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Author Rudd, J.
Title (up) From triage to treatment: An exploration of patient flow systems in emergency departments Type
Year 2005 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Emergency nursing; Hospitals; Risk management; Patient safety
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.
Call Number NRSNZNO @ research @ Serial 1209
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Author Ward, J.
Title (up) High acuity nursing Type Journal Article
Year 2001 Publication Vision: A Journal of Nursing Abbreviated Journal
Volume 7 Issue 12 Pages 15-19
Keywords Nurse-family relations; Emergency nursing; Technology
Abstract This article looks at the role of technology in nursing, and the interaction between it and human compassion and caring. The interface between critical care technologies and caring is explored, along with the social and political issues facing critical care areas.
Call Number NRSNZNO @ research @ 1298 Serial 1283
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Author Richardson, S.
Title (up) Incorporation of research into clinical practice: The development of a clinical nurse researcher position Type Journal Article
Year 2005 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 21 Issue 1 Pages 33-42
Keywords Emergency nursing; Nursing research; Hospitals
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.
Call Number NRSNZNO @ research @ Serial 536
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Author Richardson, S.
Title (up) Increasing patient numbers: The implications for New Zealand emergency departments Type Journal Article
Year 1999 Publication Accident & Emergency Nursing Abbreviated Journal
Volume 7 Issue 3 Pages 158-163
Keywords Emergency nursing; Organisational change
Abstract This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care.
Call Number NRSNZNO @ research @ 1108 Serial 1093
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Author Kerr, R.C.
Title (up) Is the graduate nurse work-ready for emergency nursing? Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Mentoring; Preceptorship; Training; Emergency nursing
Abstract In this research paper for a Master of Nursing (Clinical), the author suggests that graduate nurses can successfully adapt to emergency nursing when supported with intensive domain-specific transition programmes to complement the national nursing entry to practice (NETP) programme in New Zealand. This outcome conflicts with the present traditional emergency department recruitment strategy that nurses must have two years acute care experience. The graduate believes they are prepared for practice for any healthcare setting but do need time to resolve the rift between theory and practice. This research project confirms the perpetuation of experienced nurses' perceptions that graduates are not work-ready but are unrealistically expected to hit the floor running following ad hoc orientation ranging from three days to four weeks. By creating domain-specific programmes with a minimum twelve-week staged rotation orientation package, graduate nurses can be nurtured as emergency nurses. The influential role of the organisation and experienced nurses is vital to limit reality shock and complement NETP. Preceptorship and mentorship programmes promote the graduates' confidence in themselves to become competent team members. Limits to this research are the non-differentiation between nurses new to emergency nursing and the graduate nurse in the published studies. Assumptions have therefore been made regarding successful transition in regard to newly qualified registered nurses in the emergency department. Further study and evaluation applicable in the New Zealand context is also recommended by the author where anecdotally only a few emergency departments are involved in socialising graduate nurses into the workforce regardless of the urgent need for more first-year-of-practice clinical placements.
Call Number NRSNZNO @ research @ Serial 494
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Author Davies, M.
Title (up) Lived experiences of nurses as they engage in practice at an advanced level within emergency departments in New Zealand Type
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Emergency nursing; Nurse practitioners; Advanced nursing practice
Abstract
Call Number NRSNZNO @ research @ 682 Serial 668
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Author Horner, C.
Title (up) Maintaining rural nurses' competency in emergency situations Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Emergency nursing; Nurse practitioners; Rural nursing; Education
Abstract On call emergency health services are becoming routinely provided by some rural nurses, predominantly within the South Island. Rural nurses have been advancing their practice to accommodate the limited availability of general practitioners in rural communities. Although this is becoming routine practice, the author has been providing a service such as this for the past 12 years. This dissertation describes this practice in relationship to the present social-political context, advancing nurse competencies and her experience of rural nursing in a rural town within the South Island. Particular significance for the rural nurse is the required independent practice and overall responsibility when remote from traditional medical oversight. Providing on call emergency care with the possibility of a broad spectrum of emergency situations while maintaining competence for the unpredictable frequency (or lack of frequency) of the rural emergency is the focus of this dissertation. The professional and personal risks are high for rural nurses when placed in situations they are not prepared for or unable to remain competent to manage. Implications resulting from the critique of the health service literature on this subject are identified. Firstly, rural nurses need to be insightful of their own emergency on call expertise and limitations. Secondly, rural nurses require ongoing education and thirdly that appropriate education is available and accessible to rural nurses. Lastly, rural nurses require maintenance of competency so these emergency skills are not lost. This dissertation and the resulting recommendations embrace Nursing Council of New Zealand Nurse Practitioner Competencies. The resulting outcomes fulfilling the rural nurse's need for maintenance of competency for emergency on call care, the community's need for safe appropriate emergency care and national legislation requirements.
Call Number NRSNZNO @ research @ Serial 666
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Author Holbrook, P.
