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Green, C. (2018). Medication simulation: enhancing nursing students' clinical environmental awareness through self-care and promotion of patient safety. Whitireia Nursing and Health Journal, (25), 37–51.
Abstract: Undertakes an evidence-based practice pilot project to examine the effectiveness of simulation-based learning in teaching nursing students to become aware of the role of stress, anxiety and distraction in medication errors. Stresses the importance of medication-error prevention at the pre-licensure level, by increasing awareness of patient safety culture. Notes the need to teach nursing students self-awareness of the distractions and stresses within the clinical environment and therefore the need for self-care to avoid medication error.
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McBride-Henry, K., & Foureur, M. (2006). Medication administration errors: Understanding the issues. Australian Journal of Advanced Nursing, 23(3), 33–41.
Abstract: This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.
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Hughes, M., & Farrow, T. (2005). Invisible borders: Sexual misconduct in nursing. Nursing Praxis in New Zealand, 21(2), 15–25.
Abstract: This paper identifies the issue of sexual misconduct by nurses in New Zealand. There is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, the authors make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice.
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Warren, B. L. (2002). Intramuscular injection angle: Evidence for practice? (Vol. 18).
Abstract: This article presents the findings of a search for evidence to support the 45-60 degree angle of insertion for intramuscular injection of vaccine which is recommended in New Zealand. With the objective of discovering the evidence base for an intramuscular injection angle which differs from that recommended by the World Health Organisation and the accepted practice experienced by the author in the UK, Canada, Malawi and the USA, a comprehensive library and internet literature search was undertaken. Information was also sought by personal correspondence and contact with a range of immunisation specialists. Both the literature specifically on needle angle and that which includes needle angle within a wider investigation of technique is included. Overwhelmingly the evidence supports a 90 degree angle of needle insertion for intramuscular injection as being most effective in terms of patient comfort, safety and efficacy of vaccine.
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Wailling, J. (2016). How healthcare professionals in acute care environments describe patient safety: a case study. Master's thesis, Victoria University of Wellington, Wellington. Retrieved June 7, 2024, from http://hdl.handle.net/10063/6242
Abstract: Explores how patient safety is described from the perspective of clinicians and organisational managers in a NZ acute-care hospital, using embedded case study design. Conducts three interviews with health-care managers and 6 focus groups, comprising 19 doctors and 19 nurses. Develops the theoretical concept of safety capability: the ability to provide safe patient care based on resilient culture, anticipation and vigilance, along a continuum of safety levels.
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Smillie, A. (2006). Historical investigations: Risk management in a New Zealand hospital, 1888-1904. Nursing Praxis in New Zealand, 22(2), 33–38.
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.
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Rudd, J. (2005). From triage to treatment: An exploration of patient flow systems in emergency departments. Ph.D. thesis, , .
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.
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Börner, H. E. (2008). Evaluating safe patient handling systems: Is there a better way? Ph.D. thesis, , .
Abstract: This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being.
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McCloskey, B. A., & Diers, D. (2005). Effects of New Zealand's health reengineering on nursing and patient outcomes. Medical Care, 43(11), 1140–1146.
Abstract: This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care.
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Teunissen, C., Burrell, B., & Maskill, V. (2020). Effective surgical teams: an integrative literature review. Western Journal of Nursing Research, 42(1). Retrieved June 7, 2024, from http://dx.doi.org/https://doi.org/10.1177/0193945919834896
Abstract: Evaluates the aids and barriers for perioperative teams in functioning effectively, preventing adverse events, and fostering a culture of safety. Undertakes an integrative review of the literature. Highlights the role of theatre nurses in situational awareness (SA), running the theatre and assuming leadership of the team.
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Horsburgh, M., Merry, A., Seddon, M., Baker, H., Poole, P., Shaw, J., et al. (2006). Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative. Journal of Interprofessional Care, 20(5), 555–557.
Abstract: This article describes two interprofessional learning modules offered by the Faculty of Medical and Health Sciences at the University of Auckland to undergraduate medicine, nursing and pharmacy students. The modules, 'Maori Health“ and ”Patient Safety", have a focus on quality improvement in healthcare and are used to bring together students for a shared learning programme.The specific dimensions of healthcare quality covered in the programme are: patient safety, equity, access, effectiveness, efficacy and patient-centeredness.
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Koorey, R. (2007). Documentation of the surgical count. Dissector, 34(4), 23–6,28,30.
Abstract: The author examines the current practices around the surgical counts of sponges, sharps and instruments, which is an integral component of safe perioperative nursing practice. Current practice, legislative requirements are reviewed, and the guidelines from the Perioperative Nurses College of New Zealand are reproduced. Case studies of errors in counts are used to illustrate the legal standards of practice.
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Beaver, P. J. (2015). Contemporary patient safety and the challenges for New Zealand. Ph.D. thesis, University of Auckland, . Retrieved June 7, 2024, from http://hdl.handle.net/2292/28247
Abstract: Outlines the history, emergence, necessity, challenges, and strategies of the patient safety movement. Explores the challenges for staff working to reduce harm and implement safety improvement in NZ hospitals. Considers medical harm as a persistent and expensive threat to public health. Analyses health policy in the US, England and NZ using the theory of countervailing powers, and a shift from medical to managerial dominance. Reviews theories of accidents and risk, and the safety improvement literature. Provides staff perspectives from NZ by means of interviews with doctors, nurses and managers in two hospitals.
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Eton, S. J. (2020). Clinical handover from the operating theatre nurse to the post anaesthetic care unit nurse: a New Zealand perspective. Master's thesis, University of Otago, Christchurch. Retrieved June 7, 2024, from http://hdl.handle.net/10523/10582
Abstract: Presents findings from a study of nurse-to-nurse handover in the perioperative care setting. Describes current practices in nurse handover and surveys theatre and post-anaesthetic-care nurses from around NZ about their satisfaction with handover and whether it affects patient outcomes.
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Moir, C., Taylor, P., Seaton, P., Snell, H., & Wood, S. (2023). Changes noticed following a pressure-injury link-nurse programme. Kaitiaki Nursing Research, 14(1), 19–24.
Abstract: Identifies changes that link nurses noticed in their practice areas as a result of participating in a pressure-injury prevention programme. Uses three nurse focus groups to collect data about changes in pressure-injury prevention within their practice areas following implementation of a link-nurse programme. Talks to 22 nurses about increasing awareness of pressure injury prevention, use of assessment tools and documentation, and acquisition of injury prevention equipment.
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