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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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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Walsh, C. (2007). Personal and professional choices, tensions, and boundaries in the lives of lesbian psychiatric mental health nurses. Doctoral thesis, , .
Abstract: This study aimed to articulate how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate self-disclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse's identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants are able to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants 'know themselves' and therefore guide how they 'use self' in their therapeutic nursing. The concept of a 'licensed narrative' has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.
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McLoughlin, N. (2007). Dying to know: Advancing palliative care nursing competence with education in elderly health settings. Ph.D. thesis, , .
Abstract: This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities.
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Raleigh, S. (2007). The meaning and importance of service for health professionals. Ph.D. thesis, , .
Abstract: The primary purpose of this study was to explore and identify the meaning and importance of service for health professionals. Those who participated in this study are all registered nurses who each have between 10 and 40 years of clinical nursing and nurse lecturing experience. The participants each wrote two stories, one about the meaning of service and the other about the importance of service. Definitions of service generally suggest organised labour involving an act of help or assistance. Our intent was to understand what constituted service for each of us in the healthcare – and specifically the nursing practice/education – context. A secondary purpose of this qualitative research was guided by participatory and critical theory paradigms. Seven participants and the initiating researcher formed a co-operative inquiry group to undertake the research using a collaborative process. Within this method the leader and the group became co-participants and co-researchers. Nurses and women are identified as marginalised people and by honouring the principles of co-operative inquiry we were empowered through this process. While the initial data was analysed thematically by the lead researcher, the original 19 sub-themes were refined by participants into five themes. The findings of the participants are consistent with overseas studies on emotional labour and sentimental work. The five themes that emerged as the meaning of service are helping, giving, elements of service, acts of doing, and pride in work. This study affirmed that service has much importance to those involved and deepened our understanding of the blend of meanings service expresses.
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Hughes, H. M. (2007). Whakaohonga na Kahungatanga: Awakening from addiction. Ph.D. thesis, , .
Abstract: This thesis explores the shared experiential journeys of four Pukorero (participants) who successfully completed detoxification and recovery programmes from AOD addiction. Three questions were used to guide the research process to enable the Pukorero to identify positive aspects of their individual detoxification and recovery programmes, surface any barriers and issues they experienced, and clarify the support they received throughout the process. Kaupapa Maori and narrative inquiry was adapted to undertake this study to capture the essence of Maori thinking and reality regarding AOD. Through the use of thematic analysis the data findings of the study reflect the views from each Pukorero of Wairua, Whakapapa and Whanau as key to their successful recovery. This supports the notion that a pathway of detoxification, recovery and hope exists to enable Maori and others to take the journey to reclaim their own health and well-being, and the health and well-being of whanau, hapu, iwi, and Maori community. In honour of these Pukorero, kaumatua, tipuna, whanau, hapu, iwi, Maori katoa, and to celebrate kaupapa Maori and narrative inquiry [as the preferred methodological approach], the use of our tino ataahua reo integrated with English throughout the thesis demonstrates the interwoven connections between the two cultures enshrined in Te Tiriti o Waitangi that comprise the nation of Aotearoa me Te Waipounamu of New Zealand.
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Litchfield, M. (2007). The innovation effort: ?Are you in or are you out??.
Abstract: A graphic presentation in PDF format (April 2007) of the findings and policy implications of the developmental evaluation research programme for the Turangi Primary Health Care Nursing Innovation.
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Houliston, S. (2007). Flight nurse perceptions of factors inflencing clinical decision making in their practice environment. Master's thesis, , .
Abstract: Flight nurse perceptions of factors inflencing clinical decision making in their practice environment: a thesis presented in partial fulfilment of the requirements for the Degree of Master of Nursing at the Eastern Institute of Technology, Taradale, New Zealand
The research project sought to describe the flight nurses perceptions about the factors that influence clinical decision making in their flight nursing practice, using a descriptive survey methodology. Themes emerged as factors which participants perceived influenced clinical decision making in their flight nursing role and in the aeromedical role. These themes included pre-flight preparation, patient status, experience and education of the nurse, and the challenges associated with the physical and atmospheric environments.
