Prof. Jennifer Chipps (School of Nursing)
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| Position: | Associate Professor |
| Department: | School of Nursing |
| Faculty: | Faculty of Community and Health Sciences |
| Qualifications: | BSc Nursing Hon (WITS, South Africa) |
| BSc Psychology Hon (UNISA, South Africa) | |
| Grad Dip Nursing Administration (WITS, South Africa) | |
| Grad Dip Nursing Education (WITS, South Africa) | |
| Masters in Public Health (UNSW, Australia) | |
| Grad Dip Applied Epidemiology (VETAB, Australia) | |
| PhD (Telemedicine) (UKZN, South Africa) | |
| My publications in this repository | |
| Tel: | +27 21 959 3923 |
| Fax: | +27 21 959 2679 |
| Email: | jchipps@uwc.ac.za |
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Item Suicide mortality in NSW: geographic variation.(CSIRO, 1995) Stewart, Gavin; Chipps, Jennifer; Sayer, GeoffreyThis is the first of a series of articles on the epidemiology of suicide in NSW. We examine pooled suicide mortality data for Area and District Health Services from the time of the introduction of the ICD9-CM cause of death coding in 1979 to the most current complete year for which death data are available (1992).Item Suicide mortality in NSW: clients of mental health services.(CSIRO, 1995) Chipps, Jennifer; Stewart, Gavin; Sayer, GeoffreyThis article examines suicide by clients of mental health services in NSW. Since April1992 the Mental Health Branch of the NSW Health Department has operated an incident monitoring system which requires all public mental health services in NSW to report unexpected deaths, including suicides, of current or former clients. Part I of this article describes the information collected through this monitoring system, and Part II estimates mental health service clients' risk of suicide, compared with that of the NSW population.Item Suicide mortality in NSW: an introduction to clinical audits.(CSIRO, 1996) Stewart, Gavin; Chipps, Jennifer; Sayer, GeoffreyThis article is an introduction to the use of clinical audit to identify possible preventive approaches to suicide. We examine the ethical issues, techniques and feasibility of this method for collecting information on suicides. A more detailed report on the practicalities of clinical audit is being prepared3. For more than three decades psychological autopsies and modified psychological autopsies have been employed worldwide to study risk factors for suicide. The term psychological autopsy most commonly refers to interviews with family and friends of the victim to reconstruct the circumstances of the suicide'. Sometimes the term is limited to the determination of the mental state of the individual, and at other times the modified psychological autopsy or clinical audit includes all the investigations relevant to the suicide, including the review of medical records and the physical autopsy4. Clinical audit in this article encompasses both the psychological autopsy and the physical autopsy, and any other relevant investigations. We prefer to use the term clinical audit to stress that interviewing bereaved people requires clinical skills and because attention should be given to the potential role clinical services may play in prevention.Item Suicide attempts in NSW: associated mortality and morbidity.(CSIRO, 1996) Sayer, Geoffrey; Stewart, Gavin; Chipps, JenniferThis article is the fifth in a series on suicide in New South Wales by the Mental Health Epidemiology Group. Its aim is to provide a quantitative account of suicide attempts and the associated mortality and morbidity in NSW during 1992 (the most recent year for which data were available) as context for consideration of the overall problem of suicide in NSW.Item Admission rates as an indicator of the prevalence of severe asthma in the community(Wiley, 1998) Jalaludin, Bin; Chey, Tien; Holmwood, Marvin; Chipps, Jennifer; Hanson, Ralph; Corbett, Stephen; Leeder, StephenBACKGROUND: A reliable indicator of the prevalence of severe asthma in the community is needed to monitor population-based asthma control strategies. We examined the potential use of asthma admissions to hospital as such an indicator. METHODS: We recruited subjects from the Emergency Department (ED) of a children's hospital. The attending doctor completed the 'physician questionnaire' which included questions on the patient's asthma severity and interval severity/chronicity of asthma. The parent/guardian completed the 'parent questionnaire'. It included questions on demography, asthma knowledge and attitudes, asthma history and social support. We performed univariate and multiple logistic regression to determine predictors for hospital admission. RESULTS: Interval severity of asthma, pre-treatment severity of wheeze and low post-treatment pulse oximetry best predicted whether children presenting with asthma were admitted. Demographic variables, factors associated with access to health services and factors related to the asthma history and management were not significant predictors of admission. DISCUSSION: At the population level, it may be possible to utilise routine hospital admission rates as an indicator of the prevalence of severe asthma in the community, especially within the context of monitoring trends in asthma prevalence. Our study was conducted in a metropolitan tertiary paediatric hospital. The reliability of hospital admission rates as indicators of the prevalence of severe asthma in other hospital settings, in different population groups and over time remains to be established.Item Suicide in New South Wales: the NSW suicide data report.