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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

Book 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.

Conference Papers

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', SimHealth 2011, Sydney, Australia, September 2011 in Selected Abstracts of Free Papers Presented at the SimHealth: Innovation, Education and Research in Healthcare Conference, ed Watterson, L; Brooks, P., 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', SimHealth, Sydney, September 2011.
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.

Journal Articles

Elliott, D., McKinley, S.M., Perry, L., Duffield, C.M., Iedema, R.A., Gallagher, R., Fry, M., Roche, M.A. & allen, e. 2014, 'Clinical utility of an observational and response chart with human factors design characteristics and a track and trigger system: study protocol of a two-phase multi-site multiple methods design', JMIR Research Protocols, vol. 3, no. 3, p. e40.
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, pp. 17-40.
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Background: Stroke produces many effects that impact eating. Nutrition is fundamental for recovery and rehabilitation, but the nursing nutritional role and associated outcomes have not been delineated.
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.
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.
de Brito-Ashurst, I., Perry, L., Sanders, T., 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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Background The effectiveness of salt restriction to lower blood pressure (BP) in Bangladeshi patients with chronic kidney disease (CKD) is uncertain. Objective To test the hypothesis that a tailored intervention intended to reduce salt intake in addition
de Brito-Ashurst, I., Perry, L., Sanders, T., 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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Background Effective nutrition health interventions are theory-based, as well as being drawn from practice and research, aiming to successfully accomplish dietary behavioural changes. However, the integration of theory, research and practice to develop c
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. & Perry, L. 2012, 'Lifestyle health promotion interventions for the nursing workforce: a systematic review', Journal Of Clinical Nursing, vol. 21, pp. 2247-2261.
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Aims and objectives. Study aims were to identify the efficacy of lifestyle health promotion interventions intended to improve behavioural health risk factors and/or behavioural or clinical outcomes of working-age nurses. Background. Nurses constitute around half the health workforce but global shortages and an ageing profile challenge future supply. The occupational hazards and stresses of nursing are well known. Health promotion, possibly workplace-based, presents opportunities to safeguard the health of nurses. Design. This was a systematic review undertaken in line with guidance for reviews in health care. Methods. Seven electronic databases were searched from 2000++2011 and references of relevant papers. Two reviewers independently reviewed and critiqued retrieved papers and extracted data. Methodological features were described using the CONSORT checklists; risk of bias was assessed using the Cochrane Handbook classification.
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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Aims and objectives. To describe the healthcare experiences of young adults with type 1 diabetes who access diabetes services in rural areas of New South Wales, Australia. Background. The incidence of type 1 diabetes in childhood and adolescence is increasing worldwide; internationally, difficulties are encountered in supporting young people during their transition from children to adulthood. Consumers experiences and views will be essential to inform service redesign. Design. This was a qualitative exploratory study. Methods. Semistructured telephone interviews were conducted with 26 people aged 18-28 years living rurally, recruited through staff in four regional healthcare centres in 2008.
de Brito-Ashurst, I., Perry, L., Sanders, T., Thomas, J.E., Dobbie, H. & Yaqoob, M.M. 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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Background: People of Bangladeshi origin have the highest mortality ratio from coronary heart disease of any minority ethnic group in UK and their rate of kidney disease is three- to five-fold higher than that of the European UK population. However, there is little information regarding their dietary customs or knowledge, beliefs and attitudes towards health and nutrition. This multi-method qualitative study aimed to identify: (i) barriers and facilitators to dietary sodium restriction; (ii) traditional and current diet in the UK; and (iii) beliefs and attitudes towards development of hypertension, and the role of sodium. Methods: Methods included focus group discussions, vignettes and food diaries. Twenty female chronic kidney disease patients attended four focus group discussions and maintained food diaries; ten responded to vignettes during telephone interviews. Triangulation of the results obtained from the three methods identified categories and themes from qualitative thematic analysis. Results: Identified barriers to sodium restriction were deeply-rooted dietary beliefs, attitudes and a culturally-established taste for salt. Facilitators of change included acceptable strategies for cooking with less salt without affecting palatability. Dietary practices were culturally determined but modified by participants' prosperity in the UK relative to their previous impoverished agrarian lifestyles in Bangladesh.
