Kirkham, S., Smye, V., Tang, S., Anderson, J., Blue, C., Browne, A., et al. (2002). Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research. Research in Nursing & Health, 25(3), 222–232.
Abstract: The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations.
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Walsh, K., McAllister, M., Morgan, A., & Thornhill, J. (2004). Motivating change: Using motivational interviewing in practice development. Practice Development in Health Care, 3(2), 92–100.
Abstract: The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change.
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Marcinkowski, K., & McDonald, B. (2006). Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative. Nursing Praxis in New Zealand, 22(3), 15–21.
Abstract: This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
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Richardson, S. (2005). Incorporation of research into clinical practice: The development of a clinical nurse researcher position. Nursing Praxis in New Zealand, 21(1), 33–42.
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.
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Lyford, S., & Cook, P. (2005). The Whanaungatanga model of care. Nursing Praxis in New Zealand, 21(2), 26–36.
Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.
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Schroyen, B., & Finlayson, M. (2004). Clinical teaching and learning: An action research study. Nursing Praxis in New Zealand, 20(2), 36–45.
Abstract: Using an educational action research model, a nursing lecturer based in a polytechnic and ten students formed a research group to address one issue that was important to them. The research group chose to plan, implement and evaluate a practical change strategy aimed at improving the teaching and learning relationship between students and staff nurses in clinical settings. A sample of five staff nurses working closely with five students in the group was invited to join the study in order to gain their perspectives on the issues. The findings were that contract learning provides a strategy which, under certain conditions, offers both students and staff nurses an opportunity to improve the effectiveness of their interactions.
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Malcolm, H. (2004). Patient privacy in a shared hospital room: Right or luxury? Nursing Praxis in New Zealand, 20(1), 28–35.
Abstract: In this article the author discusses the New Zealand legislation aimed at protecting the individual's right to privacy and concludes that practice may place healthcare consumers' rights at risk. While patient privacy should be of concern to all health professionals, the focus here is on the nurse's role in relation to recently formulated competencies published by the Nursing Council of New Zealand, which includes the recommendation that care be seen to exhibit an awareness of healthcare consumers' rights to privacy alongside the expectation that nurses question practices that compromise patient privacy.
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Finlayson, M., & Gower, S. E. (2002). Hospital restructuring: Identifying the impact on patients and nurses. Nursing Praxis in New Zealand, 18(2), 27–35.
Abstract: The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.
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Carryer, J. B., Budge, C., & Russell, A. (2002). Measuring perceptions of the Clinical Career Pathway in a New Zealand hospital. Nursing Praxis in New Zealand, 18(3), 18–29.
Abstract: The authors outline the Clinical Career Pathways (CCPs) for nurses, which were first established in New Zealand during the late 1980s. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire. The development of the CCPET is described and results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital are presented. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not.
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Buisman, B. (2006). Nursing 2020: How will 'Magnet' hospitals fit in? Nursing Journal Northland Polytechnic, 10, 33–41.
Abstract: Nursing shortages, technology, advances in genetics and the knowledge explosion are trends that have an influence on the nursing profession in the future. This article will examine these trends and give an overview of what it may be like to nurse in an acute-care hospital in the year 2020. The impact of leadership, management and political influences will also be discussed. The American concept of 'Magnet' hospitals will be described as one possible solution to the issues that affect the nursing profession in New Zealand.
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Truscott, J. M., Townsend, J. M., & Arnold, E. P. (2007). A successful nurse-led model in the elective orthopaedic admissions process. NZ Medical Association website. Access free to articles older than 6 months., 120(1265).
Abstract: This paper documents a successful nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age. During the 6-month study, 31 patients with a median age of 38 years were categorised into 3 streams. 252 patients (76%) underwent a nursing-admission process without the need for further consultation with a junior medical officer or an anaesthetist. The remaining patients not included in the study were admitted and clerked by a house officer. No safety issues arose and the surgeons and anaesthetists were satisfied with the process. The junior medical officers described improved job satisfaction by being able to attend theatre, other educational opportunities, and working more closely with the consultant. The process has now been incorporated into elective orthopaedic admissions at Burwood Hospital.
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Richardson, S., Ardagh, M., & Hider, P. (2006). New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department. Access is free to articles older than 6 months, and abstracts., 119(1232).
Abstract: This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept.
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Morton, J., Williams, Y., & Philpott, M. (2006). New Zealand's Christchurch Hospital at night: An audit of medical activity from 2230 to 0800 hours. New Zealand Medical Journal, 119(1231).
Abstract: The authors conduct an audit of medical activity at Christchurch Hospital, a 650 bed tertiary centre, between 2230 and 0800 hours. They measured the volumes of tasks requiring completion overnight and identified the competencies required for this as well as the level of teamwork that existed. They found several organisational areas of concern, that indicate new approaches are required to staff the “hospital at night,” and an Out of Hours Multidisciplinary Team is recommended. Specific issues included the lack of teamwork from the Resident Medical Officers (RMOs), with some overextended while others were inactive. House officer tasks were largely generic rather than specialty specific; there was no formal handover from the afternoon or day shifts and the level of hospital medical staffing did not reflect the activity levels over the time period studied. The researchers also recommend an urgent review of the beep policy. A third of the admissions were to General Medicine, and basic medical activities (including admitting, reviewing, and prescribing drugs and fluids) for patients admitted under all specialties represented the majority of the night workload. Medical registrars had reduced some of the traditional multiple clerking by admitting patients themselves.
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Barber, A., Charleston, A., Anderson, N., Spriggs, D., Bennett, D., Bennett, P., et al. (2004). Changes in stroke care at Auckland Hospital between 1996 and 2001. Access is free to articles older than 6 months, 117(1190).
Abstract: The researchers repeat the 1996 audit of stroke care in Auckland Hospital to assess changes in stroke management since the introduction of a mobile stroke team. The audit prospectively recorded information for all patients with stroke from 1 June to 30 September 2001. They describe the work of the stroke team physician and the specialist stroke nurse and allied health staff who coordinate the multidisciplinary care of patients. Variables examined include time to arrival and medical assessment, investigations, acute management, inpatient rehabilitation, and stroke outcome. The researchers then describe recent developments in stroke care and the impact of the stroke service on patient management.
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Fraser, A. G., Williamson, S., Lane, M., & Hollis, B. (2003). Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori. Access is free to articles older than 6 months, and abstracts., 116(1176).
Abstract: Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive.
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