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Author Blanchard, D.L.
Title Developing the place and role of family within the culture of critical care nursing: An action research approach Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue (up) Pages
Keywords Relationships; Nurse-family relations; Intensive care nursing; Nursing research
Abstract This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
Call Number NRSNZNO @ research @ 494 Serial 480
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Author Patel, R.
Title Evaluation and assessment of the online postgraduate intensive care nursing course Type
Year 2006 Publication Abbreviated Journal University of Otago Library
Volume Issue (up) Pages
Keywords Education; Intensive care nursing; Nursing specialties
Abstract
Call Number NRSNZNO @ research @ 519 Serial 505
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Author Morrison, M.
Title Posthuman pathology: A postmodern art project located in critical care Type
Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue (up) Pages
Keywords Intensive care nursing; Nursing philosophy; Culture; Technology
Abstract The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care.
Call Number NRSNZNO @ research @ 580 Serial 566
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Author Pirret, A.M.
Title The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making Type
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue (up) Pages
Keywords Intensive care nursing; Clinical decision making
Abstract
Call Number NRSNZNO @ research @ 686 Serial 672
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Author Bell, J.
Title Blood glucose control using insulin therapy in critically ill adult patients with stress hyperglycaemia: A systematic review Type
Year 2007 Publication Abbreviated Journal Massey University Library
Volume Issue (up) Pages
Keywords Intensive care nursing
Abstract
Call Number NRSNZNO @ research @ 824 Serial 808
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Author Turner, C.L.E.
Title A process evaluation of a shared leadership model in an intensive care unit Type
Year Publication Abbreviated Journal Massey University, Palmerston North, Library
Volume Issue (up) Pages
Keywords Leadership; Intensive care nursing; Nursing models
Abstract
Call Number NRSNZNO @ research @ 1277 Serial 1262
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Author McNamara, N.
Title The meaning of the experience for ICU nurses when a family member is critically ill: A hermeneutic phenomenologcial study Type
Year 2007 Publication Abbreviated Journal NZNO Library
Volume Issue (up) Pages
Keywords Intensive care nursing; Nurse-family relations
Abstract This study provides insight into the experience of being an ICU nurse and relative of a critically ill patient. Analysis of data from interviews of four ICU nurses who had experienced having a family member admitted to ICU brought up several themes. These included: a nurses' nightmare, knowing and not knowing, feeling torn, and gaining deeper insight and new meaning. Recommendations for organisational support for ICU nurse/relatives, and education for staff are made, based on the findings.
Call Number NRSNZNO @ research @ 1312 Serial 1296
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Author Roberts, C.
Title The influence of nursing culture on family visiting in adult intensive care units Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Intensive care nursing; Nurse-family relations; Culture; Nursing
Abstract This dissertation considers the implications of the relationship between nurses and the patient's family, when family members visit intensive care units (ICUs) following the acute admission of a relative there. In particular it explores the issues of power and control, nurses might have in this setting, the culture that supports that, and the implications this has for practice in the New Zealand context. A comprehensive literature review on the perspective of nurses in relation to relatives visiting adult intensive care units was conducted. The author concludes that nurses modify policies related to visiting access for family members to suit themselves, and the needs of their patient. Nurses use a variety of tactics to maintain a position of power and control by looking out for themselves first, their patient second, and relatives third. The need of the patient and their families is not well understood by nurses, and nurses feel they have inadequate skills to cope with the needs and stresses of visiting relatives. The author suggests that for nurses to provide family focused care in ICU they must develop a therapeutic relationship with all concerned. ICU nursing culture affects nurses ability to focus on caring for their patients and their families. Nurses in ICU appear to need to maintain power and control over their environment but further research is needed to identify the current situation in New Zealand ICUs.
Call Number NRSNZNO @ research @ Serial 502
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Author Fielding, S.