(CSIRO, 2001) Ansari, Guncha; Chipps, Jennifer; Stewart, GavinThe NSW Suicide Prevention Strategy has identified suicide prevention as a high priority for government and the community. Death by suicide is a relatively uncommon event; however, more people in NSW now die from suicide than road injury. Nationally, two per cent of all deaths were attributed to suicide in 1998. This article describes the Suicide in New South Wales—The NSW Suicide Data Report, which has been developed and produced by the Centre for Mental Health, and presents improved information on suicide, hospitalisation following attempted suicide, and risk of suicide, both at a state and an area health service level.Item The mental health outcomes and assessment training project: creating the foundations for improved quality of care(CSIRO, 2002) Chipps, Jennifer; Raphael, Beverley; Coombs, TimThe NSW Mental Health Outcomes and Assessment Tools Training Project (MH-OAT) is a collaborative and consumer-centred project that aims to strengthen the assessment skills of the mental health care workforce. MH-OAT does this through training that supports the introduction of a process of standard documentation of clinical practice along with measures of outcomes and potential ‘case mix’ (a method of describing the different types of patients treated by the health system, which recognises that different patients require different levels of resources.Item The effectiveness of in-hospital psychosocial intervention programmes for families of critically ill patients - a systematic review.(Health and Medical Publishing Group, 2006) Brysiewicz, Petra; Chipps, JenniferBackground. A review of in-hospital psychosocial intervention studies for families with a relative in a critical care unit was conducted. Purpose of review. To review the literature on studies addressing the topic, discuss research methods critically, describe clinical outcomes and make recommendations for future research efforts. In doing so, empirically tested interventions producing positive outcomes may be applied to support families who have a relative in a critical care unit. Data sources. Research citations from 1991 to 2006 from CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane and SCOPUS databases, Internet search engines and unpublished abstracts through NEXUS were searched. Review methods. Citations were reviewed and evaluated for sample, design, intervention, threats to validity and outcomes. Review studies were limited to those that evaluated in-hospital interventions in family members of patients in a critical care unit. Results. Six studies were reviewed. Positive outcomes were reported for all of the intervention strategies. All but one of the studies reviewed studied small samples and single critical care units, and were poor in design. Conclusions. The paucity of interventional studies and the lack of systemic empirical precision to evaluate effectiveness of these interventions necessitate that future studies be methodologically rigorous.Item Fluid use in mountain bikers – self-reported practices.(Health medical publishing group (HMPG), 2007) Rose, S; Chipps, Jennifer; Peters, EBACKGROUND AND OBJECTIVES. Little is known of the fluid replacement habits of participants in mountain bike (MTB)endurance events. This survey set out to determine the current perceptions and practices of this group of endurance athletes. Method. Four hundred and twelve participants in the 3-day 2006 Sani2C (MTB) race completed questionnaires that elicited information regarding their regular fluid intake practices during competitive MTB endurance events. This included their general approach to fluid replacement, their fluid intake practices (type, amount and frequency), urine output and hydration status. RESULTS. While 70% (N = 290) reported that they based their fluid intake practices on personal past experiences, less than half the group (N = 177, 43%) were aware of official sport-specific guidelines. Although 86% (N = 354) reported making use of commercially available sport-specific drinks, consumption of water alone was reported by 34% of respondents (N = 140). The majority (N = 225, 55%) of the mountain bikers reported drinking every 16 - 30 minutes during an endurance ride, while 35% (N =144) reported drinking every 0 - 15 minutes. Fifty-three per cent (N = 182) of the male respondents and 45% (N= 23) of female respondents reported a routine intake of ≥ 750 ml per hour during endurance rides. This included 2 women who