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Author Schroyen, B.; Finlayson, M.
Title Clinical teaching and learning: An action research study Type (up) Journal Article
Year 2004 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 20 Issue 2 Pages 36-45
Keywords Education; Nursing; Hospitals
Abstract Using an educational action research model, a nursing lecturer based in a polytechnic and ten students formed a research group to address one issue that was important to them. The research group chose to plan, implement and evaluate a practical change strategy aimed at improving the teaching and learning relationship between students and staff nurses in clinical settings. A sample of five staff nurses working closely with five students in the group was invited to join the study in order to gain their perspectives on the issues. The findings were that contract learning provides a strategy which, under certain conditions, offers both students and staff nurses an opportunity to improve the effectiveness of their interactions.
Call Number NRSNZNO @ research @ Serial 545
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Author Malcolm, H.
Title Patient privacy in a shared hospital room: Right or luxury? Type (up) Journal Article
Year 2004 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 20 Issue 1 Pages 28-35
Keywords Patient rights; Law and legislation; Nursing; Hospitals
Abstract In this article the author discusses the New Zealand legislation aimed at protecting the individual's right to privacy and concludes that practice may place healthcare consumers' rights at risk. While patient privacy should be of concern to all health professionals, the focus here is on the nurse's role in relation to recently formulated competencies published by the Nursing Council of New Zealand, which includes the recommendation that care be seen to exhibit an awareness of healthcare consumers' rights to privacy alongside the expectation that nurses question practices that compromise patient privacy.
Call Number NRSNZNO @ research @ 562 Serial 548
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Author Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B.
Title Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori Type (up) Journal Article
Year 2003 Publication New Zealand Medical Journal Abbreviated Journal Access is free to articles older than 6 months, and abstracts.
Volume 116 Issue 1176 Pages
Keywords Advanced nursing practice; Hospitals; Clinical assessment; Evaluation
Abstract Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive.
Call Number NRSNZNO @ research @ 625 Serial 611
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Author Finlayson, M.; Gower, S.E.
Title Hospital restructuring: Identifying the impact on patients and nurses Type (up) Journal Article
Year 2002 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 18 Issue 2 Pages 27-35
Keywords Quality of health care; Hospitals; Organisational change
Abstract The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.
Call Number NRSNZNO @ research @ Serial 615
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Author Carryer, J.B.; Budge, C.; Russell, A.
Title Measuring perceptions of the Clinical Career Pathway in a New Zealand hospital Type (up) Journal Article
Year 2002 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 18 Issue 3 Pages 18-29
Keywords Professional development; Careers in nursing; Nursing; Hospitals
Abstract The authors outline the Clinical Career Pathways (CCPs) for nurses, which were first established in New Zealand during the late 1980s. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire. The development of the CCPET is described and results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital are presented. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not.
Call Number NRSNZNO @ research @ 634 Serial 620
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Author Walsh, K.; McAllister, M.; Morgan, A.; Thornhill, J.
Title Motivating change: Using motivational interviewing in practice development Type (up) Journal Article
Year 2004 Publication Practice Development in Health Care Abbreviated Journal
Volume 3 Issue 2 Pages 92-100
Keywords Psychiatric Nursing; Hospitals; Motivation; Older people
Abstract The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change.
Call Number NRSNZNO @ research @ Serial 718
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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 (up) 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 Hardcastle, J.
Title The meaning of effective education for critical care nursing practice: A thematic analysis Type (up) Journal Article
Year 2004 Publication Australian Critical Care Abbreviated Journal
Volume 17 Issue 3 Pages 114, 116-2
Keywords Hospitals; Nursing; Education; Nursing specialties
Abstract Using thematic analysis, this study explored the phenomenon of effective education for critical care nursing practice by asking: What does effective education for critical care nursing practice mean to nurses currently practising in the specialty? Eighty eight critical care nurses from the South Island provided written descriptions of what effective education for critical care nursing practice meant to them. Descriptive statements were analysed to reveal constituents, themes and essences of meaning. Four core themes of personal quality, practice quality, the learning process and learning needs emerged. Appropriateness or relevance for individual learning needs is further identified as an essential theme within the meaning of effective education for critical care nursing practice. Shared experiences of the phenomenon are made explicit and discussed with reference to education and practice development in the specialty. The study results lend support to education that focuses on individual learning needs, and identifies work based learning as a potential strategy for learning and practice development in critical care nursing.
