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Aim Design Data Sources Methods Results Conclusion Implication for the Profession/Patient Care Reporting Method Patient or Public Contribution To provide a contemporaneous evidentiary overview of neonatal and paediatric studies investigating alarm‐related patient safety and alarm system management. Furthermore, to describe how clinical alarm burden is captured and reported, to identify clinical devices that contribute to alarm burden, to explore alarm‐related and patient safety measures and terminologies and to review alarm management initiatives.Scoping review.A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and EBSCOhost was conducted from 2013 to 2023 using predetermined search terms, index terms, medical subject headings and truncation.Observational and qualitative studies with neonatal and paediatric populations reporting monitoring and alarm practices; and interventional studies reporting the success of alarm safety interventions were included. The quality of the included studies was assessed using the mixed methods appraisal tool.The search yielded 37 studies of acceptable quality. The majority explored alarm burden associated with physiological monitoring (n = 35; 95%). Alarm definitions were reported in 46% (n = 17) of studies, and commonly included what constituted actionable and non‐actionable alarms. While 32% (n = 12) of studies considered alarms in relation to clinical outcomes surrounding patient safety, clinician response to alarms was only reported in 19% (n = 7) of studies. Alarm and monitoring interventions were assessed in 51% (n = 19) of included studies, with categorization into six domains: changing alarm parameters, clinician education, communication and planning, technology, alarm ordering and standardization or guidelines.This review has demonstrated the enormity of alarms in clinical settings, heterogeneity of alarm definitions and outlined interventions associated with alarm burden and patient safety.Strategies to ensure appropriate alarm limits are set and clinicians are empowered through education to recognize and respond appropriately to alarms can maximize patient safety.This review adheres to the preferred reporting items for systematic reviews and meta‐analysis protocols extension for scoping reviews.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Objective: An innovative approach by two Queensland health services was taken to establish a shared maternity services' research agenda by partnering with consumers and clinicians. The objective was to set the top five research priorities to ensure that the future direction of maternity research was relevant to end-user and organisational needs. Methods: A modified James Lind Alliance (JLA) methodology was applied between August 2022 and February 2023 across two south-east Queensland Health Services which included five participating maternity units and involved partnership with consumers, healthcare professionals and clinician researchers. The reporting guideline for priority setting of health research (REPRISE) was followed. Results: There were 192 respondents to the initial harvesting survey, generating 461 research suggestions. These were aggregated into 122 unique questions and further summarised into a list of 44 research questions. The 157 eligible interim prioritisation survey respondents short-listed 27 questions ready for ranking at a final consensus workshop. The top five question themes were: (1) maternity care experience, engagement and outcomes of priority populations; (2) increasing spontaneous vaginal birth; (3) experiences and perceptions of woman/person-centred care; (4) best practice care during the 'fourth' trimester; and (5) antibiotic use during labour and birth. Conclusion: Applying an adapted JLA framework can successfully shape and establish a research agenda within Australian health services, through partnership with consumers and practicing clinicians. This is a transparent process that strengthens the legitimacy and credibility of research agendas, and it can form a replicable framework for other settings. What is known about the topic? Establishment of research agendas often neglects the participation of research end-users, consumers and practising clinicians, consequently limiting relevance and translation. What does this paper add? Prioritised specific maternity research questions were jointly generated by consumers and front-line clinicians to highlight areas of focus for research funding and support. What are the implications for practitioners? By partnering with consumers and practising clinicians health service research priorities can be established to optimise patient outcomes and ensure future research is both translational and relevant. [ABSTRACT FROM AUTHOR]

