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| Author | Rudd, J. | ||||
| Title | From triage to treatment: An exploration of patient flow systems in emergency departments | Type | |||
| Year | 2005 | Publication  |
Abbreviated Journal | ResearchArchive@Victoria | |
| Volume | Issue | Pages | |||
| Keywords | Emergency nursing; Hospitals; Risk management; Patient safety | ||||
| Abstract | To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 1209 | ||
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| Author | Turnwald, A.B. | ||||
| Title | Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department | Type | |||
| Year | 2006 | Publication |
Abbreviated Journal | ResearchArchive@Victoria | |
| Volume | Issue | Pages | |||
| Keywords | Chronically ill; Clinical assessment; Emergency nursing | ||||
| Abstract | A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 1210 | ||
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| Author | Kuehl, S. | ||||
| Title | Emergency Department re-presentations following intentional self-harm | Type | |||
| Year | 2008 | Publication |
Abbreviated Journal | ResearchArchive@Victoria | |
| Volume | Issue | Pages | |||
| Keywords | Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment | ||||
| Abstract | The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 1214 | ||
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| Author | Little, S. | ||||
| Title | An exploration of vicarious traumatisation in emergency nurses | Type | |||
| Year | 2002 | Publication |
Abbreviated Journal | Victoria University of Wellington Library | |
| Volume | Issue | Pages | |||
| Keywords | Emergency nursing; Occupational health and safety; Nursing research; Stress | ||||
| Abstract | This thesis explores the theoretical notions of suffering and caring within the nurse patient relationship in the context of emergency nursing. It includes a small pilot study that aimed to assess the feasibliity of a major research project, by describing the impact of vicarious traumatisation in emergency nurses, specifically in relation to their self capacities. This pilot study utilised a descriptive, correlational design. Data was collected by using the Inner Experience Questionnaire (IEQ) a twenty four-item questionnaire developed by Dr Pearlman (1995), and a profile sheet which identified demographic details. Twenty-seven emergency nurses participated in this pilot study. The IEQ was assessed for internal reliability by applying the Cronbachs alpha and utilising a focus group to gain insight into the usability and relevance of the questions. The internal reliability of the IEQ suggests that it may be an appropriate tool to measure disruption of self capacities in the population of emergency nurses. Although the results are limited, and conclusions cannot be drawn, findings suggest a correlation between the variables of age, experience, nursing qualifications and a history of personal trauma and the IEQ. There is evidence that emergency nurses are affected psychologically when caring for the victims of trauma in emergency departments and the IEQ has the potential as a tool to be integrated into future emergency nursing studies. A multidimensional methodological approach is recommended to capture the many contours of the complex phenomena of vicarious traumatisation and the emergency nurse. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 1249 | ||
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| Author | Bennison, C. | ||||
| Title | Emergency nurses' perceptions of the impact of postgraduate education on their practice in New Zealand | Type | |||
| Year | 2008 | Publication |
Abbreviated Journal | NZNO Library | |
| Volume | Issue | Pages | |||
| Keywords | Emergency nursing; Nursing; Education | ||||
| Abstract | ABSTRACT BACKGROUND: Emergency nursing is a specialty concerned with the care of people of all ages, with either perceived or actual unwellness presenting to the emergency department(ED) for assessment, resuscitation, investigation, treatment and review of their illness or injury. Emergency nurses apply specialty knowledge and expertise in the provision, delivery and evaluation of emergency nursing care. Over recent decades social, political and professional changes have affected nursing care delivery and nursing education. In particular the 21st century has witnessed the development of state funded postgraduate nursing education programmes, developing nurses specialty or advanced nursing knowledge, quality patient/client care and nursing practice within the tertiary education system. AIM: The aim of this study is to investigate emergency nurses? perceptions of the impact of postgraduate education on their practice in New Zealand (NZ). METHODS: This study utilises critical social theory as the overarching framework, informed by the writing of Jürgen Habermas (b.1929- ). It is the three phases of Habermas?s practical intent of critical social theory; namely enlightenment, empowerment and emancipation, that this study is concerned with. This descriptive research study employs both quantitative and qualitative methods and is therefore known as mixed-methods research. Data collection took place over 12 weeks, from August to November 2006, using a survey questionnaire obtained with permission