacy graduates between 2011 and 2022 was identified using the Australian Health Practitioners Regulation Agency (Ahpra) online registration database. The graduates' place of origin (home address at the time of course application), locations where they undertook placements, and their 2023 PPP were described using the Modified Monash Model (MM) classification system of remoteness. A multivariable logistic regression model was used to identify independent predictors of regional (MM2), or rural or remote (MM3–7) PPP.
Results
329 domestic UTAS pharmacy graduates were practicing in Australia in 2023; 58.7% were working regionally and 13.1% in a rural or remote area. Predictors of a regional PPP included regional (aRR 36.32, 95% CI 7.88, 167.33, p < 0.0001) and rural or remote origin (aRR 24.96, 95% CI 4.73, 131.81, p < 0.0001), while the number of regional placements was inversely associated (aRR 0.53, 95% CI 0.34, 0.82, p = 0.004). Rural or remote origin (aRR 26.53, 95% CI 5.50, 1.27.93, p < 0.0001) and undertaking any rural or remote placements (aRR 4.64, 95% CI 1.04, 20.79, p = 0.045) predicted a rural or remote PPP.
Conclusions
Place of origin is foundational in building the future non-metropolitan pharmacy workforce. Improving opportunities for rural and remote origin students to access and complete pharmacy courses across Australia should be prioritised.
目的：探讨塔斯马尼亚大学（UTAS）国内药学专业毕业生的原籍地和就业地点对非都市实习的预测作用。方法：使用澳大利亚卫生从业人员监管局（Ahpra）在线注册数据库，确定2011年至2022年期间所有国内UTAS药学毕业生的2023年主要执业地点（PPP）。毕业生的原籍地（申请课程时的家庭住址）、实习地点以及他们2023年的购买力平价（PPP）使用修改莫纳什模型（MM）的偏远分类系统进行描述。使用多变量logistic回归模型确定区域（MM2）或农村或偏远（MM3-7） PPP的独立预测因子。结果：2023年在澳大利亚实习的药学专业毕业生329人；58.7%在地区工作，13.1%在农村或偏远地区工作。区域购买力平价的预测因子包括区域（aRR 36.32, 95% CI 7.88, 167.33, p）。结论：原产地是建设未来非大都市药房劳动力的基础。应该优先考虑改善农村和偏远地区学生获得和完成澳大利亚各地药学课程的机会。
{"title":"Do Place of Origin and Clinical Placement Locations Predict Regional, Rural and Remote Practice Among University of Tasmania Pharmacy Graduates?","authors":"B. Jessup, P. Allen, J. Donoghue","doi":"10.1111/ajr.70118","DOIUrl":"10.1111/ajr.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the place of origin and placement locations as predictors of non-metropolitan practice among domestic pharmacy graduates from the University of Tasmania (UTAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2023 principal place of practice (PPP) for all domestic UTAS pharmacy graduates between 2011 and 2022 was identified using the Australian Health Practitioners Regulation Agency (Ahpra) online registration database. The graduates' place of origin (home address at the time of course application), locations where they undertook placements, and their 2023 PPP were described using the Modified Monash Model (MM) classification system of remoteness. A multivariable logistic regression model was used to identify independent predictors of regional (MM2), or rural or remote (MM3–7) PPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>329 domestic UTAS pharmacy graduates were practicing in Australia in 2023; 58.7% were working regionally and 13.1% in a rural or remote area. Predictors of a regional PPP included regional (aRR 36.32, 95% CI 7.88, 167.33, <i>p</i> < 0.0001) and rural or remote origin (aRR 24.96, 95% CI 4.73, 131.81, <i>p</i> < 0.0001), while the number of regional placements was inversely associated (aRR 0.53, 95% CI 0.34, 0.82, <i>p</i> = 0.004). Rural or remote origin (aRR 26.53, 95% CI 5.50, 1.27.93, <i>p</i> < 0.0001) and undertaking any rural or remote placements (aRR 4.64, 95% CI 1.04, 20.79, <i>p</i> = 0.045) predicted a rural or remote PPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Place of origin is foundational in building the future non-metropolitan pharmacy workforce. Improving opportunities for rural and remote origin students to access and complete pharmacy courses across Australia should be prioritised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leanne Rodwell, Irene Schneider, Anne Bernard, Tamara Blake, Patsi Mawn, Deearne Dodd, Jeleacha Hopkins-Lincolne, Margaret S. McElrea
Objective
Evaluate the impact on spirometry quality of a culturally responsive Indigenous Health Worker Spirometry Training and Mentoring programme (IHWS).
