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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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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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Winters, R., & Neville, S. (2012). Registered nurse perspectives on delayed or missed nursing cares in a New Zealand hospital. Nursing Praxis in New Zealand, 28(1), 19–28.
Abstract: Explores the concept of 'missed care' using a qualitative descriptive approach. Interviews 5 registered nurses within a NZ hospital about fluctuations in nursing-skill mix and staffing levels, inconsistent availability of equipment and supplies, and higher patient acuity. Identifies two main categories of missed care and nurses' resulting moral distress
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Lim, A. G., North, N., & Shaw, J. (2014). Nurse prescribing : the New Zealand context. Nursing Praxis in New Zealand, 30(2), 18–27.
Abstract: Examines the introduction of nurse prescribing in NZ with respect to the level of knowledge and skills required of practitioners for safe prescribing. Compares experiences in NZ with those in the US, UK, and Canada. Critiques the higher educational model as the standard for preparation to prescribe, while supporting alternative models for extending prescribing rights.
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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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Wynne-Jones, J., Martin-Babin, M., Hayward, B., & Villa, L. (2020). Patient safety leadership walk-rounds: lessons learrned from a mixed-methods evaluaion. Kai Tiaki Nursing Research, 11(1), 24–33.
Abstract: Assesses the impact of a patient safety leadership walk-rounds (PSLWR) programme in an Auckland hospital to provide recommendations for programme improvement. Involves senior leaders and other departmental representatives visiting wards to conduct staff and patient interviews to capture their experiences, and to assess the environment. Proposes recommendations for organisations intending to or currently implementing a PSLWR programme.
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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 3, 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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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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Beaver, P. J. (2015). Contemporary patient safety and the challenges for New Zealand. Ph.D. thesis, University of Auckland, . Retrieved June 3, 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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Zambas, S. I. (2013). The consequences of using advanced assessment skills in medical and surgical nursing: keeping patients safe. Doctoral thesis, Auckland University of Technology, . Retrieved June 3, 2024, from http://hdl.handle.net/10292/6960
Abstract: Examines the impact of advanced assessment skills on patients in medical and surgical wards through nurses' stories of using these skills. Highlights the use of auscultation, palpation and percussion by nurses for complex patient presentations within a wide range of clinical situations. Conducts 12 interviews with five nurses from paediatric and adult medical and surgical wards in a large urban hospital in NZ.
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McKelvie, R. (2019). Where we are and how we got here: an institutional ethnography of the Nurse Safe Staffing Project in New Zealand. Doctoral thesis, Massey University, Palmerston North.
Abstract: Charts a detailed description and analysis of how aspects of the strategies of the Nurse Safe Staffing Project work in everyday hospital settings. Argues that nurses' situated knowledge and work are being organised and overridden by competing institutional knowledge and priorities in a competitive institutional environment. Demonstrates the consequences for nurses, patients and staffing strategies. Conducts 30 interviews with 26 participants, including frontline nurses and participants in safe staffing projects.
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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 3, 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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Hawes, P. C. (2016). What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety? Master's thesis, Victoria University of Wellington, Wellington. Retrieved June 3, 2024, from http://hdl.handle.net/10063/6197
Abstract: Interviews 9 nurses in their first year of clinical practice to investigate how newly-qualified nurses recognise and develop those skills relating to clinical risk and patient safety. Identifies workplace culture, clinical role models, exposure to the clinical environment, experiential learning, narrative sharing, debriefing and simulation as contributing to learning and understanding clinical risk and safe patient care. Considers strategies to facilitate professional development.
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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 3, 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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Patel, R. (2021). Patient safety of older adults with cognitive impairment: Evaluation of a service improvement initiative. Master's thesis, Victoria University, Wellington. Retrieved June 3, 2024, from https://figshare.com/articles/thesis/Patient_Safety_of_Older_Adults_with_Cognitive_Impairment_Evaluation_of_a_Service_Improvement_Initiative/14214473 Victoria University of Wellington
Abstract: Assesses the impact of environmental changes on patient reportable events (falls and aggression) in older persons' wards, using the Kings Fund Healing the Healthy Environment tool to make small changes to a ward environment in order to create a more 'dementia-friendly' setting. Conducts a comparative analysis of incidents in the wards. Obtains staff perspectives on the changes, which included large-face clocks, identifiction of bed spaces, lavender oil diffusion, and viewing gardens.
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