from Ms Dianne Pelletier, Sydney, Australia. The sample included 105 emergency nurses from District Health Board (DHB) emergency departments in NZ, 10 respondents from this sample self-selected to be interviewed by telephone. Ethical approval for this study was obtained from the University of Otago Ethics Committee for research involving human participants. Data was analysed using the Statistical Package for Social Sciences (SPSS). RESULTS: Two main themes arose from the thematic analysis; these being positive and negative, these themes were further divided into 10 sub-themes. The results indicate that postgraduate study (PGS) has increased nurses? perception of their knowledge; leadership and understanding on the quality of patient care delivered, increased their academic and research skills and increased their confidence/self-esteem and recognition by their colleagues and team. Therefore the majority of respondents perceive postgraduate education has been an instrument of liberation and a process of empowerment and emancipation. A smaller percentage of respondents perceived that PGS had no effect on various aspects of patient care and another significantly smaller percentage of respondents reported negative results from PGS. This research identified similarities between this study and that of Pelletier and colleagues? (2003; , 2005; , 1998a; , 1998b) Australian study. CONCLUSION: This study adds to the existing literature on postgraduate studies undertaken by nurses. No known study has previously investigated solely emergency nurses?perceptions of the effects of PGS, either nationally or internationally. The results of this study offer enlightening information regarding emergency nurses? perceptions of their PGS within NZ and offers a platform from which other studies may be undertaken. It also has the potential to inform nurses contemplating PGS and educators facilitating these programmes,as well as provide implications for policy development by the Nursing Council of NZ, NZ Universities, DHBs and the Ministry of Health. |
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| Call Number | NRSNZNO @ research @ | Serial | 1291 | ||
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| Author | Grainger, P C | ||||
| Title | Nursing documentation in the emergency department: nurses' perspectives | Type | Report | ||
| Year | 2007 | Publication |
Abbreviated Journal | ||
| Volume | Issue | Pages | 184 pp | ||
| Keywords | Nursing Records; Emergency Nursing; Qualitative Description; Nursing Documentation; Emergency Nurses? Perspectives; Interviews, Context Specific Influences; Facilitating and Inhibiting factors | ||||
| Abstract | Explores emergency nurses? perspectives and practices about the quality, importance and value of emergency nursing documentation in relation to their personal beliefs, past experiences and preferred systems of documentation; the practical and contextual factors that influence documentation practices within an emergency department (ED); their interests in documentation tools or systems; and their interests in relation to further development of documentation practices and systems. Conducts a qualitative descriptive study in which ten emergency nurses from one ED in New Zealand were interviewed using interactive interview methods, and asked to complete a Likert scale to identify the relevance of internationally- recognised general influences on documentation to their own practices in the context of an ED. Includes recommended routes to development through partnership, participation and process engagement, and strategies including document development, knowledge advancement and support. | ||||
| Call Number | NZNO @ research @ | Serial | 1404 | ||
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| Author | Lockett, Jessica | ||||
| Title | Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: a qualitative descriptive study | Type | Book Whole | ||
| Year | 2020 | Publication |
Abbreviated Journal | ||
| Volume | Issue | Pages | 132 p. | ||
| Keywords | Emergency departments; Emergency nursing; Infectious diseases; Epidemics; Strategic planning; Surveys | ||||
| Abstract | Explores what NZ Emergency Department (ED) nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. Uses a qualitative descriptive design to allow an examination of the first-hand perspectives of ED nurses, gaining meaningful insights into a phenomenon little explored. Interviews 16 ED nurses about future pandemic planning at ED, DHB and government level. | ||||
| Call Number | NZNO @ research @ | Serial | 1691 | ||
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| Author | MacGeorge, J.M.; Nelson, K. | ||||
| Title | The experience of the nurse at triage influences the timing of CPAP intervention | Type | Journal Article | ||
| Year | 2003 | Publication |
Accident & Emergency Nursing | Abbreviated Journal | |
| Volume | 11 | Issue | 4 | Pages | 234-238 |
| Keywords | Emergency nursing; Clinical decision making; Hospitals; Quality of health care | ||||
| Abstract | This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 847 | ||
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| Author | Currie, J.; Edwards, L.; Colligan, M.; Crouch, R. | ||||
