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Professor Lin Perry

Biography

Lin is a Professor of Nursing Research and Practice Development with the Northern Hospitals Network, South Eastern Sydney Local Health District, with Prince of Wales Hospital and Sydney, Sydney Eye Hospitals.

External contact details
Phone: +61 2 9382 4709
Fax : +61 2 9382 4050
Address: G74, East Wing Edmund Blacket Building, Prince of Wales Hospital, Barker St., Randwick NSW 2031.

Newcastle Institute of Public Health / Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW
Barts and The London NHS Trust, London, UK
St Bartholomew School of Nursing and Midwifery, City University, London
Faculty of Health and Social Care Sciences, St George’s Hospital Medical School and Kingston University, London
St George’s Hospital Medical School and Mayday Healthcare NHS Trust, London
University of Plymouth, Plymouth, UK
Tor and South West College of Health, Taunton, UK

Professional

Memberships and responsibilities
National Stroke Foundation Guidelines Working Party
Stroke Services New South Wales Stroke Education Committee
Royal College of Nursing representative, Intercollegiate Working Party for Stroke, the UK national multi-professional lead body for stroke
World Stroke Organisation
Resource panel for the Australian Commission on Safety and Quality in Health Care in relation to Clinical Safety and Quality Expertise and Health Issues and Literature Reviews
UK Royal College of Nursing
UK Royal College of Nursing Research Society
UK National Nurses Nutrition Group, former Research Committee member
British Association for Parenteral and Enteral Nutrition
European Society for Clinical Nutrition and Metabolism
Founder member and Research sub-group lead of the UK National Stroke Nursing Forum
Founder member of UK Swallowing Research Group

Awards, scholarships and fellowships
Visiting Scholarship, University of Teeside, UK (2009).
Greater Metropolitan Clinical Taskforce Stroke Education Grant (2008)
Juvenile Diabetes Research Fund award (2008)
Newcastle Institute of Public Health Research Fellowship (2007-9).
Distinguished Visiting Scholarship, Australian Catholic University (2005).
Runner-up for the Nutricia Research Prize (2003).
Royal College of Nursing Educational Scholarship (2003).
Cochrane Library Prize (2000) for best application of research evidence to clinical practice.
Dept of Health Doctoral Fellowship (2000-2002).

Image of Lin Perry
Professor, Faculty of Health
Core Member, Health Services and Practice Research Strength
Education, DipN, Cert Ed., RN (Plymouth), MSc (Exeter), PhD (London)
 
Phone
+61 2 9514 4846
Room
CB10.07.207

Research Interests

Lin's research interests include implementation of evidence-based practice, service and practice development, and organisational change, predominantly within stroke and chronic disease management. She is an Editor of the Journal of Advanced Nursing, and holds a conjoint position with University of Newcastle, NSW.

Implementation of evidence-based practice
Service and practice development and evaluation
Organisational change
Stroke, diabetes, acute cardiovascular disease
Chronic disease management
Nutritional aspects of health and disease, nutritional support

Can supervise: Yes

Registered at level 1

PhD Candidate sought
Lin is currently seeking an outstanding graduate student to pursue a PhD project in health risks, health behaviours, health promotion and ageing within the nursing workforce. This scholarship is part of the Australian Research Council-funded project: Fit for the future: Safeguarding the health and wellbeing of the Australian nursing workforce to sustain future healthcare service delivery. 
Find out more and submit an expression of interest.

Research areas
Complex and Chronic Care Long-term care
Critical / Acute Care
Service development and evaluation
Diabetes, stroke
Aged and Extended Care
Action Research
Case Study
Randomised Control Trials
Survey Methods
Mixed methods

Chapters

Perry, L. 2013, 'Stroke Nutritional Management' in Encyclopedia of Human Nutrition, Waltham, MA: Academic Press, United States, pp. 219-230.
Stroke is a common and devastating event, the incidence rising with age. Approximately 125 000 and 500 000 new or recurrent strokes affect individuals each year in the UK and the US, respectively, creating a significant burden of long-term disability in survivors.

