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Author Grainger, J.
Title (down) Mind shift: Creating change through narrative learning cycles: A qualitative interpretive study of clinical conversation as an appraisal process for sexual and reproductive health nurses Type
Year 2007 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue Pages
Keywords Sexual and reproductive health; Nursing; Professional development
Abstract This thesis explores the process of an annual appraisal strategy, 'clinical conversation', from the perspective of seven nurses who were assessed using this technique. The findings demonstrate that clinical conversation is a strategy which facilitates reflection, both as a solitary exercise and with others, to ensure that learning from experience is optimised. The research used a qualitative interpretive approach informed by the model of Grounded Theory espoused by Strauss and Corbin. All eight nurses who were assessed using the clinical conversation strategy were advanced practitioners working within the scope of sexual and reproductive health. Two of the actual appraisals were observed and seven of the nurses were interviewed within eight weeks of being assessed. The outcome of the clinical conversation was primarily one of learning; the acquisition of new insights into self as practitioner. The learning was facilitated through the process of narration; telling the story of clinical practice. Three distinct narrative cycles were identified, each an experiential learning episode. The experience of undertaking a variety of assessment activities created a narrative with self and triggered an internal reflective thinking process; the experience of working with a peer created an additional narrative, a mutual dialogue reflecting back on practice; the experience of sharing practice with an assessor created a further and final narrative, a learning conversation. Each narrative can be seen as a catalyst for change. Primarily, the nurses felt differently about themselves in practice, the way they saw themselves had shifted. Such a change can be described as an alteration in perspective. These alterations in perspective led all nurses to identify ways in which they would change their actual clinical practice. In this way the nurses attempted to align their espoused beliefs about practice with their actual practice. The author notes that the study shows that each nurse responded differently to each narrative learning cycle: for some the conversation with the assessor was more of a catalyst for change than for others. In this way clinical conversation may be flexible enough to respond to a variety of differing learning styles. Learning was person specific which is an imperative for the continued professional development of already highly skilled clinicians. The implication of the research is that whilst clinical conversation was designed as a tool for appraising clinical competence, its intrinsic value lies in supporting the professional development of nurses.
Call Number NRSNZNO @ research @ 833 Serial 817
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Author Pitama, S.; Robertson, P.; Cram, F.; Gillies, M.; Huria, T.; Dalla-Katoa, W.
Title (down) Meihana model: A clinical assessment framework Type Journal Article
Year 2007 Publication New Zealand Journal of Psychology Abbreviated Journal
Volume 36 Issue 3 Pages 118-125
Keywords Nursing models; Clinical assessment; Maori; Mental health
Abstract In 1984 Mason Durie documented a framework for understanding Maori health, Te Whare Tapa Wha, which has subsequently become embedded in Maori health policy. This article presents a specific assessment framework, the Meihana Model, which encompasses the four original cornerstones of Te Whare Tapa Wha, and inserts two additional elements. These form a practice model (alongside Maori beliefs, values and experiences) to guide clinical assessment and intervention with Maori clients and whanau accessing mental health services. This paper outlines the rationale for and background of the Meihana Model and then describes each dimension: whanau, wairua, tinana, hinengaro, taiao and iwi katoa. The model provides a basis for a more comprehensive assessment of clients/whanau to underpin appropriate treatment decisions.
Call Number NRSNZNO @ research @ Serial 459
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Author Levien, J.
Title (down) Maori health: One area of risk Type Journal Article
Year 2007 Publication Nursing Journal Northland Polytechnic Abbreviated Journal Available online at coda, An Institutional Repository for the New Zealand ITP Sector
Volume 11 Issue Pages 17-21
Keywords Colonisation; Maori; Health status; Nursing
Abstract This essay explores the social and historical context of the continued incidence of rheumatic fever amongst Maori. This communicable disease is associated with poverty, inadequate housing and overcrowding. These risk factors are all higher for indigenous populations. The article traces the effects of colonisation on Maori health, and presents the Te Whare Tapa Wha health model, which is grounded in a Maori world view, and provides a framework to examine this issue. The implications for nursing practice are explored.
Call Number NRSNZNO @ research @ 1316 Serial 1300
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Author Leeks, O.
Title (down) Lesbian health: Identifying the barriers to health care Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Attitude of health personnel; prejudice; cultural safety
Abstract Homosexuality has been practiced since ancient times, but through the centuries this expression of sexual identity has moved from being acceptable to unacceptable and finally regarded in a contemporary era as a mental health problem that needed to be, and it was thought could be, cured. This paper focuses on the barriers that lesbian women perceive when wanting to access health care. Most of the research about lesbian women has been conducted in the United States with some in the United Kingdom, Canada and New Zealand. Through reviewing the available literature and grouping common themes, the author identifies three main barriers to health care that exist for lesbian women. Firstly, ignorance or insensitivity of the health care professional about the specific health care needs of this client group; secondly, homophobia or heterosexism that may be present in the health care environment; and thirdly the risk of disclosing one's sexual orientation. These barriers are discussed using the concepts of cultural safety and nursing partnership. The author concludes that the negative health care experiences that lesbian women encounter leave them feeling vulnerable and fearful. This fear and stigmatisation has resulted in lesbian women becoming an 'invisible' community. It is the assumption of heterosexuality that immediately places the lesbian woman at a disadvantage and this potentially may produce missed opportunities to provide individualised care to the lesbian client. The purpose of this work is to encourage discussion within nursing to challenge attitudes and the approach to women who identify as lesbian. The author hopes that this paper will contribute to the increasing body of knowledge in regard to this client group.
