| Records |
| Author |
Richardson, S.; Ardagh, M.; Hider, P. |
| Title |
New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department |
Type |
Journal Article |
Year  |
2006 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
| Volume |
119 |
Issue |
1232 |
Pages |
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| Keywords |
Hospitals; Clinical assessment; Interprofessional relations |
| Abstract |
This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept. |
| Call Number |
NRSNZNO @ research @ |
Serial |
526 |
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| Author |
Morton, J.; Williams, Y.; Philpott, M. |
| Title |
New Zealand's Christchurch Hospital at night: An audit of medical activity from 2230 to 0800 hours |
Type |
Journal Article |
| Year |
2006 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
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| Volume |
119 |
Issue |
1231 |
Pages |
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| Keywords |
Hospitals; Teamwork; Administration; Shiftwork; Organisational culture |
| Abstract |
The authors conduct an audit of medical activity at Christchurch Hospital, a 650 bed tertiary centre, between 2230 and 0800 hours. They measured the volumes of tasks requiring completion overnight and identified the competencies required for this as well as the level of teamwork that existed. They found several organisational areas of concern, that indicate new approaches are required to staff the “hospital at night,” and an Out of Hours Multidisciplinary Team is recommended. Specific issues included the lack of teamwork from the Resident Medical Officers (RMOs), with some overextended while others were inactive. House officer tasks were largely generic rather than specialty specific; there was no formal handover from the afternoon or day shifts and the level of hospital medical staffing did not reflect the activity levels over the time period studied. The researchers also recommend an urgent review of the beep policy. A third of the admissions were to General Medicine, and basic medical activities (including admitting, reviewing, and prescribing drugs and fluids) for patients admitted under all specialties represented the majority of the night workload. Medical registrars had reduced some of the traditional multiple clerking by admitting patients themselves. |
| Call Number |
NRSNZNO @ research @ |
Serial |
528 |
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| Author |
Cook, D. |
| Title |
Open visiting: Does this benefit adult patients in intensive care units? |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Hospitals; Intensive care nursing |
| Abstract |
As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. The aim of this dissertation was to examine the benefits for the patient, family members and nurses of appropriate visiting practices within intensive care areas in order to establish if open visiting is the best regime for patients in the adult intensive care unit (ICU). This dissertation explores visiting practices in adult critical care unit settings. Specifically, the benefits of visiting for patients, and the factors that may impede or facilitate visiting practices within the ICU were critically discussed. These factors included the benefits and disadvantages of open visiting, and the nurse as an influential factor in visiting. These areas linked together to form the basis for consideration of visiting in the ICU. Review of existing literature pertaining to visiting in the ICU indicated that patients wanted open visiting hours yet also indicated that they would like some visiting restrictions. Nurses appeared to value family input into care and were aware of patient and family needs, even though they may restrict visiting to suit their own work practices. Family members can provide the patient with psychological support, provide important historical data, assist the nurse with selected aspects of physical care, and actively encourage the patient's efforts to recover. The outcome of this exploration is the recommendation of an open visiting policy tailored to individual patients, as, the author suggests, this would foster nursing practice and ultimately benefit patients and their families. |
| Call Number |
NRSNZNO @ research @ |
Serial |
680 |
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| Author |
Gray, H.J. |
| Title |
Clinician or manager: An exploration of duty management in New Zealand hospitals |
Type |
|
| Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Nurse managers; Administration; Scope of practice; Hospitals |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 741 |
Serial |
727 |
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| Author |
Farr, A.M. |
| Title |
Satisfaction in nursing: Reality in a secondary hospital in New Zealand |
Type |
|
| Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Job satisfaction; Nursing; Hospitals |
| Abstract |
The focus for this research was nursing culture satisfaction and intent to remain working within a secondary hospital in the New Zealand public healthcare system. A specific group of 117 registered and enrolled nurses were surveyed to identify what issues would encourage them to remain working within the organisation. Descriptive data derived from the Nursing Culture Satisfaction Questionnaire found higher levels of job satisfaction and intention to stay from the staff in operating theatre, compared to other surveyed areas. Factors reported as contributing to job satisfaction included supportive, friendly staff, teamwork, and organisation size. Important issues regarding recruitment and retention include pay parity, personal satisfaction, conditions of employment, the valuing of staff and poor nurse patient ratios. Findings suggest that hospital management should foster positive work environments and respect, to promote job satisfaction and discourage nurses leaving the organisation. While pay parity was a large issue at the time of the questionnaire, the inclusion of the district health board in the nurse Multi Employer Collective Agreement may have reduced this as a contributing factor. |
