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Safety and Quality in Healthcare

At the Centre for Nursing, Midwifery and Health Services Research, we undertake innovative research to develop knowledge, evaluate effectiveness and implement change in healthcare through interventions, treatments and knowledge to transform and shape policy and practice.

Research group focus:

  • Workforce (policy, planning and delivery and mediators of healthcare system outcomes).
  • Quality improvement and quality assessment.
  • Monitoring and medical errors, adverse events, sentinel events, patient safety.
  • Accreditation policies, regulations and processes.
  • Future workforce development.

Please view the sections below for a list of our projects and publications.

Introducing an intervention to improve adherence to pressure injury (PI) evidence based guidelines: a cluster randomised trial
Dr Linda Coventry, Dr Mandy Towell, Professor Di Twigg and four external colleagues
Funding: The Western Australia Nurses Memorial Charitable Trust - $40,000

Evaluation ofstrategies to improve the recognition and response of the deteriorating patientin acute care.
Tania Beament,Professor Di Twigg, Dr Mandy Towell
Funding: Sir Charles Gairdner Hospital - $49,537

Symptomclusters in myocardial infarction: identification of patient subgroups andimpact on delay
Dr Linda Coventry and three external colleagues
Funding: Sir Charles Gairdner Hospital - $47,814

Evaluation ofinitiatives relating to Magnet hospital designation
Professor Di Twigg, HelenMyers
Funding: Sir Charles Gairdner Hospital - $30,000

Evaluation of Fiona Stanley Hospital Ward PracticeEnvironments from the Perspective of Nurses and Midwives
Professor Di Twigg, HelenMyers
Funding: HDWA - $50,000

Independentpredictors of successful vascular access cannulation in haemodialysis patientsand the development of a vascular access cannulation complexity instrument.
Dr Linda Coventry,Professor Di Twigg, Dr Mandy Towell and three external colleagues
Funding: ECU IC -$22,500

Evaluation ofthe ‘Pilot Implementation of the Framework for Safe Nurse Staffing andSkill-Mix’ in Ireland
Professor ChristineDuffield and nine external colleagues
Funding: $184,179

Measurementof staff experience and culture of healthcare organisations: A rapid review
Professor ChristineDuffieldand three external colleagues
Funding: $36,331

Fit for theFuture pilot study: Preventing weight gain in new graduate nurses
Professor ChristineDuffield and three external colleagues
Funding: $12,000

Research anddevelopment of a national framework for Advanced Practice in nursing
Professor ChristineDuffield and five external colleagues
ARC LinkageGrant - $320,000

Fit for thefuture: safeguarding the health and wellbeing of the Australian nursingworkforce to sustain future healthcare service delivery.
Professor ChristineDuffield and four external colleagues
ARC LinkageGrant - $139,438

Assessing critical thinking innurse’s development: analysis of an assessment tool.
Beth Jacob, Professor ChristineDuffield

The Impact ofFitness Levels and Leisure-Time Exercise Patterns on the Risk of OccupationalMusculoskeletal Disorders among New Graduate Registered Nurses in WA.
Judith Pugh, Professor Di Twigg,  Professor Anne Wilkinson, Anthony Blazevich– SEHS, Kylie McCormack - SEHS and one external colleague

A PilotRandomised Control Trial to Compare Failure Rates between Anti-infective CVC,PICC and Anti-infective PICC Lines.
Dr Mandy Towell,Professor Di Twigg, Dr Linda Coventry and five external colleagues

Developing andevaluating an assessment and planning instrument to facilitate resources tosupport Aboriginal people who undertake nursing education.
Professor Di Twigg, Pugh,J., plus 3 external colleagues

(SCGH)Professional Practice Model
Professor Di Twigg, Dr Linda Coventry and one external colleague

One Focus(formerly “ Evaluation of Clinical Practice Supervision Model”)
Dr Mandy Towell,Professor Di Twigg and Dr Linda Coventry

Referencecase for standardised economic analysis in nursing
Professor Di Twigg,HelenMyers

The CONTRASTResearch program: Comparing MagNet aTtributes in NuRsing between Australia andthe United STates.
Dr Linda Coventry and 6 external colleagues