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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Much emphasis is placed on expert knowledge like evidence-based stroke guidelines, with insufficient attention paid to processes required to translate this into delivery of everyday good care. This paper highlights the worth of creating a Community of Practice (CoP) as a means to achieve this. Drawing on findings from a study conducted in 2000++2002 of processes involved in establishing a nationally lauded high quality Stroke Unit, it demonstrates how successful development of a new service was linked to creation of a CoP. Recent literature suggests CoPs have a key in implementing evidence-based practice; this study supports this claim whilst revealing for the first time the practical knowledge and skills required to develop this style of working. Findings indicate that participatory and democratic characteristics of Action Research are congruent with the collaborative approach required for developing a CoP. The study is an exemplar of how practitioner researchers can capture learning from changing practice, thus contributing to evidence-based healthcare with theoretical and practical knowledge. Findings are relevant to those developing stroke services globally but also to those interested in evidence-based practice.
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., 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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Background: Nutrition affects rehabilitation through its influence on physical and mental functioning, although little attention has been paid to effects on rehabilitation outcomes. The present study aimed to describe nutritional status and food consumption in stroke patients within 2 weeks of hospital admission and before discharge, as well as to investigate the effects of nutritional and dietary factors on rehabilitation outcomes. Methods: One hundred patients from a consecutive cohort admitted to a metropolitan hospital with acute stroke were recruited and assessed by a single researcher, with 38 reassessed at discharge. Nutritional status was assessed using Mini-Nutritional Assessment and anthropometric indices and dietary intake was assessed by 1-day weighed dietary records. Rehabilitation outcomes were changes in Barthel index scores and the rehabilitation efficiency index. Results: Few (n = 9; 10%) consumed equal to or less than 100% of the estimated average requirement (EAR) for energy within 2 weeks of admission and 13 (33%) had energy intakes <50% of EAR before discharge. A small but increasing proportion (7% at admission, 13% at discharge) were identified as being malnourished across the inpatient stay. Younger age, lower Barthel index and a higher energy intake in the early stages of admission predicted the extent and rate of restoration of functional abilities by discharge (F = 7.503, P = 0.001; F = 14.558, P < 0.001). Conclusions: Given a general finding of nutritional deterioration identified for these patients, as well as the identification of energy intake as a modifiable influence on the extent and rate of recovery, there is clearly scope for the multidisciplinary development of nutritional support for stroke patients to improve rehabilitation outcomes.
Perry, L., Bellchambers, H., Howie, A., Moxey, A., Parkinson, L., Capra, S. & Byles, J.E. 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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Aim. This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Background. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. Methods. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Findings. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Conclusion. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change.
Perry, L. 2011, 'Nursing role redesign:rising to challenges or sticking in mud?', Journal of Advanced Nursing.
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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Purpose. To expand understanding of informal stroke care-giving, validated tools previously used in Hong Kong and in the UK were used with Australian stroke carers to assess their stroke-related knowledge, perceived needs, satisfaction with services received and sense of burden after stroke patients' discharge home from acute hospital care. Methods. Record audit and telephone interviews with two cohorts of 32 carers recruited in Sydney and Brisbane 1 and 3 months post-hospital discharge, using validated scales and open questions in May-July 2006. Results. Female carers, those with prior care-giving responsibility, and those interviewed at three compared to one month post-discharge reported greatest needs and burden from the care-giving role; needs alone significantly predicted burden. Getting information and being prepared for life after discharge were central concerns. Some felt this was accomplished, but inadequate information giving and communication mismatches were apparent. Conclusions. Service providers need to develop partnership working with stroke families and provide a network of services and inputs that cut across conventional boundaries between health and social care, public, private and voluntary organisations, with care plans that deliver what they delineate. Stroke care-givers have common issues across countries and healthcare systems; collaborative research-based service development is advocated.