| Call Number |
NRSNZNO @ research @ |
Serial |
743 |
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| Author |
Hunt, M. |
| Title |
Nurses can enhance the pre-operative assessment process |
Type |
Journal Article |
| Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| 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 |
Buisman, B. |
| Title |
Nursing 2020: How will 'Magnet' hospitals fit in? |
Type |
Journal Article |
| Year |
2006 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
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| Volume |
10 |
Issue |
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Pages |
33-41 |
| Keywords |
Nursing; Leadership; Hospitals |
| Abstract |
Nursing shortages, technology, advances in genetics and the knowledge explosion are trends that have an influence on the nursing profession in the future. This article will examine these trends and give an overview of what it may be like to nurse in an acute-care hospital in the year 2020. The impact of leadership, management and political influences will also be discussed. The American concept of 'Magnet' hospitals will be described as one possible solution to the issues that affect the nursing profession in New Zealand. |
| Call Number |
NRSNZNO @ research @ 1209 |
Serial |
1194 |
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| Author |
Richardson, S. |
| Title |
Incorporation of research into clinical practice: The development of a clinical nurse researcher position |
Type |
Journal Article |
| Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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| Volume |
21 |
Issue |
1 |
Pages |
33-42 |
| Keywords |
Emergency nursing; Nursing research; Hospitals |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
536 |
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| Author |
Lyford, S.; Cook, P. |
| Title |
The Whanaungatanga model of care |
Type |
Journal Article |
| Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
21 |
Issue |
2 |
Pages |
26-36 |
| Keywords |
Maori; Hospitals; Nursing models |
| Abstract |
The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme. |
| Call Number |
NRSNZNO @ research @ |
Serial |
538 |
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| Author |
Becker, F. |
| Title |
Recruitment & retention: Magnet hospitals |
Type |
|
| Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Personnel; Hospitals; Recruitment and retention; Nursing |
| Abstract |
International nursing literature indicates nursing shortages are widely recognised; however efforts to remedy poor recruitment and retention of nurses have been largely unsuccessful. This paper presents the predominant factors influencing poor recruitment and retention of nurses, such as: the image of nursing as a career, pay and conditions of employment, educational opportunities, management and decision making, and low morale and then explores how Magnet hospitals address these factors. During the 1980s, several hospitals in the United States were identified as being able to attract nursing staff when others could not, they became known as 'Magnet' hospitals. The American Nurse Credentialing Centre developed the Magnet Recognition programme to accredit hospitals that meet comprehensive criteria to support and develop excellence in nursing services. Magnet hospitals not only attract and retain satisfied nursing staff, but also have improved patient outcomes compared to non-Magnet hospitals, such as decreased patient morbidity and mortality and increased patient satisfaction. The successes of the Magnet Recognition programme in recruitment and retention of nurses is discussed in relation to its transferability outside of the United States, particularly to New Zealand as a way of improving recruitment and retention of nurses here. |
| Call Number |
NRSNZNO @ research @ |
Serial |
567 |
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| Author |
Sheward, K.A. |
| Title |
Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying |
Type |
|
| Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Palliative care; Hospitals; Communication; Nurse-patient relations |
| Abstract |
The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting. |
| Call Number |
NRSNZNO @ research @ |
Serial |
772 |
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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 |
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| Volume |
11 |
Issue |
7 |
Pages |
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| 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 |
McCloskey, B.A.; Diers, D. |
| Title |
Effects of New Zealand's health reengineering on nursing and patient outcomes |
Type |
Journal Article |
| Year |
2005 |
Publication |
Medical Care |
Abbreviated Journal |
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| 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 |
Smart, S. |
| Title |
Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view |
Type |
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| Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| 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 |
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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 |
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Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
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Issue |
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Pages |
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| 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 |
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