  • Duffield, C., Chapman, S., Rowbotham, S. & Blay N. (2017) Nurse-Performed Endoscopy Implications for the Nursing Profession in Australia, Policy, Politics, & Nursing Practice.
  • Elliott, D., Allen, E., McKinley, S., Perry, L., Duffield, C., Fry, M., Gallagher, R., Iedema, R. & Roche, M. (2017) User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study, Journal of Advanced Nursing.
  • Gardner, G., Duffield, C., Doubrovsky, A., Bui, U., Adams, M. (2017) The Structure of Nursing: A national examination of titles and practice profiles. International Nursing Review.
  • Gardner, G., Duffield, C., Doubrovsky, A., Bui, U. & Adams, M. The structure of nursing: a national examination of titles and practice profiles. International Nursing Review 64.
  • Jacob, E., Duffield, C. & Jacob, D. (2017) A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique, Journal of Advanced Nursing.
  • Seaman, K., Saunders, R., Williams, E., Harrup-Gregory, J., Loffler, H. & Lake, F. (2017) An examination of students’ perceptions of their interprofessional placements in residential aged care. Journal of Interprofessional Care, 31(2), 147–153.
  • Nicholls, R., Perry, L., Gallagher, R., Duffield, C., Sibbritt, D. & Xu, X. The personal cancer screening behaviours of nurses and midwives. Journal of Advanced Nursing, 73.
  • Nolan, S., Hendricks, J., Ferguson, S. & Towell, A. (2017) Social networking site (SNS) use by adolescent mothers: Can social support and social capital be enhanced by online social networks? – A structured review of the literature. Midwifery, 48, 24-31.
  • Perry, L.,  Xu, X., Gallagher, R. Nicholls, R., Sibbritt, D. & Duffield, C. Health, workforce characteristics, quality of life and intention to leave: a cross sectional survey of Australian nurses and midwives. Journal of Advanced Nursing.
  • Roche, M., Friedman, S., Duffield, C., Twigg, D. & Cook, R. A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a sampling study. Journal of Advanced Nursing, 73.
  • Wang, C., Whitehead, L. & Bayes, S. Global mobility in nursing: Why Chinese students leave to study nursing in Australia. Journal of Nursing Education and Practice.


