Abstract: The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.

Abstract: This article describes the effect of an education programme for Paediatric Intensive Care Unit (PICU) staff, developed as part of the roll out of revised clinical guidelines. In 2005, the International Liaison Committee on Resuscitation released advisory statements and a revised universal algorithm for Infant, Child and Adult Cardiopulmonary Resuscitation (CPR). Subsequently the New Zealand Resuscitation Council developed and disseminated revised guidelines for use within the New Zealand Healthcare System. Within the PICU the challenge of integrating new practice standards whilst ensuring compliance with CPR guidelines, was how to disseminate information to over 80 staff nurses working 12 hour shifts. Following implementation of an education programme, a survey completed by 20 staff members demonstrated that staff felt well supported with the introduction of the new CPR guidelines (90%) and confident that they understood the changes to the resuscitation guidelines (90%). Staff identified that the poster display (95%) and the mail sleeve “flyer” (80%) helped them understand the changes to CPR.

Abstract: This research project, a descriptive study using narratives, explored the application of cultural safety theory and philosophy to clinical nursing practice. This application was illustrated through the stories of four experienced Pakeha,Tauiwi registered nurses in Aotearoa/New Zealand, who described their realities of applying cultural safety to daily clinical practice. The incentive for this study had been identified in light of the current political climate, pragmatic realities and in keeping with the current state of knowledge.Cultural safety was first identified by Maori nursing students and subsequently described and articulated by Maori nurses, as being a potential solution to improving Maori health statistics in Aotearoa/New Zealand. Many Maori and Pakeha/Tauiwi in this country accept that the Treaty of Waitangi, a covenant signed between Maori and the Crown in 1840, is the incentive for giving cultural safety status and credibility. While the Nursing Council of New Zealand has supported this concept and made it a requirement for all nursing education, there is little literature written concerning its application to practice from a Pakeha/Tauiwi perspective.The perceptions and insights of these nurses were heard when they were invited to describe how they saw cultural safety as part of their daily clinical practice and recount their struggles, realities, practice and experience. The literature review supported the use of narratives as an appropriate method for this study. The philosophy and assumptions of narrative appear to match the oral tradition of nursing and thus it was considered possible to contemplate the fit of narrative to nursing research.The stories of these nurses, gave examples of best nursing practice in which cultural safety was integral to practice, and provided exemplars of possible beginnings and possible endings. The depiction of cultural safety in practice surfaced as the weaving of four themes which were consistent in all the stories – themes of reflection, reverencing, the environment, and hidden blessings and healing. The research evidence suggested that cultural safety was visible in practice in many diverse ways; it emphasised the complexity of the concept; accented its evolving status; and identified a relative consistency in defining cultural safety despite the varied contexts of practice.Although this study was limited by the small sample, the findings indicated that there were potential implications for nursing education, research, nurses and nursing practice as well as for other health care providers working in the current health care system. They suggested that actions from nurse educators, nurse managers, health care managers and clinical nurses themselves, would be needed to ensure that cultural safety continued to be part of nursing practice and contribute to the improvement of all health statistics in this country as well as to encourage an increased development in the focus on Maori health issues.Further nursing research suggested by the findings include studies to appraise cultural safety from a patient's perspective, and consideration given to the evaluation and assessment of nurses and their culturally safe practice. In addition, exploration and research could ascertain the benefits and rewards of culturally safe practice and identify ongoing educational needs as well as examining the views of other members of the multi-discipline team

Abstract: Rural nursing in the remote context of South Westland is shaped by factors common to rural nursing practice world-wide including geographical and professional isolation, living and working in a small community, providing health care to rural people and the broad, generalist and advanced scope of nursing practice. Tourism is a major industry in the townships in the proximity of the two accessible glaciers in South Westland. The practice of the nurses in these areas is significantly affected by tourists seeking health care and by providing a health service for the large number of migrant seasonal workers who service the tourist industry. Tourists seek health care from the nurses across the full spectrum of health problems and their expectations of the health care required may exceed the service that can be provided. The nurses are challenged to advance their practice to find the personal and professional resources to provide a safe service. This includes the challenge of cultural safety and personal safety. The tourist industry brings significant numbers of young people as seasonal/temporary workers to the glacier areas. This imposes a youth culture onto the existing rural culture. Nursing practice has expanded to include the specialist practice of youth health care that includes the problems of alcohol and drug misuse, sexual and reproductive health, and youth mental health. This work is drawn from the experience of the nurses working in the glacier communities. The impact of the tourism industry on their rural nursing practice includes the increasing volume of work that challenges the viability of the service, the advanced scope of practice required to meet the health needs of tourists and the seasonal tourist industry workers, and challenges to personal and professional safety.

Abstract: This thesis provides a reflexive critique of the power structures which constrain nursing actions in the practice setting, an abortion clinic, of the registered nurses who participated in this study. The development of abortion services, like other health services for women, has been based on a medical ideology of health which has created many ethical dilemmas for nurses. One of the most complex of these is the extent to which nurses should fulfil the role of client advocate. While the literature on nursing advocacy has been prolific, published research in this area is scant.The theoretical assumptions of critical social science, provide the basis for the methodological approach of action research adapted in this study. In depth, unstructured interviews involving exchange of dialogue amongst the participants with the researcher focused on the participants' experiences of their own nursing practice, with a view to uncoveing and removing restrasints, which had prevented them fulfililng an advocacy role. Diaries were also kept and used as supplementary research tools.The analysis of the data demonstrates the ways in which nurses interpret their own practice world as a system independent of their own actions. It shows how the shared understandings of the participants were 'ideologically frozen' and power relations inherent in the health care system are deep rooted and subtle, coming to be treated as natural by the nurses, and so denying them their own ability to make changes.It is suggested that opportunities for nurses coming together and engaging in such critically reflexive dialogue may provide a basis for future emancipation from traditional power structures. In this way effective and satisfying nursing practice dependent on emancipatory knowledge and a reinterpretation of power structures may result in an advocacy role for nurses

Abstract: Investigates wheether the impact of a co-located psychological service to which Primary Care Providers cn refer patients with mild to moderate mental health needs, would impact on the well-being of the providers at work. Describes Focused Acceptance and Commitment Therapy (FACT) services delivered by psychologists working in a a large primary care practice in the lower North Island. Conducts interviews with GPs, nurse practitioners (NP) and registered nurses (RN), analysing the data using thematic analysis. Finds an inverse relationship between the FACT service and the well-being of staff.

Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.