| |
Records |
Links |
|
Author |
Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P. |
|
| |
Title |
Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial |
Type |
Journal Article |
| |
Year |
2002 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
|
| |
Volume |
115 |
Issue |
1157 |
Pages |
|
|
| |
Keywords |
Emergency nursing; Time factors; Clinical assessment; Clinical decision making |
|
| |
Abstract |
The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
617 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Carter, G.E. |
|
| |
Title |
Critical thinking abilities: Evidence from students' clinical self-evaluation responses: A pilot study |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
Massey University Library |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Clinical assessment; Critical thinking |
|
| |
Abstract |
|
|
| |
Call Number |
NRSNZNO @ research @ 597 |
Serial |
583 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Clarke, R. |
|
| |
Title |
New graduate nurse experiences of using health assessment skills in practice: A descriptive qualitative study |
Type |
|
| |
Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
New graduate nurses; Clinical assessment |
|
| |
Abstract |
Use of health assessment skills is undeniably part of everyday nursing practice, guiding nursing decisions and a part of facilitating patient outcomes. Undergraduate nursing education in New Zealand includes the use of health assessment skills within the context of nursing practice. The registered nurse working in their first year of practice is required to use effective assessment skills to identify potential risks to a patient's health, while learning to adjust to the many other demands of practice, but little research has explored these experiences. The purpose of this research study was to describe the experience of using health assessment skills within the first year of practice as a registered nurse. Using a qualitative descriptive method, informed by phenomenology, interviews were conducted with six newly graduated registered nurses working within a New Zealand setting. Findings of this study revealed that graduates endeavour to incorporate the skills of health assessment taught at undergraduate level into their practice. Six main themes of health assessment philosophy; tuning in; mobilising health assessment skills; recognition; anxiety; and identification and facilitation of outcomes can be aligned with Benner's (1984) model of skill acquisition. The author suggests that these research findings are useful to inform nursing education, clinical practice and further research. An awareness of these graduate experiences provides opportunities for nurses in both clinical practice and education to facilitate and support graduate nurses' of health assessment within their nursing practice. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
682 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Fogarty, K. |
|
| |
Title |
The assessment of competence in the novice nurse in the adult intensive care unit |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Intensive care nursing; Nursing specialties; Clinical assessment |
|
| |
Abstract |
This dissertation explores the assessment of nurses' clinical competence in the adult ICU setting. Specifically, methods for the assessment of competence are critiqued for their practical application to the novice nurse with less than six months experience in ICU. The assessment methods considered are continuous clinical assessment, self-assessment, peer review, objective structured clinical examination (OSCE), portfolio and computer assisted assessment. Several criteria are applied to the methods including the ability of each method to assess skills, knowledge and attitudes or values. Each method is critiqued for its implications in terms of cost and staffing resource, benefits and barriers to implementation. In addition, reliability and validity issues are considered for each method. The outcome of this exploration is the recommendation of a combination of methods; namely, portfolio and OSCE, for the assessment of competence in the ICU novice. The author concludes that this finding enhances current understanding within the ICU specialty of the multidimensional nature of competence assessment. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
574 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B. |
|
| |
Title |
Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori |
Type |
Journal Article |
| |
Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
|
| |
Volume |
116 |
Issue |
1176 |
Pages |
|
|
| |
Keywords |
Advanced nursing practice; Hospitals; Clinical assessment; Evaluation |
|
| |
Abstract |
Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive. |
|
| |
Call Number |
NRSNZNO @ research @ 625 |
Serial |
611 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Kuehl, S. |
|
| |
Title |
Emergency Department re-presentations following intentional self-harm |
Type |
|
| |
Year |
2008 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
|
| |
Abstract |
The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
1214 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
|
| |
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Macfarlane, K. |
|
| |
Title |
Communicating changes in a patient's condition: A critical incident approach |
Type |
|
| |
Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Communication; Clinical assessment; Physicians; Nursing; Relationships |
|
| |
Abstract |
This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
724 |
|
| Permanent link to this record |
