Domestic and family violence (DFV), and intimate partner violence against women, is the number one cause of death and disability in women aged 15–44.
This project aims to describe current DV screening practices in 10 emergency departments (EDs)s servicing unique populations.The study describes social worker referrals from the ED, surveys ED staff on their attitudes and practices about DFV and DFV screening, and interviews ED nursing and medical staff. It also outlines social workers’ time spent doing DFV referrals from ED, and current ED screening practices.

The results will give an insight into the barriers that may exist to screening and offers potential solutions to these barriers.

Deliberate Clinical Inertia is the art of doing nothing as a positive response, focusing on avoiding harm. The concept aligns with Choosing Wisely and promotes care in resource use and encourages patients and doctors to ask the question: ‘Do I really need this test or treatment?’.

Many research projects at Gold Coast University Hospital, such as Deliberate Clinical Inertia, focus on finding treatments that are less invasive for patients, cheaper for the system, easier to administer for the staff, and lead to the same or better health outcomes for the patients.

In the emergency department (ED), deciding who does and who does not need antibiotics can be difficult. An emergency doctor cannot perform a test that tells them who needs antibiotics or what type of antibiotic type to prescribe.

This study describes how many patients receive antibiotics in the ED and what proportion of these antibiotics are not required or have been given incorrectly (incorrect type or dose).

The study results will allow us to:

1. estimate the proportion of ED patients who receive antibiotics
2. determine if a problem exists with when and how Australian EDs give antibiotics in a busy environment.

Most patients need intravenous cannula (a small plastic tube, inserted into the vein) in the emergency department, but many suffer multiple attempts before the health provider is successful. This can cause patient distress and delays the time to diagnose and to carry out potentially life-saving treatments. The study examines current practices of inserting intravenous (IV) cannulas in the Emergency Department at the Gold Coast University Hospital.

From this research, an ultrasound-guided cannulation training program, and other visual and written materials have been suggested. This will enable better recognition of patients with difficult intravenous access and increase ultrasound use during cannulation.

Fractures through the neck of the 5th metacarpal (little finger hand bone) are known as Boxer’s Fractures, as they often occur during a punch. Boxer’s fractures are traditionally managed in plaster. But, recently, some have suggested that to ‘buddy tape’ the little and ring fingers together allows similar recovery with full mobilisation advantage. Evidence to recommend one treatment over another is insufficient.

This was a randomised controlled study where patients with Boxer’s fractures were randomised to either plaster or buddy tape. The study found similar functional outcomes at twelve weeks from the two groups, but earlier return to work in the buddy group.

This study also found that buddy taping benefits include:

• less time spent in emergency
• simple community follow-up at the patient’s discretion.

This study aims to determine emergency department (ED) physicians’ perceptions/beliefs towards neuropathic medication prescriptions to prevent chronic musculoskeletal symptoms.

The priority is also to learn about treatments for acute musculoskeletal neck pain resulting from whiplash in emergency departments. Specifically, we will explore if pregabalin is being used for whiplash, and if ED physicians might consider prescribing it.

Musculoskeletal neck pain can lead to health issues. The study will explore areas and interventions that reduce this health burden. This audit will inform future study design and help translate results into practice.

In addition, more insight into patients at risk of persistent pain after a musculoskeletal injury will help design and interpret other studies, and lead to interventions that improve patient outcomes.

Read more about the project.

Alcohol misuse is a major health issue and can cause many diseases and injury conditions. The extent of alcohol related presentations to the emergency department is likely underestimated.

This research project aims to provide an overview of alcohol-related presentations to understand their prevalence as well as the group’s demographic profile, clinical characteristics, care delivery and outcomes.

The anticipated knowledge from this study can be used to inform future research, especially related to the implementation and evaluation of evidence-based interventions in the emergency department.

Shortness of breath (dyspnoea) is a common reason for presentation to Emergency Departments. The causes can include flare up due to chronic conditions such as asthma, heart failure, or chronic lung disease.

Significant knowledge about patients admitted to hospital with common causes is available. However, information about dyspnoea as a symptom is inconclusive. Cause distribution, the proportion of patients requiring admission and whether treatment complies with evidence-based guidelines is also unclear.

With reliable data on this symptom across several hospitals in different countries, the study results can highlight care improvement opportunities.

When patients have a serious infection, it can lead to sepsis, which means the infection can affect vital organs. If the blood pressure is low due to sepsis, traditionally doctors would give intravenous fluids. However, evidence suggests that too much fluid may be harmful. What the best amount of fluid is and when medications that support the blood pressure (also called vasopressors) should start is unknown.

This study showed that a restricted fluid and early vasopressor schedule in emergency department patients with suspected sepsis and hypotension appears practical. A future trial is necessary with high-risk patient recruitment to determine effects on clinical outcomes in this setting.