Acute Care and Cardiovascular Disease

The Acute Care and Cardiovascular Disease team’s program of research is focused on projects that evaluate patient outcomes directly related to interventions by nurses and the multidisciplinary team. This program includes projects that involve primary, secondary and tertiary prevention innovations and covers a seamless transition between health care services and community. There is also a major focus for improving access to acute and specialist care for socially and geographically disadvantaged groups. All studies involve collaborative relationships between nursing partners, multidisciplinary colleagues, stakeholders and industry partners.


A rusted metal loveheart  

Cardiotoxicity after cancer treatment

Cardiotoxicity resulting in left ventricular failure can be an adverse outcome of cancer therapy. Patients may survive cancer only to develop heart failure, which has a higher mortality than cancer. Our projects seek to understand predictors of cardiotoxicity risk and develop strategies to prevent and reverse cardiotoxicty and manage the cardiac health of cancer survivors.

Current projects

Heart Failure following cancer treatment: Characteristics, survival and mortality in a linked health data analysis from Queensland, Australia
Investigators: Clark, R, Berry, NM, Chowdhury M, Versace, V, Roder, D, McCarthy, A, Ullah, S, Atherton J, Koczwara, B
Funder: Institute of Health and Biomedical Innovation of Queensland University of Technology under Collaborative Research Development Grant Scheme; and Flinders University
Dates: 2011-2016
Description: To gain an understanding of differences in patient characteristics and mortality between those who developed HF after chemotherapy compared to those who did not.

The Double Jeopardy Project: Development of a risk assessment and stratification tool, clinical pathway and evidence-based practice guidelines for the comprehensive assessment, monitoring and management of patients with cardiotoxicity
Investigators: Clark, R, McCarthy, A, Atherton J, Berry, NM, Marin, T, Koczwara, B
Funder: Heart Foundation Vanguard Grant, 2014
Dates: 2015–2016
Description: To develop processes that identify patients at risk, develop evidence-based practice guidelines, and ensure referral to cancer survivorship programs and/or specialist heart failure programs.

Does Cancer break your heart?: A linked SA/NT health data analysis for assessing the potential for Cardiotoxicity following cancer treatment.
Investigators: Clark, R, Berry, NM, Chowdhury M, McCarthy, A, Versace, V, Roder, D, Ullah, S, Atherton J, Koczwara, B
Funder: Flinders Medical Foundation
Dates: 2015-2016
Description: This project uses data from South Australia and the Northern Territory to build on the Queensland analysis to gain a better understanding of the nature of cardiotoxicity.

The Australian Outback

Rural Environments and Cardiovascular Health (REACH) Collaboration

The REACH collaboration is a newly formed group of multidisciplinary health researcher’s with a common goal of improving the cardiovascular health of rural and remote South Australians.

Current projects

Clinician attitudes to cardiac rehabilitation: an enabler or barrier?
Investigators: Clark, R, Jones, Dollman, J, Berry N, Tiramacco, R, Tideman P.
Funder: Flinders University and the University of South Australia
Dates: 2015-2016
Description: To evaluate to attitudes and beliefs of the clinicians within the most influential sphere of influencing patients to commit to lifestyle change to prevent CVD or a second heart attack.

How can we better support families living with cardiovascular disease and depression?
Investigators: Clark, R, Jones, Dollman, J, Berry N, Tiramacco, R, Tideman P.
Funder: Flinders University and the University of South Australia
Dates: 2015-2016
Description: To implement a family focused intervention to identify how we can get better at working with families living with heart and mood problems to stick with care and treatment.

A tractor on a farm  

Access and outcomes to cardiovascular disease services in rural and remote Australia

Geography and population distribution influence the location of health resources that support the management of an acute cardiac event, and an individual’s cardiac risk cannot be considered in isolation from the population to which they belong. This research seeks to explore how where patients live impacts on their health outcomes.

Current projects

A linked health data analysis of the association between population composition, geographic accessibility to cardiac services and cardiovascular disease outcomes.
Investigators: Berry N, Clark R, Versace, V, Coffee N.
Funder: Faculty of Medicine, Nursing and Health Sciences Small Grants - Seeding
Dates: 2015-2016
Description: Validating the objective utility of the Cardiac ARIA index by determining the association between the index score and cardiac morbidity and mortality rates within the population of SA and NT.

ARIA vs Cardiac ARIA.
Investigators: Clark R, Versace, V, Berry N,, Coffee N.
Dates: 2015

Geographic hotspot analysis of cardiac mortality.
Investigators: Clark R, Versace, V, Coffee N.
Dates: 2015

A person holding an iPhone

Innovative models of care for cardiac rehabilitation and secondary prevention

Effective models of care for rehabilitation and secondary prevention in cardiac care include providing relevant education and information in understandable and accessible formats. Apps, computer programs that can be carried on portable electronic devices, may offer a convenient way to provide relevant information that provides timely information that is easily accessible for many.

