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Author Banks, J.; McArthur, J.; Gordon, G.
Title Flexible monitoring in the management of patient care process: A pilot study Type Journal Article
Year 2000 Publication Lippincott's Case Management Abbreviated Journal
Volume 5 Issue 3 Pages 94-106
Keywords Hospitals; Cardiovascular diseases; Nursing
Abstract This article describes a study conducted on the internal medicine, general surgical, and vascular wards of a large metropolitan hospital to assess the impact of a networked monitoring system and portable patient monitors. This pilot study was developed to address the needs of hospital patients who require continuous non-invasive vital signs monitoring (including heart rate, non-invasive blood pressure, pulse oximetry, cardiac waveform monitoring) with the addition of surveillance from a cardiac intensive care area. Data were collected from 114 patients over a three-month period to identify a patient group that could be managed appropriately under the new system and to determine the effect that flexible monitoring had on patient care management. Findings include identification of a specific patient group that can be managed successfully outside the cardiac intensive care area using this system. Other findings suggest a way to improve the management of patient monitoring in the general ward areas.
Call Number NRSNZNO @ research @ Serial (down) 1091
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Author Marcinkowski, K.
Title Shortening hospital stays for orthopaedic patients Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 11 Pages 28-29
Keywords Surgery; Evidence-based medicine; Guidelines
Abstract The author provides a review of current protocols and presents new ways to manage the care of patients undergoing total joint arthroplasty, hip and knee replacement surgery.
Call Number NRSNZNO @ research @ Serial (down) 1022
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Author Wallis, R.
Title Preventing post-anaesthetic shaking Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 10 Pages 22-24
Keywords Surgery; Evidence-based medicine; Nursing; Guidelines
Abstract The author presents her experience investigating the incidence of post-anaesthetic shaking in the recovery room ward, and develops a clinical tool for its treatment. Several theories about post-anaesthetic shaking are examined. The cases of 1296 patients who had major regional or general anaesthetics over four consecutive months in the previous year are studied. The incidence of post-anaesthetic shaking and correlating core body temperature readings with post-anaesthetic shaking are examined. A protocol for reducing/treating post-anaesthetic shaking is developed on the basis of the findings of the study.
Call Number NRSNZNO @ research @ Serial (down) 1021
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Author Perry, I.
Title Identifying the 'norms' of nursing culture Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 9 Pages 20-22
Keywords Nursing; Nursing philosophy
Abstract The author investigates the premises that form the basis of nursing practice in acute care. Assumptions about patients and caregiving are often at odds with each other. The origins of these tenets are mapped from Florence Nightingale through to present nursing theorists. Overlapping areas of nursing and medical care in the acute care setting are examined, and the conflict that can arise between traditional nursing care and the expected medical nursing role is examined. He argues that the challenge for acute care nurses is to find a balance between normative nursing and the medical model.
Call Number NRSNZNO @ research @ 1036 Serial (down) 1020
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Author Ho, T.
Title Ethical dilemmas in neonatal care Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 7 Pages 17-19
Keywords Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making
Abstract The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
Call Number NRSNZNO @ research @ 1035 Serial (down) 1019
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Author Carr, J.
Title Ensuring consent is informed Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 7 Pages 22-23
Keywords Patient rights; Law and legislation
Abstract The author examines the concept of informed consent as it applies to patients and as it is obtained by nurses. The principles of autonomy, beneficence and non-maleficence are discussed. How these principles inform critical care nursing is explored and five inappropriate uses of technology in resuscitation are used as examples.
Call Number NRSNZNO @ research @ Serial (down) 1018
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Author Paterson, M.