Call Number NRSNZNO @ research @ Serial 816
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Author Mackay, B.
Title (down) Leadership strategies for role development in primary health care nursing Type Journal Article
Year 2007 Publication Nursing Journal Northland Polytechnic Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector
Volume 11 Issue Pages 31-39
Keywords Primary health care; Leadership; Professional development
Abstract This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
Call Number NRSNZNO @ research @ 1049 Serial 1033
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Author Naidu, A.
Title (down) Is scholarship an integral component of advanced nursing practice? Type Journal Article
Year 2007 Publication Whitireia Nursing Journal Abbreviated Journal
Volume 14 Issue Pages 50-53
Keywords Advanced nursing practice; Professional development
Abstract This article defines scholarship and how it links to nursing. It explores how nurses perceive scholarship and how it can enhance their practice. While agreeing that scholarship plays a vital role in the image of nursing as a professional practice, the article's main focus is on scholarship as an integral component of advanced nursing practice.
Call Number NRSNZNO @ research @ Serial 1035
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Author Floyd, S.; Meyer, A.
Title (down) Intramuscular injections: What's best practice? Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 6 Pages 20-22
Keywords Professional competence; Registered nurses; Quality of health care; Evidence-based medicine
Abstract The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
Call Number NRSNZNO @ research @ Serial 986
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Author Pullon, S.; McKinlay, E.M.
Title (down) Interprofessional learning: The solution to collaborative practice in primary care Type Journal Article
Year 2007 Publication New Zealand Family Physician Abbreviated Journal The Royal New Zealand College of General Practitioners website
Volume 34 Issue 6 Pages 404-408
Keywords Interprofessional relations; Education; Primary health care; Communication
Abstract In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions.
Call Number NRSNZNO @ research @ Serial 458
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Author North, N.
Title (down) International nurse migration: Impacts on New Zealand Type Journal Article
Year 2007 Publication Policy, Politics, & Nursing Practice Abbreviated Journal
Volume 8 Issue 3 Pages 220-228
Keywords Recruitment and retention; Registered nurses
Abstract Nurse migration flows in and out of New Zealand are examined to determine impacts and regional contexts. A descriptive statistics method was used to analyse secondary data on nurses added to the register, New Zealand nurse qualifications verified by overseas authorities, nursing workforce data, and census data. It found that international movement of nurses was minimal during the 1990s, but from 2001 a sharp jump in the verification of locally registered nurses by overseas authorities coincided with an equivalent increase in international registered nurses added to the local nursing register. This pattern has been sustained to the present. Movement of local registered nurses to Australia is expedited by the Trans-Tasman Agreement, whereas entry of international registered nurses to New Zealand is facilitated by nursing being an identified “priority occupation”. The author concludes that future research needs to consider health system and nurse workforce contexts and take a regional perspective on migration patterns.
Call Number NRSNZNO @ research @ Serial 711
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Author Spence, D.; Anderson, M.
Title (down) Implementing a prescribing practicum within a Master's degree in advanced nursing practice Type Journal Article
Year 2007 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 23 Issue 2 Pages 27-42
Keywords Advanced nursing practice; Education; Nurse practitioners; Prescribing; Teaching methods
Abstract This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.
Call Number NRSNZNO @ research @ Serial 457
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Author Johnson, S.
Title (down) Hope in terminal illness Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Palliative care; Terminal care; Psychology
Abstract Hope is considered an elusive, vague, over-used, and ambiguous concept in nursing practice which lacks clarity, but hope is essential to the quality of life in the terminally ill. Therefore, hope is an important concept to research further. A gap in nursing research has been identified in the area of hope in terminal illness. The aims of this research were to clarify the concept of hope as perceived by patients with a terminal illness; to develop hope as an evidence-based nursing concept; and to contribute new knowledge and insights about hope to the relatively new field of palliative care. Utilising Rodgers' (2000b) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology (from the disciplines of nursing and medicine) have been reviewed and analysed. Hope's attributes, antecedents, consequences, social-cultural variations, temporal variations, surrogate terms, and related concepts have been considered. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness. Ten essential attributes of the concept were identified in this research: positive expectation, personal qualities, spirituality, goals, comfort, help / caring, interpersonal relationships, control, legacy, and life review. The evolution of hope in terminal illness has evolved from patients hoping for a prosperous healthy future to an enrichment of being is more important than having or doing. Patients' hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones. Hope in the terminal phase of one's illness is orientated in the past and the present, hope in the here and hope in the now. The author concludes that by completing all the steps to Rodgers' (2000b) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved, providing a solid conceptual foundation for further study. Recommendations are made for hope-enhansing strategies, that may help to maximise the quality of life of terminally ill patients in the future.
