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Author Brookes, K.
Title Moving stories from nurses in flight Type
Year 2001 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Nursing specialties; Advanced nursing practice; Intensive care nursing; Feminist critique
Abstract This thesis contains a collection of stories gifted by four New Zealand Retrieval Team nurses who are experienced in the transport of patients. These nurses are commonly called flight nurses and they assist in the transport of patients via helicopter, fixed-wing aeroplane, large commercial aeroplanes and ambulances. While their practice is not exclusively in the helicopter there is an emphasis on this mode of transport in this thesis. Flight nursing is a scope of nursing practice where the use, and visibility, of nurses' stories is rare. The specific context of this research is positioned in one tertiary intensive care unit in New Zealand but it is anticipated that the stories from four flight nurses and the author's subsequent thoughts on them will resonate with flight nurses in other regions. The stories were collected using a storytelling methodology that has been informed by qualitative and feminist perspectives. The stories were either gathered and shaped using interview and transcription techniques with the storyteller and the researcher, or written by the storyteller. The thesis has been written as a narrative and chronicles the journey to the point of receiving the stories and the lines of inquiry in which they subsequently directed the author. The stories are central to this research and appear in their entirety. The reader is encouraged to create their own meaning from the stories. The stories themselves have several common threads, which are planning, communication, teamwork and the unexpected. The threads underpinning the stories are not unique to flight nursing practice and have been discussed in other scopes of practice. One area the author has chosen to explore in more depth is the impacts of technology, privacy, narrative pedagogy and disenfranchisement on the visibility of flight nurses' stories. The other area she has chosen for discussion is advanced and specialty nursing practice as it relates to flight nurses. As a result of this discussion she proposes her own view for advanced and specialty practice in flight nursing.
Call Number NRSNZNO @ research @ Serial 918
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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 (up) 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 NRSNZNO @ research @ Serial 923
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Author Hardcastle, J.
Title What is the potential of distance education for learning and practice development in critical care nursing in the South Island of New Zealand? Type
Year 2003 Publication Abbreviated Journal Massey University Library
Volume Issue (up) Pages
Keywords Intensive care nursing; Nursing; Education
Abstract
Call Number NRSNZNO @ research @ Serial 1116
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Author Ryder-Lewis, M.
Title Reliability study of the Sedation-Agitation Scale in an intensive care unit Type
Year 2004 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue (up) Pages
Keywords Intensive care nursing; Interprofessional relations
Abstract This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience.
Call Number NRSNZNO @ research @ Serial 1203
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Author Rummel, L.
Title Safeguarding the practices of nursing: The lived experience of being-as preceptor to undergraduate student nurses in acute care settings Type
Year 2001 Publication Abbreviated Journal Massey University, Albany, Library
Volume Issue (up) Pages
Keywords Preceptorship; Nursing; Education; Identity; Intensive care nursing
Abstract This thesis used a Heideggerian Hermeneutic approach to explore the experiences of registered nurses who act as preceptors to undergraduate student nurses. The researcher interviewed fifteen volunteer registered nurses twice as preceptors to investigate their experience. The data generated was audio-taped and analysed. Four dominant themes emerged. The first, 'Becoming attuned – the call', related to registered nurses responding to the call to be preceptors to students in their clinical placement. The second, “The emerging identity of being-as preceptor: keeping the student in mind”, related to preceptors cultivating their own identity as preceptors as they worked with students in the world of nursing practice. The third, 'Assessing where the student is at: the preceptor and preceptee working and growing together', related to a constant evaluation by preceptors of students' knowledge, readiness to learn, and the provision of learning opportunities. The fourth, 'Preceptors as builders of nursing practice through teaching reality nursing', facilitated the preceptee's experience of the real world of nursing practice. An overall constitutive theme: 'Preceptors as the safeguarders of the practices of nursing', emerged as the essence of the experience.
Call Number NRSNZNO @ research @ Serial 1263
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Author Haji Vahabzadeh, Ali
Title Optimal Allocation of Intensive Care Unit nurses to Patient-At-Risk-Team Type Book Whole
Year 2018 Publication Abbreviated Journal
Volume Issue (up) Pages 224 p.
Keywords Intensive Care Units; Intensive care nursing; Patients; Mortality; Health economics
Abstract Explains the need for nurse-led Patient-at-Risk-Teams(PART) to prevent unnecessary ICU admissions. Investigates which nurse allocation policy between PART and ICU would result in the best outcomes for patients and hospitals. Provides econometric models to estimate the impact of critical care nurses on hospital length of stay. Proposes queueing and simulation models to obtain the optimal nurse allocation policy for minimising the ICU mortality rate. Validates proposed models at Middlemore Hospital from 2015 to 2016. Estimates the financial and mortality impact of allocating another nurse to PART per shift.
Call Number NZNO @ research @ Serial 1647
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Author Evans, S.
Title Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes Type Journal Article
Year 2003 Publication Pediatric Intensive Care Nursing Abbreviated Journal
Volume 4 Issue (up) 2 Pages 7
Keywords Nursing specialties; Intensive care nursing; Equipment and Supplies
Abstract The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
Call Number NRSNZNO @ research @ Serial 926
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Author Wright, R.
Title Linking theory with practice Type Journal Article
Year 2001 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 7 Issue (up) 2 Pages 14-15
Keywords Intensive care nursing; Nurse-family relations; Nursing models
Abstract This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
Call Number NRSNZNO @ research @ Serial 1012
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Author Pirret, A.M.
Title The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making Type Journal Article
Year 2007 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 23 Issue (up) 3 Pages 145-155
Keywords Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education
Abstract The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.
Call Number NRSNZNO @ research @ Serial 933
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Author Lui, D.M.K.
Title Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 2. Survey results Type Journal Article
Year 2003 Publication Journal of Neonatal Nursing Abbreviated Journal
Volume 9 Issue (up) 3 Pages 91-96
Keywords Intensive care nursing; Paediatric nursing; Ethics; Attitude of health personnel
Abstract Discontinuation of life support measures for an extremely low birthweight or very premature baby is controversial and difficult for both the parents and the healthcare professional involved in caring for the infant. This study seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Part 1 reviewed the literature on this subject. Part 2 reports the results of a survey carried out in a New Zealand NICU.
Call Number NRSNZNO @ research @ 966 Serial 950
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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 (up) 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 NRSNZNO @ research @ Serial 958
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Author Powell, J.
Title Caring for patients after an ICU admission Type Journal Article
Year 2002 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 8 Issue (up) 7 Pages 24-25
Keywords Intensive care nursing; Nurse-patient relations; Trauma; Communication
Abstract The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education.
Call Number NRSNZNO @ research @ Serial 954
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Author Hansen, G.
Title The role of massage in the care of the critically ill Type Journal Article
Year 2002 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 8 Issue (up) 7 Pages 14-16
Keywords Nursing; Alternative therapies; Intensive care nursing
Abstract This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated.
Call Number NRSNZNO @ research @ Serial 1010
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Author Ho, T.
Title Ethical dilemmas in neonatal care Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue (up) 7 Pages 17-19
Keywords Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making
Abstract The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
Call Number NRSNZNO @ research @ 1035 Serial 1019
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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 (up) 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 NRSNZNO @ research @ Serial 962
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