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Biomedical subjects

J Lumby

Publications and source records attributed to J Lumby.

17 recordsLinked to original sources
PubMed1999

Measuring outcomes from the patients' perspective.

This descriptive study examines the outcomes of care from the perspective of patients following a recent orthopaedic admission at a teaching hospital in Sydney. Results were extracted and analysed from transcripts of audio-taped focus groups. Participants identified five nursing activities that made a positive difference to patient outcomes. These activities were: (i) patient-controlled analgesia; (ii) water-filled gloves placed under patients' heels; (iii) cream rubbed into patients' heels; (iv) an explanation, at pre-admission clinic, of the impending operation; and (v) being informed about the details of their treatment while in hospital. Three activities that participants felt made a negative difference to their outcome were also identified, as were seven activities not performed by nursing staff that participants felt would have made a positive difference to their outcome. The results from this study reinforce the importance of basic nursing care, and the value of measuring outcomes, not only from the professional perspective, but also from the patients' viewpoint.

Arthroplasty, Replacement, Hip↗
PubMed1998

Exploring the precursors of outcome evaluation in Australia: linking structure, process and outcome by peer review.

Reviews of the structure of the health system and the processes that contributed to them were the main forms of evaluation within nursing in Australia during the 1970s and 1980s. The documentation of the end result of care, or outcome evaluation, was rarely undertaken until more recent times. The development and implementation of formal assessment tools such as Qualpacs, the Phaneuf Nursing Audit, the Rush Medicus Nursing Process Methodology, Monitor, and Senior Monitor indicated the focus on structure and process evaluation. This paper examines how nursing care delivered to patients during the l970s and 1980s was evaluated, and explores why structure and process review were necessary precursors to outcome evaluation in the nineties. The necessity of linking structure and process analysis is discussed, in order to perform effective outcome evaluation to close the feedback loop between quality assessment and quality improvement. Peer review is one mechanism that can be used to achieve this. How this may also be a form of evidence-based practice which results in health gains for patients is also explored.

Australia↗
PubMed1998

Outcome evaluation in nursing in Australia, 1960-1980.

While empirical evaluation of the outcome of patient care has come to the fore in recent years due to political initiatives, there has always been a professional interest by nurses in the end result of their care. A review of the literature shows that outcome evaluation was advocated for nursing as early as the 1860s by Florence Nightingale. This article explores the evolvement of outcome evaluation within nursing in Australia, discussing its origins during the 1960s and 1970s. The measurement of patient outcomes is more relevant than ever before, with the recent drive for an evidence-based approach to nursing care.

Australia↗
PubMed1997

Liver transplantation: the death/life paradox.

Transplantation of organs has increased dramatically over the last 3 decades. The Australian National Liver Transplant Unit was established in 1985 at Royal Prince Alfred Hospital. Their first 5 years was reported in a paper in 1992 in which survival was defined as 'going home'. The study reported in this paper followed a 3 year study with one woman who experienced a liver transplant in which survival had many dimensions, of which going home was not one. This post doctoral study of 2 years extended the earlier work with one woman by exploring the experience with eight 'survivors'. It highlighted the paradox of facing life and death at the same time, which occurs when one has a terminal illness but is on a waiting list for a donor organ which could be life saving. Focus groups were used as the methodology while story telling within the group became the means by which individuals and the group recalled and made meaning of their experiences.

Adaptation, Psychological↗
PubMed1994

Context and culture--the influence on role transition for first-line nurse managers.

The role of nurse managers at all levels is the subject of much debate in Australia. It has been argued that their role is not essential and increasingly new organisational structures are being implemented which do not include nurse managers. This paper describes reasons why nurses, who are mainly female, face conflict when making the transition to the role of manager in the male dominated health care system of today. It argues that the values which nurses are able to bring to these positions are those increasingly valued by the community they serve. It is not nurses who should change, but the values held by the organisations in which they are employed if society's needs are to be well served.

Australia↗
PubMed1994

Caring nurses: the dilemma of balancing costs and quality.

This paper explores the tensions visible in the rhetoric and practice of today's health care system. This system is becoming dominated by the views of economic rationalists where decisions are based on principles more frequently associated with private enterprise. One could argue that health care should be managed as a business, however, the ethics which guide such a business must be examined closely to ensure the integrity of the caring which is implicit in much of the practice in health care. Individuals in today's society value humanistic functions more than ever before. The caring function of nursing is perhaps the most significant determinant of the quality of care received from a patient's perspective, and one to which there is little cost attached in dollar terms. While it is difficult to measure and cost the caring that nurses provide, it must be done to ensure that these qualities are maintained and enhanced. More importantly, strategies must be developed to provide cost-effective quality indicators of the caring function implicit in the nurse's role. (This is an abridged version of a paper delivered at the Nursing Economic$ International Symposium 1993 in Hobart, Tamsania.)

Australia↗
PubMedDate not supplied

Comparing professional and patient outcomes for the same episode of care.

Following an acute hospital admission, patients' perceptions of the acceptability of their own outcomes were compared with professionally derived outcomes of care developed for the same patients by nurses. Professional opinion was obtained from the Nursing Practice--Casemix and Outcomes Project undertaken by the Sydney Metropolitan Teaching Hospitals Nursing Consortium, where patient outcomes were classified by nurses into three groups: Outcomes Acceptable; Outcomes Not Acceptable but Justified and Outcomes Not Acceptable and Not Justified. Fifteen male patients in the present study discussed their outcomes following recent orthopaedic surgery at a series of focus groups organised according to the three outcome categories. Findings from the study showed the majority of patients were satisfied with their outcomes. Patient agreement with nurses regarding the acceptability of outcomes was highest for patients from the Outcomes Acceptable group and lowest for those from the Outcomes Not Acceptable and Not Justified group. This work is significant in that it is one of the first nursing studies to compare outcomes developed by practitioners for a particular group of patients with actual outcomes experienced by the same group of patients.

Adult↗