Conferences

Clay-Williams, R., Kelly, M.A., Everett, B., Perry, L. & McDonnell, G. 2012, 'Modelling clinical judgement improved health care delivery:using "how nurses think" to manage the deteriorating patient', Selected Abstracts of Free Papers Presented at the SimHealth: Innovation, Education and Research in Healthcare Conference, Wolters Kluwer: Lippincott Williams & Wilkins, Simulation in Health care, pp. 66-66.
This study aims to construct a model for learning reasoning in the workplace, using computer based system dynamic processes, to support clinical decision-making in relation to detection and management of the deteriorating patient. Assessment and timely management of a deteriorating patient is a priority area for improvement highlighted by several Government, independent and health agency reports. Computer modelling of judgement processes can identify areas of difficulty in decision-making and assist nurses and other health care professionals to recognise and seek timely assistance for patients who deteriorate. Seminal work by Benner and Tanner on "how expert nurses think" led to the publication of Tanner's theoretical model of clinical judgement. This model maps the primary processes involved in clinical reasoning, and forms the basis of curricula in nursing courses internationally and within Australia. By explicitly modelling the time nurses take to progress through the processes of decision-making when planning and providing patient care, we can identify points where potential error and harm could occur, and thereby potentially improve patient outcomes.
Clay-Williams, R., Kelly, M.A., Everett, B., Perry, L. & McDonnell, G. 2011, 'Modelling clinical judgement improved health care delivery: using 'how nurses think' to manage the deteriorating patient'.
This papaer presents a dynamic model of reasoning, using computer based system dynamic processes based on a model of 'how nurses think' to support clinical decision-making in relation to detection and management of the deteriorating patient.
Gall, M., Lennon, S., Clarke, K., Cross, S., Cunningham, R., Edmans, J., Fitzpatrick, C., Hancock, N., Hoffman, A., Jones, A., Perry, L. & Walker, M. 2010, 'Intercollegiate Working Party for Stroke. Profession-specific audit in stroke care: Making rehab practice evidence based', Journal of Human Nutrition and Dietetics, British Dietetic Association, Birmingham, pp. 374-374.

