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Author Walsh, K.; Moss, C.; Lawless, J.; McKelvie, R.; Duncan, L.
Title Puzzling practice: A strategy for working with clinical practice issues Type Journal Article
Year 2008 Publication International Journal of Law and Psychiatry Abbreviated Journal
Volume 14 Issue 2 Pages 94-100
Keywords Nursing philosophy; Clinical decision making; Problem solving
Abstract The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
Call Number (down) NRSNZNO @ research @ Serial 838
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Author Atherfold, C.
Title Will someone walk with me? A case study exploration of graduate nurses' perceptions of the preceptored experience Type
Year 2008 Publication Abbreviated Journal Unitec New Zealand Library
Volume Issue Pages
Keywords Preceptorship; New graduate nurses
Abstract The transition from student to registered nurse is a challenging and often stressful time in a nurse's career. This thesis is a case study research project that explores the graduate nurses' perceptions of preceptorship as a strategy to support this transition at Lakes District Health Board (DHB). As a provider of graduate nurse programmes since 1995, Lakes DHB has provided preceptorship for the nurse in the initial period of clinical practice. Annual evaluation by questionnaire identified that this has been applied in a range of ways in different clinical settings with varying degrees of effectiveness. Further inquiry into graduate nurses' perceptions of the preceptored experience during the first twelve weeks of practice within Lakes DHB forms the basis of this research project. The intention is to utilise this insight to further inform the development of preceptor education programmes and application of the preceptor role in the practice setting. Using the case study research method, data has been collected from fourteen participants using semi-structured interviews, focus groups and secondary data from the previous year's questionnaire undertaken by preceptors and graduate nurses. Thematic analysis of the data has resulted in two categories, each with three associated themes. The first category relates to functional factors in the way the preceptorship role is applied. This explores the role of the Clinical Nurse Educator (CNE), organisation within the unit and the teaching of clinical skills. The second category relates to psychosocial considerations and includes the graduate's sense of being scared and advocacy of the preceptor, socialisation and team support, and the preceptor's own experience as a registered nurse. Recommendations from the research include the allocation of a dedicated preceptor selected with consideration for relational ability; complementary rostering and workload allocation to ensure that the preceptor and graduate nurse work together; early notification when preceptor arrangements break down; implementation of a clinical coaching plan; and strengthening the CNE's role as a leader facilitating and supporting preceptorship in the units. Opportunities for further research that arise from the study include the perceptions of the preceptors and the nursing leadership in clinical areas. Structuring the application of preceptorship, to ensure that all of these aspects are woven throughout the graduate nurse's transition results in Korowai Aroha, a cloak of covering for a supported transition that facilitates the development of practice.
Call Number (down) NRSNZNO @ research @ Serial 866
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Author Honeyfield, Margy
Title The necessity of effective nursing leadership for the retention of professional hospital nurses Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages 64
Keywords Recruitment and retention; Leadership; Nursing; Policy
Abstract The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise.
Call Number (down) NRSNZNO @ research @ Serial 868
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Author Dredge, A.
Title Satisfaction with and importance of selected preceptor characteristics: A new graduate perspective Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords New graduate nurses; Preceptorship; Training
Abstract This pilot descriptive study examines and measures the characteristics of preceptors of new graduate registered nurses undertaking the Nurse Entry to Practice Programme in an acute hospital in New Zealand. Thirty-three new graduate registered nurses at the five month stage of the programme completed a questionnaire pertaining to the characteristics of their preceptors. The questionnaires were adapted from the Ferrans and Powers (1998) Quality of Life Questionnaire. The adapted questionnaires were designed to measure the importance, satisfaction and overall quality of the preceptor's characteristics as perceived by the new graduate registered nurse, using a Likert Scale. Literature both international and national was examined to gain an understanding of the importance of the characteristics in question, in relation to the new graduate registered nurse preceptee experience. Descriptive data revealed the importance of characteristics as perceived by the new graduate nurse preceptee, and how satisfied the new graduate nurse was with their particular preceptor's characteristics. The results identified that the majority of new graduates were satisfied with the characteristics of their preceptor but there was evidence of negative discrepancies between the mean importance and satisfaction scores. The range of data between the scores of the overall quality of the preceptor uncovered areas where the quality of preceptorship was unsatisfactory as perceived by the new graduate nurse. The discrepancies in the data were examined and recommendations made for additional research, regarding selection and evaluation of preceptors of the new graduate registered nurse within the hospital environment.