Aim: To develop focused priorities to inform the revision of Australia's Sudden Unexpected Death in Infancy (SUDI) risk reduction public health programme. Methods: A content expert consensus research activity was designed using two consensus techniques. The two‐phase study employed a Delphi process (phase 1) and a Nominal Group workshop technique (phase 2). The Delphi invited 56 national and international content experts. The Nominal Group comprised 17 Australasian experts and stakeholders to ensure priority setting was relevant to the Australian context. Results: Phase 1 established a ranked thematic list of 10 key SUDI risk reduction themes. Phase 2 addressed three nominal questions producing prioritised lists for: key‐message wording; contextual information and strategies to support caregiver implementation of key messages; and considerations in redesigning and dissemination of a safe sleep campaign. The top four priority themes were: sleep position, sleep space, smoking and surface‐sharing. Conclusion: This two‐phase priority setting was successful in establishing clearly defined infant safe sleep priorities. International content expert participation in phase 1 strengthened priority setting outcomes while phase 2 ensured final outcomes provided a strong national focus reflective of identified needs of Australian families. Findings provide a foundation from which important components can be considered when revising and developing future SUDI risk reduction programmes. [ABSTRACT FROM AUTHOR]

Reducing sleep-related infant mortality is a national and global health priority. The leading category of post-neonatal mortality in Australia is sudden unexpected death in infancy (SUDI). Suboptimal breastfeeding practice is associated with increased risk of infants dying suddenly and unexpectedly. Human breastmilk is universally acknowledged to be the optimal form of nutrition, contributing to child survival and conferring immunologic advantage over formula-feeding. This paper presents an analysis of data from the 2017 Infant Caregiver Awareness and Routines Evaluation among Queenslanders (I-CARE Qld) Study to establish the maternal and infant characteristics, infant care practices and sleep-related factors that influence breastfeeding duration within a contemporary Australian cohort. A cross-sectional survey of 3341 Queensland caregivers with infants approximately 3 months old was conducted. Statistically significant predictors for breastfeeding cessation at 8 weeks were found using univariable and multivariable analyses. These include: young maternal age, single, less educated, smoker, public patient, higher pre-pregnancy body mass index (BMI), the birth of a male infant, delivery via caesarean section, in-hospital formula supplementation, admission to a neonatal nursery, dummy use and infant sleep location. Given the increased risk of sudden infant death related to suboptimal breastfeeding practices, further consideration and strategies targeting these potentially at-risk population groups are required. [ABSTRACT FROM AUTHOR]

Introduction: Central venous access devices (CVADs) are commonly used for the treatment of paediatric cancer patients. Catheter locking is a routine intervention that prevents CVAD-associated adverse events, such as infection, occlusion and thrombosis. While laboratory and clinical data are promising, tetra-EDTA (T-EDTA) has yet to be rigorously evaluated or introduced in cancer care as a catheter lock., Methods and Analysis: This is a protocol for a two-arm, superiority type 1 hybrid effectiveness-implementation randomised controlled trial conducted at seven hospitals across Australia and New Zealand. Randomisation will be in a 3:2 ratio between the saline (heparinised saline and normal saline) and T-EDTA groups, with randomly varied blocks of size 10 or 20 and stratification by (1) healthcare facility; (2) CVAD type and (3) duration of dwell since insertion. Within the saline group, there will be a random allocation between normal and heparin saline. Participants can be re-recruited and randomised on insertion of a new CVAD. Primary outcome for effectiveness will be a composite of CVAD-associated bloodstream infections (CABSI), CVAD-associated thrombosis or CVAD occlusion during CVAD dwell or at removal. Secondary outcomes will include CABSI, CVAD-associated-thrombosis, CVAD failure, incidental asymptomatic CVAD-associated-thrombosis, other adverse events, health-related quality of life, healthcare costs and mortality. To achieve 90% power (alpha=0.05) for the primary outcome, data from 720 recruitments are required. A mixed-methods approach will be employed to explore implementation contexts from the perspective of clinicians and healthcare purchasers., Ethics and Dissemination: Ethics approval has been provided by Children's Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC) (HREC/22/QCHQ/81744) and the University of Queensland HREC (2022/HE000196) with subsequent governance approval at all sites. Informed consent is required from the substitute decision-maker or legal guardian prior to participation. In addition, consent may also be obtained from mature minors, depending on the legislative requirements of the study site. The primary trial and substudies will be written by the investigators and published in peer-reviewed journals. The findings will also be disseminated through local health and clinical trial networks by investigators and presented at conferences., Trial Registration Number: ACTRN12622000499785., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)