Dr Maryann Street

Dr Maryann Street is a Senior Research Fellow in the Deakin University  Quality and Patient Safety (QPS) Strategic Research Centre - Eastern Health partnership. Maryann has been a principal investigator in collaborative multi-site research across Health Services.   Her research has focused on  issues including clinical risk in transitions of care, improving health care quality and patient safety through evidence-based practice and engaging patients to improve health care outcomes. Specific research studies include evaluating patient participation in nursing handover in acute care settings, improving patient outcomes associated with emergency care for older and vulnerable patients, risk management in patient care, nursing assessment for the safe and timely discharge of patients from post-anaesthetic care and the role of nurses in end-of-life advanced care planning.

Maryann is committed to research excellence and integrity, and is a member of the Eastern Health Research Ethics Subcommittee for assessment of applications for low-risk research proposals. She also undertakes review of research proposals for Deakin University Human Ethics Advisory Group (HEAG).

Dr Maryann Street's  research focus is  the delivery of quality, safe and evidence-based patient care, especially during transitions of care, improving health care quality and patient safety through evidence-based practice and enhancing patient participation in care. Specific research studies include evaluating patient participation in nursing handover,  improving patient outcomes associated with emergency care for older and vulnerable patients, risk management in patient care, nursing assessment for the safe and timely discharge of patients from post-anaesthetic care and the role of nurses in end-of-life advanced care planning.

• Australian Association of Gerontology (AAG)
• College of Emergency Nurses Australasia (CENA)
• Australian Society of Clinical & Experimental Pharmacologists and Toxicologists (ASCEPT)
• Fellow and Member of International Society for Quality in Healthcare (ISQua)
• Health Services Research Association of Australia N New Zealand (HSRAANZ)

Dr Maryann Street has co-supervised six Bachelor of Nursing (Honours), one Master of Nursing Practice and two PhD students to completion and is currently supervising three Honours student. She has completed the Deakin University fast track training program for HDR supervision.

Bachelor of Nursing (Honours) projects

• "Patient Experience of Medical Emergency Team activation calls"
• “Pre-operative management and post-operative outcomes for older patients undergoing major emergency surgery”
• “Factors influencing cardiomatabolic monitoring practices for adults in mental health in-patient units”
• “Dialysis nurses’ attitudes towards an Accredited Exercise Physiologist intra-dialytic exercise program”
• “Exploring the relationship between patient experience, nurse satisfaction and direct care hours”
• “Emergency care of women with vaginal bleeding and / or abdominal pain in early pregnancy”

Masters of Nursing Practice projects

• "Factors that determine length of stay and readiness for discharges from the Post Anaesthetia Care Unit: A retrospective clinical audit"

Doctorate of Philosophy
May 2013 – Dec 2014 Jintana Damkliang “Use of an Evidence-Based Care Bundle by Thai Emergency Nurses” (Co-supervisor with Prof. Julie Considine, Prof. Bridie Kent)

Sep 2017 - July 2020 Vanessa Watkins “Labouring together – collaborative alliances in maternity care in Victoria, Australia: a mixed methods study”. (Co-supervisor with Professor Alison M Hutchinson and Professor Cate Nagle).

HNR 412 Bachelor of Nursing (Honours)

HNN 725 and HNN 726 Masters of Nursing Practice Minor Thesis

Nursing Research

Health Services Research

Quantitative Research Methodology

Emergency Care for Older people

Nursing assessment for patient discharge from the Post-Anaesthetic Care Unit

Nursing Research Health Services Research Patient safety during transitions in care Quantitative analysis

• Patient safety

• Street M, Considine J, Berry D, Gray E, Mapes J, Liskaser R, Papageorgiou S, Dempster J. Older age and communication deficit do not appear to impact patient participation in nursing handover. 53rd Australian Association of Gerontology Virtual Conference, Online November 18th-20th November 2020.
• Howard R, Kuhn L, Millar F, Street M. October 2019. Integrating physical and mental health care: Cardiometabolic monitoring practices in three mental health inpatient units. Australian College of Mental Health Nurses 45th International Mental Health Nursing Conference, 8-10th of October 2019, Sydney, New South Wales - oral presentation. International Journal of Mental Health Nursing 28:23 (1page) October 2019.
• Howard R, Kuhn L, Millar F,  Street M. Examining the characteristics of cardiometabolic monitoring and physical health assessment of mental health consumers within the first 72-hours of admission to a mental health inpatient unit. Australian College of Nurses National Nursing Forum, 21st-23rd of August 2019, Hobart, Tasmania - oral presentation.
• Considine J, Street M, Bucknall T, Rawson H, Hutchinson A, Dunning T, Botti M, Duke M, Mohebbi M & Hutchinson A. November 2015. Emergency transfers from subacute to acute care: prospective case-time-control study. 51st Australian Association of Gerontology Conference. Melbourne, 21st-23rd November 2018.
• Street M, Considine J, Bucknall T, Rawson H, Hutchinson AF, Botti M, Duke MM, Mohebbi M, Hutchinson AM, Dunning T.  Resuscitation plans for older subacute care patients following clinical deterioration. 51st Australian Association of Gerontology Conference, Melbourne, 21st - 23rd November 2018.
• Berry D, Street M, Considine C. Service use by older people who frequently attend Emergency Departments. 51st Australian Association of Gerontology Conference, Melbourne, 21st - 23rd November 2018.
• Berry D, Street M, Considine C. ‘Hello, you’ve looked after me before’. Service use by older people with very frequent emergency department attendance. 16th International Conference for Emergency Nursing (ICEN), Melbourne, October 2018
• Street M, Phillips N, Haesler E, Kent B. Refining nursing assessment and management in the Post-Anaesthetic Care Unit: a new discharge criteria tool to minimise surgical patient risk. 2018 ACORN & ASIORNA International Conference, Adelaide, South Australia, May 2018.
• Briggs K,  Botti M, Phillips NM, Street M. The Rite of Passage - PACU length of stay. 2018 ACORN & ASIORNA International Conference, Adelaide, South Australia, May 2018.
• Kuhn L, Page K, Street M, Rolley J, Considine J. (2017). The Influence of Gender on Evidence-Based Practice for Patients with Acute Coronary Syndrome: A Retrospective Multi-Site Australian Study. Heart, Lung and Circulation, 26, S321. doi:http://dx.doi.org/10.1016/j.hlc.2017.06.646
• Street M, Berry D, Mohebbi M, Considine J. Development of a risk predication model for older people staying more than four hours in the emergency department. ISQua’s 34th International Conference, London, United Kingdom, October 2017 (poster).
• Street M, Berry D & Considine J. Characteristics and outcomes of older people who frequently attend the emergency department: A comparative cohort study. ISQua’s 34th International Conference, London, United Kingdom, October 2017 (poster).
• Street M, Considine J, Berry D, Mohebbi M, Cross A. Influences on Emergency Department length of stay for older people. Australian Association of Gerontology 49th National Conference, Canberra, ACT, November 2016 (Oral Presentation).