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Howie, J. (2007). Choosing the place of birth : how primigravida women experiencing a low-risk pregnancy choose the place in which they plan to give birth in New Zealand. Master's thesis, , .
Abstract: A thesis submitted to the Otago Polytechnic Dunedin, in partial fulfilment of the degree of Master of Midwifery.
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Alleyne, D. (2007). The context of nursing in New Zealand prisons from historical and contemporary perspectives. Master's thesis, , .
Abstract: This dissertation by Deborah Alleyne explores the current context of nursing in New Zealand prisons through rediscovering the history of its introduction and development, and review of relevant literature. Prison nursing is recognised as a unique branch of the wider nursing profession by virtue of the environment in which nurses work and the population for whom they provide care. Four key themes are identified from the literature review: custody versus caring; nurses' relationship with custody staff; nurses' relationship with prisoners; isolation.
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Barber, M. (2007). Nursing and living in rural New Zealand communities: an interpretive descriptive study. Master's thesis, , .
Abstract: A thesis submitted in partial fulfilment of the requirements of the degree of Master of Nursing at Otago Polytechnic, Dunedin, New Zealand. June 2007
This study used an interpretive descriptive method to gain insight into and
explore key issues for rural nurses working and living in the same
community. Four Rural Nurse Specialists were recruited as participants. The
nurses had lived and nursed in the same rural community for a minimum of
12 months. Participants were interviewed face to face and their transcribed
interviews underwent thematic analysis.
The meta-theme was: the distinctive nature of rural nursing. The themes
identified were: interwoven professional and personal roles; complex role of
rural nurses and relationships with the community. A conceptual model was
developed to capture the relationship between the meta-theme and the
themes. A definition for rural nursing was developed from the findings.
This research identified some points of difference in this group of rural
nurses from the available rural nursing literature. It also provides a better
understanding of the supports Rural Nurse Specialists need to be successful
in their roles, particularly around the recruitment and retention of the rural
nursing workforce.
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Grainger, P. C. (2007). Nursing documentation in the emergency department: nurses' perspectives. Master's thesis, Victoria University of Wellington, Wellington.
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.
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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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Wilkinson, J. A. (2007). The New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealand. Doctoral thesis, Massey University, Wellington.
Abstract: Traces the development of the nurse practitioner role in NZ since its establishment in 2001, using a discourse analytical approach to examine those discourses that have defined the role. Employs both textual and discursive analysis of texts from published literature and from nine interviews with individuals influential in the evolution of the role. Examines political perspectives and disciplinary practices dating back to the Nurses Registration Act of 1901. Considers the implications of an autonomous nursing profession in both practice and regulation.
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Blake-Palmer, E. (2007). Seeing the world through orthopaedic eyes: The experience of being an orthopaedic nurse: A hermeneutic study. Ph.D. thesis, , .
Abstract: This study explores the experience of being an orthopaedic nurse. As an orthopaedic nurse the author had concerns that the validity of orthopaedic nursing as a unique scope of practice was being questioned. In this thesis, the case for orthopaedic nursing is argued, by showing it as a specialty in its own right. A qualitative approach informed by the author's interpretation of philosophical hermeneutics as articulated by Heidegger (1927/1962) and Gadamer (1976; 1989) was undertaken. Phenomenology seeks to uncover 'taken-for granted' meanings in everyday experience and hermeneutic research recognises that the historical and cultural horizons of participants and researcher influence the interpretation. Eight nurses working in various orthopaedic settings were interviewed. Data was analysed using the interpretive thematic approach described by van Manen (1990). The nurses' stories from practice yielded two essential themes, 'being part', and 'gaining and maintaining integrity'. The author concludes that these themes interrelate and together reveal meanings and insights about being an orthopaedic nurse. 'Being part', shows the essential nature of relationships between orthopaedic nurses and others. 'Gaining and maintaining integrity' describes the embodied nature of the phenomenon. The overall thematic finding 'seeing the world through orthopaedic eyes' reveals the nature of orthopaedic nursing as a unique scope of practice.
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