Manning, J. (2007). Skin-to-skin care of the very low birth weight infant: Taking a risk and making it happen. Ph.D. thesis, , .
Abstract: Parent-infant skin-to-skin care has become an advocated aspect of care in neonatal intensive care units nationally within New Zealand and internationally. However the implementation of this care by nurses can be limited by a number of factors within the practice environment. This dissertation presents a critical analysis of literature alongside reflection on the author's own practice experience to explore factors that may be constraining the use of skin-to-skin care with the very low birth weight infant in the neonatal intensive care unit. These factors are examined through a lens of risk taking behaviour underpinned by the grounded theory work of Dobos (1992). The concept of risk is explored in order to develop an understanding of why, in the author's view, the practice of skin-to-skin care of very low birth weight infants may have declined in recent years. For neonatal nurses skin-to-skin care of the very low birth weight infant presents challenges related to the environment, physiological stability of the infant and changes over the past 10 years in the clinical management of very low birth weight infants. As progress is made toward the design, development and eventual move to a new unit in Dunedin recommendations pertaining to the change in physical space, the introduction of a structured model for nursing care and implications for nursing practice development in relation to skin-to-skin care are described.
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Baur, P. (2004). Patients who present to the emergency department but do not wait: An exploratory study. Ph.D. thesis, , .
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Bickley, J. (2002). A study of medical, nursing, and institutional not-for-resuscitation (NFR) discourses. Ph.D. thesis, , .
Abstract: This study investigates the way that medical, nursing and institutional discourses construct knowledge in the specific context of Not-for-resuscitation (NFR)in a New Zealand general hospital where NFR guidelines are available in the wards and from the regional ethics committee. The thesis argues that there are ranges of techniques that staff use to construct NFR knowledge, enacted through various forms of speech and silence, which result in orderly and disorderly experiences for patients nearing death. The study was conducted through a critical analysis of the talk of health professionals and the Chairperson of the Regional Ethics Committee.
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O'Malley, J. (2001). Critical social analysis of acute institutionally based mental health nursing following an action research project. Ph.D. thesis, , .
Abstract: This study using action research involving twelve registered nurses worked toward improving nursing care in an acute mental health in-patient service. Following focus groups with consumers, families, nurses, doctors, and allied health professionals, the action research group developed projects over eighteen months to improve continuity and consistency of nursing care. There was a subsequent restructuring of nursing service to better define leadership, accountability and to strengthen care delivery. The second half of the thesis involves a critical social analysis of the research data and produces a theory of mental health nursing which, the author suggests, has wide application in practice.
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Scott, S., Johnson, Y., & Caughley, B. (2003). An evaluation of the new graduate orientation programme: Introduced at Capital Coast District Health Board's Wellington Hospital in March 1998. [Wellington]: Massey University.
Abstract: This report presents a longitudinal research study which evaluated the effectiveness of the twelve months New Graduate Orientation Programme introduced at Capital Coast District Health Board's Wellington Hospital in March 1998. The programme was implemented to assist new nursing graduate's transition into the role of registered nurse. The evaluation project took place over a three-year period. Three annual intakes of new graduates enrolled in the New Graduate Orientation Programme were surveyed by questionnaire on their completion of the programme.
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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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Barratt, R. (2008). Behind barriers: patients' perceptions of hospital isolation for methicillin-resistant Staphylococcus aureus (MRSA). Ph.D. thesis, , .
Abstract: This study explored the experiences of hospitalised patients in methicillin resistant Staphylococcus aureus (MRSA) isolation in New Zealand and the meaning that those patients made of those experiences. The research question of this study was 'What is the lived experience of patients in MRSA isolation?' An interpretive phenomenological approach was undertaken for this research, informed by the philosophical hermeneutic tenets of Heidegger (1927/1962). Audio-taped, semi-structured interviews were used to collect data from a purposive sample of ten adults who were in MRSA isolation in various wards in a large acute care hospital in the central North Island. Three salient themes emerged from the data. The first, 'being MRSA positive', summarises the meaning of having an identity of being MRSA positive. The second theme, 'being with others', is concerned with the effect that being in isolation for MRSA has on interpersonal relations. 'Living within four walls' is the third theme and reveals the significance that the physical environment of the MRSA isolation room has on the experience of MRSA isolation. Within the discussion of these themes, excerpts from the interviews are provided to illuminate the meanings and interpretations made. Recommendations are made for nursing practice and education.
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Chenery, K. (2001). 'Can mummy come too?' Rhetoric and realities of 'family-centred care' in one New Zealand hospital, 1960-1990. Ph.D. thesis, , .