reported regular intakes of between 1 500 and 2 000 ml/hr. Only 7 (2%) reported receiving medical care for dehydration following their participation in previous MTB rides. CONCLUSIONS. This survey indicates that although more than half of the mountain bikers did not acknowledge specific awareness of the official fluid replacement guidelines, over 80% reported drinking regularly during a race, and 52% (N = 212) reported a usual intake of ≥ 750 ml/hr during endurance races. Until scientific studies have carefully examined the hydration status and fluid replacement needs of mountain bikers, MTB cyclists are cautioned against the practice of over-hydrating.Item Student evaluation of a Clinical Self-Study Laboratory(Elsevier, 2007) Saakane, Keetsemang; Mugarurwa, John; Shahidi, Timothe'e; Maputhege, Maphosa; Chipps, Jennifer; Brysiewicz, PetraINTRODUCTION: Being clinically competent is an essential component of any nursing curricula to ensure that on completion the nursing graduates are able to practice safely and effectively as a nurse. Clinical Self-Study Laboratories have become increasingly popular in nursing education in recent years as a way of ensuring a variety of skills are taught to the nursing students. These clinical skills laboratories are used to teach communication and interpersonal skills, psychomotor skills, promote the development of collaborative skills required in nursing as well as being able to help integrate theory and practice [Morgan, R., 2006. Using clinical skills laboratories to promote theory–practice integration during first practice placement: an Irish perspective.However, it is essential that these programs be subject to routine quality assurance and effectiveness evaluation. METHODOLOGY: The purpose of the study was to conduct a process evaluation of the implementation of the Clinical Self-Study Laboratory (CSSL) in the School of Nursing, University of KwaZulu-Natal. The process evaluation included a descriptive quantitative satisfaction survey of first and third year Bachelor of Nursing students, a checklist to assess the quality of the CSSL equipment and a retrospective record review of utilisation of the CSSL by students. RESULTS: The CSSL appears to be well implemented and utilized by students. Students reported that it was accessible and that the equipment in the laboratory was of a reasonable quality. A few students reported dissatisfaction with some of the equipment and requested that more equipment and trained personnel be made available.Item The effectiveness of cultural competence training for health professionals in community based rehabilitation: a systematic review of the literature.(Wiley, 2008) Chipps, Jennifer; Brysiewicz, Petra; Simpson, BarbaraAims: To find and review studies in which investigators evaluated cultural-competence training in community-based rehabilitation settings; critique study methods, describe clinical outcomes, and make recommendations for future research. Background: A review of the effectiveness of cultural-competence training for health professionals in community-based rehabilitation settings was conducted. Data Sources: Research citations from 1991–2006 in CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane, Google, NEXUS, and unpublished abstracts were searched. Methods: Searching, sifting, abstracting, and assessing quality of relevant studies by three reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. A meta-analysis was not conducted because the studies did not address the same research question. Results: Five studies and one systematic review were evaluated. Positive outcomes were reported for most training programs. Reviewed studies generally had small samples and poor design. Conclusions/Implications: The paucity of studies and lack of empirical precision in evaluating effectiveness necessitate future studies that are methodologically rigorous to allow confident recommendations for practice.Item Technology enhanced learning for remote nurses in KwaZulu-Natal.(International information management corporation, 2010) Chipps, Jennifer; Mars, MauriceThe paper describes a project at the School of Nursing at the University of KwaZulu-Natal in Durban South Africa to increase access to university based education through the use of videoconference specialist education for nurses in rural areas of KwaZulu-Natal. Objectives: To evaluate the perceptions of lecturers and participants on the use of video-conferencing for nurse education. METHODOLOGY: Two surveys were conducted: a perceptions survey with lecturers of the School of Nursing and an initial and second survey with participants of a pilot advanced midwifery education programme conducted by video-conferencing. RESULTS: Both participants and lecturers had very little prior experience of video-conferencing, but felt that it would increase access for rural nurses to high quality specialist education. Concerns were mainly about technical issues in running and conducting the sessions and the application of progressive education strategies using