Journal articles

Elliott, D., McKinley, S., Perry, L., Duffield, C., Iedema, R., Gallagher, R., Fry, M., Roche, M. & Allen, E. 2014, 'Clinical utility of an observation and response chart with human factors design characteristics and a track and trigger system: study protocol for a two-phase multisite multiple-methods design.', JMIR Res Protoc, vol. 3, no. 3, p. e40.
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Clinical deterioration of adult patients in acute medical-surgical wards continues to occur, despite a range of systems and processes designed to minimize this risk. In Australia, a standardized template for adult observation charts using human factors design principles and decision-support characteristics was developed to improve the detection of and response to abnormal vital signs.
James, S., Gallagher, R., Dunbabin, J. & Perry, L. 2014, 'Prevalence of vascular complications and factors predictive of their development in young adults with type 1 diabetes: systematic literature review.', BMC Res Notes, vol. 7, p. 593.
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Vascular complications curtail life expectancy and quality of life in type 1 diabetes and development at younger ages is particularly detrimental. To date no review has summarised the prevalence or factors predicting their development in young adults.
Perry, L., Hamilton, S., Williams, J. & Jones, S. 2013, 'Nursing Interventions for Improving Nutritional Status and Outcomes of Stroke Patients: Descriptive Reviews of Processes and Outcomes', WORLDVIEWS ON EVIDENCE-BASED NURSING, vol. 10, no. 1, pp. 17-40.
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Lucas, B., Cox, C., Perry, L. & Bridges, J. 2013, 'Pre-operative preparation of patients for total knee replacement: An action research study', International Journal of Orthopaedic and Trauma Nursing, vol. 17, no. 1, pp. 79-90.
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Aims and objectives: To examine the development and impact of a multidisciplinary preparation clinic for patients undergoing total knee replacement (TKR) surgery.
de Brito-Ashurst, I., Perry, L., Sanders, T.A.B., Thomas, J.E., Dobbie, H., Varagunam, M. & Yaqoob, M.M. 2013, 'The role of salt intake and salt sensitivity in the management of hypertension in South Asian people with chronic kidney disease: a randomised controlled trial', HEART, vol. 99, no. 17, pp. 1256-1260.
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de Brito-Ashurst, I., Perry, L., Sanders, T.A.B., Thomas, J.E., Dobbie, H. & Yaqoob, M.M. 2013, 'Applying research in nutrition education planning: a dietary intervention for Bangladeshi chronic kidney disease patients', JOURNAL OF HUMAN NUTRITION AND DIETETICS, vol. 26, no. 4, pp. 403-413.
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Lucas, B., Cox, C., Perry, L. & Bridges, J. 2013, 'Changing clinical team practices in preparation of patients for Total Knee Replacement: Using Social Cognitive Theory to examine outcomes of an action research study', International Journal of Orthopaedic and Trauma Nursing, vol. 17, no. 1, pp. 140-150.
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To examine, through the lens of Social Cognitive Theory, the process of change when developing a preparation programme for patients awaiting Total Knee Replacement Surgery.
Pontivivo, G., Rivas, K., Gallard, J., Yu, N. & Perry, L. 2012, 'A new approach to improving hand hygiene practice in an inner city acute hospital in Australia', Australian Infection Control Association, vol. 17, no. 2, pp. 57-63.
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Healthcare-associated infections occur in 5-15% of hospitalised patients, with 30-50% preventable. Hand hygiene is a basic and essential but poorly conducted method to limit infection in hospitals. This practice development approach to implementing the '5 Moments for Hand Hygiene' national initiative aimed to increase compliance with the recommended hand hygiene practices, anticipating this outcome would be reflected in lower rates of healthcare-associated infections. Methods: Multiple methods were employed during October 2009-October 2010 within a multi-disciplinary initiative, although nurses were mainly recruited. Three medical wards, four surgical wards and the Intensive Care Unit were targeted. Project activities were informed by principles of practice development, solution-focussed coaching and models of behaviour change. Activities included active learning sessions, coaching, audit and feedback, competitions, creativity and fun. Outcomes were observations of hand hygiene compliance and routinely collected rates of Staphylococcus aureus bacteraemia. Results: Overall hand hygiene audits showed statistically significant improvement in compliance, from 62 to 75% in quarterly audits. Compliance rates among nurses and medical staff increased significantly from 70 to 80% and from 43 to 63%, respectively, while changes for allied health practitioners, from 61 to 65% compliance, did not achieve significance. Recorded rates of Staphylococcus aureus bacteraemia reduced from between 0.6 and 2.55 infections per 10000 occupied bed days pre-project to between 0 and 0.65 infections per 10000 occupied bed days during the project period. Conclusions: Multiple methods using a practice development framework can be successful in effecting changes in hand hygiene behaviour among all health care workers. Study methods took planning and commitment but were highly rewarding, particularly considering the magnitude of the issue for patient and clinician safety.
Chan, C.W. & Perry, L. 2012, 'Lifestyle health promotion interventions for the nursing workforce: a systematic review', JOURNAL OF CLINICAL NURSING, vol. 21, no. 15-16, pp. 2247-2261.
