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Author Neville, S.J.; Gillon, D.; Milligan, K.
Title New Zealand registered nurses' use of physical assessment skills: A pilot study Type Journal Article
Year 2006 Publication Vision: A Journal of Nursing Abbreviated Journal (up)
Volume Issue 14(1) Pages
Keywords Clinical assessment; Nursing; Evaluation
Abstract The objective of this project was to ascertain registered nurses' use of selected physical assessment skills before and after participation in a health assessment course. A pre- (also referred to as part I) and post- (part II) test design was used to investigate the research aim. Participants were obtained via a convenience sample. A questionnaire was completed at the beginning of the educational programme and then four to six weeks after completion of the assessment course. A two tailed t-test was used to identify any significant differences in the characteristics of participants from part I (N = 206) to part II (N = 145), with no differences identified. However, there was an overall mean percentage difference of 17.1% in the use of physical assessment skills after having completed the educational programme. In conclusion, the researchers found that four to six weeks after completion of a health assessment course, nurses were using the skills learned to improve their nursing practice more frequently than before the programme.
Call Number NRSNZNO @ research @ 879 Serial 863
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Author Pirret, A.M.
Title A preoperative scoring system to identify patients requiring postoperative high dependency care Type Journal Article
Year 2003 Publication Intensive & Critical Care Nursing Abbreviated Journal (up)
Volume 19 Issue 5 Pages 267-275
Keywords Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment
Abstract The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number NRSNZNO @ research @ 904 Serial 888
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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 (up)
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 Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal (up)
Volume 12 Issue 3 Pages 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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Author Palmer, S.G.
Title Application of the cognitive therapy model to initial crisis assessment Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal (up)
Volume 12 Issue 1 Pages 30-38
Keywords Mental health; Clinical assessment; Psychiatric Nursing
Abstract This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
Call Number NRSNZNO @ research @ 1085 Serial 1070
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Author Pitama, S.; Robertson, P.; Cram, F.; Gillies, M.; Huria, T.; Dalla-Katoa, W.
Title Meihana model: A clinical assessment framework Type Journal Article
Year 2007 Publication New Zealand Journal of Psychology Abbreviated Journal (up)
Volume 36 Issue 3 Pages 118-125
Keywords Nursing models; Clinical assessment; Maori; Mental health
Abstract In 1984 Mason Durie documented a framework for understanding Maori health, Te Whare Tapa Wha, which has subsequently become embedded in Maori health policy. This article presents a specific assessment framework, the Meihana Model, which encompasses the four original cornerstones of Te Whare Tapa Wha, and inserts two additional elements. These form a practice model (alongside Maori beliefs, values and experiences) to guide clinical assessment and intervention with Maori clients and whanau accessing mental health services. This paper outlines the rationale for and background of the Meihana Model and then describes each dimension: whanau, wairua, tinana, hinengaro, taiao and iwi katoa. The model provides a basis for a more comprehensive assessment of clients/whanau to underpin appropriate treatment decisions.
Call Number NRSNZNO @ research @ Serial 459
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Author Hamer, H.P.; McCallin, A.
Title Cardiac pain or panic disorder? Managing uncertainty in the emergency department Type Journal Article
Year 2006 Publication Nursing & Health Sciences Abbreviated Journal (up)
Volume 8 Issue 4 Pages 224-230
Keywords Emergency nursing; Clinical assessment; Diagnosis
Abstract This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented.
Call Number NRSNZNO @ research @ Serial 689
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Author Lesa, R.; Dixon, D.A.
Title Physical assessment: Implications for nurse educators and nursing practice Type Journal Article
Year 2007 Publication International Nursing Review Abbreviated Journal (up)
Volume 54 Issue 2 Pages 166-172
Keywords Advanced nursing practice; Clinical assessment; Cardiovascular diseases; Nursing; Education
Abstract In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.
Call Number NRSNZNO @ research @ Serial 786
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Author Holloway, K. T.
Title The future for nursing education: UKCC review has relevance for New Zealand Type Journal Article
Year 2000 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 16 Issue 2 Pages 17-24
Keywords Nursing; Education; Recruitment and retention; Clinical assessment; Policy
Abstract The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation.