Research Gate profile

https://www.researchgate.net/profile/Maryann_Street

 

Twitter: @maryann_street

Deakin University Centre for Quality and Patient Safety (QPS) Research

Institute for Health Transformation

2017       Awarded an Academic Study Program to be conducted in Trimester 2, 2017. The program is to explore ways to foster patient and public involvement (PPI) in health services research and to describe the patient’s experience of health care. It includes visits with international researchers in the United Kingdom at University of Plymouth, PenCLARHC, the Health Foundation, CLAHRC South London and the Centre for Implementation Science at Kings College London. The program also covers a visit to the University of Agden, Norway as an invited visiting academic.
2015        Awarded Fellowship to the International Society for Quality in Healthcare (ISQua) on completion of the global education program, delivered by leading experts in quality and safety in healthcare, to stimulate thought and innovation, increase competence and confidence, encourage good practice and set the benchmark for healthcare quality.

2013     Awarded Oral Presentation Award for Best Paper presentation entitled “Improving patient outcomes and access to Emergency care for older people from Aged Care Homes”  at 2013 International Nursing Conference on Health, Healing, & Harmony: Nursing Values, in Thailand.

2010    Awarded “Best Research Presentation” at the Eastern Health Research Forum for presentation of “Eastern Health Emergency Department presentations by Residential Aged Care patients: what are the clinical and cost implications?” This award included a contribution of $1000 towards attendance at a conference to present this research.

Major Research projects include:

1. Patient participation in nursing handover.

Nursing handover is a frequent safety-critical activity in hospitals. Patient participation in nursing handover at the bedside increases patient safety and promotes a positive healthcare experience. Eastern Health Point of Care Audits showed that between 10% and 25% of nursing handovers were not conducted in the patient’s presence and the level to which patients were actively involved in nursing handover was unknown. This research study aimed to explore patient participation in nursing handover at Eastern Health.

A prospective observational study was undertaken on 10 wards (medical, surgical, rehabilitation and geriatric evaluation and management) at six hospitals. A total of 117 change-of-shift from morning to afternoon nursing handovers were observed,  followed by a short semi-structured interview with 33 patients, and interviews with the 20 nurses giving handover. We found that patients were active participants in one-third (33%), passive participants in a further 47% and for 20% the patient had no input at all. A complex interplay of factors that impacted the level of participation were identified as were strategies to enhance patient participation. These findings will inform nurses about the best way to effectively help patients, especially those who are older or have communication deficits, be more involved in bedside nursing handover.

2. Transitions of care for older people through the Emergency Department
Frequent presentations and longer stay in the Emergency Department for older people, including those from Residential Aged Care, are associated with diminished quality of care, increased morbidity and excess mortality. A study of the impact of In-reach Services at Eastern Health for people transferred from Residential Aged Care to the Emergency Department (ED) showed improved patient outcomes such as fewer presentations to the Emergency Department,  reduced length of stay and lower admission rates. The proportion of admitted patients who were discharged with an End of Life palliative care plan increased almost three-fold. 
A further study compared matched cohorts of older people from Residential Aged Care with those from the community. The findings suggested that systemic rather than clinical factors were most strongly predictive of access block. The most recent study identified 12 factors which independently predict whether an older person will remain in ED longer than 4 hours and developed a clinically reliable prediction model. 

The findings have been published in Health & Social Care in the Community, Australasian Journal on Ageing, Australasian Emergency Nursing Journal,  European Journal of Emergency Medicine and the International Journal for Quality in Health Care.

3. Nursing Assessment of patients for safe discharge from the Post-anaesthetic Care Unit (PACU)
Dr Street and colleagues obtained almost $140,000 funding from the HCF Health and Medical Research Foundation for a pilot study to evaluate an evidence-based Discharge Scoring Tool to be used by nurses in the PACU. The study aimed to give nurses a better tool for patient assessment, improve patient outcomes and reduce adverse events, thus reducing health care costs. This pre- and post- implementation study was conducted  in three Eastern Health PACUs . Previous work by Dr Street and colleagues informed the development of improved evidence-based PACU documentation for use at all Eastern Health sites.  The findings of the intervention study were published in BMJ Open.