Honours students published
The aim in generating new knowledge through research is to share it. Two medical students who completed an honours year with Monash Rural Health in Bendigo last year have both had papers published this year drawing on their honours year research.
Better communication needed to respect patients' end-of-life wishes
At the end of their life many people do not want life-prolonging treatment administered, but Laura Panozzo's research revealed that this often happens. She looked at the prevalence of advance care plans in a regional Victorian hospital, whether those plans had been communicated from general practice to the hospital and whether the hospital acted on patients' wishes during end-of-life care.
She found that only 9.7% of patients who died in the hospital had a plan in their records. Even where the hospital did have a plan for a patient, in come cases those plans were not implemented. This included cases where a plan explicitly preferenced against treatment and it was given, including intubation, surgery, antibiotics and medication.
Her research highlighted the need for medical records systems to be refined and and communication between general practices and hospitals to be more consistent. She also identified future work should include identifying populations that could bendfit most from having a plan such as those who are socially isolated and do not have a substitute decision-maker.
Laura said: "[The honours] year has reignited my passion for high-quality, regional healthcare while engaging my interest in continuing with research in the future."
Her paper was published in the Australian Journal of General Practice in May.
Surviving an in-hospital cardiac arrest: world first study
What happens to patients who suffer a cardiac arrest in hospital? Not much data is available in Australia and worldwide about the short- and long-term outcomes of treatment. So Zak Doherty conducted the first ever Australian study of survival outcomes beyond one year of an in-hospital cardiac arrest. His research has the longest patient follow-up period in the literature worldwide.
He looked at 18 years of data at a regional Victorian hospital. He found that over half survived the arrest, but only 32% survived to discharge. A number of factors including the patient's age, where the arrest occurred, an increasing resuscitation duration and the patient having a not-for-resuscitation order were associated with a decreased rate of survival to discharged. For those how survived to discharge, the risk of death was significantly higher for the first three years. After that, the impact of the arrest on survival decreases.
Of his honours year Zak said: "This year has been the best part of my medical degree so far... My supervisors have taught me a lot about research, but they have taught me more about what my future career can be like."
Zak's paper was published in Resuscitation.