| Records |
| Author |
Smillie, A. |
| Title |
Historical investigations: Risk management in a New Zealand hospital, 1888-1904 |
Type |
Journal Article |
| Year |
2006 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
22 |
Issue |
2 |
Pages |
33-38 |
| Keywords |
Risk management; History; Patient safety |
| Abstract |
This article examines historical events within one hospital and compares them with contemporary risk management practices. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints – one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. Analysis of the processes followed in investigating these occurrences reveals that these historic investigations were small in scale and less bureaucratic than contemporary practice, and were based on a culture of blame. This is contrasted with modern risk management practices which are more focused on understanding what can be learned from the incident with respect to preventing recurrence. |
| Call Number |
NRSNZNO @ research @ 539 |
Serial  |
525 |
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| Author |
Drake, M.; Stokes, G. |
| Title |
Managing pre-registration student risk: A professional and legislative minefield |
Type |
Journal Article |
| Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
20 |
Issue |
1 |
Pages |
15-27 |
| Keywords |
Risk management; Education; Law and legislation; Nursing |
| Abstract |
This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues. |
| Call Number |
NRSNZNO @ research @ |
Serial |
546 |
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| Author |
Bryson, L.W. |
| Title |
Nurse-led heart failure services: A review of the literature |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Nursing specialties; Management; Nurse practitioners; Cardiovascular diseases |
| Abstract |
This research paper reports on the findings of a literature review conducted to establish and analyse the international magnitude, context and effectiveness of nurse-led heart failure initiatives. The research revealed that the underlying philosophy in establishing nurse-led disease management programmes of care is that, by treating chronic heart failure as a continuum, it is possible to decrease exacerbations and improve patient outcomes. Regardless of the type of heart failure management programme, critical components of care include a collaborative supportive approach that educates and empowers the patient (including family/whanau) to recognise the early indicators of exacerbation, access expedient care, and to adhere to evidence based treatments. The author points to significant evidence to support the establishment of nurse-led heart failure programmes. The positive outcomes associated with this model of care delivery include decreased readmissions, reduction in mortality, and cost efficiencies. However, the organisational model of care, or programme components that are the most effective in optimising patient outcomes, need to be selected on the basis of local healthcare infrastructure, services and resources. The author suggests that New Zealand has a unique opportunity to encompass the recent emergence of the Nurse Practitioner role in facilitating, coordinating and monitoring of heart failure programmes across the continuum of care. The delivery of evidence-based, cost effective, heart failure programmes is a prerequisite to improving the delivery of optimal treatment and ensuring that heart failure patients have the opportunity to attain quality care outcomes. |
| Call Number |
NRSNZNO @ research @ |
Serial |
558 |
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| Author |
Grayson, S. |
| Title |
Nursing management of the rheumatic fever secondary prophylaxis programme |
Type |
|
| Year |
2001 |
Publication |
|
Abbreviated Journal |
University of Auckland Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Community health nursing; Management; Nursing specialties |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 576 |
Serial |
562 |
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| Author |
McKenna, B. |
| Title |
Risk assessment of violence to others: Time for action |
Type |
Journal Article |
| Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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| Volume |
18 |
Issue |
1 |
Pages |
36-43 |
| Keywords |
Mental health; Workplace violence; Risk management; Nursing; Nurse-patient relations; Psychiatric nursing |
| Abstract |
The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings. |
| Call Number |
NRSNZNO @ research @ |
Serial |
621 |
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| Author |
Holbrook, P. |
| Title |
Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Emergency nursing; Drug administration; Nursing; Pain management |
| Abstract |
Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles. |
| Call Number |
NRSNZNO @ research @ |
Serial |
664 |
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| Author |
Spence, D.; Wood, E.E. |
| Title |
Registered nurse participation in performance appraisal interviews |
Type |
Journal Article |
| Year |
2007 |
Publication |
Journal of Professional Nursing |
Abbreviated Journal |
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| Volume |
23 |
Issue |
1 |
Pages |
55-59 |
| Keywords |
Registered nurses; Management; Professional development; Attitude of health personnel |
| Abstract |
This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice. |
| Call Number |
NRSNZNO @ research @ |
Serial |
840 |
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| Author |
Strochnetter, K.T. |
| Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
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| Year |
2000 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Interprofessional relations; Pain management; Nursing |
| Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
| Call Number |
NRSNZNO @ research @ |
Serial |
909 |
| Permanent link to this record |
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| Author |
Gosnell, M. |
| Title |
Postoperative pain assessment: A retrospective review of nursing documentation |
Type |
|
| Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Pain management; Nursing |
| Abstract |