this technology CONCLUSION: Videoconferenced academic specialist nursing programs would provide technology enhanced learning for remote nurses in KwaZulu-Natal, but for optimal use, the presenters need to be trained in the use of VC.Item The use of synchronous videoconferencing teaching to increase access to specialist nurse education in rural Kwazulu-Natal, South Africa(KM&EL, 2010) Chipps, JenniferABSTRACT: In KwaZulu-Natal more than 50% of the population lives in the rural area but most of the health workers are based in urban centres where teaching hospitals and high incomes are common. Nursing provides the backbone of health care in the public sector. Specialist nurses such as advanced midwives or specialist HIV nurses are in short supply. Teaching via live synchronous videoconference (VC) provides an opportunity to extend specialist education to nurses at rural hospitals. AIM: The aim of the study was to review and evaluate the current use of videoconference education for nurses in KwaZulu-Natal.METHODOLOGY: A review the literature on VC education in nursing using bibliometric review strategies was conducted and two nurses’ education courses conducted via videoconferencing was evaluated against a set of criteria developed and validated by the Department of TeleHealth at the University. RESULTS: 81 publications addressing videoconference nurse education were found, most being published after 2000. Over half were descriptive studies, but were still valuable for informing this study. Based on the evaluation of the two courses against the set of criteria, the two courses were aligned sufficiently well with the measurement criteria. Additionally, the delivery of the courses via videoconferencing allowed for the identification of potential cost savings.DISCUSSION: This evaluation indicates that these two courses have been successfully implemented using VC. In the light of the potential savings of time and money, VC can be used to teach specialist nursing courses to rural nurses. Recommendations to improve the VC courses included orientation training for presenters and encouraging more research regarding the effectiveness of VC as a teaching modality for clinical nurses in rural areas. CONCLUSION: More attention should be given to developing the infrastructure and skills to make this technology available and commonly used in health services in under-resourced public health services and hospitals. Additional research is also suggested.Item Readiness of health-care institutions in KwaZulu-Natal to implement telespsychiatry(2012) Chipps, Jennifer; Mars, MauriceWe assessed the preparedness of health districts and designated hospitals in the KwaZulu-Natal (KZN) province for proposed telepsychiatry services. An e-health readiness questionnaire for developing countries was administered to managers of health districts and managers of designated psychiatric hospitals by telephone interview. Ten of the 11 district managers and managers/medical officers of 45 of 58 designated hospitals were interviewed. Notwithstanding some concerns regarding the tool, low levels of e-health readiness were found. District managers recorded e-health readiness scores of 137–217 out of 300. This was similar to the hospital managers, who recorded readiness scores of 121–260 out of 300. For telepsychiatry to succeed in KZN, an awareness programme will be required to facilitate the necessary change management.Item Videoconference-based education for psychiatry registrars at the University of KwaZulu-Natal, South Africa(OMICS group, 2012) Chipps, Jennifer; Ramlall, Suvira; Mars, MauriceObjective: Psychiatry registrars form the backbone of specialized psychiatric service provision in South Africa. Medical schools are centralized while clinical services need to be widespread and accessible. Video-conferencing has the potential to link registrars at satellite hospitals with academic centers. The study thus evaluated of the use of videoconferencing in a Psychiatry Education Program delivered via videoconferencing. Method: To evaluate the implementation of the videoconference-based psychiatry registrar program, a pre- and post evaluative design was used. This involved all registrars in the 2008 and 2009 academic education program at the University of KwaZulu-Natal, South Africa. Access to education, satisfaction, suitability and costs of the psychiatry registrar education were studied. Results: In the evaluation of the Registrar Program, general satisfaction with the videoconferencing program was reported, though concerns were expressed about the level of interaction using this mode, the quality of the transmitted pictures of the anatomy specimens and the quality of the sound. Access to education was improved with potential cost savings identified. Conclusion: Well supported and planned videoconference-based teaching is a feasible, cost-effective and acceptable method of supporting registrars at sites distant from academic centers.Item Practice guidelines for videoconference-based telepsychiatry in South Africa(OMICS