- NHMRC - APP1184032 “‘Deadly Ears at Discharge’ - A hospital-based randomised controlled trial of an additional ear and hearing assessment to inform discharge planning by a trained Aboriginal Ear Health Worker in Aboriginal children with chronic ear infection.”
- NT Health
- University of Sydney
The “Deadly Ears in Deadly Hands” trial will assess whether Aboriginal Health Professional (Aboriginal Health Practitioner, Worker or Registered Nurse)-assisted hospital discharge planning will improve ear health outcomes. Aboriginal children who are in-patients at Royal Darwin Hospital and are at increased risk of severe otitis media will be eligible.
Primary Research Question: In hospitalised Aboriginal children who are at risk of severe otitis media, does ear health discharge planning coordinated by an Aboriginal Health Professional improve ear health outcomes in the next 4-8 months?
- Adherence to recommended treatment plans
- Sensitivity and specificity of the routine clinical ear examination at Royal Darwin Hospital
- Family satisfaction with hospital discharge planning and overall hospital care
- Prevalence of ear disease in hospitalised Aboriginal children and the clinical course of ear disease after discharge
Aboriginal children in the Northern Territory have among the highest rates of severe otitis media reported in the world. In this setting, accurate diagnosis is challenging and good health outcomes are hard to achieve. We have developed evidence-based guidelines that are suitable for advising families about the best options for ongoing management. The largest benefit comes from following the recommended management of the most severe ear disease (acute otitis media with perforation, chronic suppurative otitis media, and chronic otitis media with effusion plus hearing loss). However, this relies on the accurate assessment of ear disease and its associated hearing loss. The impact that a trained Aboriginal Health Professional within the hospital setting can have on health outcomes (compared to standard care) is not known.
Aboriginal children admitted to Royal Darwin Hospital are eligible if they are at increased risk of the most severe ear disease. At screening, potential participants will receive an ear examination from a trained Aboriginal Health Professional to identify whether they have or are at risking of developing severe otitis media. Eligible participants will be randomised to either enhanced discharge planning by an Aboriginal Health Professional or to routine care. The Aboriginal Health Professional will spend time with the participants and their families each day that they are in hospital, offering them support and health education to prepare them for their discharge from hospital. We will then follow the children up 4-8 months after discharge to assess their outcomes through their medical records and a follow-up ear health check.
Implications for policy and practice:
We are aiming to provide the evidence needed to show that Aboriginal Health Professionals are uniquely skilled to add significant value to the Royal Darwin Hospital Paediatric Wards.
- 2021 - 2026