Biomedical subjects

V F Irurita

Publications and source records attributed to V F Irurita.

6 recordsLinked to original sources

PubMed2001

Balancing and compromising: nurses and patients preserving integrity of self and each other.

This paper brings together the perspective of both nurses and patients of the experience of nursing care delivery in acute care hospital settings. Initially, two grounded theory studies of the phenomenon of high-quality nursing care were conducted concurrently and in the same settings; one focussed on patients' experiences (Irurita, 1993. From person to patient: nursing care from the patient's perspective. Department of Nursing Research, Sir Charles Gairdner Hospital), the other on those of nurses (Williams, 1994. Unpublished report, Department of Nursing Research Sir Charles Gairdner Hospital, Perth, Western Australia). Similarities between the findings of both studies led the authors, using grounded theory methods, to re-examine and compare the findings and raw data, with additional data collected by theoretical sampling. The previous findings were integrated and extended, resulting in the development of a theory of Balancing and Compromising in response to the shared problem of threats to integrity, especially encountered when broader environmental and contextual conditions were unfavourable. This reciprocal process used by nurses and patients to preserve their own and each other's integrity involved: contributing to care--cooperating; prioritising and rational sacrificing; justifying compromised care and lowering expectations; and protecting self by attracting or repelling. Both positive and negative outcomes resulted.

Acute Disease↗

PubMed1999

The problem of patient vulnerability.

In a recent study undertaken in Western Australia to explore the quality of nursing care from the perspective of adult patients in acute care hospitals, the core problem found to be shared by the study participants was that of vulnerability. The study used grounded theory method and the main source of data was in-depth interviews with 23 patients following discharge from an array of hospitals. Vulnerability was related to an inability to retain control of their life situation and/or to protect themselves against threats to their integrity (physical and emotional wholeness, intactness). Different levels of vulnerability were found to indicate different types of nursing intervention in order to achieve positive outcomes in terms of patient satisfaction. Specific factors causing and contributing to patient vulnerability were identified. This paper presents these aspects of the study findings. Measures for reducing vulnerability are proposed.

Activities of Daily Living↗

PubMed1999

Factors affecting the quality of nursing care: the patient's perspective.

The study described in this paper explored the adult patient's perspective of quality nursing care in acute-care hospital settings in Western Australia. Using grounded theory methodology, the author sought also to discover factors perceived by patients to influence the delivery of high quality nursing care. The findings revealed that patients perceived different levels, in terms of quality, of the care delivered. The level of quality of care was found to depend on certain contextual and intervening conditions pertaining to the broader environment, the organisation and personal factors of the nurse and patient. Variations in patient satisfaction and patients' feelings of vulnerability were related to the levels of care they received. The factors perceived by patients as either inhibiting or enhancing the quality of nursing care are the focus of this paper.

Acute Disease↗

PubMed1994

Optimism, values, and commitment as forces in nursing leadership.

In a grounded theory study of nursing leadership undertaken in Western Australia, a substantive theory of optimizing as a leadership process was developed. In a context of repression and turbulence, optimizing meant "making the best of the situation, making optimal use of available and potential resources." The author discusses the aspects of the leaders' optimism, values, and commitment, and how these variables appeared to influence the level of optimizing attempted or achieved.

Attitude of Health Personnel↗

PubMedDate not supplied

Therapeutically conducive relationships between nurses and patients: an important component of quality nursing care.

The relationship between nurses and patients was identified as an important component of quality nursing care in two grounded theory studies carried out concurrently in Perth, Western Australia. Interviews with 22 nurses and 23 patients provided the primary sources of data. Analysis was performed using the constant comparative method. Comparison of the findings of these two studies focussed on aspects of the nurse-patient relationship and revealed additional information concerning the establishment of relationships, the association with quality nursing care, as well as factors influencing relationship development. This research demonstrated that the overriding contextual condition needed for relationship development was the availability of adequate time.

Attitude of Health Personnel↗

PubMedDate not supplied

How nurses can survive under DRGs.

In an attempt to arrest spiralling health care costs, the US in April 1983 took the bold step of changing the method of payment for government-paid inpatient services from a cost-based retrospective reimbursement system to a prospective payment system (PPS) based on diagnosis related groups (DRGs). Since then Medicare payments to hospitals have been based on a fixed predetermined payment per case, discharge or per diem, or an overall revenue limitation, regardless of costs actually incurred. Naturally, this method has fostered fundamental changes throughout the US health care system, particularly for nursing: among them, the reduction of nursing staff and nurses resuming some functions previously taken over by ancillary staff. While the pros and cons of DRGs continue to create controversy, their use in planning and management of hospitals is being seriously explored in at least seven other countries, including Australia. "Should Australia adopt DRGs, what will be the effects on the health care services?" asks Vera F. Irurita, the author of the following article. But in the meantime, she places a call to nurses to start now to prepare for the future challenge...for their own survival.

Australia↗