Current Projects

Led by: Professor Amanda Ullman (23 June 2021)

This is a UQ CHRC and Children's Health Queensland initiative. The goal of the program is to foster new collaborative and translational research across the Queensland Children's Hospital and Centre for Child Health Research precinct by increasing the number of new clinician researchers and fostering the development of existing early career researchers. The program is designed for health professionals from a range of clinical disciplines, including biomedical, medical, nursing, allied health, health science and social science. The program will enable new researchers to begin their research career through a facilitated and applied process of clinical research training, research project development, and mentorship.

Led by: Mari Takashima

Invasive devices are an essential part of the treatment and management of ill children,

are used to deliver therapies including fluid, nutrition and important medications such as antibiotics. Common invasive devices include intravascular catheters, urinary catheters, mechanical ventilators and nasogastric tubes. As a portal of entry into a patient’s body, this can create an opportunity for harmful microorganisms to move from the external environment into the patient’s internal system. Harmful microorganisms can originate from the patient’s own body, visitors, health care workers or other contaminated sources within a hospital. Invasive devices can also disrupt the body’s normal defence mechanisms against such harmful microorganisms, making infection more likely. Compared to adult patients, children are at greater risk of developing certain types of infections during their time in hospital, including infections caused by invasive devices.

Funded by the Queensland Health, Nursing and Midwifery Research Fellowships, the aim of this audit is to identify the number of invasive devices being used to provide medical treatment to children in Australian paediatric hospitals, how the devices are managed and any complications they cause. These data will help to provide information on how to improve health care practices surrounding invasive devices and reduce their rate of harm.

Led by: Deanne August

More than forty per-cent of neonates who are admitted to a neonatal intensive care unit (NICU)develop healthcare-associated skin injuries1, yet measurement and sequelae of these injuries is poorly understood. This lack of understanding is likely related to possible subjectivity of visual assessment, which is the current standard for skin injury confirmation and severity. Adult studies have demonstrated challenges with the accuracy of injury confirmation by visual assessment; which is likely more challenging for neonatal skin as distinctions between broken and unbroken neonatal skin may only be millimetres of tissue. Without precise measurement of mechanical force skin injuries it is impossible to evaluate practice improvements or long-term impact. Technologies such as pH meters or laser speckle imaging might provide more quantifiable differences in injured tissue but these technologies are untested for neonatal skin injuries. Therefore, we will assess feasibility and accuracy of new technologies, and measure sequelae of neonatal skin injury into infancy.

Funded by the RBWH Foundation, this research aims to assess accuracy and feasibility of new technologies to measure skin injuries in neonates, and to compare these measurements across their long-term treatment and prevention.

Led by: Professor Amanda Ullman 

Across Australia every year, children undergoing treatment for cancer experience more than 250 bloodstream infections, 70 deep vein thromboses and 300 blockages - all caused from their central line. This central venous access device (CVAD) is vital as it administers treatments such as chemotherapy drugs and supportive therapies including blood transfusions and antibiotics, however we need to prevent harm. When the CVAD is not in use, it is locked it with fluid. This fluid lock is an opportunity to prevent CVAD-associated complications.

In this world-first trial, the research team will evaluate the effectiveness of the CVAD lock solution compared to usual care to reduce infections, thromboses and blockages for children being treated for cancer. This is a Type-1 Hybrid effectiveness-implementation three-arm, superiority, effectiveness RCT which will compare the clinical-effectiveness of routine CVAD lock solutions with - (i) normal saline, (ii) heparinised saline, and (iii) T-EDTA, to prevent CVAD-associated complications (CABSI, thromboses, occlusions). Simultaneously, a mixed-methods implementation study will assess the acceptability, costs and implementation challenges of alternative CVAD lock solutions in paediatric cancer care, to prepare for translation of the intervention to practice. A 3-year recruitment period will occur across metropolitan and regional paediatric cancer care networks in Queensland, Victoria, New South Wales and New Zealand.

This project is funded by the Accelerating Collaborative Cancer Research (ACCR) grant from Cancer Council Queensland.

Video link: https://youtu.be/XJ3pPoH1abU

Led by: Professor Amanda Ullman 

Peripherally inserted central catheters (PICCs) play a significant role in modern healthcare, >140,000 PICCs are used by patients in Australia each year to receive anti-cancer agents, anti-microbials, hydration, nutrition, and for repeated blood tests. However PICC complications are rife - 30% of PICCs are associated with serious complication and fail prior to treatment completion. These complications include deep vein thrombosis (DVT)  and catheter-associated bloodstream infection (CABSI), and result in treatment delays, high healthcare costs, morbidity and mortality. Innovative PICC antimicrobial and "non-stick" materials may hold the key to reducing preventable harm associated with PICC use.

