Discharge interventions for First Nations people with a chronic condition or injury: a systematic review.

BACKGROUND: Aboriginal and Torres Strait Islander peoples have a unique place in Australia as the original inhabitants of the land. Similar to other First Nations people globally, they experience a disproportionate burden of injury and chronic health conditions. Discharge planning ensures ongoing care to avoid complications and achieve better health outcomes. Analysing discharge interventions that have been implemented and evaluated globally for First Nations people with an injury or chronic conditions can inform the implementation of strategies to ensure optimal ongoing care for Aboriginal and Torres Strait Islander people. METHODS: A systematic review was conducted to analyse discharge interventions conducted globally among First Nations people who sustained an injury or suffered from a chronic condition. We included documents published in English between January 2010 and July 2022. We followed the reporting guidelines and criteria set in Preferred Reporting Items for Systematic Review (PRISMA). Two independent reviewers screened the articles and extracted data from eligible papers. A quality appraisal of the studies was conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement. RESULTS: Four quantitative and one qualitative study out of 4504 records met inclusion criteria. Three studies used interventions involving trained health professionals coordinating follow-up appointments, linkage with community care services and patient training. One study used 48-hour post discharge telephone follow-up and the other text messages with prompts to attend check-ups. The studies that included health professional coordination of follow-up, linkage with community care and patient education resulted in decreased readmissions, emergency presentations, hospital length of stay and unattended appointments. CONCLUSION: Further research on the field is needed to inform the design and delivery of effective programs to ensure quality health aftercare for First Nations people. We observed that discharge interventions in line with the principal domains of First Nations models of care including First Nations health workforce, accessible health services, holistic care, and self-determination were associated with better health outcomes. REGISTRATION: This study was prospectively registered in PROSPERO (ID CRD42021254718).

Codesigning informative resources for families of Aboriginal and Torres Strait Islander children who sustained a burn injury: a protocol for a participatory action research study.

INTRODUCTION: Parents of children hospitalised in a burn unit experience psychological trauma and later post-traumatic stress. Aboriginal and Torres Strait Islander families whose child has been admitted to a burn unit encounter additional burdens through a culturally unsafe healthcare system. Psychosocial interventions can help reduce anxiety, distress and trauma among children and parents. There remains a lack of interventions or resources that reflect Aboriginal and Torres Strait Islander people's perspective of health. The objective of this study is to codevelop a culturally appropriate informative resource to assist Aboriginal and Torres Strait Islander parents whose child has been hospitalised in a burn unit. METHODS: In this participatory research study, the development of a culturally safe resource will build on Aboriginal and Torres Strait Islander families' experiences and voices, complemented by the knowledge and expertise of an Aboriginal Health Worker (AHW) and burn care experts. Data will be collected through recorded yarning sessions with families whose child has been admitted to a burn unit, the AHW and burn care experts. Audiotapes will be transcribed and data will be analysed thematically. Analysis of yarning sessions and resource development will follow a cyclical approach. ETHICS AND DISSEMINATION: This study has been approved by the Aboriginal Health and Medical Research Council (AH&MRC) (1690/20) and the Sydney Children's Hospitals Network ethics committee (2020/ETH02103). Findings will be reported to all participants and will be disseminated with the broader community, the funding body and health workers at the hospital. Dissemination with the academic community will be through peer-reviewed publications and presentations in relevant conferences.

Biobrane™ and skin staples: beware of necrotic ulceration.

Biobrane™ is a product used for temporary wound coverage post major paediatric burn wound debridement. We report two cases of necrotic ulceration associated with the use of Biobrane™ with skin staples. We suggest securing Biobrane™ with alternatives such as adhesive tapes and glue to prevent the occurrence of this adverse outcome.

Pediatric treadmill injuries: a public health issue.

BACKGROUND: Treadmill injuries in children tend to be severe and are becoming increasingly common. We present an overview of this problem to promote public awareness, education, and to advocate a prevention strategy for this preventable injury. METHODS: Medical records of all children with treadmill-related injuries during a 6-year period (January 2001-November 2006) from 2 tertiary pediatric hospitals were reviewed. Data on patient demographics, injury related data, types of surgical procedure, and outcome of treatment were collected. RESULTS: Forty-four children with treadmill-related injuries were admitted in a 6-year period (2001-2006). Each year, the incidence increased with 17 (39%) cases occurring in 2006 so far. The median age of injury at the time of incident was 2.8 years (range, 8 months-12 years). There was a higher incidence in males (55%) compared with females (45%). Most of these injuries were to the hand (75%), full-thickness burns (59%), <1% of total burn surface area (TBSA) (73%), and occurred while the treadmill was in use by an adult (34%). Twenty-one (47%) children required skin grafting surgery. CONCLUSION: Treadmill-related burn injuries in children are a serious public health issue and warrants considerable attention. Adult supervision is paramount, and prevention strategies should include child safety features in equipment designs.

Cap gun burns in children.

AIM: To document the frequency of cap gun burns in children and identify strategies for prevention of this mechanism of injury. METHODS: Retrospective case note review of children under 16 years of age treated at The Children's Hospital at Westmead between January 1999 and December 2004 with burns secondary to toy cap guns. RESULTS: Five boys were treated over the 5-year study period. None was supervised at the time of injury and in three cases the caps appeared to explode with minimal handling. All burn wounds healed without operative intervention and only one child suffered permanent sequelae from the burn injury. CONCLUSION: Cap gun burns appear a rare mechanism of burn injury not previously reported. Recently produced caps may be more susceptible to spontaneous explosion. Adequate adult supervision may have prevented some of the injuries. There appears be a need for greater awareness regarding the dangers of these toys.