Methods
Participation in two-day face-to-face IHWS including post-training telehealth mentoring
Design
Submission of spirometry reports before training (T1), after training (T2) and after telehealth mentoring (T3).
Setting
Urban, rural and remote primary healthcare services in Queensland Australia.
Participants
Primarily Australian First-Nations Health Workers.
Main Outcome Measures
Two raters used nine-point quality criteria to score spirometry at T1, T2 and T3. Inter-rater reliability was assessed using Cohen's original kappa. Reports submitted at a minimum of two time-points were included in the analysis. A linear mixed model analysis and post hoc analysis assessed differences in total scores across different timepoints.
Results
Between 2011 and 2018, 360 participants (75.5% Indigenous) attended 43 workshops. Of the 284 participants attending workshops #1–#34, 56.7% (161/284) hadn't performed spirometry before IHWS and were excluded from comparative analysis because spirometry reports could be submitted at only one timepoint (T2). Introduction of telehealth mentoring sessions from workshop #35, increased spirometry submission for assessment at T2 from 9.9% (28/284) to 68.4% (52/76). Thirty-six participants submitted reports at two timepoints or more. Spirometry quality improved across all timepoints (p < 0.001). Inter-rater reliability was good or very good (0.83–0.91).
Conclusion
Two-day F2F culturally responsive IHWS training increases the quality of spirometry testing. Further increases in quality occur after telehealth mentoring. This model could be adapted to teach spirometry to First-Nation's health workers of other nations.
{"title":"A Culturally Responsive Indigenous Health Worker Spirometry Training and Mentoring Programme (IHWS) Increases Quantity and Quality of Spirometry Performed in Primary Care","authors":"Leanne Rodwell, Irene Schneider, Anne Bernard, Tamara Blake, Patsi Mawn, Deearne Dodd, Jeleacha Hopkins-Lincolne, Margaret S. McElrea","doi":"10.1111/ajr.70112","DOIUrl":"10.1111/ajr.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate the impact on spirometry quality of a culturally responsive Indigenous Health Worker Spirometry Training and Mentoring programme (IHWS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participation in two-day face-to-face IHWS including post-training telehealth mentoring</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Submission of spirometry reports before training (T1), after training (T2) and after telehealth mentoring (T3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Urban, rural and remote primary healthcare services in Queensland Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Primarily Australian First-Nations Health Workers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Two raters used nine-point quality criteria to score spirometry at T1, T2 and T3. Inter-rater reliability was assessed using Cohen's original kappa. Reports submitted at a minimum of two time-points were included in the analysis. A linear mixed model analysis and post hoc analysis assessed differences in total scores across different timepoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2011 and 2018, 360 participants (75.5% Indigenous) attended 43 workshops. Of the 284 participants attending workshops #1–#34, 56.7% (161/284) hadn't performed spirometry before IHWS and were excluded from comparative analysis because spirometry reports could be submitted at only one timepoint (T2). Introduction of telehealth mentoring sessions from workshop #35, increased spirometry submission for assessment at T2 from 9.9% (28/284) to 68.4% (52/76). Thirty-six participants submitted reports at two timepoints or more. Spirometry quality improved across all timepoints (<i>p</i> < 0.001). Inter-rater reliability was good or very good (0.83–0.91).