| Records |
| Author |
McKerras, R. |
Title  |
Waiting in the emergency department – it doesn't have to take all day |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing |
| Abstract |
This thesis explores the nature of the emergency department environment as it continues to challenge emergency nurses to meet the health needs of an increasingly complex emergency department population. The emergency nurse is also facing conflict and challenge with regard to workplace safety and patient rights. The author suggests that, until recently, very little debate or consideration has been given to the moral dilemmas raised in the ability of emergency department staff to deliver timely and appropriate care in an overcrowded environment. She goes on to say that, in New Zealand, there is no national consistency with regard to the waiting crisis, no national guidelines and no national consensus putting the emergency nurse at risk. This thesis argues the need to acknowledge waiting times as a significant safety issue at a national level as increasing waiting times continue to impact on patient outcomes and nursing practice. It challenges current practice, in particular the role of the emergency nurse and the potential to legitimise expansion of the role to improve the patient experience of waiting in the emergency department. |
| Call Number |
NRSNZNO @ research @ |
Serial |
512 |
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| Author |
Blackmore, L.A. |
| Title |
Triaging patients away from the emergency department: A review of the issues |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing |
| Abstract |
With the intention of decreasing emergency department demand, there has been a focus on determining those patients who do not require the services of the emergency department so they can be redirected away to an alternative health care provider or facility. Co-locating an after-hours primary health care facility near to the emergency department is a model under consideration in some district health boards. This model suggests that a substantial proportion of the patients currently managed in the emergency department can be assessed and managed in a general practice setting. It is envisaged that by redirecting the lower acuity patients away from the emergency department, overcrowding will be relieved. This is despite evidence demonstrating that low acuity patients are not the cause of emergency department overcrowding. Moreover, being treated at the emergency department is the only safety net for many people in the community who cannot afford alternative care. This research report discusses the literature regarding the practice of referring or redirecting patients away from the emergency department and the issues associated with this model. In doing this, it looks at the Australasian Triage Scale, the system used to ensure patients are seen in order of clinical urgency, because it has been suggested that this system could be used as a tool to refer patients away from the emergency department. The author concludes that even though some people could be seen by another health care provider, the triage system is not an appropriate tool for achieving this. While it is tempting to believe that patients in the lower triage categories are prime candidates for being referred away, there is evidence from hospital statistics that patients in these categories have a high number of hospital admissions and in-hospital death rates. Additionally, to complicate matters, there is no universal definition of what constitutes an 'appropriate' emergemcy department presentation and no consensus of opinion amongst health professionals in deciding patients' 'appropriateness'. For these reasons it is unethical to expect nurses who administer the triage system to use it for the purpose of referring people away from the emergency department. |
| Call Number |
NRSNZNO @ research @ |
Serial |
736 |
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| Author |
Gabolinscy, B. |
| Title |
Triage codes: A predictor of nursing care time in the emergency department |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
|
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Time factors |
| Abstract |
This thesis explores triage code as a predictor of direct nursing care time, thus its potential usefulness in a model for calculating and allocating nurse requirements in emergency departments. A framework for nursing work is proposed. This framework is based on the works of O'Brien-Pallas, Irvine, Peereboom, and Murray (1997) and Houser (2003). It suggests that the structures of environmental complexity, nursing characteristics, patient nursing complexity, and patient medical condition and severity, impact on the processes of direct and indirect nursing care to affect patient outcomes. A prospective, non-experimental study was undertaken to examine the relationship between direct nursing care time and triage code. Six potential confounding variables were selected for this study: length of stay, age, ethnicity, sex, complaint type, and discharge category. Data were collected for 261 visits over a three day period in one New Zealand emergency department. Patient visits averaged 200 minutes. The mean direct nursing care time per visit was 49 minutes. On average, patients with more urgent triage codes, longer length of stay, or who were not discharged, received more direct nursing care. The model developed predicted 49% of variation in direct nursing care time (p < .05) related to triage code (16%), length of stay (31%) and disposition category (2%). The author suggests that further exploration of the proposed framework has potential to develop a model allowing managers to identify nurse staffing required for optimal nursing care in emergency departments. |
| Call Number |
NRSNZNO @ research @ 481 |
Serial |
468 |
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| Author |
Curtis, K.; Donoghue, J. |
| Title |
The trauma nurse coordinator in Australia and New Zealand: A progress survey of demographics, role function, and resources |
Type |
Journal Article |
| Year |
2008 |
Publication |
Journal of Trauma Nursing |
Abbreviated Journal |
|
| Volume |
15 |
Issue |
2 |
Pages |
34-42 |
| Keywords |
Emergency nursing; Personnel; Nurse managers; Economics |
| Abstract |
An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective |
| Call Number |
NRSNZNO @ research @ |
Serial |
964 |
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| Author |
MacGeorge, J.M.; Nelson, K. |
| Title |
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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| Author |
Lockett, Jessica |
| Title |
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 |
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Abbreviated Journal |
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| 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 |
Blair, K.M. |
| Title |
Recognising the sick patient: An emergency nurses view: A research paper |
Type |
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| Year |
2006 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
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| 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 |
Ritchie, M.S. |
| Title |
Process evaluation of an emergency department family violence intervention programme |
Type |
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| Year |
2004 |
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 |
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 |
Baur, P. |
| Title |
Patients who present to the emergency department but do not wait: An exploratory study |
Type |
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| Year |
2004 |
Publication |
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Abbreviated Journal |
Massey University Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Emergency nursing; Hospitals |
| Abstract |
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| Call Number |
NRSNZNO @ research @ |
Serial |
849 |
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| Author |
Grainger, P C |
| Title |
Nursing documentation in the emergency department: nurses' perspectives |
Type |
Report |
| Year |
2007 |
Publication |
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Abbreviated Journal |
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| Volume |
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Issue |
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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 |
Topliss, J. |
| Title |
Nursing by telephone in mental health emergency settings: What underpins and informs clinical practice? |
Type |
Miscellaneous |
| Year |
2005 |
Publication |
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Abbreviated Journal |
Bill Robertson Library, Otago Polytechnic |
| Volume |
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Issue |
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Pages |
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| 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 |
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 |
Horner, C. |
| Title |
Maintaining rural nurses' competency in emergency situations |
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; 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 |
Davies, M. |
| Title |
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 |
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| Keywords |
Emergency nursing; Nurse practitioners; Advanced nursing practice |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 682 |
Serial |
668 |
| Permanent link to this record |
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| Author |
Kerr, R.C. |
| Title |
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 |
| Permanent link to this record |
