Nursing and midwifery research makes impact

Professor Marion Eckert, Director of the Rosemary Bryant AO Research Centre (RBRC) at University of South Australia

When the opportunity arose to lead the evolution of Australia’s innovative Rosemary Bryant AO Research Centre three years ago, Professor Marion Eckert grabbed it with both hands.

“The most exciting part is we’re really trying to foster an enthusiasm for nurses and midwives to lead and embrace research and in particular translational research to make a difference,” she explains.

“We’re the largest health workforce across the health system and at the forefront of care. Whilst there is a lot of research that is happening which is quite good by nurses and midwives across the country, this is really looking at how we engage and promote nursing and midwifery research and really try and lead and embed it across the health system.”

Since launching in 2016, Professor Eckert says the RBRC, a partnership between the Rosemary Bryant Foundation and University of South Australia, has focused its attention on health service evaluation, nursing and midwifery workforce research, translational health research, health policy and safety and quality.

When the centre began Professor Eckert, the Director of the RBRC, was its sole employee, but the team has now grown to 16 and includes a diverse group of experts delving into areas such as midwifery and nurse-led care, consumer-centred care, health service reform, disruptive technology, health service policy and the nursing and midwifery workforce.

Research highlights already include a 2017 statewide climate survey reporting the health service challenges and wellbeing of South Australian nurses and midwives that covered issues such as retention, sustainability, staff shortages and burnout rates, and found more than 30% were contemplating leaving the profession in the next five years.

Professor Eckert says nurses and midwives are seeking to quantify their care outcomes and changes to the clinical environment, and the impact these changes can have through health service research to validate and support them in their everyday clinical environment.

“Another area they’re very interested in is having good quality data to argue for improved healthcare and changes so one of the things we’ve been doing is looking at clinical predictive risk models.”

In this space, Professor Eckert says the RBRC’s team of epidemiologists, organisational psychologists, data analyst, anthropologists, statisticians and behavioural researchers has been investigating clinical risk predictors by observing nurse-specific data emerging from hospitals such as the amount of agency staff, sick leave, falls, and medication errors.

They have now developed an algorithm for clinical risk predictors to quantify positive and negative predicted outcomes.

The indicators are often individually considered but not collectively, feedback from nurses suggested in partnership with a local health network, so an algorithm was developed to quantify care requirements through the use of data to predict when risk is at its greatest.

Professor Eckert says the risk predictor model will allow nursing management/executive to identify clinical risk, such as when there is sick leave, and an agency quota on a particular ward, and then configure wards around what is happening to reduce the likelihood of adverse events, which can have a significant cost burden on the health system and individual.

“If we can get these sorts of things right and it’s useful to nursing and midwifery leaders and clinicians then they can quantify why they need changes in their staff or why they need different services or service realignment.”

Aside from the RBRC, Professor Eckert’s other key interest lies in cancer nursing and cancer research.

With a keen interest in continuous quality improvement and research she completed post graduate studies, completing a graduate Diploma Applied Science, two Masters Degrees, one in Population Health and the other in Clinical Nursing, a Professional Doctorate and Diploma of Education and executive leadership training to ensure she was contemporary.

During this time she progressed her clinical roles, from hyperbaric, to vascular then cardiac nursing where she rose to be in charge of the Interventional Cardiology Unit at the Royal Adelaide Hospital for over a decade.

After various roles that included working at the Joanna Briggs Institute, the Director Southern Adelaide Local Health Network Nursing and Midwifery Education and Research Centre, Executive Director of Nursing and Patient Services, Southern Adelaide Local Health Network, Professor Eckert was appointed Cancer Council SA’s General Manager leading research, prevention, support and advocacy.

More recently selected as the inaugural Professor of Cancer Nursing by the University of South Australia (UniSA) and Chair of the Cancer Care Research Group, Professor Eckert says her work in this field is currently focused on cancer survivorship and monitoring people’s quality of life.

“We know that in SA alone there’s over 25 people every day diagnosed with cancer and we know that those people diagnosed with cancer, we know a lot about the type of cancer they have but we don’t know anything about how well they survive their cancer and what their quality of life is. We don’t track or monitor that anywhere in Australia at a population level so we don’t know who falls through the cracks and in particular how disadvantaged groups and community are tracking.”

Professor Eckert argues Australia’s health system survives on “good luck rather than good systems” when it comes to understanding what best evidence reveals about people’s quality of life.

Awarded a Churchill Fellowship in 2015 that enabled her to travel overseas and observe international systems tracking the quality of life of cancer survivors, Professor Eckert says her latest research is exploring how to undertake a similar program in South Australia with the hope of expanding nationally.

“At the moment, we’re looking at people that have had breast surgery and plan to track their quality of life for the duration of time post-surgery. We don’t know anything about people’s fear of reoccurrence or financial toxicity or how they feel about, if they’re 25 around reproduction, returning to work, etc. There’s a lot of things that are different for someone who’s 25 with cancer to someone who’s 75.”

Back at the RBRC, Professor Eckert says the road ahead is challenging but very optimistic as the centre continues to build its brand and raise awareness about the importance of investing in translational research that influences the clinical environment with nurses and midwives at the forefront.

“I’m just so excited to be part of an innovative, forward-thinking centre and work with such a dynamic team,” she says.

“The important aspect for us will be to make sure we continue to be contemporary and that we’re relevant to clinicians and stakeholders and policymakers. To do that, we cannot rest on our laurels and that’s about learning from our national and international partners and making sure that we push ahead.

“Ultimately, our goal and our vision is to embed the RBRC as national leaders in nursing and midwifery research and be recognised for improving health, and workforce outcomes, through quality research.”

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