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Two-day F2F culturally responsive IHWS training increases the quality of spirometry testing. Further increases in quality occur after telehealth mentoring. This model could be adapted to teach spirometry to First-Nation's health workers of other nations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philip J. Batterham, Louise M. Farrer, Leanna Woods, Mark E. Larsen, Priya Martin, Adam Hulme
<p>Rural and regional areas of Australia are underserved by health services, which has been shown to result in poorer health outcomes [<span>1</span>]. Multiple policy initiatives have not significantly shifted the accessibility gap faced by rural communities in recent decades. Alternative, effective and creative solutions to improve rural pathways for care are therefore urgently needed to fill the gap, which may include growing the rural workforce, developing community-based models of care, and delivering services through evidence-based digital interventions. The focus of this special issue is on the latter use of digital interventions, which may be an important part of the solution to increase access to evidence-based care in rural Australia. While digital solutions alone cannot fill the gap and are not always a substitute for face-to-face services, they can provide efficient and effective delivery of evidence-based care in many areas of health.</p><p>Digital interventions are delivered using, for example, internet or mobile technology and include therapeutic interventions, prevention and health promotion interventions, interventions to monitor or manage health conditions, informational and educational interventions related to health outcomes or service use, and social interventions, along with the use of big data or passive sensing to enhance the delivery of care for rural health consumers. Interventions may be self-guided or clinician-supported, and may also build on innovative features of technology such as artificial intelligence. Alongside an expansion in digital interventions, telehealth services represent a related aspect of digital health that has proliferated rapidly during the COVID-19 pandemic [<span>2</span>].</p><p>There are many challenges to the delivery of healthcare in rural areas, both for traditional face-to-face services and digital services. Tensions within the health system may limit innovation and implementation of technology-based services, based largely on the assumption that the efficiency of digital services may compromise quality care [<span>3</span>]. There also remain evidence gaps about the impacts and effectiveness of digital interventions on health outcomes specifically within rural areas. This special issue aimed to fill gaps in the evidence and implementation of digital interventions for rural and regional areas of Australia, considering a broad range of applications to diverse health conditions and settings across eight original research articles, one commentary and one narrative review.</p><p>The special issue has a core focus on the implementation of digital health in rural Australia. A meta-review by Krahe et al. [<span>4</span>] summarises the key enablers and barriers to implementation, noting benefits such as improved accessibility and patient satisfaction. They emphasise the need for locally tailored interventions and consider implementation factors that encompass inner and outer settings, individual n
