The pragmatic approach: how one nurse looked at small techniques for major health outcomes for children.
If the hospital is a place you know well due to your child’s complex and chronic conditions – you quickly learn nurses are central to your child’s care. They are there to provide support,
answer questions and administer care. They are the strongest resource in our healthcare system, they understand the science and their patients.
Professor Amanda Ullman was one of those nurses who spent her clinical career working in the former Royal Children’s Hospital, Brisbane (now the Queensland Children’s Hospital) Paediatric Intensive Care Units, caring for children and their families through their toughest days. When helping those families, it was all too often that children who had complex health conditions, like cancer, had to be treated for secondary conditions, like sepsis, which potentially could have been prevented with better nursing practices.
It was during that time Professor Ullman started to question fundamental clinical practices that nurses engaged in, and saw an opportunity to question common understanding, like how medications were administered, to improve outcomes for children.
“While working in the PICU, my clinical curiosity led me to question my fundamental practices - something as simple as how I administer medications.
“These everyday moments led me to a research program to prevent infections associated with central venous catheters, and now other complications associated with invasive devices,” Professor Ullman said.
Professor Ullman completed her PhD in 2016, investigating how to prevent infections and other complication associated with central venous catheters – the tubing by which chemotherapy, blood transfusion and antibiotics are administered for our sickest patients. Major highlights have been leading an Australian-United States collaborative to define safety criteria on vascular access device selection, known as the Michigan Appropriate Guideline for Intravenous Catheters in paediatrics (miniMAGIC) (now part of every day global practice) and demonstrating the impact of modern materials being integrated new catheter technologies (published in New England Journal of Medicine).
Today, as conjoint Professor and Chair in Paediatric Nursing (the University of Queensland and Children’s Health Queensland), Amanda is leading a world-first trial, investigating a new approach to prevent blood clots, blockages and infections for children undergoing treatment for cancer. This research, funded by the Cancer Council Queensland, is comparing the clinical-effectiveness of using a ‘lock’ solution in between anti-cancer therapies that incorporates a low-dose chemical known as T-EDTA. The hypothesis is that this chemical will reduce or even prevent the likelihood of therapy complications, allowing children to receive the uninterrupted therapy they need to cure their cancer.
Professor Ullman says her career in nursing helped her see the pragmatic, simple yet effective ways to improve paediatric outcomes.
“As nurses there are many ways to care for our patients and their families. For me and many others, research is a vital way to ensure nursing and all healthcare practices are innovative and effective. Nurses are experts in communication, team dynamics, evidence translation, and pragmatism. This is why patients and families have huge trust in the care we provide,” Professor Ullman said.
“Working with children and families everyday allows us to see the simple ways we can improve health outcomes for them. By adopting rigorous research methods to simple clinical techniques, like administering medication, we are able to dramatically improve the health outcomes of children, which is incredibly fulfilling.”
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