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Keene, J. M. (2006). The role of the nurse in the outpatient setting.
Abstract: Outpatient nurses are often seen as nurses who are less important or skilled and can no longer physically cope with working in busy wards. This report is aimed to challenge this presumption and show that there are many educated and highly skilled nurses working in these departments. The diversity of the role of the nurse within the continued advancement of nursing practice in the outpatient department is evidence to disprove the perceptions other nurses have of the outpatient nurse. The purpose of this report was to discuss the changing role of the outpatient nurse from 'handmaiden' to 'autonomous practitioner', and secondly, to discuss nurse-led services and what experience and/or skills these nurses are expected to have to fulfill these roles. Literature was gathered to inform this report from the academic circles, policy from the Ministry of Health, the District Health Board website, and in relation to the author's own role with the outpatient department.
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McBride-Henry, K., & Foureur, M. (2006). Medication administration errors: Understanding the issues. Australian Journal of Advanced Nursing, 23(3), 33–41.
Abstract: This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.
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Neville, S. J., & Alpass, F. (2006). Older men and worries: The impact on well-being. Available online from Eastern Institute of Technology, 14(1), 4–7.
Abstract: The aim of this research was to investigate the relationship between worries and psychological well-being, and self-rated health in older men. A cross-sectional survey method was used to investigate the research aim. A group of men aged 65 years and over (n = 217), who lived in a small New Zealand city, participated in this study. Results from this research revealed that worries about physical abilities and health were significantly related to a decrease in psychological well-being and self-rated health. Gerontological nurses are challenged to be cognisant of older men's concerns about their health and physical ability.
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Clark, P. N. (2006). The potential for nurse-led clinics on oncology at Southland District Health Board. Ph.D. thesis, , .
Abstract: The author points to a “waiting list crisis” occurring in ambulatory oncology services at Southland District Health Board (SDHB), and notes that the literature suggests this is occurring both nationally and globally. This is due to factors such as an increase in the number of people aged 65 years and over, many of whom will develop cancer. Furthermore new drug therapies and indications for treatment have led to increased numbers of patients referred for oncological assessment in the out-patient clinics. The author notes that, at SDHB, this delay for patients to be seen at a first specialist assessment appointment is causing concern for patients, managers and the medical and nursing staff involved. This dissertation analyses relevant literature in order to explore the nature and outcomes of nurse-led clinics. A range of studies indicate that effective care can be provided by nurses working in a variety of nurse-led clinics settings. These studies reveal ways in which a nurse-led clinic might be established and delivered in oncology services and, the author suggests, this will go some way to provide a solution for SDHB. These clinics would assess and monitor the follow-up of selected patients with stable disease and established care plans such as patients receiving adjuvant chemotherapy for bowel and breast cancer. This would allow medical oncologists to see more new patients at first assessment and the follow-up of complex cases, and could go some way in relieving the current waiting lists. The educational preparation and competency of nurses leading such a clinic are considered.
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Mockett, L., Horsfall, J., & O'Callaghan, W. (2006). Education leadership in the clinical health care setting: A framework for nursing education development. Nurse Education in Practice, 6(6), 404–410.
Abstract: This paper describes how a new framework for clinical nursing education was introduced at Counties Manukau District Health Board. The project was initiated in response to the significant legislative and post registration nursing education changes within New Zealand. The journey of change has been a significant undertaking, and has required clear management, strong leadership, perseverance and understanding of the organisation's culture. The approach taken to managing the change had four stages, and reflects various change management models. The first stage, the identification process, identified the impetus for change. Creating the vision is the second stage and identified what the change would look like within the organisation. To ensure success and to guide the process of change a realistic and sustainable vision was developed. Implementing the vision was the third stage, and discusses the communication and pilot phase of implementing the nursing education framework. Stage four, embedding the vision, explores the process and experiences of changing an education culture and embedding the vision into an organisation. The paper concludes by discussing the importance of implementing robust, consistent, strategic and collaborative processes that reflect and evaluate best educational nursing practice.
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Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53(2), 94–101.
Abstract: This paper explores the concept of innovation in nursing, the inherent set of characteristics that need to be present in order for innovations to succeed, and the barriers that impede innovation from occurring. Successful innovations developed and implemented by nurses are featured, and organisational factors necessary to support innovation are described. This paper is based on a presentation given by the author at the 23rd Quadrennial ICN Congress and 7th International Regulation Congress in Taipei in May 2005.
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Tuitea, I. (2006). Solution focused nursing: An alternative model for assessing psychosis and mai aitu in mental health.