澳大利亚农村和区域地区的保健服务不足，这已被证明会导致较差的健康结果[10]。近几十年来，多项政策举措并未显著改变农村社区面临的可及性差距。因此，迫切需要替代性、有效和创造性的解决方案来改善农村的护理途径，以填补这一空白，其中可能包括增加农村劳动力、开发基于社区的护理模式，以及通过基于证据的数字干预措施提供服务。本期特刊的重点是数字干预措施的后一种使用，这可能是增加澳大利亚农村获得循证护理的解决方案的重要组成部分。虽然数字解决方案本身不能填补这一空白，也并不总是替代面对面服务，但它们可以在许多卫生领域提供高效和有效的循证护理。数字干预措施是利用互联网或移动技术提供的，包括治疗干预措施、预防和健康促进干预措施、监测或管理健康状况的干预措施、与健康结果或服务使用有关的信息和教育干预措施以及社会干预措施，同时利用大数据或被动感知来加强向农村保健消费者提供护理。干预措施可以是自我指导的，也可以是临床医生支持的，也可以建立在人工智能等技术的创新特征之上。随着数字干预措施的扩大，远程医疗服务是数字卫生的一个相关方面，在2019冠状病毒病大流行期间迅速扩散。在农村地区提供保健服务面临许多挑战，无论是传统的面对面服务还是数字服务。卫生系统内部的紧张关系可能会限制以技术为基础的服务的创新和实施，这在很大程度上是基于数字服务的效率可能会损害医疗质量的假设。数字干预措施对健康结果的影响和有效性，特别是在农村地区，也存在证据差距。本期特刊旨在填补澳大利亚农村和区域地区数字干预措施的证据和实施方面的空白，考虑到在八篇原创研究文章、一篇评论和一篇叙述性评论中对不同健康状况和环境的广泛应用。该特刊的核心重点是在澳大利亚农村实施数字保健。Krahe等人的荟萃综述总结了实施的关键推动因素和障碍，并指出了诸如改善可及性和患者满意度等益处。它们强调有必要采取因地制宜的干预措施，并考虑到实施因素，包括内部和外部环境、个人需求、干预特点以及考虑到现有系统和可用资源的仔细实施规划。在澳大利亚农村公平实施数字服务的关键是将澳大利亚原住民纳入交付模式的设计中。Nasir等人，[5]报告了与患有慢性病的澳大利亚土著共同设计进程，以发展虚拟保健服务，促进初级保健的提供。特刊中的三篇文章提供了各种数字工具的实施规划示例。Le等人研究了临床医生和消费者在实施数字心理健康服务方面的观点的异同，注意到在临床医生的支持下，与使用数字干预措施的能力、机会和动机相关的一致的促成因素。Hambleton等人确定了实施的要素，这些要素可能对农村数字服务治疗神经性厌食症的成功至关重要。Talay等人确定了数字减肥服务相对于传统面对面服务的好处。本期特刊还展示了数字干预措施对各种健康状况的潜在影响。Dear等人抽取了大量参与国家数字服务的慢性疼痛患者样本，以证明农村和城市环境中疼痛和心理健康方面的患者满意度和临床改善是一致的。同样，史泰博等人发现有证据表明，在线心理健康诊所为农村地区的人们提供了有效的护理，同时也惠及了可能得不到治疗的弱势群体。数字服务在受灾害影响的社区中也可能发挥至关重要的作用，Curtin等人的研究表明，联合远程医疗服务可以为受森林大火影响的儿童提供有效的结果和高满意度。最后，Li等人。 [12]展示了一种新型数字筛查程序的实用性，该程序使用人工智能算法来检测西澳大利亚偏远地区的糖尿病视网膜病变。特刊中包括的研究强调了数字干预在不影响患者满意度的情况下改善澳大利亚农村各种健康状况的健康结果的潜力。数字工具的许多方面提供了获得护理的更好途径，并促进了现有服务的更广泛覆盖。尽管数字技术带来了诸多好处，但它并不是解决农村卫生服务领域巨大差距的灵丹妙药。确保数字干预措施周到地融入现有的护理途径，支持临床医生和消费者的护理偏好，并确保它们得到充分的资源，对于最大限度地提高卫生效益至关重要，同时承认还需要进行更广泛的系统改革，以支持农村社区的健康。这些作者热切地期待着进一步数字技术的到来，这为农村社区的健康和福祉展示了巨大的希望。菲利普J.巴特汉姆：概念化，写作-原稿；Louise M. Farrer：概念化，写作-评论和编辑；琳娜·伍兹：概念、写作、评论和编辑；Mark E. Larsen：概念化，写作-评论和编辑；Priya Martin：概念化，写作-审查和编辑；亚当·休姆：概念化，写作-原稿。作者没有什么可报告的。数据共享不适用于本文，因为在当前研究中没有生成或分析数据集。
{"title":"Special Issue Editorial: Digital Interventions to Improve Rural Health Outcomes","authors":"Philip J. Batterham, Louise M. Farrer, Leanna Woods, Mark E. Larsen, Priya Martin, Adam Hulme","doi":"10.1111/ajr.70110","DOIUrl":"10.1111/ajr.70110","url":null,"abstract":"<p>Rural and regional areas of Australia are underserved by health services, which has been shown to result in poorer health outcomes [<span>1</span>]. Multiple policy initiatives have not significantly shifted the accessibility gap faced by rural communities in recent decades. Alternative, effective and creative solutions to improve rural pathways for care are therefore urgently needed to fill the gap, which may include growing the rural workforce, developing community-based models of care, and delivering services through evidence-based digital interventions. The focus of this special issue is on the latter use of digital interventions, which may be an important part of the solution to increase access to evidence-based care in rural Australia. While digital solutions alone cannot fill the gap and are not always a substitute for face-to-face services, they can provide efficient and effective delivery of evidence-based care in many areas of health.