Call Number NRSNZNO @ research @ Serial 873
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Author Pirret, A.M.
Title A preoperative scoring system to identify patients requiring postoperative high dependency care Type (up) Journal Article
Year 2003 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 19 Issue 5 Pages 267-275
Keywords Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment
Abstract The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number NRSNZNO @ research @ 904 Serial 888
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Author Chadwick, A.; Hope, A.
Title In pursuit of the named nurse Type (up) 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 924
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Author Richardson, S.
Title Coping with outbreaks of the norovirus Type (up) Journal Article
Year 2005 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 11 Issue 7 Pages
Keywords Infection control; Risk management; Occupational health and safety; Hospitals
Abstract The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
Call Number NRSNZNO @ research @ Serial 981
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Author Hunt, M.
Title Nurses can enhance the pre-operative assessment process Type (up) Journal Article
Year 2006 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 12 Issue 10 Pages 20-22
Keywords Nursing specialties; Clinical assessment; Hospitals; Surgery
Abstract This reports on an initiative at Whakatane Hospital, where a Nurse-Led pre-assessment (NLPA) was delivered at an outpatients clinic. NLPA involves taking a comprehensive medical history, a nursing assessment, physical examination, airway assessment, ordering appropriate investigations and carefully documenting the process and results. More valuably, it provides an opportunity for the patient to participate in planning their care. The aim of this initative was to short circuit delays and congestion in existing pre-assessment clinics, streamline the pre-assessment process and reduce the number of patient visits to hospital. Reducing cancellations of surgery (often on the day of surgery) and “did not appear” (DNA) numbers were also objectives. After a small pilot, a six-month trial was funded by the Ministry of Health. Over the six-month trial, 373 patients attended NLPA; 178 patients required anaesthetist review before surgery, and 198 could proceed directly to surgery following NLPA. An anonymous postal survey was made of patients, who indicated satisfaction with the service. Other outcomes are discussed, and the trial was deemed successful. Follow up plans have been disrupted by restructuring at the hospital and the clinic has yet to be implemented.
Call Number NRSNZNO @ research @ 1005 Serial 989
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Author Burrell, B.
Title Mixed-sex rooms: Invading patients' privacy? Type (up) Journal Article
Year 2003 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 9 Issue 4 Pages 26-28
Keywords Cross-cultural comparison; Patient rights; Hospitals; Nursing; Gender
Abstract The author considers the issue of mixed-sex rooming (MSR) in New Zealand hospitals. A review of the literature is presented, with a focus on the attitudes and experiences of patients in the UK, where the issue has been most practised and studied. Findings of a survey of a group of New Zealand female patients are presented. The patients feelings of embarrassment and loss of dignity and privacy are discussed. The legal issues are explored, with the practice evaluated against the patient's rights detailed in the Code of Health and Disability Services and the Privacy Act 1993.
Call Number NRSNZNO @ research @ Serial 1000
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Author McCloskey, B.A.; Diers, D.
Title Effects of New Zealand's health reengineering on nursing and patient outcomes Type (up) Journal Article
Year 2005 Publication Medical Care Abbreviated Journal
Volume 43 Issue 11 Pages 1140-1146
Keywords Patient safety; Organisational change; Nursing; Hospitals
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.
Call Number NRSNZNO @ research @ Serial 1052
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Author Carter, H.; McKinlay, E.M.; Scott, I.; Wise, D.; MacLeod, R.
Title Impact of a hospital palliative care service: Perspective of the hospital staff Type (up) Journal Article
Year 2002 Publication JBI Reports Abbreviated Journal
Volume 18 Issue 3 Pages 160-167
Keywords Palliative care; Hospitals; Attitude of health personnel; Cancer
Abstract The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.
Call Number NRSNZNO @ research @ Serial 1075
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