Call Number NRSNZNO @ research @ Serial 922
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Author Payne, D.; Goedeke, S.
Title (down) Holding together: Caring for clients undergoing assisted reproductive technologies Type Journal Article
Year 2007 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 60 Issue 6 Pages 645-653
Keywords Nursing specialties; Sexual and reproductive health; Communication; Multidisciplinary care teams
Abstract This paper reports a study to investigate the roles and experiences of nurses caring for clients undergoing assisted reproductive technologies (ART). Nurses are in a potentially unique position in the assisted reproductive technology environment as they maintain a more constant contact with the client. A qualitative approach was taken and a convenience sample of 15 nurses from New Zealand was interviewed in 2005. Data were analysed using interpretive description. The overarching theme identified was that of the potential role of the nurse to 'hold together' multiple components of the assisted reproductive technology process: holding together clients' emotional and physical experiences of assisted reproductive technologies; holding together the roles of different specialist team members; and holding together personal own emotions. It encompasses practices such as information-giving, interpreting, supporting and advocating. The researchers note that recognition of and support for the complexity of the role of ART nurses may positively contribute to clients' experiences.
Call Number NRSNZNO @ research @ 985 Serial 969
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Author Bradshaw, W.
Title (down) Helping clients move towards health change Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 7 Pages 16-18
Keywords Health promotion; Psychology; Nursing; Case studies; Smoking
Abstract The author reflects on his use of the American psychotherapist James Prochaska's stages of change theory. This model deals with individuals and how they move towards change, through stages of pre-contemplation to maintenance of changed behaviours. He presents examples of his use of the model with clients, when dealing with issues of smoking cessation and weight loss. He analyses his practice and interactions with clients, and affirms that stages of change model can be a useful tool to bring about change within clients. He suggests it gives clients the opportunity to contemplate change and gives nurses working in health promotion the opportunity to be part of the change process.
Call Number NRSNZNO @ research @ Serial 985
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Author McDonald, S.; Willis, G.; Fourie, W.; Hedgecock, B.
Title (down) Graduate nurses and their experience of postgraduate education within a Graduate Nurse programme Type Report
Year 2007 Publication Abbreviated Journal Copies can be obtained from The Department of Nursing and Health Studies, Manukau Institute of Techn
Volume (Monograph Series 2/2007) Issue Pages
Keywords Nursing; Education; New graduate nurses; Teaching methods; Students
Abstract The authors note that the literature identifies that the transition from tertiary based training to the realities of industry expectations can be a stressful period for graduates. Various District Health Boards offer postgraduate papers within their graduate nursing programmes, resulting in graduates being expected to perform the role of a beginning practitioner as well as embark on postgraduate education during this first year. As yet, the authors note, there is little evidence available to substantiate the efficacy and impact of such papers. The purpose of this study was to explore graduate nurse's experience of postgraduate education within the Graduate Nurse Programme. The report contains the results of a survey of nurses within the Programme. This report details the results of that survey and make recommendations for consideration.
Call Number NRSNZNO @ research @ Serial 911
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Author Mitchell, P.
Title (down) Grade-1 pressure ulcer: Review of prevention evidence for “at risk” patients in an acute environment Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Nursing
Abstract This dissertation is a review of evidence underpinning the recommendations for pressure ulcer prevention from four national guidelines frequently used as a foundation for best practice. The focus is on grade-1 pressure ulcer prevention for “at risk” patients, in the acute environment. Rationale: Prevention is better than cure. While preventive strategies maybe effective are they supported by evidence? Results: The strongest evidence for best practice appears to be limited to an established fact that standard hospital mattresses should at least be replaced by high specification foam, pressure reducing mattresses for patients “at risk” or vulnerable to pressure ulcer development. Repositioning, skin assessment, skin protection and maintenance, traditionally the basis of pressure ulcer prevention, appear to have a paucity of strong supportive evidence. Further evidence is emerging on clinically important areas such as erythema and mattresses. Implications for Nursing: The organisational or ministerial support for education of the multidisciplinary team, especially nurses in risk assessment and prevention strategies. This support is required both in release time and finances for education and in adequate funding for preventive strategies. The author concludes that strong evidence to support the recommendations of the guidelines appears to remain limited, particularly in the acute environment. Expert opinion would appear to remain the basis for current best practice for pressure ulcer prevention. The volume and consistency of this evidence worldwide is substantial and adds validity to the recommendations. Best practice includes firstly risk assessment, skin assessment, maintenance of skin temperature, moisture, and condition, and the importance of repositioning, in conjunction with an appropriate support surface. However gaps remain in the supportive evidence in many of these fields. Advances in practice include pressure relief or reduction considerations for all surfaces the patients encounter. There appears to be no gold standard for prevention of pressure ulcer development.
Call Number NRSNZNO @ research @ Serial 814
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