Smillie, A. (2006). Historical investigations: Risk management in a New Zealand hospital, 1888-1904. Nursing Praxis in New Zealand, 22(2), 33–38.
Abstract: This article examines historical events within one hospital and compares them with contemporary risk management practices. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints – one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. Analysis of the processes followed in investigating these occurrences reveals that these historic investigations were small in scale and less bureaucratic than contemporary practice, and were based on a culture of blame. This is contrasted with modern risk management practices which are more focused on understanding what can be learned from the incident with respect to preventing recurrence.
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Drake, M., & Stokes, G. (2004). Managing pre-registration student risk: A professional and legislative minefield. Nursing Praxis in New Zealand, 20(1), 15–27.
Abstract: This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues.
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Palmer, J. (2018). Benefits of rigid dressings following lower-limb amputation. Kai Tiaki Nursing Research, 9(1), 38–39.
Abstract: Performs an integrative review of five randomised controlled trials, and five retrospective case analyses to explore the benefits of using rigid dressings following lower-limb amputation for people with compromised circulation.
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Hooker, M. (2010). Implementing the rheumatic fever guidelines: Identifying the challenges and crossing the theory practice divide. Master's thesis, , .
Abstract: A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Health Sciences, The University of Auckland, 2010.
Background:
The 2006 New Zealand (NZ) Guidelines for Rheumatic Fever (RHF) (National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006) have an over-arching objective to support appropriate management of RHF to prevent recurrent attacks and reduce mortality and morbidity from RHF and Rheumatic Heart Disease (RHD) (Craig, Anderson, & Jackson, 2008; National Heart Foundation of New Zealand and Cardiac Society of Australia and New Zealand, 2006).
Aims:
The aims of this study were to audit current practice and service provision associated with RHF programmes and initiatives in NZ District Health Boards (DHBs) against the 2006 NZ Guidelines for RHF and to identify the barriers and facilitators to clinicians meeting the guidelines.
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Noble-Adams, R. (2012). Cancer Connect New Zealand : description and retrospective audit. Nursing Praxis in New Zealand, 28(3), 24–34.
Abstract: Retrospectively audits the Cancer Connect New Zealand (CCNZ)service to review, assess and describe 156 paper records of CCNZ matches made between July 2008-July 2009. Records baseline demographic data of those using and providing the CCNZ service.
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Powell, S. (2010). The older nurse in the workplace: retention or retirement. Master's thesis, Victoria University of Wellington, Wellington.
Abstract: Examines the issues facing the older nurse in NZ. Recruits two groups of Clinical/Charge Nurse Managers (CNM) in two District Health Boards (DHB) to interview about the issues confronting older nurses and the strategies they use to retain them.
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Whitehead, N. (2007). Quality and staffing: Is there a relationship in aged residential care. Master's thesis, , .
Abstract: This thesis reports a mixed methods study, longitudinal in nature, of consenting Age Related Residential Care (ARRC) hospitals in the upper half of the North Island, which was conducted to examine several factors, including AARC hospital efficiency at producing adverse event free days for residents. An interpretativist approach examined what best practice strategies were implemented by the ARRC hospitals that were identified to be most successful at producing adverse event free days for the residents.
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Dulieu, F. (2005). Collaborative practice: A study in bridging the gap to transform the delivery of specialist palliative nursing care in residential aged care facilities.
Abstract: This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau. The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education programme while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care.
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McKenzie-Green, B. (2003). Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study. Ph.D. thesis, , .
Abstract: Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities.
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Bland, M. F. (2005). The challenge of feeling 'at home' in residential aged care in New Zealand. Nursing Praxis in New Zealand, 21(3), 4–12.
Abstract: In this research report, a resident reveals the challenges associated with firstly becoming a nursing home resident, and then trying to establish a new sense of 'home'. The story supports a conclusion that nurses' knowledge of the unique 'admission story' of each resident, and their individual understandings of home, is essential in promoting their ongoing comfort. Although approximately 30,000 older adults live in residential aged care, little research has been done on their experience.
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Bland, M. F. (2004). All the comforts of home? A critical ethnography of residential aged care in New Zealand. Ph.D. thesis, , .
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Kiata, L., Kerse, N., & Dixon, R. (2005). Residential care workers and residents: The New Zealand story. Access is free to articles older than 6 months, and abstracts., 118(1214).
Abstract: The aim of this study was to describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand was undertaken, with completed surveys received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The authors conclude that the age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.
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Yu, S. [F. ]. (2021). Exploring resilience in Intensive Care Nurses in New Zealand. Ph.D. thesis, University of Auckland, Auckland.
Abstract: Investigates intensive care nurses' resilience levels and their association with personal factors and physical activity behaviour; physical work activity behaviour during a 12-hour shift; and clustered physical activity profiles and associations with resilience. Performs a cross-sectional study with intensive care nurses from four units at three hospitals in Auckland. Employs accelerometry to measure participants' physical activity during four days, two at work and two in their own time, and uses the Connor-Davidson Resilience Scale to measure resilience levels.
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Whitehead, N., Parsons, J., & Dixon, R. (2015). Quality and staffing : is there a relationship in residential aged care? Kai Tiaki Nursing Research, 6(1), 28–35.
Abstract: Explores whether there is a relationship between staffing and quality indicators in residential care of older people, in both rest homes and continuing-care hospitals. Conducts a longitudinal survey of 18 residential-care rest homes and 16 continuing-care hospitals in the greater Auckland region to explore the relationship between direct-care staffing levels, skill mix and quality indicators. Collects data over a 6-month period on type of staffing, including registered nurses, enrolled nurses, and support workers; quality indicators, including falls, new fractures, pressure ulcers, weight loss, urinary tract infections (UTI), poly-pharmacy or multiple medications, presence of indwelling catheters and use of daily restraints. Uses logistic analysis to analyse the inverse relationship between staffing levels and adverse events, and whether there is an association between staff type and the incidence of the five quality indicators.
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Kussmaul, J. (2020). An investigation of occupational health and safety workplaces and working conditions in comparison to nursing care quality in residential aged care facilities (RACFs) in New Zealand. Doctoral thesis, University of Auckland, Auckland.
Abstract: Identifies critical factors related to the occupational health and safety of workplaces and working conditions in residential aged-care facilities (RACF), from the perspective of nursing staff. Correlates quality indicators for occupational health and safety for workplaces and in working conditions with nursing care quality based on the InterRAI Clinical Assessment Protocols (CAP). Uses a mixed-method approach to conduct an audit of workplace health and safety and environmental conditions in 17 RACFs. Surveys 398 registered nurses (RN), enrolled nurses (EN), and Healthcare Assistants (HCA) about the mental and physical stressors in their work.
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