An essential part of nursing practice for the nurse on the surgical floor is to relieve the discomfort of post operative pain for patients in their care. Post operative pain management encompasses a series of processes from assessing pain, providing relief, assessment of measures used to relieve pain through to documentation in the patient record. Yet literature, both internationally and from Australia and New Zealand, suggests that post operative pain continues to be poorly managed despite having the means to provide more than adequate relief. Events leading up to the commencement of this study indicated that locally, post operative pain assessment, including documentation in the patient record may be substandard. The objective of this study was to develop and test an audit tool; undertake a retrospective audit of nursing records, including nursing notes and the nursing care plan, in respect of what postoperative pain assessments nurses document in the patient record; evaluate data and make recommendations for practice. Methodology: A five part, 23 question Likert scale audit tool, designed specifically for this study was used to collect data over a period of two months. In total 40 patient records that met the inclusion criteria were audited.The results indicate that local practice reflects poor documentation standards found in other studies. The most complete recordings were those entered on specifically designed charts such as the Patient Controlled Analgesia and Epidural charts (N 28) but this did not carry over into the patient record. Despite that fact that the patient's self reports of pain is said to be the single most reliable indicator of pain, there was only four occasions when the patient's verbal response to pain was recorded. None of those responses were according to any type of pain rating scale. Evidence of evaluation following measures used to relieve pain was more likely to be recorded if pain was poorly controlled or when side effects such as nausea were experienced by the patient. The author concludes that overall the audit has highlighted many gaps in what is or is not recorded in the patient record in respect of post operative pain assessment and has highlighted the need to develop standards of practice that will improve post operative pain management practices. |
| Call Number |
NRSNZNO @ research @ |
Serial |
915 |
| Permanent link to this record |
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| Author |
Huntington, A.D.; Gilmour, J.A. |
| Title |
A life shaped by pain: Women and endometriosis |
Type |
Journal Article |
| Year |
2005 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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| Volume |
14 |
Issue |
9 |
Pages |
1124-1132 |
| Keywords |
Female; Diseases; Nurse practitioners; Pain management; Endometriosis; Feminist critique |
| Abstract |
The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition. |
| Call Number |
NRSNZNO @ research @ |
Serial |
940 |
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| Author |
King, S.L.J.; Walsh, K. |
| Title |
'I think PCA is great, but . . .'- Surgical nurses' perceptions of patient-controlled analgesia |
Type |
Journal Article |
| Year |
2007 |
Publication |
International Journal of Nursing Practice |
Abbreviated Journal |
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| Volume |
13 |
Issue |
5 |
Pages |
276-283 |
| Keywords |
Nurse-patient relations; Drug administration; Pain management |
| Abstract |
This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semi-structured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being `I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education. |
| Call Number |
NRSNZNO @ research @ |
Serial |
972 |
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| Author |
Richardson, S. |
| Title |
Coping with outbreaks of the norovirus |
Type |
Journal Article |
| Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
11 |
Issue |
7 |
Pages |
|
| Keywords |
Infection control; Risk management; Occupational health and safety; Hospitals |
| Abstract |
The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages. |
| Call Number |
NRSNZNO @ research @ |
Serial |
981 |
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| Author |
Gregory, R.; Kaplan, L. |
| Title |
Understanding residuals in Guillain-Barre Syndrome |
Type |
Journal Article |
| Year |
2008 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
10 |
Issue |
7 |
Pages |
16-18 |
| Keywords |
Diseases; Nursing; Management |
| Abstract |
The authors review the literature on the residual effects of Guillain-Barre Syndrome (GBS), which can include fatigue, foot drop or numbness, reduced mobility and nerve tingling. In GBS the peripheral nerves are attacked by the body's defence system, an auto-immune attack, and as a result, the myelin sheath and axons of nerves are impaired. The pathophysiology of the illness and long term effects are presented, and implications for nursing care and rehabilitation are discussed. Two case studies are included which illustrate coping with the long-term effects of GBS, the effect of GBS residuals on extreme fatigue and depression. |
| Call Number |
NRSNZNO @ research @ 1013 |
Serial |
997 |
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| Author |
Crowe, M.; Carlyle, D. |
| Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
| Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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| Volume |
43 |
Issue |
1 |
Pages |
19-27 |
| Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
| Abstract |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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| Author |
Barton, J. |
| Title |
Pain knowledge and attitudes of nurses and midwives in a New Zealand context |
Type |
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| Year |
2001 |
Publication |
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Abbreviated Journal |
NZNO Library |
| Volume |
|
Issue |
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Pages |
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| Keywords |
Nursing; Pain management; Attitude of health personnel |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 1140 |
Serial |
1125 |
| Permanent link to this record |
