Bronagh Walsh | University of Southampton (original) (raw)
Papers by Bronagh Walsh
Annals of internal …, Jan 1, 2004
BMJ, Jan 1, 2001
To compare post-acute intermediate care in an inpatient nurse-led unit with conventional post-acu... more To compare post-acute intermediate care in an inpatient nurse-led unit with conventional post-acute care on general medical wards of an acute hospital and to examine the model of care in a nurse-led unit. Randomised controlled trial with six month follow up. Urban teaching hospital and surrounding area, including nine community hospitals. 238 patients accepted for admission to nurse-led unit. Care in nurse-led unit or usual post-acute care. Patients' length of stay, functional status, subsequent move to more dependent living arrangement. Inpatient length of stay was significantly longer in the nurse-led unit than in general medical wards (14.3 days longer (95% confidence interval 7.8 to 20.7)), but this difference became non-significant when transfers to community hospitals were included in the measure of initial length of stay (4.5 days longer (-3.6 to 12.5)). No differences were observed in mortality, functional status, or living arrangements at any time. Patients in the nurse-led unit received significantly fewer minor medical investigations and, after controlling for length of stay, significantly fewer major reviews, tests, or drug changes. The nurse-led unit seemed to be a safe alternative to conventional management, but a full accounting of such units' place in the local continuum of care and the costs associated with acute hospitals managing post-acute patients is needed if nurse-led units are to become an effective part of the government's recent commitment to intermediate care.
Journal of Advanced …, Jan 1, 2001
Nurse-led intermediate care units are being set up across the UK primarily as potential solutions... more Nurse-led intermediate care units are being set up across the UK primarily as potential solutions to hospital bed crises. This paper draws on data collected as part of a comprehensive evaluation of one 10-bedded nurse-led unit (NLU) located in the South of England. It explores the potential for enhanced nursing roles provided by such units by focusing on the views of NLU nursing staff and other professional groups within the Hospital Trust where the unit is located. A total of 38 in-depth audio-taped qualitative interviews were conducted with NLU nursing staff and with a range of other professional groups (managers, acute ward nurses and doctors). These data indicated that models of nurse-led postacute care do provide opportunities for nurses to develop enhanced nursing roles in which care associated with concepts of therapeutic nursing can be provided. However, even though the nurses derived satisfaction from their work on the NLU this model of care was seen by junior and middle grade nurses and other professional groups as being of low status. In contrast to senior nurses' views, they did not equate work on the NLU with the continuing professionalization of nursing. Senior nurses viewed the route to developing nursing on the NLU as involving nurses as doctor substitutes (extended roles) rather than as working in separate but complementary therapeutic domains (enhanced roles). NLUs provide opportunities for nurses to develop enhanced roles in which they can work autonomously in providing elements of therapeutic nursing aimed at improving patient outcomes at discharge. However, education, training and leadership will be needed to ensure that such opportunities are well understood and are optimized to the benefit of nurses and their patients.
![Research paper thumbnail of Nurse-Led Inpatient Care: Opening the [] Black Box'](https://attachments.academia-assets.com/51406670/thumbnails/1.jpg)
](International journal of …, Jan 1, 2003
Clinical Effectiveness in Nursing, Jan 1, 1999
International journal of nursing …, Jan 1, 2003
Journal of Clinical …, Jan 1, 2007
Biological Research For …, Jan 1, 2010
During the aging process, remodeling of several body systems occurs, and these changes can have a... more During the aging process, remodeling of several body systems occurs, and these changes can have a startling effect upon the immune system. The reduction in sex steroids and growth hormones and declines in vitamin D concentration that accompany the aging process are associated with increases in the baseline levels of inflammatory proteins. At the same time, inflammation arising from atherosclerosis and other chronic diseases further contributes to the inflammatory milieu and effects a state of chronic inflammation. This chronic inflammation, or ''inflammaging'' as it has been termed, seems to be associated with a host of adverse effects contributing to many of the health problems that increase morbidity and decrease both quality of life and the ability to maintain independence in old age. For nurses to be truly informed when caring for older people and to ensure that they have a detailed understanding of the complexities of older people's health needs, they must have a knowledge of the physiological and immunological changes with age. This is the first of a two-part article on inflammatory processes in aging. These age-related changes are presented here, including an examination of the impact of genetic and lifestyle factors. The effect of these changes on the health of the individual and implications for practice are described in Part 2.