| Title | A time for international standards? Comparing the Emergency Nurse Practitioner role in the UK, Australia and New Zealand | Type | Journal Article | ||
| Year | 2007 | Publication |
Accident & Emergency Nursing | Abbreviated Journal | |
| Volume | 15 | Issue | 4 | Pages | 210-216 |
| Keywords | Emergency nursing; Cross-cultural comparison; Nursing; Education | ||||
| Abstract | The aim of this paper is to compare the Emergency Nurse Practitioner role in the UK, Australia and New Zealand. Whilst geographically distant, the role of the Emergency Nurse Practitioner within these three countries shares fundamental similarities, causing the researchers to question, is this a time to implement international standards for the role? The Emergency Nurse Practitioner role in all three countries is gradually establishing itself, yet there are shared concerns over how the role is regulated and deficits in standardisation of scope of practice and educational level. Together these issues generate confusion over what the role embodies. The authors suggest that one method of demystifying the Emergency Nurse Practitioner role would be to progress towards international standards for regulation, education and core components of practice. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 971 | ||
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| Author | Richardson, S. | ||||
| Title | Increasing patient numbers: The implications for New Zealand emergency departments | Type | Journal Article | ||
| Year | 1999 | Publication |
Accident & Emergency Nursing | Abbreviated Journal | |
| Volume | 7 | Issue | 3 | Pages | 158-163 |
| Keywords | Emergency nursing; Organisational change | ||||
| Abstract | This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care. | ||||
| Call Number | NRSNZNO @ research @ 1108 | Serial | 1093 | ||
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| Author | Horner, C. | ||||
| Title | Emergency health provision and maintaining competency | Type | Book Chapter | ||
| Year | 2008 | Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 125-136) | Abbreviated Journal | Ministry of Health publications page |
| Volume | Issue | Pages | |||
| Keywords | Rural nursing; Professional competence; Emergency nursing | ||||
| Abstract | This chapter focuses on issues associated with rural nursing and the provision of emergency care for patient(s) located remotely from secondary hospital services. All emergencies have diverse characteristics, but the rural practitioner also contends with having sole practice, professional and geographical isolation, and the lack of regular experience. The chapter reviews the PRIME (Primary Response in Medical Emergency) recommendations and training, and looks in particular at the issues around the maintenance of competency for the rural nurse providing emergency on call health care that includes managing medical and accident emergencies in the absence of a medical practitioner. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 756 | ||
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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 | NRSNZNO @ research @ | Serial | 964 | ||
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| Author | Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P. | ||||
| Title | Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial | Type | Journal Article | ||
| Year | 2002 | Publication |
New Zealand Medical Journal | Abbreviated Journal | Access is free to articles older than 6 months, and abstracts. |
| Volume | 115 | Issue | 1157 | Pages | |
| Keywords | Emergency nursing; Time factors; Clinical assessment; Clinical decision making | ||||
| Abstract | The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 617 | ||
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| Author | Hamer, H.P.; McCallin, A. | ||||
| Title | Cardiac pain or panic disorder? Managing uncertainty in the emergency department | Type | Journal Article | ||
| Year | 2006 | Publication |
Nursing & Health Sciences | Abbreviated Journal | |
| Volume | 8 | Issue | 4 | Pages | 224-230 |
| Keywords | Emergency nursing; Clinical assessment; Diagnosis | ||||
| Abstract | This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 689 | ||
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| Author | Richardson, S. | ||||
| Title | Incorporation of research into clinical practice: The development of a clinical nurse researcher position | Type | Journal Article | ||
| Year | 2005 | Publication |
Nursing Praxis in New Zealand | Abbreviated Journal | |
| Volume | 21 | Issue | 1 | Pages | 33-42 |
| Keywords | Emergency nursing; Nursing research; Hospitals | ||||
| Abstract | The author backgrounds the development of the role of an innovative Nurse Researcher (Emergency Medicine) role at Christchurch Hospital. She describes the emergency department and the factors leading to the creation of the role. Specific nursing research projects are reviewed, and the nature of nursing in relation to research is discussed. The author argues that the nurse researcher is integral to the expansion of evidence-based nursing, and that the role of Clinical Nurse Researcher in the emergency department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance. | ||||
| Call Number | NRSNZNO @ research @ | Serial | 536 | ||
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