  • Brown, J., Christiansen, A., Kelly, C., Kirkcaldy, A., Kirton, J., Simpson, P., Zubairu. (2016). An Evaluation of NHS England’s care maker programme final report. Published Online.
  • Christiansen, A., Barnes, T., Bewley, T., Kaehne, E., Lynes, D., Kirkcaldyba, A. (2016). An evaluation of the Open and Honest Care Programme in acute NHS trusts in Northern England. Journal of Nursing Management.  DOI: 10.1111/jonm.12379.
  • Christiansen. A., Obrien, M., Kirton. J., Zubairu. K., Bray, L. DeliveringCompassionate Care: the Enablers and Barriers. British Journal of Nursing. 10.12968/bjon.2015.24.16.833.
  • Cope, V., Jones, B., & Hendricks, J. (2016). Residential aged care nurses: portraits of resilience. Contemporary Nurse. DOI: 10.1080/10376178.2016.1246950
  • Cope, V., Jones, B.,Hendricks, J. (2016).Why nurses chose to remain in the workforce: Portraits of resilience.Collegian. (2016) 23, 87-95.
  • Cope, V., Sundin, D., Smyth, A., Wang, C., Baum, G., Ewens, B. and Foxall, F. (2016). The hidden benefits of writing retreats: Academic development and social interaction for nurses. Journal of Nursing Education and Practice Vol. 6, No. 11. DOI: 10.5430/jnep.v6n11p73. ERA Eligible. Impact Factor N/A
  • Crevacore C., Jonas-Dwyer D., Nicol P. The effect of an enrollednursing registration pathway program on undergraduate nursing students'confidence level: A pre- and post-test study. Nurse Education Today. PII:S0260-6917(16)00009-5 DOI: doi: 10.1016/j.nedt.2015.12.020 3165.
  • Duffield, C. VI: Workforce. Journal of Advanced Nursing. DOI:10.111.
  • Duffield, C., Roche, M., Twigg, D., Williams A. and Clarke, S. Aprotocol to assess the impact of adding nursing support workers to wardstaffing. Journal of Advanced Nursing. DOI: 10.1111/jan.12965.
  • Elliott, D., Allen, E.,McKinley, S., Perry, L., Duffield, C.,Fry, M., Gallagher, R., Ledema, R., and Roche, M. User acceptance of observationand response charts with a track and trigger system: a multisite staff survey. Journalof Clinical Nursing. DOI: 10.1111/jocn.13303.
  • Gardner, G., Duffield, C., Doubrovsky, A. andAdams, M. Identifying advanced practice: A national survey of a nursing workforce.International Journal of Nursing Studies. DOI: 10.10.16/j.ijnurstu.2015.12.001.
  • Issacs, A., Jacob, E., Raymond, A., Jones, J.,McGail, M., Drysdale, M. Cultural desire need not improve with culturalknowledge: A cross-sectional study of student nurses. Nurse Education inPractice. DOI:
  • Jacob, E., McKenna, L., D’Amore, A. Educators’ expectations ofroles, employability and career pathways of registered and enrolled nurses inAustralia. Nurse Education in Practice.
  • Jacob, E., McKenna, L., D’Amore, A. Role expectations ofdifferent levels of nurse on graduation: A mixed methods approach. AustralianJournal of Nursing Practice. DOI:
  • McWilliams, T., Hendricks, J., Twigg, D., Wood, F., & Giles, M. (2016). Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings. Burns.
  • Nicholls, R., Perry, L., Duffield, C., Gallagher R., & Pierce, H. (2016). Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. Journal of Advanced Nursing. DOI: 10.1111/jan.13185.