Title (up) Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
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 Topliss, J.
Title (up) Nursing by telephone in mental health emergency settings: What underpins and informs clinical practice? Type Miscellaneous
Year 2005 Publication Abbreviated Journal Bill Robertson Library, Otago Polytechnic
Volume Issue Pages
Keywords Mental health; Emergency nursing
Abstract This dissertation is an exploration of what underpins and informs clinical nursing practice by telephone in mental health emergency settings. A critical review of the literature provides the foundation for discussion. Points of reflection explore links between the literature and the author's own experience and thoughts about clinical practice. Findings are presented within three main sections. 'Historical Context' considers the development and function of mental health emergency service telephone work. Practical aspects are discussed under `Service Provision Context.' 'Nursing Context' explores the fundamental skills involved in clinical reasoning and the preparation of staff for telephone work. Whilst 'Best practice' in the area of nursing by telephone is yet to be well defined, this work aims to provide a foundation for further inquiry, research and dialogue.
Call Number NRSNZNO @ research @ 676 Serial 662
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Author Grainger, P C
Title (up) Nursing documentation in the emergency department: nurses' perspectives Type Report
Year 2007 Publication Abbreviated Journal
Volume Issue Pages 184 pp
Keywords Nursing Records; Emergency Nursing; Qualitative Description; Nursing Documentation; Emergency Nurses? Perspectives; Interviews, Context Specific Influences; Facilitating and Inhibiting factors
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.
Call Number NZNO @ research @ Serial 1404
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Author Baur, P.
Title (up) Patients who present to the emergency department but do not wait: An exploratory study Type
Year 2004 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Emergency nursing; Hospitals
Abstract
Call Number NRSNZNO @ research @ Serial 849
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Author Ritchie, M.S.
Title (up) Process evaluation of an emergency department family violence intervention programme Type
Year 2004 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Emergency nursing; Evaluation
Abstract Family violence is common and there are significant long-term negative health effects from victimisation. Health professionals are now recognised as key providers of family violence intervention. The Hawke's Bay District Health Board HBDHB) launched a Family Violence Intervention Programme in the emergency department in 2002, in accordance with national directives. The Family Violence Intervention Programme includes routine questioning for partner abuse within social history assessments for all women 16 years and over who seek healthcare services. Nurses assumed responsibility for implementing this programme into emergency department practice. Establishing partner abuse screening in practice requires an organisational and attitudinal change. Achieving and sustaining this change can be difficult. Evaluation was considered an essential aspect of the systems approach adopted within the HBDHB Family Violence Intervention Programme to support change. The aim of this study was to identify the enablers and barriers to routine questioning in the emergency department one year after the programme was launched and the strategies to address these barriers. The staff who have responsibility for routinely questioning women were considered well placed to provide this information. The methodology selected was evaluation research using semi-structured interviews. The design included member checking and triangulation of the findings. Eleven emergency department staff members participated in five (two group and three single) interviews. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department setting. Barriers to questioning exist and enablers can eliminate or minimise these. Enablers such as policy and training support routine questioning. Barriers identified included the lack of privacy and time. Participants suggested strategies to overcome these. These barriers, enablers and solutions were either personal or organisational in origin and all had a common theme of safety. An outcome of the study was the development of a model of barriers and enablers to ensure safety when routinely questioning women for partner abuse. This evaluation has utility within the HBDHB as it informs programme progression. However, the evaluation has wider implications. The experiences of the emergency department staff led to the emergence of key themes that may inform the development of comparable programmes. Introducing routine questioning requires a practice change; a multifaceted approach focusing on safety can assist staff to achieve that change.
Call Number NRSNZNO @ research @ Serial 851
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Author Blair, K.M.
Title (up) Recognising the sick patient: An emergency nurses view: A research paper Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making
Abstract This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration.
Call Number NRSNZNO @ research @ Serial 467
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Author Lockett, Jessica
Title (up) Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: a qualitative descriptive study Type Book Whole
Year 2020 Publication Abbreviated Journal
Volume Issue Pages 132 p.
Keywords Emergency departments; Emergency nursing; Infectious diseases; Epidemics; Strategic planning; Surveys
Abstract Explores what NZ Emergency Department (ED) nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. Uses a qualitative descriptive design to allow an examination of the first-hand perspectives of ED nurses, gaining meaningful insights into a phenomenon little explored. Interviews 16 ED nurses about future pandemic planning at ED, DHB and government level.
Call Number NZNO @ research @ Serial 1691
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Author MacGeorge, J.M.; Nelson, K.
Title (up) The experience of the nurse at triage influences the timing of CPAP intervention Type Journal Article
Year 2003 Publication Accident & Emergency Nursing Abbreviated Journal
Volume 11 Issue 4 Pages 234-238
Keywords Emergency nursing; Clinical decision making; Hospitals; Quality of health care
Abstract This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
Call Number NRSNZNO @ research @ Serial 847
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