Publishing Group, 2012) Chipps, Jennifer; Ramlall, Suvira; Mars, MauriceTelepsychiatry, the practice of psychiatry over distance using information and communication technologies is, after teleradiology, the most practiced form of telemedicine in the world. As with any new technology, clinical service, or intervention in medicine, it is prudent to have guidelines for the safe and efficacious use of the technology in clinical practice. Guidelines facilitate best practice and provide both clinicians and patients with a set of standards and procedures that serve to protect their interests. Protection is particularly important when dealing with vulnerable groups.Item Mental health legislation: does it protect the rights of people with mental health problems?(SU LIS, 2012) Simpson, Barbara; Chipps, JenniferThe International Federation of Social Work places a concern with human rights and social justice at the core of its definition of social work. Social work values are based on “respect for the equality, dignity and worth of all people” (IFSW, 2000), and social work practice has a special concern for vulnerable and oppressed people. People with mental health problems are amongst the most vulnerable members of society and in South Africa they comprise a considerable proportion of our society. According to the South African Stress and Health Survey (Herman, Steyn, Seedat, Heeringa, Moonal & Williams, 2009), the lifetime prevalence for any mental health problems in South Africa is 30.3% and neuropsychiatric disorders rank third in their contribution to the burden of disease in South Africa (Bradshaw, Norman & Schneider, 2007).Item Global and diverse evidence: challenges in application to lower middle income countries(2012) Chipps, Jennifer; Brysiewicz, PetraItem Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence(OMICS Publishing Group, 2012) Chipps, Jennifer; Mars, MauriceOBJECTIVE: A review of systematic reviews of the effectiveness and feasibility of videoconference-based telepsychiatry services for resource constrained environments was conducted. Specifically with the aim of producing an evidence-based review of the effectiveness and feasibility of videoconference-based telepsychiatry services in resource constrained countries like South Africa. METHODS: Eight key questions on telepsychiatry effectiveness and feasibility were identified and inclusion and exclusion criteria were developed. Review of citations from 2000-2011 from CINAHL, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews (CCTR), Cochrane Controlled Trial Registry (CCTR), Database of Abstracts of Reviews of Effectiveness (DARE), unpublished abstracts through NEXUS and internet search engines (Google/Google scholar) was conducted. RESULTS: Ten systematic reviews were included for review. Despite the methodological limitations and heterogeneity of the systematic reviews, there appears to be good evidence of effectiveness (reliability and improved outcomes) and feasibility (use, satisfaction, acceptability and cost) for videoconference-based telepsychiatry internationally. The application of this evidence in lower middle income countries is dependent on the integration of telepsychiatry into local health system contexts. CONCLUSION: Based on the evidence, resource constrained countries such as South Africa should be encouraged to develop telepsychiatry programs along with rigorous evaluation methods.Item Developing telepsychiatry services in KwaZulu-Natal - an action research study(OMICS Publishing Group, 2012) Chipps, Jennifer; Ramlall, Suvira; Madigoe, Thebe; King, Howard; Mars, MauriceOBJECTIVE: In 2009, the Departments of Psychiatry and Telehealth of the University of KwaZulu-Natal (UKZN) initiated a three year project to develop telepsychiatry services in KwaZulu-Natal. This paper describes the challenges and opportunities of this project. METHOD:This was a collaborative, in situ health service project and an action research framework was adopted. Over the three years, following a needs assessment and an e-health Readiness Assessment, two action research cycles were completed. Cycle 1: The preparation, implementation and evaluation of educational material, technical requirements and clinical guidelines and clinical support materials. Cycle 2: Preparation and evaluation of educational and clinical outreach sessions. RESULTS: Videoconference education sessions were beneficial to health staff without post-qualification psychiatry training. A flexible format for education improved knowledge outcomes. Clinical sessions are feasible, but require administration and technical support for facilitation. With facilitator training, 128Kbps is a suitable bandwidth for education but 384Kbps is preferred for clinical consultation. CONCLUSION: Telepsychiatry offers tremendous potential to facilitate the three strategies suggested by the World Psychiatric Association to address the treatment gap, save time and costs and improve access to the small pool of specialist psychiatrists in resource constrained environments.