| Records |
| Author |
Strochnetter, K.T. |
| Title |
Influences on nurses' pain management practices within institutions: A constructivist approach |
Type |
|
Year  |
2000 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Interprofessional relations; Pain management; Nursing |
| Abstract |
Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient. |
| Call Number |
NRSNZNO @ research @ |
Serial |
909 |
| Permanent link to this record |
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| Author |
Grayson, S. |
| Title |
Nursing management of the rheumatic fever secondary prophylaxis programme |
Type |
|
| Year |
2001 |
Publication |
|
Abbreviated Journal |
University of Auckland Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Community health nursing; Management; Nursing specialties |
| Abstract |
|
| Call Number |
NRSNZNO @ research @ 576 |
Serial |
562 |
| Permanent link to this record |
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| |
| Author |
Barton, J. |
| Title |
Pain knowledge and attitudes of nurses and midwives in a New Zealand context |
Type |
|
| Year |
2001 |
Publication |
|
Abbreviated Journal |
NZNO Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Nursing; Pain management; Attitude of health personnel |
| Abstract |
|
| Call Number |
NRSNZNO @ research @ 1140 |
Serial |
1125 |
| Permanent link to this record |
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| Author |
McKenna, B. |
| Title |
Risk assessment of violence to others: Time for action |
Type |
Journal Article |
| Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
18 |
Issue |
1 |
Pages |
36-43 |
| Keywords |
Mental health; Workplace violence; Risk management; Nursing; Nurse-patient relations; Psychiatric nursing |
| Abstract |
The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings. |
| Call Number |
NRSNZNO @ research @ |
Serial |
621 |
| Permanent link to this record |
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| |
| Author |
Elbe, E. |
| Title |
The private world of nursing related to incident reporting |
Type |
|
| Year |
2002 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Medical errors; Organisational culture; Risk management; Nursing |
| Abstract |
The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as thay can have stressful consequences for the nurses involved. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1147 |
| Permanent link to this record |
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| Author |
Litchfield, M. |
| Title |
The successful design and delivery of rural health services: The meaning of success |
Type |
Report |
| Year |
2002 |
Publication |
|
Abbreviated Journal |
Accessible from www.moh.govt.nz |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Rural health services; Management; Primary health care |
| Abstract |
A report on the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of ?successful design and delivery of rural health services? as a step towards a measurement tool. Participants were grouped as general practitioners (GPs), nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health. |
| Call Number |
NZNO @ research @ |
Serial |
1328 |
| Permanent link to this record |
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| |
| Author |
Crowe, M.; Carlyle, D. |
| Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
| Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
|
| Volume |
43 |
Issue |
1 |
Pages |
19-27 |
| Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
| Abstract |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
| Permanent link to this record |
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| Author |
Drake, M.; Stokes, G. |
| Title |
Managing pre-registration student risk: A professional and legislative minefield |
Type |
Journal Article |
| Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
20 |
Issue |
1 |
Pages |
15-27 |
| Keywords |
Risk management; Education; Law and legislation; Nursing |
| Abstract |
This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues. |
| Call Number |
NRSNZNO @ research @ |
Serial |
546 |
| Permanent link to this record |
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| |
| Author |
Holbrook, P. |
| Title |
Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Drug administration; Nursing; Pain management |
| Abstract |
Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles. |
| Call Number |
NRSNZNO @ research @ |
Serial |
664 |
| Permanent link to this record |
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| Author |
Huntington, A.D.; Gilmour, J.A. |
| Title |
A life shaped by pain: Women and endometriosis |
Type |
Journal Article |
| Year |
2005 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
|
| Volume |
14 |
Issue |
9 |
Pages |
1124-1132 |
| Keywords |
Female; Diseases; Nurse practitioners; Pain management; Endometriosis; Feminist critique |
| Abstract |
The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition. |
| Call Number |
NRSNZNO @ research @ |
Serial |
940 |
| Permanent link to this record |
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| Author |
Richardson, S. |
| Title |
Coping with outbreaks of the norovirus |
Type |
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 |
| Permanent link to this record |
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| Author |
Smart, S. |
| Title |
Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Pain management; Paediatric nursing; Hospitals; Pharmacology |
| Abstract |
This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses. |
| Call Number |
NRSNZNO @ research @ 1194 |
Serial |
1179 |
| Permanent link to this record |
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| Author |
Rudd, J. |
| Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
| Permanent link to this record |
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| Author |
Lewis, T. |
| Title |
Euthanasia: A Foucauldian analysis |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
ScholarlyCommons@AUT |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Law and legislation; Euthanasia; Ethics; Pain management; Terminal care; Nursing; Palliative care |
| Abstract |
This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the “right-to-die”. It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what the author termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of “truth” regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. These findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing profession's lack of preparation to deal with euthanasia if it becomes a legal option in end of life care. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1226 |
| Permanent link to this record |
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| Author |
MacDonald, R. |
| Title |
Mammography screening for breast cancer: Does it reduce the mortality rate? |
Type |
Journal Article |
| Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
| Volume |
|
Issue |
|
Pages |
8-12 |
| Keywords |
Breast cancer; Screening; Risk management; Health education; Cancer |
| Abstract |
This paper critically examines the literature on mammography as a breast cancer screening modality. It looks at what the New Zealand consumer is being told about the scientific uncertainties about the effectiveness of mammography and the substantial risks involved with it. This literature review raises concerns about the lack of information available for healthy women to make a fully informed decision about mammography screening. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1304 |
| Permanent link to this record |