</p><p>Digital interventions are delivered using, for example, internet or mobile technology and include therapeutic interventions, prevention and health promotion interventions, interventions to monitor or manage health conditions, informational and educational interventions related to health outcomes or service use, and social interventions, along with the use of big data or passive sensing to enhance the delivery of care for rural health consumers. Interventions may be self-guided or clinician-supported, and may also build on innovative features of technology such as artificial intelligence. Alongside an expansion in digital interventions, telehealth services represent a related aspect of digital health that has proliferated rapidly during the COVID-19 pandemic [<span>2</span>].</p><p>There are many challenges to the delivery of healthcare in rural areas, both for traditional face-to-face services and digital services. Tensions within the health system may limit innovation and implementation of technology-based services, based largely on the assumption that the efficiency of digital services may compromise quality care [<span>3</span>]. There also remain evidence gaps about the impacts and effectiveness of digital interventions on health outcomes specifically within rural areas. This special issue aimed to fill gaps in the evidence and implementation of digital interventions for rural and regional areas of Australia, considering a broad range of applications to diverse health conditions and settings across eight original research articles, one commentary and one narrative review.</p><p>The special issue has a core focus on the implementation of digital health in rural Australia. A meta-review by Krahe et al. [<span>4</span>] summarises the key enablers and barriers to implementation, noting benefits such as improved accessibility and patient satisfaction. They emphasise the need for locally tailored interventions and consider implementation factors that encompass inner and outer settings, individual n","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenni Suen, Rangika L. Fernando, Maria C. Inacio, Maria Crotty, Xiaoping Lin, Gillian E. Caughey
Objective
Quality indicators (QIs) specific to older adults receiving health care in rural and remote settings can be used to monitor healthcare quality, inform service improvements, and outcomes for these populations. This scoping review aimed to identify population-based QIs used to evaluate healthcare quality received by older people in rural and remote settings.
Methods
Two academic databases and grey literature sources were searched to identify population-based rural QI monitoring programs or rural QIs, routinely used and reported since 2012. QI program and specific characteristics, including country of origin, dimension of care quality captured, domain represented, QI type, data sources used, reporting strategies, and care settings were summarised.
Findings
Nine QI programs from seven countries with 52 QIs were identified. The QIs measured quality-of-service delivery (n = 28, 54%), accessibility (n = 11, 21%), resources (n = 9, 17%), and hospital readmissions (n = 4, 8%). Most QIs were outcome (n = 25, 48%) or process (n = 19, 37%) indicators, considering the dimension of safe healthcare. Three QIs (6%) measured rural hospital readmission in older people residing in rural areas.
Conclusions
Three QIs measuring the proportion of older adults with unplanned rural hospital readmission were identified that could facilitate consistent reporting and benchmarking of care provided to older adults residing in rural and remote communities. Given the known disparities in equitable access and quality of healthcare for older people residing in rural and remote areas, these findings highlight the need for QIs across all quality dimensions to monitor healthcare quality and drive improvements in access and quality of healthcare.