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Perry, L., Lowe, J.M., Steinbeck, K.S. & Dunbabin, J.S. 2012, 'Services doing the best they can: service experiences of young adults with type 1 diabetes mellitus in rural Australia', JOURNAL OF CLINICAL NURSING, vol. 21, no. 13-14, pp. 1955-1963.
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Jones, S.E., Hamilton, S., Perry, L., O'Malley, C. & Halton, C. 2011, 'Developing workable research methods: Lessons from a pilot study with vulnerable participants and complex assessments', Journal of Research in Nursing, vol. 16, no. 4, pp. 307-318.
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Following acute stroke, deterioration in nutritional status and weight loss is common; few studies have investigated this, perhaps due to difficulties with recruitment and completion of complex assessments with stroke patients. This study reports the feasibility of a study protocol to determine predictors of nutritional intake in stroke patients. The aim of the study was to test the feasibility of a protocol to measure taste and smell function, and explore links with dietary intake following stroke. Patients were recruited from one Acute Stroke Unit in 2007/8. Data were collected at three time-points and entailed standardised validated assessments of taste and smell function, diet, appetite and mood state. Recruitment of this vulnerable population to a demanding assessment schedule was challenging. Of a cohort of 166 admissions, six were recruited and complete data collected from four participants. Slow recruitment was largely due to exacting inclusion criteria and rapid hospital discharge. Those who completed all assessments reported the schedule as tolerable and acceptable. This study illustrated the difficulties of recruiting this vulnerable population. Identification of reasons for slow recruitment facilitated development of measures to address them. It was possible to format a complex and lengthy assessment schedule to be acceptable to vulnerable participants.
Kilbride, C., Perry, L., Flatley, M., Turner, E. & Meyer, J. 2011, 'Developing theory and practice: Creation of a Community of Practice through Action Research produced excellence in stroke care', JOURNAL OF INTERPROFESSIONAL CARE, vol. 25, no. 2, pp. 91-97.
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Hodge, A., Perry, L., Daly, B., Hagness, C. & Tracy, D. 2011, 'Revision and Evaluation of an 'advanced' nursing role in an Australian emergency department', Australasian Emergency Nursing Journal, vol. 14, no. 2, pp. 120-128.
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Background: Extended Practice Nurse roles have been initiated in various forms in many Australian Emergency Departments. Although common, evaluation of these roles is scarce in the literature. Methods: A four phase practice development project was launched to review contemporary models of Extended Practice Nurse, revise an existing Extended Practice Nurse model called the Advanced Clinical Nurse (ACN), develop and standardise a supporting education and accreditation structure, and implement an evaluative framework for the revised ACN model. Results: A standardised education and accreditation structure was implemented, an 8 h ACN rostered shift commenced, and a mixed method evaluative framework initiated. Compared to management without an ACN, where an ACN was involved, mean medical management time of limb injuries and mean total length of stay was 42 min and 48 min shorter, respectively. Mean time to analgesia by an ACN was 22 min. Improvement in satisfaction was documented within subacute and waiting room patients. Median 'time to treatment' by an ACN was 6 min. Conclusions: Preliminary evaluation of the revised ACN model indicated practice benefits within early care delivery and patient flow. Continued standardisation of Extended Practice Nurse roles within New South Wales, Australia is necessary. The evaluative framework enabled greater understanding of this ACN role.
Nip, W.F.R., Perry, L., McLaren, S. & Mackenzie, A. 2011, 'Dietary intake, nutritional status and rehabilitation outcomes of stroke patients in hospital', JOURNAL OF HUMAN NUTRITION AND DIETETICS, vol. 24, no. 5, pp. 460-469.
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Perry, L., Bellchambers, H., Howie, A., Moxey, A., Parkinson, L., Capra, S. & Byles, J. 2011, 'Examination of the utility of the Promoting Action on Research Implementation in Health Services framework for implementation of evidence based practice in residential aged care settings', JOURNAL OF ADVANCED NURSING, vol. 67, no. 10, pp. 2139-2150.
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Perry, L. & Middleton, S. 2011, 'An investigation of family carers' needs following stroke survivors' discharge from acute hospital care in Australia', DISABILITY AND REHABILITATION, vol. 33, no. 19-20, pp. 1890-1900.
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Appel, C., Mayston, M. & Perry, L. 2011, 'Feasibility study of a randomized controlled trial protocol to examine clinical effectiveness of shoulder strapping in acute stroke patients', CLINICAL REHABILITATION, vol. 25, no. 9, pp. 833-843.
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de Brito-Ashurst, I., Perry, L., Sanders, T.A.B., Thomas, J.E., Yaqoob, M.M. & Dobbie, H. 2011, 'Barriers and facilitators of dietary sodium restriction amongst Bangladeshi chronic kidney disease patients', JOURNAL OF HUMAN NUTRITION AND DIETETICS, vol. 24, no. 1, pp. 86-95.
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Perry, L., Steinbeck, K.S., Dunbabin, J.S. & Lowe, J.M. 2010, 'Lost in transition? Access to and uptake of adult health services and outcomes for young people with type 1 diabetes in regional New South Wales', MEDICAL JOURNAL OF AUSTRALIA, vol. 193, no. 8, pp. 444-449.