Title Dealing with life and death decisions Type Journal Article
Year 2000 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 6 Issue 7 Pages 14-16
Keywords Ethics; Nursing; Patient rights; Clinical decision making; Euthanasia
Abstract This article examines the implications for nurses of not-for-resuscitation orders and orders to withdraw treatment. The rights of patients and correct procedure in the case of not-for-resuscitation or do-not-resuscitate orders are considered, as well as the ethical dilemma facing nurses in cases of the withdrawal of treatment. Guidelines are offered to assist nurses in reaching an ethical decision to withdraw treatment. Euthanasia is defined and case law decisions on not-for-resuscitation and treatment withdrawal are cited.
Call Number NRSNZNO @ research @ Serial (down) 1017
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Author Chadwick, A.; Hope, A.
Title In pursuit of the named nurse Type Journal Article
Year 2000 Publication Australasian Journal of Neuroscience Abbreviated Journal
Volume 13 Issue 4 Pages 6-9
Keywords Advanced nursing practice; Hospitals; Evaluation; Nurse-family relations; Nurse-patient relations
Abstract This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
Call Number NRSNZNO @ research @ Serial (down) 924
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Author Strochnetter, K.T.
Title Influences on nurses' pain management practices within institutions: A constructivist approach Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
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 (down) 909
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Author Rose, A.
Title Is case management an efficient and effective model of care for complex patients in an acute medical setting? Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Clinical decision making; Culture; Nursing; Quality assurance
Abstract This thesis looks at the prospect of developing and implementing case management as a model of care for complex patients in an acute medical setting. An extensive literature review was conducted to explore the concept of case management and to identify the role of the case manager, including the qualities and qualifications required for the position. Clinical pathways are a tool used in case management so these are also included in the literature review. As the author had been involved in the development of the first clinical pathway for Hutt Valley Health, this is used as an example to clarify how case management and clinical pathways can be used in conjunction. A discussion chapter examines the advantages and disadvantages of case management which shows that it can be an effective and efficient model of care through the development of clinical pathways. The ethical implications of case management are also considered. The thesis concludes with recommendations for the continued development of case management as a model of care to improve the quality of care for both patients and the organisation. During the course of the thesis, other areas that are worth further investigation have also been identified, such as the relevance of case management to different cultures. The thesis suggests that a proposal for case management for complex patients in the acute care setting is developed along with a job description for the role of the case manager.
Call Number NRSNZNO @ research @ Serial (down) 908
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Author Harker, D.Y.
Title Nurses as patients: The stories of two woman nurse educators as recipients of nursing care Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing; Education; Preceptorship; Feminist critique
Abstract In this research two nurse-patients have engaged in a conversation about their experience of 'being nursed'. The project sets out to address the following questions: How might our experiences as nurses who have been hospitalised be drawn upon to influence positive changes in nursing practice? What effect might our experiences of hospitalisation have on us as nurses and on our nursing practice? The study utilises narrative as inquiry and the method of story telling and auto/biography to tell the stories of Maria (a pseudonym) and the researcher herself. This interpretive research has been informed by the feminist process and sits within a postmodern framework. Maria's stories were audio taped and transcribed before being prepared for analysis using 'core story creation', and the process of 'emplotment' (Emden, 1998b). The author's reflective topical autobiographical narrative was constructed through the processes described by Johnstone (1999). Three distinct qualities emerged from both experiences. The first, 'knowing as nurse-patient' contains the three sub-themes of 'having knowledge', 'expectations of being nursed', and 'knowledge gained'. The second distinct quality 'being nursed' contains the two sub-themes of 'feeling safe and cared for' and 'presencing'; and the third, 'not being nursed', contains the four sub themes 'feeling vulnerable', 'invisibility of nurses', 'getting out' and 'feeling let down'. The sub-theme 'getting out' includes three additional sub themes of 'wanting to get out and not wanting to be there', 'leaving and the need for closure' and 'not wanting to go back'. The author notes that nursing does make a difference to patient care. However, for patients to receive therapeutic care, new graduate nurses must be preceptored/mentored by experienced nurses in supportive programmes. Suggestions for further research have been identified.
Call Number NRSNZNO @ research @ Serial (down) 907
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Author Marshall, D.C.