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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Objective: The majority of stroke patients experience upper limb motor impairment and reduced ability to perform basic activities. Shoulder strapping has been reported as a beneficial adjunct to rehabilitation therapies but has not been rigorously triall
Perry, L. 2010, 'Is BMI an accurate measure of nutritional status in older people?', Nursing Times, vol. 105, no. 37, pp. 12-12.
Perry, L., Steinbeck, K., Dunbabin, J. & Lowe, J. 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.
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Objective: To document diabetes health services use and indices of glycaemic management of young people with type 1 diabetes from the time of their first contact with adult services, for those living in regional areas compared with those using city and s
Perry, L. 2010, 'Guidelines and person-centred care: the devil in the detail', Journal of Advanced Nursing.
Increasing the explicit use of evidence-based practice (EBP) is an international aim. A substantial literature has grown around this, particularly in relation to processes by which to introduce evidence-based change into clinical practice. Commonly, these entail introduction of guidelines.
Perry, L. 2010, 'Audit and feedback: examining the effectiveness of practice-based learning', Journal of Advanced Nursing.
de Brito-Ashurst, I., Perry, L., Sanders, T., Thomas, J.E., Yaqoob, M.M. & Dobbie, H. 2009, 'Dietary salt intake of Bangladeshi patients with kidney disease in East London: An exploratory case study', e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, vol. 4, no. 1, pp. e35-e40.
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Reducing dietary salt intake is a health promotion priority. This is particularly important in persons with kidney disease. Food surveys indicate that UK South Asian populations have high salt intakes, yet little is known of the cooking and eating habits of these groups. The aim of this study was to explore and describe salt-related dietary practices of Bangladeshi chronic renal failure patients.
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.
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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Purpose: To examine the support required by family carers for stroke survivors. Methods: Forty-two family carers were recruited for surveys of needs, knowledge, satisfaction, and competence in caring before and 4 - 6 weeks after discharge from an Acute Stroke Unit (ASU). Results: Information deficits about dealing with psychological, emotional, and behavioural problems and local service information were priorities before and after discharge. Younger female carers (under 56 years) were least satisfied with communication with ASU staff. Face to face contact was valued. After discharge younger female carers, particularly of non-White ethnic groups, reported lower levels of competence in caring and higher burden. Knowledge of stroke risk factors was low in all groups. High satisfaction with treatment and therapy in the ASU, was not transferred to the community. Carers reported feeling alone and described uncoordinated services. Conclusions: Carers are able to anticipate and prioritise their needs, value communication with staff and involvement with discharge-planning, but particular difficulties were experienced by younger female carers and those from non-White ethnic groups. This requires particular attention when developing targeted interventions for family carers from a mixed ethnic community. In-depth and longitudinal studies are needed to detail psychosocial needs and guide practice particularly amongst non-White family carers.
Perry, L. 2006, 'Promoting evidence-based practice in stroke care in Australia', Nursing Standard, 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. A semi-structured interview schedule was developed, piloted and used to guide interviews with academic and clinical staff in five state capital cities in Australia. Data were analysed and findings reviewed by clinical and academic participants. Four distinct but not mutually exclusive models and common but variously applied pathways for translation of evidence into clinical practice were identified. Key influential factors included context and local culture, the nature of evidence and role of clinical expertise. Implementation and change management strategies were recognised as emerging priorities.
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.
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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', Nursing Standard, 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.

Other research activity

Perry, L. 2010, 'National Clinical Guidelines for Stroke Management'.
National Clinical Guidelines for Stroke Management http://www.strokefoundation.com.au/clinical-guidelines

Reports

Perry, L. 2010, 'National Clinical Guidelines for Stroke Management', National Stroke Foundation, Melbourne, Australia, pp. 1-167.
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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. 2007, 'Profession-specific audit in stroke care: making rehab practice evidence based', St Bartholomew and Royal London Charitable Foundation December 2007, London, City University.