Abstract: This study explores the development of 'family-centred care' in New Zealand as part of an international movement advanced by 'experts' in the 1950s concerned with the psychological effects of mother-child separation. It positions the development of 'family-centred care' within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children's emotional health. It examines New Zealand nursing, medical and related literature between 1960 and 1990 and considers both professional and public response to these concerns. The experiences of some mothers and nurses caring for children in one New Zealand hospital between 1960 and 1990 illustrate the significance of these responses in the context of one hospital children's ward and the subsequent implications for the practice of 'family-centred care'. This study demonstrates the difference between the professional rhetoric and the parental reality of 'family-centred care' in the context of one hospital children's ward between 1960 and 1990. The practice of 'family-centred care' placed mothers and nurses in contradictory positions within the ward environment. These contradictory positions were historically enduring, although they varied in their enactment.
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Rudd, J. (2005). From triage to treatment: An exploration of patient flow systems in emergency departments. Ph.D. thesis, , .
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.
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Gibson, C. (2005). Hearing the adolescents' voice: A study evaluating the use of conjoint analysis for use with adolescents to determine preferences for inpatient hospital facilities. Ph.D. thesis, , .
Abstract: This research used the economic technique of conjoint analysis and an informal discussion to canvas opinions regarding ideal combination of inpatient facilities and the use of cell phones in hospital. The content of the conjoint analysis was, with the exception of the inclusion of the question regarding the use of cell phones, derived from the literature. Because conjoint analysis does not appear to have been used with adolescents one of the questions to be answered was whether this was a method of research that could be used with adolescents. The research was undertaken with 29 young people, most of who were from CanTeen (the adolescent cancer support group) in Wellington. The conjoint analysis, and discussion with the adolescents supported the general findings from the literature that adolescents do not want to be nursed in either overtly paediatric or, in their words, 'dull adult wards', as they enjoy bright lively surrounds. Ideally they would like to be nursed with their peer group and so have the opportunity to interact with young people of their age. The research demonstrated that adolescents are able to understand the concept of conjoint analysis and also supported findings from overseas that these healthcare consumers value having their opinions canvassed and are well able to give constructive and well thought out opinions. A report on the findings of this research will be presented to Capital and Coast District Health Board with the expectation that it will be considered when the final decisions are made regarding the upgrading of Wellington Hospital's present facilities as it is anticipated that these facilities will contain dedicated adolescent beds within the paediatric unit.
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Vermeulen, J. (2002). “And there's the likes of me”: A phenomenological study of the experience of four women inpatients at a mental health unit. Ph.D. thesis, , .
Abstract: This research draws on the experiences of four women whilst they were inpatients at the Mental Health Unit in Southland. The Husserlian path of phenomenology was followed and in-depth interviewing used to collect data. Colaizzi's method of analysis enabled accurate interpretation of transcripts. The overall goal of this research was to provide health professionals with an opportunity to inform their practice, based on what consumers were saying about their experience of hospitalisation. Themes emerged through participants relating their experience by using comparisons with either their outside world or previous episodes of hospitalisation. Through analysis, two fundamental structures became evident within the findings. These were 'the environment as containment' and 'the road to recovery'. The author concludes that this study raises significant issues surrounding the experience of hospitalisation at the Mental Health Unit that have implications for future research and for future service delivery.
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Litchfield, M. (1997). The language of nursing practice in hospitals. (Vol. Proceedings of the National Nursing Informatics Co).
Abstract: A paper presenting the findings of a small research project involving a group of self-selected senior nurses of Wellington Hospital to explore the nature of nursing practice in the care and management of hospitalised patients and to formalise the language that would acknowledge its significance in the current effort of hospitals to define patient care pathways. The nature of hospital nursing practice was described in themes of a generic process of nurse-patient care that articulates a distinct specialism of hospital nursing, whatever the hospital department in which nurses hold positions.
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Payne, S. (2007). The nurse's role in promoting health of vulnerable children (0-5 yr olds) through coordinated care: Margaret May Blackwell Study Fellowship. Margaret May Blackwell Travel Study Fellowship Reports. Wellington, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: Explores the provision of emergency paediatric care internationally. Visits children's hospitals in the US, Canada, the UK and Australia. Part of the Margaret May Blackwell Scholarship Reports series.
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Mockford, A. (2009). The exploration of systems and technologies to enhance the healthcare of children under five. Margaret May Blackwell Travel Study Fellowship Reports. Waikato, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: The well known premise that 'healthy children grow into healthy adults' should reinforce the need for us to engage with parents and caregivers to ensure that we support them with meeting their child's health care needs. This scholarship enabled the author to see what the UK, Sweden, the US, and Canada were doing to strengthen and support children under five and their families across the continuum of care. Part of the Margaret May Blackwell Scholarship Reports series.
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Moore, J. (2005). Breaking down barriers in child healthcare (0-5) years. Margaret May Blackwell Travelling Fellowship 2005. Margaret May Blackwell Travel Study Fellowship Reports. Christchurch: Nursing Education and Research Foundation (NERF).
Abstract: Travels to Australia, Canada, the US and the UK to investigate various methods of procedural sedation for 0-5-year-olds in paediatric Emergency Departments. Describes the types of sedation used and the recovery periods. Transcribes the interviews he conducted with Emergency Department staff in each country. Part of the Margaret May Blackwell Scholarship Reports series.
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