H1N1 2009 influenza (human swine influenza): A descriptive study of the response of an influenza...
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H1N1 Influenza 2009: A descriptive study of the response of an influenza assessment clinic
collaborating with an emergency department in Australia
Jamie RanseLecturerDisciplines of Nursing and MidwiferyFaculty of Health University of Canberra
Phone: +61 (0)2 6201 5380Fax: +61 (0)2 6201 5128Email: [email protected] Blog: www.jamieranse.comTwitter: jamieranse
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research team
Mr Jamie Ranse1,2
Mr Shane Lenson3
Mr Matthew Luther4
Dr Lily Xiao1
1. University of Canberra2. Flinders University3. Royal College of Nursing, Australia 4. Calvary Health Care ACT
Research GrantACT Health: Practice Development Grant
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overview
• Background• Aims• Method• Results• Discussion
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background
• In June 2009 the WHO elevated their pandemic index to Phase 6.
• Worldwide as at February 2010:– 213 countries– 16,455 deaths
• Australia as at February 2010:– 37,700+ cases– 13% hospitalised (M = 31 yrs)– 14% of these required ICU (M= 40yrs)– 191 deaths (M=48 yrs)
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background: emergency departments
• 30% increase in patient presentations• Change in function• Strategies
– Separate triage areas– Surge clinics– Influenza Assessment Clinic (IAC)
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background: influenza assessment clinic
• Opened based on ED demand / trigger points• First day clinic on 26th May 2009• Monday – Friday; 0900 – 1700• Surge outside business hours• Collocated
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aim
• This study described the profile of patients presenting to the IAC and ED with influenza-like symptoms, and tested the relationships that influenced the collaboration between the IAC and ED.
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method
Design• This study was retrospective in nature, utilising a
descriptive study design
Setting• Calvary Hospital is a 334 bed community hospital in the
city of Canberra, in the Australian Capital Territory• The public ED has approximately 45,000 presentations
per annum• Canberra is an inland city of approximately 350,000
people
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method
Sample and population • Non-probability purposive sampling • All patients that presented to the Calvary Hospital IAC
and ED during the period of 3 June 2009 to 3 July 2009• Sample included all presentations from the above
population that presented with influenza-like symptoms, and included a total of 1106 persons
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method: data collection
Data collection• Retrospectively from an existing ED patient information
system• IAC utilised an existing ED patient information system• An independent identifying code, as a data collection and
patient tracking tool. • Date, time, complaint, disposition and demographic
information.
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method
Data analysis• Demographic characteristics for Descriptive statistics• t-test for interval data• Mann-Whitney U test for ordinal data• Chi-square test for nominal data
Protection of human participants• Approved by a human research ethics committee
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results
Frequency of presentations
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results
Frequency of presentations
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results
Frequency of presentations
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results
Demographics
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results
Admissions and discharges
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results
Admissions and discharges
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results
Admissions and discharges
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results
Caseload
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discussion
• Increase in patient presentations on average of 36 per day; similar to the Victorian experience of a 30% increase
• Patients presented in the AM• Research should explore factors that influence patient
presentation times• IAC on a surge basis
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discussion
• Patients who presented to the ED were younger (M=23) than the IAC (M=30)
• Few of the patients that presented were over the age of 65 (N=24/1106; 2.2%)
• Need to report nationally (ILS)
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discussion
• A sustainable IAC like model needs to exist• Test models during seasonal influenza periods, rather
than a reactive composition during a pandemic response.• Prospective data collection
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limitations
• A single Australian IAC and ED• Results may differ in differing influenza strains • Did not provide epidemiological information about the
attack rate of confirmed H1N1 2009
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more information?
Australasian Emergency Nursing Journal
Australian Journal of Emergency Management
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H1N1 Influenza 2009: A descriptive study of the response of an influenza assessment clinic
collaborating with an emergency department in Australia
Jamie RanseLecturerDisciplines of Nursing and MidwiferyFaculty of Health University of Canberra
Phone: +61 (0)2 6201 5380Fax: +61 (0)2 6201 5128Email: [email protected] Blog: www.jamieranse.comTwitter: jamieranse