Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Spence, D., & Anderson, M. (2007). Implementing a prescribing practicum within a Master's degree in advanced nursing practice. Nursing Praxis in New Zealand, 23(2), 27–42.
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.
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Finlayson, M., & Aitken, L. H. (2007). New Zealand nurses' reports on hospital care: An international comparison. Nursing Praxis in New Zealand, 23(1), 17–28.
Abstract: The authors present the results of a 2001 New Zealand survey on nurses' perception of staffing, work organisation and outcomes, comparing this with the 2001 International Hospital Outcomes Study (US, Canada, England, Scotland and Germany). The report describes the findings for job dissatisfaction, burnout and the intent to leave, the work climate in hospitals, workforce management, the structure of nurses' work, and quality of care. The authors discuss these findings and their implications for nursing in New Zealand.
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Carryer, J. B., & Russell, L. (2007). Nurses' understandings of the Professional Development Recognition Programme. Nursing Praxis in New Zealand, 23(2), 5–13.
Abstract: Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursing, is the Nursing Council of New Zealand. In 2002 a tool was developed to measure knowledge and attitudes of the then CCP which was tested with 239 nurses. This paper is a report on the second application of the tool in the same hospital in New Zealand. Results show that knowledge and attitudes of the PDRP are similar to those found in the previous study. It also suggests that greater understanding of the PDRP and the implementation process increases the likelihood of a positive response to the programme.
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Rodgers, V., & Neville, S. J. (2007). Personal autonomy for older people living in residential care: An overview. Nursing Praxis in New Zealand, 23(1), 29–36.
Abstract: This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.
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Marcinkowski, K., & McDonald, B. (2006). Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative. Nursing Praxis in New Zealand, 22(3), 15–21.
Abstract: This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
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Bolitho, S., & Huntington, A. D. (2006). Experiences of Maori families accessing health care for their unwell children: A pilot study. Nursing Praxis in New Zealand, 22(1), 23–32.
Abstract: The aim of this study was to explore with a small number of Maori families their experiences of accessing health care when their children were unwell with a respiratory condition. A qualitative research methodology was used in the study. Participating families were among those experiencing an admission to a children's ward between July and December 2003. Four families were interviewed. They discussed in depth their experience of accessing health care for their unwell children. Data were analysed using thematic analysis, and three common themes were evident: family resources, choice of health service provider and parents' feelings of vulnerability. The findings highlight that while socio-economic status plays a large part in determining the ease with which families can access the needed health care, there are other barriers within the health system which also pose difficulties for Maori.
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Janssen, J. (2006). Fat simple: A nursing tool for client education. Nursing Praxis in New Zealand, 22(2), 21–32.
Abstract: This article summarises the current level of knowledge regarding dietary effects on serum cholesterol. Information from a literature review was used to design a table that identifies how changes in diet and activity can alter components of a person's lipid profile. Nurses can use the resulting table as a simple tool to give clients targeted education based on their individual cholesterol results. This tool illustrates that not all dietary recommendations to the public are beneficial to serum cholesterol levels and it also explains why popular diets such as the Atkins, Mediterranean, and glycaemic index / load can produce more cardio-protective profiles than the traditional low fat diet.
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Phibbs, S., & Curtis, B. (2006). Gender, nursing and the PBRF. Nursing Praxis in New Zealand, 22(2), 4–11.
Abstract: The authors examine gender based disparities for academics with respect to remuneration, academic grading and Perfomance Based Research Fund (PBRF) scores, whereby women do less well than men in each of these areas. In this article individualised explanations for the failure of women to progress are set in the context of a critical exploration of the PBRF evaluation methodology. It is argued that both academia and the PBRF research assessment exercise embody a form of academic masculinity that systematically disadvantages women in general and nursing in particular.
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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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Vallant, S. R., & Neville, S. J. (2006). The relationship between student nurse and nurse clinician: Impact on student learning. Nursing Praxis in New Zealand, 22(3), 23–33.
Abstract: The purpose of this descriptive interpretive study was to explore relationships between student nurses and nurse clinicians. Eleven student nurses at the end of a three year Bachelor of Nursing programme in one institution participated in focus group interviews. Data gathered from the three focus groups were analysed using an inductive approach. Five categories, namely 'being invisible in the relationship', 'not stepping on toes', 'lost opportunities for learning', 'nurturance' and 'reciprocity' emerged from data analysis. These are presented with appropriate quotes to demonstrate the essence of participant experiences. Findings indicated that when students experienced relationships with clinicians as not being positive, this inhibited learning. Conversely, when students saw the clinician as participating actively and positively in the student/clinician relationship then student learning was enhanced. This evidence forms the basis for recommending further complementary research into the clinician's attitudes and perceptions related to their teaching role.
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Phillips, B. N. (2005). A survey of mental health nurses' opinion of barriers and supports for research. Nursing Praxis in New Zealand, 21(1), 24–32.
Abstract: This paper reports the findings of a preliminary survey of two district health boards, which shows that high workloads and lack of relief staffing appear as the greatest hurdles to mental health nurses participating in practice-based nursing research. A further constraint on their participation is lack of research expertise and experience. Consultative discussions with senior mental health nurses support these conclusions. In this paper, mentoring and flexible research designs are promoted as possible ways of overcoming these barriers.
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McPherson, G., Horsburgh, M., & Tracy, C. (2005). A clinical audit of a nurse colposcopist: Colposcopy, cytology, histology correlation. Nursing Praxis in New Zealand, 21(3), 13–23.
Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.
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Richardson, S. (2005). Incorporation of research into clinical practice: The development of a clinical nurse researcher position. Nursing Praxis in New Zealand, 21(1), 33–42.
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.
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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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