Call Number NRSNZNO @ research @ Serial 848
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Author Macfie, B.
Title Assessing health needs and identifying risk factors Type Journal Article
Year 2006 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal (up)
Volume 12 Issue 6 Pages 16-18
Keywords Infants; Parents and caregivers; Clinical assessment; Risk factors; Plunket
Abstract In 2004, Plunket nurses from eight areas around New Zealand participated in collecting data for a research project on health needs assessment practices. This project aimed to examine risk factors identified by Plunket nurses, what areas of health need considered to be priorities; grading of health needs; and how closely the results of health need assessment aligned with the individual clients' deprivation score. The researchers examine the assessment of health needs against the use of the Deprivation Index, which indicates a specific population in a specific area, as a funding model. This study appeared to show there are two distinct groups of clients assessed as high needs: those with risk factors such as family violence and severe parental mental illness, and who may live in an area of 1-7 deprivation; and those with multiple risk factors which include poverty, low education, and/or reluctance to access services and support, and who usually live in dep 8-10 areas. This research supports the anecdotal evidence that significant health needs exist outside the lower deprivation areas.
Call Number NRSNZNO @ research @ Serial 974
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Author Neville, S.J.; Gilmour, J.A.
Title Differentiating between delirium and dementia Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal (up)
Volume 13 Issue 9 Pages 22-25
Keywords Dementia; Psychiatric Nursing; Clinical assessment; Older people
Abstract Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources.
Call Number NRSNZNO @ research @ Serial 983
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Author Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N.
Title Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal (up)
Volume 46 Issue 1 Pages 95-109
Keywords Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori
Abstract The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
Call Number NRSNZNO @ research @ Serial 1060
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Author Whittle, R.
Title Decisions, decisions: Factors that influence student selection of final year clinical placements Type
Year 2007 Publication Abbreviated Journal (up)
Volume Issue Pages
Keywords Clinical assessment; Nursing; Education; Students
Abstract Clinical practice is an essential and integral component of nursing education. The decision-making process involved in student selection of clinical placements is influenced by a range of factors which are internal or external to students. As there was little research that explored these factors and the influence they have on student decisions, the author sought to investigate this further. A mixed-method approach was used, using a questionnaire and focus group interview, to give breadth and depth to the research. This study found that students are particularly influenced by previous positive experiences, or an interest in a particular area of practice. Their personality will also influence their placement decisions. Nurse preceptors and clinical lecturers also provide a key support role to students in the clinical environment.
Call Number NRSNZNO @ research @ Serial 1103
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Author Harris, C.; Crozier, I.; Smyth, J.; Elliot, J.; Watson, P.B.; Sands, J.; Cuddihy, R.
Title An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI Type Manuscript
Year 2007 Publication Abbreviated Journal (up)
Volume Issue Pages
Keywords Hospitals; Clinical assessment; Cardiovascular diseases; Guidelines; Teaching methods
Abstract This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
Call Number NRSNZNO @ research @ Serial 1157
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Author Kussmaul, Joerg
Title An investigation of occupational health and safety workplaces and working conditions in comparison to nursing care quality in residential aged care facilities (RACFs) in New Zealand Type Book Whole
Year 2020 Publication Abbreviated Journal (up)
Volume Issue Pages 270 p.
Keywords Residential Aged Care Facilities; Ocuupational health and safety; Working conditions; InterRAI; Clinical Assessment Protocols Job stress; Registered nurses; Enrolled nurses; Healthcare assistants
Abstract Identifies critical factors related to the occupational health and safety of workplaces and working conditions in residential aged-care facilities (RACF), from the perspective of nursing staff. Correlates quality indicators for occupational health and safety for workplaces and in working conditions with nursing care quality based on the InterRAI Clinical Assessment Protocols (CAP). Uses a mixed-method approach to conduct an audit of workplace health and safety and environmental conditions in 17 RACFs. Surveys 398 registered nurses (RN), enrolled nurses (EN), and Healthcare Assistants (HCA) about the mental and physical stressors in their work.
Call Number NZNO @ research @ Serial 1655
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