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Biomedical subjects

J Pearse

Publications and source records attributed to J Pearse.

13 recordsLinked to original sources
PubMed2000

Designing a nationally acceptable system of hospital peer grouping.

Little has been published on the design, use and evaluation of peer groupings of hospitals. This article explores the issue in the context of public hospitals in New South Wales. The process, established over the last two years by New South Wales Health, aims to meet six principles of peer grouping. Through a six-step procedure, the methodology focuses on the classification of hospitals by role, size and measure of acuity. Further research is needed to compare benchmarking across States and to identify which of the methodologies should be adopted nationally.

Hospitals, Public↗
PubMed1998

Casemix funding in rural NSW: exploring the effects of isolation and size.

The New South Wales Department of Health (NSW Health) wishes to make appropriate use of casemix data as inputs to the determination of funding levels for small rural hospitals. However, other factors such as hospital size and degree of isolation might need to be taken into account. The study reported here involved correlation of actual expenditures with those predicted by use of a casemix model alone, across 105 small public hospitals in the State. We then explored the extent to which the correlation could be increased by the addition of distance and isolation variables. It was found that actual costs were highly correlated with those predicted from the casemix data alone, and that the correlation increased when both the distance and the size variables were introduced. However, contrary to expectations, reduced size was associated with reduced costs, and reduced isolation was associated with increased costs. It was concluded that, while the predicted relationships may be present, they are likely to be relatively weak and are probably being masked by other factors not present in the model. In particular, it seems likely that there are variations in severity within the acute admitted patient category which are not fully explained by the casemix instrument used in this study (the DRG classification). We suggest that other terms be introduced to control for this possibility before any further attempt is made to test whether size and distance factors can be identified which work in the expected direction.

Catchment Area, Health↗
PubMed1992

Infection control. Nursing management of a patient with hepatitis A and B.

The Infection Control precautions for hepatitis B are those of "Blood and Body Fluid Precautions" and those of "Universal Precautions". Gloves, preferably latex, are worn when there is to be contact with blood and body fluid. Goggles/masks are worn when there is a danger of splashing or aerosol of blood-contaminated secretions. A plastic apron, or water repellant gown, may be indicated if there is a danger of splashing. Hand washing before and after contact with blood and body fluid, even if gloves are worn. Specimens are treated as biohazard. Refuse and linen are treated as infectious. It is important to establish if the patient is in the acute phase, a carrier, or not. Education of the patient about the disease, is very important, especially in the carrier. This poses a problem when there is a language barrier. This is a sensitive subject and must be handled tactfully, especially if the mode of transmission was sexual. Safe sex must be discussed. The partner, and the newborn baby must be assessed and immunised. The transmission of hepatitis A is mainly faeco-oral, and the infection control measures those called "Enteric Precautions", or blood and body fluid precautions. These include the wearing of latex gloves when handling faeces, urine, saliva, and blood. Handwashing is essential. The patient has his own bedpan, urinal, crockery and cutlery. Isolation is continued for the first two weeks of the illness, and one week after the onset of jaundice. The Infection Control management for hepatitis A is slightly different to that of hepatitis B, C, and Non-A Non-B.

Cross Infection↗