Current projects

Cardiac patient perceptions of information presented to them in hospital and at discharge
Investigators: Berry, N, Clark, R, Astley, C, Du, H, Wonggom, P, Wechkunanukul, K, Tongpeth, J
Dates: 2015-2016
Description: To gain an understanding of the perceptions of cardiac patients in South Australian public hospitals of information provided to them by hospital staff on their condition and treatment

The developing and evaluation of a Simple avatar-based Application for improVing chest pain Education: The SAVE study
Investigators: Clark, RA, Du, H, Tongpeth J
Dates: 2014-2018

The development and evaluation of an avatar based education application for improving self-care education in heart failure patients.
Investigators: Clark, RA, Du, H, Avatars Wonggom, P
Dates: 2015-2019

I wish I could have my heart attack again: Addressing health literacy in chest pain education using an avatar based application.
Investigators: Du, H, Clark, RA, Tongpeth J
Dates: 2015-2016

Recently completed projects

Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure
Investigators: Clark R, Fredericks, B, Buitendyk N, Adams, M, Howie-Esquivel J, Dracup, K, Berry N, Atherton, J, Johnson, S.
Funder: Queensland University of Technology (QUT), University of California San Francisco (UCSF) Atlantic Philanthropic Project Grant; IHBI Collaborative Research Development Grant (2011); and the Commonwealth Funded Health Collaborative Research Network (CQUniversity Australia & QUT) (2013).
Dates: 2011-2015
Description: to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community.

Self-efficacy as a mediator to improve self-care behaviour and health related quality of life (HRQoL) in chronic heart failure patients.
Investigators: Du H, Newton P, Everett B, Salamonson Y, Davidson P.
Dates: July 2014-July 2015


Clark, R., Fredericks, B., Buitendyk, N., Adams, M., Howie-Esquivel, J., Dracup, K., Berry, N., Atherton, J. and Johnson, S. (2015). Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure. Rural and Remote Health. 15, Article. 3231. Available from:

A woman with her grandaughter, meeting with a doctor  

Involving family members in patient care

Family members and carers play an important role in patient care when a person is in hospital. Effective interactions with health professionals may lead to improved health outcomes and save lives.

Current projects

Patients, family members and carers views on involvement in recognising and responding to patient deterioration through the rapid response / Medical Emergency Team (MET) call system
Investigators: King, L, Peacock, G, Clark, R
Dates: 2015

What are the factors and perceptions impacting family presence during cardiopulmonary resuscitation (CPR) in Australian acute healthcare settings?
Investigators: Giles, T, Muir-Cochrane, E, de Lacey, S
Dates: 2015-2016
Description: To examine the attitudes, beliefs and actions of health professionals, family members and surviving resuscitation patients to determine what factors influenced decision-making around family presence during a resuscitation event.

The unique experiences and needs of the family member who is also a nurse, during hospitalisation of a critically ill family member.
Investigators: Giles, T, Ullah, S, Hall, K, Williamson, V, Parry, Y.
Dates: 2013
Description: to develop and validate a questionnaire that can be used to explore the experiences, challenges and needs of nurses who have a family member hospitalised with a critical illness.

Determinants of student nurse self-efficacy in learning about concepts related to evidence based practice for health care.
Investigators: Blackman, I, Giles T
Dates: Due for completion 2015
Description: This study examined the newly graduating nurses’ self-rated capacity to embrace and apply evidence-based practice to the clinical demands of nursing practice

Recently completed projects

Nurses’ experiences of their child’s hospitalisation for an acute illness
Investigators: Lines L (Masters student); Giles, T, Mannix T
Dates: 2014


Blackman, I. and Giles, T. (2015). Psychometric evaluation of a self-report Evidence Based Practice tool using Rasch analysis. Worldviews on Evidence-Based Nursing, 2(5), 253-264. 

Giles, T.M., de Lacey, S.L. and Muir-Cochrane, E.C. (2015). Coding, constant comparisons and core categories: a worked example for novice constructivist grounded theorists. Advances in Nursing Science, Accepted 12 August 2015

Giles, T. and Williamson, V. (2015). Torn between dual roles: the experiences of nurse-family members when a loved one is hospitalised in a critical condition. Journal of Clinical Nursing, 24(21-22), 3095-3106. 

Lines, L., Mannix, T.G. and Giles, T.M. (2015). Nurses' experiences of the hospitalisation of their own children for acute illnesses. Contemporary Nurse.

Lines, L., Mannix, T.G. and Giles, T.M. (2015). The missing voice of the Nurse-Parent: A literature review. Neonatal, Paediatric and Child Health Nursing, 18(3), 25-34.

Giles, T.M. and Hall, K. (2014). Qualitative systematic review: the unique experiences of the nurse-family member when a loved one is admitted with a critical illness. Journal of Advanced Nursing, 70(7), 1451-1464.

Giles, T., King, L. and De Lacey, S. (2013). The timing of the literature review in grounded theory research: An open mind versus an empty head. Advances in Nursing Science, 36(2),  E29-E40.


A midwife caring for a baby in an infant warmer  

Neonatal early discharge

Current projects

Home and Away: the effects of a neonatal early discharge program – A matched case controlled study
Investigators: Mannix, T, Morris, S, Marshall, P, Kaambwa, B, Sweet, L, Hudson, N, Byrne, G.
Dates: 2015
Description: to determine the outcomes of the Neonatal Early Discharge (NED) program at Flinders Medical Centre. We are interested in whether there is any difference in neonatal length of stay, family stress, costs and feeding outcomes for babies who go home on the NED program.



If you would like to discuss opportunities for research collaboration, are interested in gaining access to our research expertise, or would like to undertake a research higher degree with us, please contact:

Professor Robyn Clark
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