Call Number (down) NRSNZNO @ research @ Serial 912
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Author Farmer, D.
Title Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Primary health care; Nursing
Abstract The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community.
Call Number (down) NRSNZNO @ research @ Serial 913
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Author Harry, J.
Title Professional development in nursing through the pages of Kai Tiaki: A comparative analysis – 1920 to 1930 and 2000 to 2006 Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Professional development; Nursing
Abstract Kai Tiaki, first published in New Zealand in 1908, provides a means of communication among New Zealand nurses. It is currently the journal of the New Zealand Nurses Organisation members and previously was aligned to the New Zealand Trained Nurses' Association in the 1920s. This dissertation examines what nurses write about professional development through the pages of Kai Tiaki. Two time periods are examined, 1920 to 1930 and 2000 to 2006.

Central to the discussion on professional development is post-registration education. Post-registration education in nursing commenced in New Zealand in 1928, and has progressed to the current day where nurses can engage in post-graduate nursing to master and doctoral level. Kai Tiaki provides a channel for nurses to discuss and debate their thoughts on post-registration and post-graduate education. Two key themes emerge from analysis. Firstly, the survival mode of nurses highlights oppression as a contributing factor to professional development. Secondly, examining the role of the New Zealand Trained Nurses Association (1920s) and the New Zealand Nurses Organisation (2000s) presents an understanding of the political nature of the journal itself and how this influences professional development. This dissertation provides critical reflection on professional development for nurses through the pages of Kai Tiaki and provides suggestions for future research.
Call Number (down) NRSNZNO @ research @ Serial 916
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Author Johnson, H.
Title Clinical trials in the intensive care setting: A nursing perspective Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Evaluation; Intensive care nursing
Abstract As carers of patients who are clinical research participants, nurses' contribution to the success of clinical trials is acknowledged in the literature. Ethical dilemmas and challenges that clinical trials may present for nurses are also recognised. Although there is some discussion regarding these issues, few studies explore and identify the perceptions of intensive care nurses regarding clinical trials and how they may impact on nursing practice. This thesis explores and describes the viewpoints and experiences of sixty intensive care nurses from a tertiary level referral centre in New Zealand engaged in clinical research activities. The descriptive study utilised a self-administered questionnaire to gather information regarding nurses' roles in clinical trials, associated issues encountered and contributory factors, and the impact of issues on nursing practice, stress and satisfaction levels. Suggestions for potential strategies to minimise the impact of issues on nurses' practice were also sought. Descriptive statistical and content data analyses identified three key areas in which nurses' encounter issues associated with clinical trials and their practice: nurses' workload; ethical concerns; educational preparation and support. The findings indicate that, when issues exist in these areas, routine patient care can be delayed, the enactment of nurses' patient advocacy role can be affected, and nurses' stress and satisfaction levels can be negatively impacted upon. The perceptions of a group of intensive care nurses who are enveloped in the daily balance of patient care, the need for clinical research, and their professional obligations are discussed in this thesis. While the study's findings are reflective of one group of nurses in a distinct practice setting, their experiences can prompt other nurses, research teams and clinical leaders to reflect upon their own clinical research environment.
Call Number (down) NRSNZNO @ research @ Serial 923
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Author Koorey, R.
Title Is there a place for clinical supervision in perioperative nursing? Type Journal Article
Year 2008 Publication Dissector Abbreviated Journal
Volume 35 Issue 4 Pages 15-17
Keywords Nursing models; Clinical supervision; Nursing specialties
Abstract This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided.
Call Number (down) NRSNZNO @ research @ Serial 928
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Author Tweed, C.; Tweed, M.
Title Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program Type Journal Article
Year 2008 Publication American Journal of Critical Care Abbreviated Journal
Volume 17 Issue 4 Pages 338-347
Keywords Intensive care nursing; Training; Evaluation
Abstract The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.