Perry, L. 2009, 'Is BMI an accurate measure of nutritional status in older people.', Nurs Times, vol. 105, no. 37, p. 12.
Perry, L., Grange, A., Heyman, B. & Noble, P. 2008, 'Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals.', J Nurs Manag, vol. 16, no. 3, pp. 315-326.
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To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: * providing academic support to enable research involvement of nurses, midwives and allied health professionals; * supporting dissemination of research into practice; * contributing to research strategy development.
Perry, L., Grange, A., Heyman, B. & Noble, P. 2008, 'Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals', Journal of Nursing Management, vol. 16, no. 3, pp. 315-326.
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Aims To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: providing academic support to enable research involvement of nurses, midwives and allied health professionals; supporting dissemination of research into practice; contributing to research strategy development. Background Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these. Methods A mixed methods approach was used. Results Responses were generally very positive. The post effected improvements in the research culture and perceived increase in research-related activities. Conclusion The post made substantial progress towards its aims. This approach may be useful in other healthcare locations to build research capacity. Implications for nursing management Challenged by increasing priority accorded to research capacity and service research implementation yet recognition of barriers to achievement, this study offers insights from one means to address this.
Mackenzie, A., Perry, L., Lockhart, E., Cottee, M., Cloud, G. & Mann, H. 2007, 'Family carers of stroke survivors: needs, knowledge, satisfaction and competence in caring', DISABILITY AND REHABILITATION, vol. 29, no. 2, pp. 111-121.
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Perry, L. 2006, 'Promoting evidence-based practice in stroke care in Australia.', Nurs Stand, vol. 20, no. 34, pp. 35-42.
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To explore approaches to the promotion of evidence-based practice from academic and clinical perspectives by visiting acute stroke units and collaborating centres of the Joanna Briggs Institute, an international network of academic centres.
Kilbride, C., Meyer, J., Flatley, M. & Perry, L. 2005, 'Stroke units: The implementation of a complex intervention', Educational Action Research, vol. 13, no. 4, pp. 479-504.
This article reports on selected findings from an action research study that looked at the lessons learnt from setting up a new in-patient stroke service in a London teaching hospital. Key participants in the design and evaluation of this 2-year study included members of the multi-professional stroke team and support staff within the unit, the hospital management team and representatives of patients and carers. Mixed methods (focus groups, indepth interviews, audits, documentary analysis, participant observation field notes) were used to generate data. Findings demonstrated positive change over time with four main themes emerging from the process: building a team; developing practice-based knowledge and skills in stroke; valuing the central role of the nurse in stroke care; and creating an organisational climate for supporting change. The interplay of these non-linear, but interrelated factors is supported by complexity theory, which includes exploration of how the sum of a whole can be more than its constituent parts. Findings are likely to be of interest to practitioners, managers and policy makers interested in supporting change in a learning organisation.
Perry, L., Brooks, W. & Hamilton, S. 2004, 'Exploring nurses perspectives of stroke care.', Nurs Stand, vol. 19, no. 12, pp. 33-38.
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In recent years stroke has been recognised as a national clinical, research and policy priority. Stroke nurses and stroke nursing are important contributors, but previous studies have highlighted lack of clarity and contradictions in the nursing role. A stroke nursing conference in 2002 offered the opportunity to explore nurses' vision for the future through a series of focus group meetings. Many examples of good practice were identified, for example, nursing contributions to risk factor management and secondary prevention, service co-ordination and development, follow-up and support of stroke patients and their families. However, areas for further development include realigning services to a patient focus and ensuring equitable access, integrating services, supporting development of the nursing research evidence base and providing career and educational frameworks for nurses in stroke care. Nurses set out a vision for stroke nursing in which current strengths and developments are consolidated and disseminated in a dynamic, multiprofessional, integrated patient-focused service.

Reports

Perry, L. National Stroke Foundation 2010, National Clinical Guidelines for Stroke Management, pp. 1-167, Melbourne, Australia.
National Clinical Guidelines for Stroke Management
Gall, M.J., Lennon, S., Clarke, K., Cross, S., Cunningham, R., Edmans, J., Fitzpatrick, C., Hancock, N., Hoffman, A., Jones, A., Perry, L. & Walker, M. St Bartholomew and Royal London Charitable Foundation December 2007 2007, Profession-specific audit in stroke care: making rehab practice evidence based, London, City University.