Title The preceptor's role in student evaluation: An investigation Type
Year 2000 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Preceptorship; Students; Teaching methods
Abstract
Call Number NRSNZNO @ research @ Serial (down) 906
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Author Williams, B.G.
Title The primacy of the nurse in New Zealand 1960s-1990s: Attitudes, beliefs and responses over time Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Nursing; History; Registered nurses
Abstract Exploring the past, and pulling ideas through to the present, to inform the future can make a valuable contribution to nurses and nursing in New Zealand. By gaining some understanding of the attitudes and beliefs nurses held, and how these influenced their responsiveness, we can learn what active responses might help inform our future. Nurses in New Zealand, as individuals and within the profession as a whole, reveal the primacy of the nurse – nurses who have made and can continue to make a difference to the health of the peoples of New Zealand. A hermeneutic process was used to interpret material, from international texts, national texts and public records over four decades, the 1960s to 1990s. This was supplemented and contrasted with material from twelve oral history participants. Analysis of the material led to the emergence of four themes: Nurses' decision-making: changes over time; An emerging understanding of autonomy and accountability; Nurses as a driving force; and Creating a nursing future. These four themes revealed an overall pattern of attitudes, beliefs and responses of the New Zealand registered nurse. The themes surfaced major revelations about the primacy of the nurse in New Zealand, nurses confident in their ability to take the opportunity, seize the moment, and effect change. The author suggests that the contribution this thesis makes to the discipline of nursing is an understanding of how the nurse actively constructs the scope of a professional response to the context. The author notes that the thesis demonstrates how nurses can learn from the past, that the attitudes and beliefs that underpin our active responses can either move us forward, or retard our progress. As nurses we can also learn that to move forward we need particular attitudes, beliefs and responses, that these are identifiable, and are key factors influencing our future, thus ensuring the continued primacy of the nurse.
Call Number NRSNZNO @ research @ Serial (down) 905
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Author Jones, B.
Title Saving lives and changing dirty nappies: Illuminating nursing in the neonatal nurse practitioner role: The New Zealand experience Type
Year 2000 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Neonatal nursing; Nurse practitioners
Abstract
Call Number NRSNZNO @ research @ 919 Serial (down) 903
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Author Maddocks, W.A.
Title Soft tissue massage in nursing practice: An analysis Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Alternative therapies; Nursing
Abstract The use of massage by nurses is a popular activity in many fields of nursing practice. The last ten to fifteen years have seen a rising popularity in the literature. Whilst the literature within nursing is plentiful it often does not present the empirical evidence necessary to support nursing actions. The objective of this analysis is to present the extant literature discussing soft tissue massage from a Western health perspective. Massage has first been contextualised as an ancient as well as modern healing activity. There is evidence of early modern medical interest in the therapeutic benefits of massage for a number of ailments. From this contextual perspective it is then possible to track the evolution of modern complementary health practices since 1980, and the professional and practical issues surrounding their use. Against the backdrop of twenty-first century health care there is increased evidence of the importance of maintaining the human aspect of caring, and massage is seen as an ideal way to provide this. The author argues that the discipline of modern nursing must increase its awareness of the empirical evidence around the use of massage, to provide safe and effective nursing care. This physiological and psychological evidence is presented and critiqued, based on the principles of evidence-based practice. This critique has enabled some sound research-based practical statements on the effects of massage to be made. These statements will enhance the practice of massage within a nursing context. The final part of the journey has been to explore the actual practice of massage within nursing, including the current use of massage by a sample of New Zealand nurses. The educational opportunities have also been presented, alongside some main professional issues. Massage can now be viewed as a legitimate nursing tool that has value in a range of nursing settings by enhancing the quality of patient care. The techniques are easy to learn, simple to perform and do not add undue workload to nurses. The author notes that there is a considerable amount of literature to support this, but the quest for further knowledge cannot be ignored.
Call Number NRSNZNO @ research @ Serial (down) 902
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