{"title":"Identification of Quality Indicators Used to Monitor, Evaluate and Improve Rural and Remote Care for Older People: A Scoping Review","authors":"Jenni Suen, Rangika L. Fernando, Maria C. Inacio, Maria Crotty, Xiaoping Lin, Gillian E. Caughey","doi":"10.1111/ajr.70105","DOIUrl":"10.1111/ajr.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Quality indicators (QIs) specific to older adults receiving health care in rural and remote settings can be used to monitor healthcare quality, inform service improvements, and outcomes for these populations. This scoping review aimed to identify population-based QIs used to evaluate healthcare quality received by older people in rural and remote settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two academic databases and grey literature sources were searched to identify population-based rural QI monitoring programs or rural QIs, routinely used and reported since 2012. QI program and specific characteristics, including country of origin, dimension of care quality captured, domain represented, QI type, data sources used, reporting strategies, and care settings were summarised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Nine QI programs from seven countries with 52 QIs were identified. The QIs measured quality-of-service delivery (<i>n</i> = 28, 54%), accessibility (<i>n</i> = 11, 21%), resources (<i>n</i> = 9, 17%), and hospital readmissions (<i>n</i> = 4, 8%). Most QIs were outcome (<i>n</i> = 25, 48%) or process (<i>n</i> = 19, 37%) indicators, considering the dimension of safe healthcare. Three QIs (6%) measured rural hospital readmission in older people residing in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Three QIs measuring the proportion of older adults with unplanned rural hospital readmission were identified that could facilitate consistent reporting and benchmarking of care provided to older adults residing in rural and remote communities. Given the known disparities in equitable access and quality of healthcare for older people residing in rural and remote areas, these findings highlight the need for QIs across all quality dimensions to monitor healthcare quality and drive improvements in access and quality of healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12603340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary: To evaluate adherence to statewide guidelines for managing fever in infants < 90 days old presenting to rural hospital EDs in southern NSW. Comparisons were made between level 1–2 and level 4 rural hospitals. Secondary: To assess the utility of laboratory markers in differentiating bacterial from viral infections.
Design
Retrospective observational study.
Setting
Wagga Wagga Base Hospital, a regional centre in NSW, Australia.
Participants
One hundred thirty-four febrile children aged 0–90 days.
Main Outcome Measures
Adherence to guideline-recommended investigations (basic bloods, blood culture, urine culture, lumbar puncture) and management (antibiotics, time to antibiotics). Positive predictive values of CRP, white cell count (WCC) and neutrophil count for serious bacterial infections (SBIs) were calculated.
Results
Guideline adherence: blood tests 79%, blood culture 79%, urine culture 76%, lumbar puncture 56% and parenteral antibiotics 83%. Adherence to blood/urine cultures was higher in the < 1 month age group than the 30–90 day age group. Investigations and management at level 1–2 hospitals were similar to the level 4 hospital, except regarding urine cultures in the < 1 month old age group. We observed higher CRP levels in infants diagnosed with SBIs compared to those without.
Conclusion
Management of febrile infants < 90 days in southern NSW rural hospitals aligns well with guidelines, except for lumbar punctures in infants < 1 month. Level 1–2 hospitals performed investigations as thoroughly as level 4 hospitals, except regarding urine culture in the youngest age group. Future research could explore guideline adjustments to reduce over-investigation and unnecessary antibiotic use.
{"title":"Management of Febrile Infants in a Rural Hospital: Comparison to Clinical Guidelines","authors":"Nathaniel Teng, John Preddy","doi":"10.1111/ajr.70115","DOIUrl":"10.1111/ajr.70115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p><i>Primary</i>: To evaluate adherence to statewide guidelines for managing fever in infants < 90 days old presenting to rural hospital EDs in southern NSW. Comparisons were made between level 1–2 and level 4 rural hospitals. <i>Secondary</i>: To assess the utility of laboratory markers in differentiating bacterial from viral infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Wagga Wagga Base Hospital, a regional centre in NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred thirty-four febrile children aged 0–90 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Adherence to guideline-recommended investigations (basic bloods, blood culture, urine culture, lumbar puncture) and management (antibiotics, time to antibiotics). Positive predictive values of CRP, white cell count (WCC) and neutrophil count for serious bacterial infections (SBIs) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Guideline adherence: blood tests 79%, blood culture 79%, urine culture 76%, lumbar puncture 56% and parenteral antibiotics 83%. Adherence to blood/urine cultures was higher in the < 1 month age group than the 30–90 day age group. Investigations and management at level 1–2 hospitals were similar to the level 4 hospital, except regarding urine cultures in the < 1 month old age group. We observed higher CRP levels in infants diagnosed with SBIs compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Management of febrile infants < 90 days in southern NSW rural hospitals aligns well with guidelines, except for lumbar punctures in infants < 1 month. Level 1–2 hospitals performed investigations as thoroughly as level 4 hospitals, except regarding urine culture in the youngest age group. Future research could explore guideline adjustments to reduce over-investigation and unnecessary antibiotic use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号