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Author Marcinkowski, K.; McDonald, B.
Title Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative Type Journal Article
Year 2006 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 22 Issue 3 Pages 15-21
Keywords Surgery; Hospitals; Economics
Abstract This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
Call Number NRSNZNO @ research @ 533 Serial 519
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Author Malcolm, H.
Title Patient privacy in a shared hospital room: Right or luxury? Type Journal Article
Year 2004 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 20 Issue 1 Pages 28-35
Keywords Patient rights; Law and legislation; Nursing; Hospitals
Abstract In this article the author discusses the New Zealand legislation aimed at protecting the individual's right to privacy and concludes that practice may place healthcare consumers' rights at risk. While patient privacy should be of concern to all health professionals, the focus here is on the nurse's role in relation to recently formulated competencies published by the Nursing Council of New Zealand, which includes the recommendation that care be seen to exhibit an awareness of healthcare consumers' rights to privacy alongside the expectation that nurses question practices that compromise patient privacy.
Call Number NRSNZNO @ research @ 562 Serial 548
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Author Carryer, J.B.; Budge, C.; Russell, A.
Title Measuring perceptions of the Clinical Career Pathway in a New Zealand hospital Type Journal Article
Year 2002 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 18 Issue 3 Pages 18-29
Keywords Professional development; Careers in nursing; Nursing; Hospitals
Abstract The authors outline the Clinical Career Pathways (CCPs) for nurses, which were first established in New Zealand during the late 1980s. This paper introduces a new instrument, the Clinical Career Pathway Evaluation Tool (CCPET) designed to assess nurses' and midwives' knowledge of and attitudes towards their Clinical Career Pathway. The 51 item instrument takes the form of a self-report questionnaire. The development of the CCPET is described and results from an initial application of the instrument with 239 nurses and midwives in a New Zealand hospital are presented. Results indicate that knowledge levels were moderate in this sample and were correlated with both positive and negative attitudes. Results of t-test comparisons indicated that, on average, the group who had already completed a CCP portfolio had greater knowledge and more positive attitudes than the group who had not.
Call Number NRSNZNO @ research @ 634 Serial 620
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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 Buisman, B.
Title Nursing 2020: How will 'Magnet' hospitals fit in? Type Journal Article
Year 2006 Publication Nursing Journal Northland Polytechnic Abbreviated Journal (up)
Volume 10 Issue 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 Walsh, C.; Boyd, L.; Baker, P.; Gavriel, A.; McClusky, N.; Puckey, T.C.; Sadler, D.; Stidworthy, A.
Title It was time for me to leave: A participatory action research study into discharge planning from an acute mental health setting Type Report
Year 2001 Publication Abbreviated Journal (up)
Volume Issue Pages
Keywords Psychiatric Nursing; Patient satisfaction; Hospitals; Administration
Abstract
Call Number NRSNZNO @ research @ 1275 Serial 1260
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Author McDonald, S.
Title A study to investigate the role of the registered nurse in an acute mental health inpatient setting in New Zealand: Perceptions versus reality Type Report
Year 2000 Publication Abbreviated Journal (up)
Volume Issue Pages
Keywords Registered nurses; Hospitals; Psychiatric Nursing
Abstract
Call Number NRSNZNO @ research @ 1283 Serial 1268
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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 (up)
Volume 119 Issue 1231 Pages
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 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 (up)
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 (up)
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 Schroyen, B.; Finlayson, M.
Title Clinical teaching and learning: An action research study Type Journal Article
Year 2004 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 20 Issue 2 Pages 36-45
Keywords Education; Nursing; Hospitals
Abstract Using an educational action research model, a nursing lecturer based in a polytechnic and ten students formed a research group to address one issue that was important to them. The research group chose to plan, implement and evaluate a practical change strategy aimed at improving the teaching and learning relationship between students and staff nurses in clinical settings. A sample of five staff nurses working closely with five students in the group was invited to join the study in order to gain their perspectives on the issues. The findings were that contract learning provides a strategy which, under certain conditions, offers both students and staff nurses an opportunity to improve the effectiveness of their interactions.
Call Number NRSNZNO @ research @ Serial 545
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Author Finlayson, M.; Gower, S.E.
Title Hospital restructuring: Identifying the impact on patients and nurses Type Journal Article
Year 2002 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 18 Issue 2 Pages 27-35
Keywords Quality of health care; Hospitals; Organisational change
Abstract The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.
Call Number NRSNZNO @ research @ Serial 615
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Author Walsh, K.; McAllister, M.; Morgan, A.; Thornhill, J.
Title Motivating change: Using motivational interviewing in practice development Type Journal Article
Year 2004 Publication Practice Development in Health Care Abbreviated Journal (up)
Volume 3 Issue 2 Pages 92-100
Keywords Psychiatric Nursing; Hospitals; Motivation; Older people
Abstract The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change.
Call Number NRSNZNO @ research @ Serial 718
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Author MacGeorge, J.M.; Nelson, K.
Title The experience of the nurse at triage influences the timing of CPAP intervention Type Journal Article
Year 2003 Publication Accident & Emergency Nursing Abbreviated Journal (up)
Volume 11 Issue 4 Pages 234-238
Keywords Emergency nursing; Clinical decision making; Hospitals; Quality of health care
Abstract This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
Call Number NRSNZNO @ research @ Serial 847
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