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Author |
Peri, K.; Kerse, N.; Kiata, L.; Wilkinson, T.; Robinson, E.; Parsons, J.; Willingale, J.; Parsons, M.; Brown, P.; Pearson, J.R.; von Randow, M.; Arroll, B. |
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Title |
Promoting independence in residential care: Successful recruitment for a randomized controlled trial |
Type |
Journal Article |
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Year  |
2008 |
Publication |
Journal of the American Medical Directors Association |
Abbreviated Journal |
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Volume |
9 |
Issue |
4 |
Pages |
251-256 |
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Keywords |
Research; Geriatric nursing; Rest homes; Evaluation; Attitude of health personnel |
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Abstract |
The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success. |
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Call Number |
NRSNZNO @ research @ 803 |
Serial |
787 |
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Author |
Walsh, K.; Moss, C.; Lawless, J.; McKelvie, R.; Duncan, L. |
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Title |
Puzzling practice: A strategy for working with clinical practice issues |
Type |
Journal Article |
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Year |
2008 |
Publication |
International Journal of Law and Psychiatry |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
94-100 |
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Keywords |
Nursing philosophy; Clinical decision making; Problem solving |
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Abstract |
The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored. |
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Call Number |
NRSNZNO @ research @ |
Serial |
838 |
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Author |
Honeyfield, Margy |
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Title |
The necessity of effective nursing leadership for the retention of professional hospital nurses |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
64 |
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Keywords |
Recruitment and retention; Leadership; Nursing; Policy |
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Abstract |
The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise. |
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Call Number |
NRSNZNO @ research @ |
Serial |
868 |
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Author |
Sye, J. |
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Title |
A fine balance |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights |
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Abstract |
The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates. |
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Call Number |
NRSNZNO @ research @ 911 |
Serial |
895 |
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Author |
Farmer, D. |
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Title |
Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Nursing |
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Abstract |
The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community. |
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Call Number |
NRSNZNO @ research @ |
Serial |
913 |
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Author |
Harry, J. |
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Title |
Professional development in nursing through the pages of Kai Tiaki: A comparative analysis – 1920 to 1930 and 2000 to 2006 |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional development; Nursing |
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Abstract |
Kai Tiaki, first published in New Zealand in 1908, provides a means of communication among New Zealand nurses. It is currently the journal of the New Zealand Nurses Organisation members and previously was aligned to the New Zealand Trained Nurses' Association in the 1920s. This dissertation examines what nurses write about professional development through the pages of Kai Tiaki. Two time periods are examined, 1920 to 1930 and 2000 to 2006.
Central to the discussion on professional development is post-registration education. Post-registration education in nursing commenced in New Zealand in 1928, and has progressed to the current day where nurses can engage in post-graduate nursing to master and doctoral level. Kai Tiaki provides a channel for nurses to discuss and debate their thoughts on post-registration and post-graduate education. Two key themes emerge from analysis. Firstly, the survival mode of nurses highlights oppression as a contributing factor to professional development. Secondly, examining the role of the New Zealand Trained Nurses Association (1920s) and the New Zealand Nurses Organisation (2000s) presents an understanding of the political nature of the journal itself and how this influences professional development. This dissertation provides critical reflection on professional development for nurses through the pages of Kai Tiaki and provides suggestions for future research. |
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Call Number |
NRSNZNO @ research @ |
Serial |
916 |
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Author |
Johnson, H. |
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Title |
Clinical trials in the intensive care setting: A nursing perspective |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Evaluation; Intensive care nursing |
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Abstract |
As carers of patients who are clinical research participants, nurses' contribution to the success of clinical trials is acknowledged in the literature. Ethical dilemmas and challenges that clinical trials may present for nurses are also recognised. Although there is some discussion regarding these issues, few studies explore and identify the perceptions of intensive care nurses regarding clinical trials and how they may impact on nursing practice. This thesis explores and describes the viewpoints and experiences of sixty intensive care nurses from a tertiary level referral centre in New Zealand engaged in clinical research activities. The descriptive study utilised a self-administered questionnaire to gather information regarding nurses' roles in clinical trials, associated issues encountered and contributory factors, and the impact of issues on nursing practice, stress and satisfaction levels. Suggestions for potential strategies to minimise the impact of issues on nurses' practice were also sought. Descriptive statistical and content data analyses identified three key areas in which nurses' encounter issues associated with clinical trials and their practice: nurses' workload; ethical concerns; educational preparation and support. The findings indicate that, when issues exist in these areas, routine patient care can be delayed, the enactment of nurses' patient advocacy role can be affected, and nurses' stress and satisfaction levels can be negatively impacted upon. The perceptions of a group of intensive care nurses who are enveloped in the daily balance of patient care, the need for clinical research, and their professional obligations are discussed in this thesis. While the study's findings are reflective of one group of nurses in a distinct practice setting, their experiences can prompt other nurses, research teams and clinical leaders to reflect upon their own clinical research environment. |
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Call Number |
NRSNZNO @ research @ |
Serial |
923 |
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Author |
DeSouza, R. |
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Title |
Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Research in Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
125-135 |
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Keywords |
Cultural safety; Nursing models; Cross-cultural comparison; Maori |
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Abstract |
The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process. |
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Call Number |
NRSNZNO @ research @ 943 |
Serial |
927 |
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Author |
Koorey, R. |
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Title |
Is there a place for clinical supervision in perioperative nursing? |
Type |
Journal Article |
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Year |
2008 |
Publication |
Dissector |
Abbreviated Journal |
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Volume |
35 |
Issue |
4 |
Pages |
15-17 |
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Keywords |
Nursing models; Clinical supervision; Nursing specialties |
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Abstract |
This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided. |
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Call Number |
NRSNZNO @ research @ |
Serial |
928 |
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Author |
Gardner, A.; Hase, S.; Gardner, G.; Dunn, S.; Carryer, J.B. |
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Title |
From competence to capability: A study of nurse practitioners in clinical practice |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
Author copy available 12 months after publication from QUT ePrints |
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Volume |
17 |
Issue |
2 |
Pages |
250-258 |
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Keywords |
Nurse practitioners; Professional competence; Advanced nursing practice; Evaluation |
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Abstract |
This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners. |
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Call Number |
NRSNZNO @ research @ 945 |
Serial |
929 |
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Author |
Tweed, C.; Tweed, M. |
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Title |
Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program |
Type |
Journal Article |
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Year |
2008 |
Publication |
American Journal of Critical Care |
Abbreviated Journal |
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Volume |
17 |
Issue |
4 |
Pages |
338-347 |
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Keywords |
Intensive care nursing; Training; Evaluation |
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Abstract |
The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline. |
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Call Number |
NRSNZNO @ research @ |
Serial |
958 |
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Author |
Major, G.; Holmes, J. |
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Title |
How do nurses describe health care procedures? Analysing nurse-patient interaction in a hospital ward |
Type |
Journal Article |
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Year |
2008 |
Publication |
Australian Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
25 |
Issue |
4 |
Pages |
58-70 |
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Keywords |
Communication; Nursing; Nurse-patient relations |
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Abstract |
This study examines the communication strategies used by nurses on the ward in one aspect of the job, namely the ways that they describe health procedures to patients. The data used in this project was collected by nurses on a busy hospital ward as part of Victoria University's Language in the Workplace Project. Three nurses carried minidisc recorders as they went about their normal working day, recording their conversations with patients, visitors, and other staff. The data was collected in a women's hospital ward. All patients, nurses, cleaners and ward clerks were female; two doctors were female and two were male. Twenty three instances where nurses described procedures to patients were identified in the data set. The analysis identified several typical components; indicated there was no fixed order of components; and demonstrated that all except the core component of describing the procedure were optional rather than obligatory elements. The researchers note this is qualitative and exploratory research. The findings demonstrate the benefit of discourse analysis within a sociolinguistic framework for the analysis of nurse-patient interaction. The results indicate that health discourse is not one-sided, nor is it as straightforward as many nursing textbooks suggest. |
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Call Number |
NRSNZNO @ research @ 975 |
Serial |
959 |
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Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
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Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
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Keywords |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
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Abstract |
The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU. |
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Call Number |
NRSNZNO @ research @ |
Serial |
962 |
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Author |
Kool, B.; Thomas, D.; Moore, D.; Anderson, A.; Bennetts, P.; Earp, K. |
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Title |
Innovation and effectiveness: Changing the scope of school nurses in New Zealand secondary schools |
Type |
Journal Article |
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Year |
2008 |
Publication |
Australian & New Zealand Journal of Public Health |
Abbreviated Journal |
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Volume |
32 |
Issue |
2 |
Pages |
177-180 |
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Keywords |
School nursing; Maori; Pacific peoples; Socioeconomic factors; Evaluation; Scope of practice |
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Abstract |
The aim of this research was to describe the changing role of school nurses in eight New Zealand secondary schools from low socio-economic areas with high Pacific Island and Maori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland(2002-05) was made. Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. The researchers conclude that school nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. The researchers go on to say that co-ordination of school nurses either at a regional or national level is required. |
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Call Number |
NRSNZNO @ research @ |
Serial |
963 |
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Author |
Curtis, K.; Donoghue, J. |
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Title |
The trauma nurse coordinator in Australia and New Zealand: A progress survey of demographics, role function, and resources |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Trauma Nursing |
Abbreviated Journal |
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Volume |
15 |
Issue |
2 |
Pages |
34-42 |
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Keywords |
Emergency nursing; Personnel; Nurse managers; Economics |
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Abstract |
An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective |
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Call Number |
NRSNZNO @ research @ |
Serial |
964 |
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