Call Number (down) NRSNZNO @ research @ Serial 958
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Author Harding, T.S.; North, N.; Perkins, R.
Title Sexualizing men's touch: Male nurses and the use of intimate touch in clinical practice Type Journal Article
Year 2008 Publication Research & Theory for Nursing Practice Abbreviated Journal
Volume 22 Issue 2 Pages 88-102
Keywords Male nurses; Nurse-patient relations; Gender
Abstract Drawn from a larger study, this article reports the experiences of a group of male nurses regarding the use of intimate physical touch. Using discourse analysis, interview data from 18 male nurses were analysed and related to existing text on men as nurses. The analysis reveals that although touch is important in nursing care, it is problematic for men because discourses have normalised women's use of touch as a caring behaviour and have sexualised men's touch. Participants described their vulnerability, how they protected themselves from risk, and the resulting stress. The complicity of nurses in sexualising men's touch and the neglect of educators in preparing men for providing intimate care are revealed. A paradox emerged whereby the very measures employed to protect both patients and men as nurses exacerbate the perceived risk posed by men carrying out intimate care. The authors suggest that deconstructing and reframing prevailing discourses around nursing, gender, and caring involving touch can help to legitimise men's involvement in physical caring.
Call Number (down) NRSNZNO @ research @ Serial 960
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Author Kent, B.
Title Surgeon assistant's role within the New Zealand health care setting Type Journal Article
Year 2008 Publication Dissector Abbreviated Journal
Volume 36 Issue 1 Pages 20-27
Keywords
Abstract This article examines the role of the surgeon assistant, identifying and discussing the factors that have stimulated the development globally and the present situation within the New Zealand health care setting. This article offers thought-provoking material that aims to provide the perioperative nurse with a clearer direction and purpose to practice, and to what the future may hold.
Call Number (down) NRSNZNO @ research @ Serial 961
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Author Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J.
Title Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units Type Journal Article
Year 2008 Publication Journal of Clinical Nursing Abbreviated Journal
Volume 17 Issue 8 Pages 1035-1043
Keywords Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison
Abstract The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.
Call Number (down) NRSNZNO @ research @ Serial 962
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Author Kool, B.; Thomas, D.; Moore, D.; Anderson, A.; Bennetts, P.; Earp, K.
Title Innovation and effectiveness: Changing the scope of school nurses in New Zealand secondary schools Type Journal Article
Year 2008 Publication Australian & New Zealand Journal of Public Health Abbreviated Journal
Volume 32 Issue 2 Pages 177-180
Keywords School nursing; Maori; Pacific peoples; Socioeconomic factors; Evaluation; Scope of practice
Abstract The aim of this research was to describe the changing role of school nurses in eight New Zealand secondary schools from low socio-economic areas with high Pacific Island and Maori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland(2002-05) was made. Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. The researchers conclude that school nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. The researchers go on to say that co-ordination of school nurses either at a regional or national level is required.
Call Number (down) NRSNZNO @ research @ Serial 963
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Author Curtis, K.; Donoghue, J.
Title The trauma nurse coordinator in Australia and New Zealand: A progress survey of demographics, role function, and resources Type Journal Article
Year 2008 Publication Journal of Trauma Nursing Abbreviated Journal
Volume 15 Issue 2 Pages 34-42
Keywords Emergency nursing; Personnel; Nurse managers; Economics
Abstract An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective
Call Number (down) NRSNZNO @ research @ Serial 964
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Author Diers, D.
Title “Noses and eyes”: Nurse practitioners in New Zealand Type Journal Article
Year 2008 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 24 Issue 1 (Mar) Pages 4-10
Keywords Cross-cultural comparison; Nurse practitioners; History of nursing
Abstract Principles for understanding and evolving nurse practitioner practice, politics and policy are distilled from 40 years of experience in the United States and Australia. The issues in all countries are remarkably similar. The author suggests that some historical and conceptual grounding may assist the continuing development of this expanded role for nursing in New Zealand.
Call Number (down) NRSNZNO @ research @ Serial 965
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