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Biomedical subjects

J A Royle

Publications and source records attributed to J A Royle.

9 recordsLinked to original sources
PubMed1999

Intrapartum antibiotics and early onset neonatal sepsis caused by group B Streptococcus and by other organisms in Australia. Australasian Study Group for Neonatal Infections.

OBJECTIVE: Early onset group B streptococcal (EOGBS) infection, the major neonatal infection in industrialized countries, can be prevented by intrapartum antibiotics, but population studies are lacking. This study aimed to determine the incidence of early onset infections caused by group B Streptococcus (GBS) and other organisms in Australia and to assess intrapartum antibiotic use. DESIGN: Longitudinal, prospective surveillance of neonatal infections in Australian neonatal units from 1991 to 1997. Early onset infection defined as clinical sepsis in first 48 h after birth, with positive cultures of blood or cerebrospinal fluid or positive urine GBS antigen detection. RESULTS: The incidence of EOGBS sepsis fell from 2.0 per 1000 live births (95% confidence interval, 1.4, 2.5) in 1991 to 1993, to 1.3 (1.2, 1.4) in 1993 to 1995, to 0.5 (0.4, 0.7) in 1995 to 1997 (P < 0.0001). The incidence in Aboriginal babies was 5.2 (1.8, 8.6) in 1991 to 1993, 5.1 (3.0, 7.2) in 1993 to 1995 and 1.8 (1.1, 2.5) in 1995 to 1997 (P < 0.05). The incidence of early onset infections caused by organisms other than GBS also fell, from 1.2 per 1000 live births (0.8, 1.7) in 1991 to 1993, to 0.8 (0.7, 0.9) in 1993 to 1995 and 0.5 (0.3, 0.7) in 1995 to 1997 (P < 0.0001). In 1991, 3 of 9 study hospitals had a formal policy on intrapartum antibiotic use, whereas in 1997 all 11 hospitals had a formal policy (P=0.002). CONCLUSIONS: A steady fall in EOGBS infections in Australia from 1991 to 1997 has been associated with increasing use of intrapartum antibiotics. Increased antibiotic use is probably causal in the fall in GBS, because the incidence of early onset infections caused by other organisms has also fallen.

Anti-Bacterial Agents↗
PubMed1998

Kawasaki disease in Australia, 1993-95.

AIM: To describe the epidemiology, management, and rate of cardiac sequelae of Kawasaki disease in Australia. DESIGN: Cases were notified to the Australian Paediatric Surveillance Unit, an active national surveillance scheme, from May 1993 to June 1995. RESULTS: 139 cases of Kawasaki disease were confirmed. In 1994, the annual incidence was 3.7/100,000 children < 5 years old. Sixteen children were not admitted to hospital. Coronary artery abnormalities were reported in 35 (25%) children. Two patients were diagnosed at postmortem examination. Sixty six per cent of patients were diagnosed within 10 days of onset and 81% of these received intravenous gammaglobulin within 10 days. Forty five of the notified children did not fulfil the study criteria because of streptococcal infection or insufficient clinical criteria. One child with streptococcal infection had coronary artery dilatation. CONCLUSION: Diagnosis of Kawasaki disease was delayed beyond 10 days in one third of patients, and almost 20% of children who could have received gammaglobulin within 10 days did not. The distinction between Kawasaki disease, streptococcal infection, and other possible diagnoses is problematic in some children.

Adolescent↗
PubMed1997

Do nurses have the information resources and skills for research utilization?

While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.

Computer User Training↗
PubMed1996

The research utilization process: the use of guided imagery to reduce anxiety.

In the rapidly changing health care environment, nurses need to keep current with developments, assess their applicability to practice, and make changes where appropriate. There is evidence that nursing research is underutilized and that a considerable gap exists between nursing research and practice (Bostrum & Suter, 1993; Brett, 1987; Sokop & Coyle, 1990). The objectives of a study carried out on a bone marrow transplant unit in a teaching hospital were to: (1) by introducing a framework for research-based care, enhance research utilization in a selected setting, and (2) evaluate the outcomes of research utilization on a specific clinical nursing problem chosen by nurses and researchers. This paper describes the research utilization process and its outcomes, presents an evaluation of the participatory approach from the perspective of the participating nurses, and discusses facilitators and barriers to research utilization. Guided imagery was the intervention used to decrease patient anxiety.

Adult↗
PubMed1995

Linking the professional literature to nursing practice: challenges and opportunities.

Occupational health nurses face the challenge of rapidly changing, increasingly complex work environments. To respond, they must have access to information and know how to manage it effectively to improve their clinical performance and achieve better client outcomes. Information technology has already had an impact on nursing. Many nurses routinely use computers to access laboratory reports, client records, and administrative programs. However few nurses make use of opportunities provided by information technology to access professional literature as a tool for applying new research to their practice.

Humans↗
PubMedDate not supplied

Literature search and retrieval in the workplace.

Nurses do not adequately access and use information to enhance knowledge-based practice. A computerized literature search and retrieval system was installed on a selected hospital unit to evaluate its utility in a work setting. Thirty-three nurses were taught how to use six CD-ROM bibliographic and full-text databases, electronically request articles from the librarian, and to critique the literature. The training program was evaluated by questionnaire and subsequent use of the system. Qualitative data regarding the perceived impact were collected using focus groups. The Michigan Organizational Assessment Questionnaire was administered before and after the intervention. Following training, nurses used the system to successfully answer questions related to patient care, general health issues, and education courses.

CD-ROM↗