Biological Research For …, Jan 1, 2010
Aging is accompanied by declining function and remodeling of body systems. In particular, changes... more Aging is accompanied by declining function and remodeling of body systems. In particular, changes to the immune and endocrine systems have far-reaching effects that cause an increase in cytokine release and decrease in anti-inflammatory feedback systems. The chronic inflammation that ensues has been named ''inflammaging.'' Inflammaging is associated with many detrimental effects that combine to increase morbidity and mortality. The sickness behavior that arises from inflammatory processes and the side effects of chronic diseases lead to a constellation of symptoms that decrease quality of life and affect the well-being of the individual. Part 2 of this two-part article provides an overview of the health effects of inflammaging, addressing the extent to which it contributes to the syndromes of frailty and disability with aging.
Age and ageing, Jan 1, 2005
International Journal of …, Jan 1, 2007
Age and ageing, Jan 1, 2008
BMJ, Jan 1, 2005
... Divisions: Faculty of Medicine, Health and Life Sciences > School of Health Sciences. ... more ... Divisions: Faculty of Medicine, Health and Life Sciences > School of Health Sciences. ID Code: 162307. Deposited By: Dr Bronagh Walsh. Deposited On: 19 Aug 2010 11:52. Last Modified: 20 Aug 2010 01:51. Associated Staff Only: edit my ePrint. ...
Journal of Clinical Nursing, Jan 1, 2007
... Dr Magi Sque, Senior Lecturer, School of Nursing and Midwifery The unpopular researcher: how ... more ... Dr Magi Sque, Senior Lecturer, School of Nursing and Midwifery The unpopular researcher: how can researchers and clinicians work together to make the best use of unexpected research findings. Dr Bronagh Walsh, Senior Lecturer, School of Nursing and Midwifery ...
Annals of internal …, Jan 1, 2004
BMJ, Jan 1, 2001
To compare post-acute intermediate care in an inpatient nurse-led unit with conventional post-acu... more To compare post-acute intermediate care in an inpatient nurse-led unit with conventional post-acute care on general medical wards of an acute hospital and to examine the model of care in a nurse-led unit. Randomised controlled trial with six month follow up. Urban teaching hospital and surrounding area, including nine community hospitals. 238 patients accepted for admission to nurse-led unit. Care in nurse-led unit or usual post-acute care. Patients' length of stay, functional status, subsequent move to more dependent living arrangement. Inpatient length of stay was significantly longer in the nurse-led unit than in general medical wards (14.3 days longer (95% confidence interval 7.8 to 20.7)), but this difference became non-significant when transfers to community hospitals were included in the measure of initial length of stay (4.5 days longer (-3.6 to 12.5)). No differences were observed in mortality, functional status, or living arrangements at any time. Patients in the nurse-led unit received significantly fewer minor medical investigations and, after controlling for length of stay, significantly fewer major reviews, tests, or drug changes. The nurse-led unit seemed to be a safe alternative to conventional management, but a full accounting of such units' place in the local continuum of care and the costs associated with acute hospitals managing post-acute patients is needed if nurse-led units are to become an effective part of the government's recent commitment to intermediate care.