  • Nicholls, R., Perry, L., Gallagher, R., Duffield, C. & Sibbritt, D. (2016). The personal cancer screening behaviours of nurses and midwives. Journal of Advanced Nursing, DOI: 10.1111/jan.13221
  • Nicholls, R., Perry, L., Duffield, C., Gallagher, R. & Pierce, H. (2016). Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. Journal of Advanced Nursing, DOI: 10.1111/jan.13185
  • Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., Bichel-Findlay J. & Nicholls, R. (2016). Does nurses’ health affect their intention to remain in their current position? Journal of Nursing Management, DOI: 10.1111/jonm.12412;jsessionid=06A765F31498A4A7E1FE8F9696FA0FD5.f02t03
  • Perry, L., Lamont, S., Brunero, S., Gallagher, R., Duffield, C. & Sibbritt, D. (2016). “Mental health day” sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health. Journal of Advanced Nursing, DOI: 10.1111/jan.13212
  • Raymond, A., Jacob, E., Jacob, D. Peer learning a pedagogicalapproach to enhance online learning: A qualitative exploration. Nurse EducationToday.
  • Redknap, R., Twigg, D., Towell, A. What interventionscan improve the mental health nursing practice environment? InternationalJournal of Mental Health Nursing. DOI: 10.1111/inm.12187.
  • Roche, M., Duffield, C., Friedman, S., Twigg, D.and Dimitrelis, S. Changes to nurses' practice environment over time. Journalof Nursing Management. DOI: 10.111/jonm.12371.
  • Roche, M., Friedman, S., Duffield, C., Twigg, D. & Cook, R. (2016.) A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a work sampling study. Journal of Advanced Nursing, DOI: 10.1111/jan.13224
  • Saunders, C., Carter,D.J., Bryce Law, Q., Jordan, A., Duffield,C., & Bichel-Findlay. J. Cancer patient experience measures: Anevidence review. Journal of Psychosocial Oncology. DOI: 10.1080/07347332.2016.11557717.
  • Slatyer, S., Cramer, J.;Pugh, J., & Twigg, D. Barriersand enablers to retention of Aboriginal Diploma of Nursing students in WesternAustralia: An exploratory descriptive study. Nurse Education Today. DOI: 10.1111/jocn.13303.
  • Stanley D., Beament T., Falconer D., Haigh M.,Saunders R., Stanley K., Wall P. & Nielson S. The male of the species: aprofile of men in nursing.  Journal ofAdvanced Nursing.
  • Twigg, D., Cramer, J., Pugh,J. Nurse Staffing and Workload Drivers in Small Rural Hospitals: AnImperative for Evidence. Journal of Rural Nursing and Healthcare. DOI:10.14574/ojrnhc.v16i1.370.
  • Twigg, D., Myers, H., Duffield, C., Pugh, J., Gelder, L., & Roche, M. (2016). The impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes: An analysis of administrative health data. International Journal of Nursing Studies. DOI:
  • Wang, C. C. Closing the gap: Comparing nursing registrationsystems between Australia and China. Chinese Nursing Research.
  • Wang, C. C., Whitehead,L. & Bayes, S. Nursingeducation in China: meeting the global demand for quality health care. InternationalJournal of Nursing Sciences.
  • Winton Schreuders, L., Geelhoed, E., Bremmer, A., Finn, J., and Twigg, D., (2016). Feasibility of using payroll data to estimate hospital nurse staffing. Collegian.
  • Witney, C., Hendricks, J., & Cope, V. Variationof Kozinets’ framework and application to nursing research. Nurse Researcher. 23(5):36-41. DOI:10.7748/nr.23.5.36.s8.


