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.

Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.

Abstract: Recent Nursing Council of New Zealand guidelines for competence-based practising certificates and the fact that all nurse educators must have a current practising certificate prompted the Nursing Schools within the Tertiary Accord of New Zealand (TANZ) to explore issues surrounding current competency in practice and how this can be maintained by nurse educators. The authors note that discussions related to competence-based practising certificates generally refer to competence only in terms of direct patient care. They set out to clarify the issue with specific reference to nurse educators who, by the nature of their scope of practice, often do not carry a patient caseload. They review the literature relating to currency of practice and draw on the findings of a survey of TANZ Nursing Schools and provide a position on how currency of practice applies to nurses working in an educational setting. They present strategies to maintain clinical, teaching and scholarly currency and make some suggestions for providing evidence that currency of practice is maintained.

Abstract: Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursing, is the Nursing Council of New Zealand. In 2002 a tool was developed to measure knowledge and attitudes of the then CCP which was tested with 239 nurses. This paper is a report on the second application of the tool in the same hospital in New Zealand. Results show that knowledge and attitudes of the PDRP are similar to those found in the previous study. It also suggests that greater understanding of the PDRP and the implementation process increases the likelihood of a positive response to the programme.

Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.

Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.

Abstract: This article draws on Australian experience to gain insight to three specific areas of health assessment that are topical in New Zealand, which has recently introduced the concept into nursing training. The issues are annual registration based on evidence of competence to practice, a review of undergraduate curricula, and the development of nurse practitioner/advanced nurse practitioner roles. The meaning of the concept 'health assessment' is also clarified in order to provide consistency as new initiatives in nursing are currently being developed.