Abstract: The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.
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Manning, J. (2006). Building trust with families in neonatal intensive care units. Kai Tiaki: Nursing New Zealand, 12(6), 18–20.
Abstract: Establishing a trusting relationship is a key therapeutic intervention for nurses working with families of hospitalised children. This article is an exploration of the definition of trust. Specifically, it considers how parents come to trust (or not) nurses in neonatal intensive care unit (NICU) helps to reveal the meaning of parent-nurse trust and how this affects nursing practice. Understanding and meeting parental needs is important in developing and sustaining trust. The medical model of care often dominates in NICU. This is a deficit model that focuses on illness and treatment. However, the use of a nursing framework, such as developmentally supportive family centred care, focuses on recognising and building on the strengths of the family, by fostering trust to equip the family with the capacity to manage their infant's health care.
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Meldrum, L. B. B. (2006). Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand.
Abstract: New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.
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Gage, J., Everrett, K. D., & Bullock, L. (2006). Integrative review of parenting in nursing research. Journal of Nursing Scholarship, 38(1), 56–62.
Abstract: The authors synthesise and critically analyse parenting research in nursing. They focused on studies published between 1993 and 2004 by nurse researchers in peer-reviewed journals. Data were organised and analysed with a sample of 17 nursing research studies from core nursing journals. The majority of parenting research has been focused on mothers, primarily about parenting children with physical or developmental disabilities. Research about fathers as parents is sparse. Parenting across cultures, parenting in the context of family, and theoretical frameworks for parenting research are not well developed. The authors conclude that the scope of nursing research on parenting is limited.
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Hames, P. V. M. (2006). Patient advocacy: A concept analysis.
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McBride-Henry, K., & Foureur, M. (2006). Organisational culture, medication administration and the role of nurses. Practice Development in Health Care, 5(2), 208–222.
Abstract: This research study was designed to identify ways of enhancing patient safety during the administration of medications within the New Zealand context. The researchers employed a multi-method approach that included a survey using the Safety Climate Survey tool, focus groups and three clinical practice development groups. The authors conclude that the outcomes of this study indicate that practice development initiatives, such as the ones outlined in this project, can have a positive effect on nurses' perceptions of organisational safety, which in turn has been demonstrated to have a positive impact on patient safety.
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Chapman, C. (2006). The elective way: An exploration of pre-operative education for orthopaedic joint replacements.
Abstract: This research paper provides a description and analysis of literature and research focusing on pre-operative education programmes available internationally and nationally for patients receiving total joint replacements. This discussion differentiates between pre-assessment and pre-operative education to provide an understanding that both aspects are important in there own right. Together pre-assessment and pre-operative education complement each other to provide total care for patients awaiting total joint replacement surgery. One way of alleviating apprehension experienced by the patient about their surgery is by providing appropriate joint replacement education programmes that meet their needs. This type of programme is a form of empowerment which provides patients with appropriate and relevant information. This allows the patient to be actively involved in their own care and enable them to make informed decisions. The importance of education, information and communication; anxiety and pain; family and peer support; mobility and insecurity is a common thread in the literature where patients describe their experiences and concerns following a total joint replacement. These concepts are discussed and related to why pre-operative education programmes are recommended to help alleviate patients concerns and are important in providing a total multidisciplinary approach to care.
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Watkins, B. E. (2006). Making meaning of a personal experience of discrimination in relation to a disability: An exploration of the literature.
Abstract: This paper explores the reaction of the author's colleagues when she returned to work disabled after recovering from an injury. In order to understand the new experience of disability and discrimination and to help answer what changed the behaviour of colleagues, the author considered evidence from the published literature. After considering many different models of disability, the social model of disability helped clarify and frame her own experience. Reflecting on this literature and personal experience, she suggests that there is acknowledgement that society's attitudes are changing slowly through governmental action and the activism of the disabled. However, she goes on to say, it is only through progressing education, experiencing disability, and continuing emancipatory research that progress will be made to release people with disabilities from their bonds of prejudice and oppression.
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Lim, A. G., & Honey, M. (2006). Integrated undergraduate nursing curriculum for pharmacology. Nurse Education in Practice, 6(3), 163–168.
Abstract: This article presents an integrated approach to pharmacology education for nurses aligned with constructivist learning theory, as taught at the School of Nursing, University of Auckland. The weaving of pharmacology through the three-year undergraduate curriculum is described, showing the development of a pharmacology curricula thread. The significance of supporting curricula content in areas such as communication skills, law and ethics, as well as sound biological science and physiology knowledge are highlighted.
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