  • Buchan, J., Twigg, D., Dussault, G., Duffield, C., Stone, P. (2015).Policies to sustain the nursing workforce:        an international perspective.International Nursing Review. 62(2), 162 – 170.
  • Cope, V. Jones, B, Hendricks,J. (2015). Methodology – Portraiture: a methodology where success andpositivity can be explored and reflected. Nurse Researcher – The InternationalJournal of Research Methodology in Nursing and Health Care, (2015) 22, (3), 6 -12.
  • Cope, V. Jones, B, Hendricks,J. (2015). Why nurses chose to remain in the workforce: Portraits ofresilience. Collegian, (2015).
  • Cope, V. Jones, B, Hendricks,J. (2015). Resilience as resistance to the new managerialism: portraitsthat reframe nursing through quotes from the field. Journal of Nursing Management,(2015). DOI:0.1111/JONM.12279.
  • Duffield, C., Roche, M., Dimitrelis, S, Buchan J. and Homer, C.(2015). Instability in patient and nurse characteristics, unit complexity, andpatient and system outcomes. Journal of Advanced Nursing. 71(6), 1288 - 1298.
  • Geale, S., Beament, T., Gibson, N., Fowler, A.Baker, M., Smith,G. (2015). International Practicum:Not just another overseas jaunt – Supporting learning Objectives and the developmentof graduate attributes. Journal of Nursing Education and Practice, Vol.5,No.11, 96 - 102.
  • Geale, S., & Jacob, E. (2015). BP measurement:practice without evidence. Are we teaching it wrong? Australian Nursing andMidwifery Journal, 23(2), 34.
  • Hendricks, J., Cope, V., & Baum, G. (2015). Postgraduate nurses’insights into the nursing leadership role. Do they intuitively link the role topatient safety? JNEP, 5(9).
  • Jacob, E., McKenna, L., & D’Amore, A. (Online July 2015). Educators’expectations of roles, employability and career pathways of registered andenrolled nurses in Australia, Nurse Education in Practice, doi: 10.1016/j. nepr.2015.05.011.
  • Jacob, E., McKenna, L., & D’Amore, A. (2015). The changingskill mix in Nursing: considerations for and against different levels of nurse,Journal of Nursing Management. 23(4), 421-426, DOI: 10.1111/jonm.12162.
  • Jacob, E., Raymond, A., Jacob. A., Jones, J., Drysdale, M., &Isaacs, A. (Online July 2015). Exploration of nursing degree students’ contentexpectations of a dedicated Indigenous health unit, Collegian: The AustralianJournal of Nursing Practice, Scholarship and Research,doi:10.1016/j.colegn.2015.06.001.
  • Mata, G. (2015). Teaching of safe practices to ourgraduates. Australian Nursing & Midwifery Journal 23(1), 39.
  • Mata, G., Oliver, K., Geale, S. & Jacob, E (2015). Infection control: it’snot just what you wear - it’s how you take it off, Australian Nursing andMidwifery Journal, 23(3), 39.
  • Merrick, A., Duffield, C., Fry M. and Stasa H.(2015). Trust and decision – making: how nurses in Australian general practice negotiaterole limitations. Collegian: The Australian Journal of Nursing PracticeScholarship and Research. DOI information: 22(2), 225 - 232.
  • Perry, L., Lamont, S.,Brunero, S. Gallagher, R. and Duffield,C. (2015). The mental health of nurses in acute teaching hospital settings:a cross-sectional survey. BMC Nursing, 14:15 DOI: 10.1186/s12912-015-0068-8.
  • Pugh, J.D., Gelder, L., Williams, A.M., Twigg, D., Wilkinson, A.M.,& Blazevich, A.J. (2015, September 28). Validity and reliability of anonline extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E2) tomeasure nurses’ fitness. Journal of Clinical Nursing, Advanced onlinepublication. doi:0.1111/jocn.12971.
  • Pugh, J.D., Twigg, D., Giles, M., Myers,H., Gelder, L., Davis, S.M., & King, M. (2015). Impact and costs of home-basedtrial of void compared to the day care setting. Journal of Advanced Nursing,71(3), 559-5569. doi: 10.1111/jan.12525.
  • Roche, M., Duffield, C., Dimitrelis, S. and Frew,B. (2015). Leadership skills for nursing unit managers to decrease intention toleave. Nursing: Research and Reviews. 5, 57 - 64.
  • Towell, A., Nel, W., & Muller, A. (2015). Model of Emotionalintelligence for the facilitation of wholeness of critical care nurses in SouthAfrica. Health SA Gesondheid.
  • Twigg, D., Duffield, C. (2015). Policies to sustain the nursing workforce:an international perspective’ International Nursing Review. January, 2015.
  • Twigg, D., Gelder, L. & Myers, H. (2015). The impact of understaffed shifts onnurse-sensitive outcomes. Journal of Advanced Nursing, 71(7): 1564-1572. doi: 10.1111/jan.12616.
  • Twigg, D., Myers, H., Duffield, C., Giles, M. & Evans, G.(2015). Is there an economic case for investing in nursing care – what does theliterature tell us? Journal of Advanced Nursing. 71(5): 975-990.doi:10.1111/jan.12577.
  • Twigg, D., Pugh, J., Gelder, L., & Myers, H. (2015, April 16). Foundations of a nursing -sensitiveoutcome indicator suite for monitoring public patient safety in WesternAustralia. Collegian. Advanced online publication. doi:10.1016/j.colegn.2015.03.007.
  • Wang, C., Andre, K., & Greenwood, K. M. (2015). Chinesestudents studying at Australian universities with specific reference to nursingstudents: A narrative literature review: Nurse Education Today 35(4): 195 – 208doi:10.1016/j.nedt.2014.12.005.
  • Wang, C., & Geale, S. (2015). The power of story: Narrativeinquiry as a methodology in nursing research. International Journal of NursingSciences 2(2): 195 – 198 doi:10.1016/j.ijnss.2015.04.014.
  • Wang, C., & Greenwood, K. M. (2015). Chinese nursing students’culture – related learning styles and behaviours: A discussion paper.International Journal of Nursing Sciences 2(3):doi:10.1016/j.ijnss.2015.07.009.


  • Tania Beament
  • Carol Crevacore: Delegation practicesbetween Registered Nurse and the Assistant in nursing.
  • Gemma Evans: The impact ofcommunication satisfaction on paediatric nurses’ job satisfaction and intentionto stay.
  • Yvonne Farmer
  • Amanda Fowler: A mixed method study onNursing graduate support programs in rural and remote areas of WesternAustralia.
  • Kylie McCullough: The Delivery of Primary Health Care in Remote AustralianCommunities: A Grounded Theory Study of the Perspective of Nurses.
  • Tania McWilliams
  • Melanie Murray
  • Mary Ryder: Nurse practitioners and leadership.
  • Duncan Wright

Masters by Research

  • Julie Barry
  • Shelley McRae
  • Peri Mickle
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