The PICNIC trial is an NHMRC-funded multi-centre, superiority RCT evaluating the effectiveness of an (i) anti-thrombogenic and (ii) anti-microbial PICCs against standard care (non-valved power injectable polyurethane catheters). Three Queensland tertiary hospitals will be involved in recruiting participants from both Medical and Surgical units, including paediatric and adult cohorts. >1000 participants will be recruited, with an eight weeks follow-up period (or until catheter failure). The PICNIC trial will also examine PICC related cost-effectiveness, haematological and microbiological endpoints against traditional polyurethane PICCs. The trial is due to finish recruitment in July 2022 - and you can read the protocol here https://bmjopen.bmj.com/content/11/4/e042475.

Led by: Associate Professor Bronwyn Griffin(contact bronwyn.griffin@griffith.edu.au)

Over 4000 children present to Australian burns services every year. Contemporary burn care aims to speed up a patient’s time to healing which directly avoids the child's risk of developing a lifelong scar. We know that applying negative pressure wound therapy (NPWT) to a child's burn within 72 hours post-injury will improve a child's time to healing, decreasing the risk of scarring and the cost of healthcare. Partnering with Australia’s four major paediatric burns centres, Children’s Hospital Westmead (NSW), Queensland Children’s Hospital (Qld), Royal Children’s Hospital (Vic) and Perth Children’s Hospital (WA), we are co-designing a NPWT Pathway and implementation strategies. The pathway and implementation strategies will be evaluated via  a stepped-wedge randomised controlled trial. Ultimately improving access to high-value burn care and consequently,  improving outcomes for childhood burns nationally. A/Prof Griffin, from Griffith University, will be leading the trial from QCH.

Led by:  Tricia Kleidon tricia.kleidon@health.qld.gov.au

Technology-fueled medical treatment has increased the life expectancy of infants and children with complex pathologies.  Peripheral intravenous catheters (PIVCs) are essential to this, however, insertion is often difficult, and failure is common.  I will use modern technology (ultrasound) to understand why and how PIVCs dysfunction, harming children.  I will achieve this by systematically reviewing studies evaluating cutting-edge PIVC insertion technologies.  I will use knowledge gained from these systematic reviews and meta analyses to inform the largest prospective study in paediatrics, revealing the impact of techniques and technologies on vessel pathology at insertion, during dwell and post removal, using ultrasound.  These data will be used to drive the future PIVC innovation, in paediatrics and beyond.

Led by: Siriporn Vetcho; siriporn.vetcho@griffithuni.edu.au

This PhD study aims to develop, implement, and evaluate innovation to facilitate FCC by improving respect, collaboration, and support in a Thai NICU. The multistage, mixed-methods study design applied the Participatory Intervention Model (PIM) to guide the innovation’s development, implementation, and evaluation to facilitate FCC. This study was conducted in a tertiary care hospital in southern Thailand prior to and during COVID-19 (February 2020-January 2021). Pre-implementation, parental and staff perceptions of FCC were measured via the Perceptions of Family Centred Care -Parent (PFCC-P) and -Staff (PFCC-S) survey. Stakeholders developed the FCC innovations based on the COVID-19 restrictions, pre-survey results, parents’ and staff’ interviews, and integrative review, which were then implemented. The post-implementation evaluation was via repeated surveys. Comparisons were made pre-and post-implementation, with Mann-Whitney U test statistics for parents and Wilcoxon’s Rank Sum for staff. This study indicates that the provision of FCC was maintained and even improved, despite the challenges of COVID-19 restricting NICU access. The key finding was that the innovations incorporated in the NICU were primarily based on communication strategies without high technology. Communication is essential to collaborate between families and healthcare providers to promote parents as partners in neonatal care.

Led by: Dr Helen Petsky

This project will be used to prioritise and direct future research projects and will be valuable to focus research energies for all members of PATTERN moving forward. Research funding bodies are seeking to identify the maximum benefit and health outcomes that are of relevance and importance to both service users and healthcare professionals. This study will identify the research questions that consumers and healthcare professionals want answered. As a network, we can work towards answering these questions. 

The study aims:
1. To bring together clinicians, consumers and health service executives to identify and prioritise research questions in paediatrics;
2. To agree by consensus the 'top ten' most important research questions from those identified.

Led by: Dr Amy Mitchell

Childhood eczema places an enormous burden on children and families. While good evidence for therapeutic interventions exists, ongoing non-compliance with treatment is common and presents a serious problem, increasing morbidity and impacting quality of life for children and families. Existing approaches have a record of failure in improving adherence.

This study will improve family-centred care and clinical outcomes for children with eczema by translating evidence-based parenting support into clinical practice within existing eczema care services, to improve treatment adherence, reduce disease severity, and improve quality of life. Funded by the Children's Hospital Foundation Translator Grant (ref. 50223)

Project Link ANZCTR

Led by: Brooke Charters

PIVC (peripheral intravenous catheter) insertion and management is challenging with more than 25% of devices failing in the paediatric population. Failure may require a child to undergo traumatic reinsertion procedures, delay important medical treatment and prolong the length of hospital stay. One way to reduce PIVC failure is with effective PIVC dressing and securement, by ensuring correct catheter position in the vein.

The aim of this study is to evaluate securement devices for PIVCs in the paediatric emergency department to determine which method is most effective for reducing PIVC failure, associated costs, acceptability, and patient distress.

Project Link:

Emergencyfoundation.org.au