Journal of Advanced …, Jan 1, 2001
Nurse-led intermediate care units are being set up across the UK primarily as potential solutions... more Nurse-led intermediate care units are being set up across the UK primarily as potential solutions to hospital bed crises. This paper draws on data collected as part of a comprehensive evaluation of one 10-bedded nurse-led unit (NLU) located in the South of England. It explores the potential for enhanced nursing roles provided by such units by focusing on the views of NLU nursing staff and other professional groups within the Hospital Trust where the unit is located. A total of 38 in-depth audio-taped qualitative interviews were conducted with NLU nursing staff and with a range of other professional groups (managers, acute ward nurses and doctors). These data indicated that models of nurse-led postacute care do provide opportunities for nurses to develop enhanced nursing roles in which care associated with concepts of therapeutic nursing can be provided. However, even though the nurses derived satisfaction from their work on the NLU this model of care was seen by junior and middle grade nurses and other professional groups as being of low status. In contrast to senior nurses' views, they did not equate work on the NLU with the continuing professionalization of nursing. Senior nurses viewed the route to developing nursing on the NLU as involving nurses as doctor substitutes (extended roles) rather than as working in separate but complementary therapeutic domains (enhanced roles). NLUs provide opportunities for nurses to develop enhanced roles in which they can work autonomously in providing elements of therapeutic nursing aimed at improving patient outcomes at discharge. However, education, training and leadership will be needed to ensure that such opportunities are well understood and are optimized to the benefit of nurses and their patients.
International journal of …, Jan 1, 2003
Clinical Effectiveness in Nursing, Jan 1, 1999
International journal of nursing …, Jan 1, 2003
Journal of Clinical …, Jan 1, 2007
Biological Research For …, Jan 1, 2010
During the aging process, remodeling of several body systems occurs, and these changes can have a... more During the aging process, remodeling of several body systems occurs, and these changes can have a startling effect upon the immune system. The reduction in sex steroids and growth hormones and declines in vitamin D concentration that accompany the aging process are associated with increases in the baseline levels of inflammatory proteins. At the same time, inflammation arising from atherosclerosis and other chronic diseases further contributes to the inflammatory milieu and effects a state of chronic inflammation. This chronic inflammation, or ''inflammaging'' as it has been termed, seems to be associated with a host of adverse effects contributing to many of the health problems that increase morbidity and decrease both quality of life and the ability to maintain independence in old age. For nurses to be truly informed when caring for older people and to ensure that they have a detailed understanding of the complexities of older people's health needs, they must have a knowledge of the physiological and immunological changes with age. This is the first of a two-part article on inflammatory processes in aging. These age-related changes are presented here, including an examination of the impact of genetic and lifestyle factors. The effect of these changes on the health of the individual and implications for practice are described in Part 2.
Biological Research For …, Jan 1, 2010
Aging is accompanied by declining function and remodeling of body systems. In particular, changes... more Aging is accompanied by declining function and remodeling of body systems. In particular, changes to the immune and endocrine systems have far-reaching effects that cause an increase in cytokine release and decrease in anti-inflammatory feedback systems. The chronic inflammation that ensues has been named ''inflammaging.'' Inflammaging is associated with many detrimental effects that combine to increase morbidity and mortality. The sickness behavior that arises from inflammatory processes and the side effects of chronic diseases lead to a constellation of symptoms that decrease quality of life and affect the well-being of the individual. Part 2 of this two-part article provides an overview of the health effects of inflammaging, addressing the extent to which it contributes to the syndromes of frailty and disability with aging.
Age and ageing, Jan 1, 2005
International Journal of …, Jan 1, 2007
Age and ageing, Jan 1, 2008
BMJ, Jan 1, 2005
... Divisions: Faculty of Medicine, Health and Life Sciences > School of Health Sciences. ... more ... Divisions: Faculty of Medicine, Health and Life Sciences > School of Health Sciences. ID Code: 162307. Deposited By: Dr Bronagh Walsh. Deposited On: 19 Aug 2010 11:52. Last Modified: 20 Aug 2010 01:51. Associated Staff Only: edit my ePrint. ...
Journal of Clinical Nursing, Jan 1, 2007
... Dr Magi Sque, Senior Lecturer, School of Nursing and Midwifery The unpopular researcher: how ... more ... Dr Magi Sque, Senior Lecturer, School of Nursing and Midwifery The unpopular researcher: how can researchers and clinicians work together to make the best use of unexpected research findings. Dr Bronagh Walsh, Senior Lecturer, School of Nursing and Midwifery ...