Title Learning to do, learning to be: The transition to competence in critical care nursing Type
Year 2006 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue (up) Pages
Keywords Intensive care nursing; Preceptorship; Nursing specialties
Abstract Making the transition to an area of specialist nursing practice is challenging for both the learner and staff who are responsible for education and skill development. This study uses grounded theory methodology to explore the question: “How do nurses learn critical care nursing?” The eight registered nurses who participated in this study were recruited from a range of intensive care settings. The criteria for inclusion in the study included the participant having attained competency within the critical care setting. Data was collected from individual interviews. This study found that nurses focus on two main areas during their orientation and induction into critical care nursing practice. These are learning to do (skill acquisition) and learning to be (professional socialisation). The process of transition involves two stages: that of learning to do the tasks related to critical care nursing practice, and the ongoing development of competence and confidence in practice ability. The relationship of the learner with the critical care team is a vital part of the transition to competency within the specialist area. This study identifies factors that influence the learner during transition and also provides an understanding of the strategies used by the learners to attain competency. These findings are applicable to educators and leaders responsible for the education and ongoing learning of nurses within critical care practice. The use of strategies such as simulated learning and repetition are significant in skill acquisition. However attention must also be paid to issues that influence the professional socialisation process, such as the quality of preceptor input during orientation and the use of ongoing mentoring of the learner.
Call Number NRSNZNO @ research @ Serial 509
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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 (up) 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
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Author Fahey, M.
Title Family centred care in the newborn intensive care unit: Creating a supportive environment Type
Year 2003 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Intensive care nursing; Infants; Nurse-family relations
Abstract The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant.
Call Number NRSNZNO @ research @ Serial 592
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Author Hall, J.
Title Building trust to work with a grounded theory study of paediatric acute care nurses work Type
Year 2004 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue (up) Pages
Keywords Nurse-family relations; Nurse-patient relations; Children; Paediatric nursing; Intensive care nursing
Abstract Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident.
Call Number NRSNZNO @ research @ Serial 597
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Author Cook, D.
Title Open visiting: Does this benefit adult patients in intensive care units? Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Hospitals; Intensive care nursing
Abstract As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. The aim of this dissertation was to examine the benefits for the patient, family members and nurses of appropriate visiting practices within intensive care areas in order to establish if open visiting is the best regime for patients in the adult intensive care unit (ICU). This dissertation explores visiting practices in adult critical care unit settings. Specifically, the benefits of visiting for patients, and the factors that may impede or facilitate visiting practices within the ICU were critically discussed. These factors included the benefits and disadvantages of open visiting, and the nurse as an influential factor in visiting. These areas linked together to form the basis for consideration of visiting in the ICU. Review of existing literature pertaining to visiting in the ICU indicated that patients wanted open visiting hours yet also indicated that they would like some visiting restrictions. Nurses appeared to value family input into care and were aware of patient and family needs, even though they may restrict visiting to suit their own work practices. Family members can provide the patient with psychological support, provide important historical data, assist the nurse with selected aspects of physical care, and actively encourage the patient's efforts to recover. The outcome of this exploration is the recommendation of an open visiting policy tailored to individual patients, as, the author suggests, this would foster nursing practice and ultimately benefit patients and their families.
Call Number NRSNZNO @ research @ Serial 680
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Author Evans, S.
Title Silence kills: Communication around adverse events in ICU Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Intensive care nursing; Communication; Interprofessional relations
Abstract The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety.
Call Number NRSNZNO @ research @ Serial 741
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Author Marshall, K.
Title Enteral nutrition within 72 hours after spinal chord injury: Complexities and complications Type
Year 2007 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue (up) Pages
Keywords Nursing; Intensive care nursing
Abstract Good nutrition is essential following acute spinal cord injury. Poor nutrition can lead to the deleterious effects of protein-calorie induced hypermetabolism and poor functional and rehabilitation outcomes. Nutritional management for patients with acute cervical or high thoracic spinal cord injury admitted to the Canterbury District Health Board's Burwood Spinal Unit and Christchurch Hospital's Department of Intensive Care Medicine (CHDICM) differ. The Burwood Spinal Unit has a delayed approach to nutritional management in contrast to the implementation of early enteral feeding by CHDICM. This prompted a literature review to critically consider the evidence underpinning clinical practice in this field. Literature revealed that nutritional management in the first 72 hours after spinal cord injury is a complex process. The complexities of when to commence, the method of delivering, and the target dose of enteral nutrition in the first 72 hours after spinal cord injury are due to the perceived risk of a spinal ileus and the ensuing, such as adverse effects on abdominal and respiratory function, resulting from enteral feeding intolerance. Literature revealed that delayed nutrition is largely based on expert opinion, while early enteral feeding has limited but stronger scientific research evidence. Nevertheless, it is desirable to use the best evidence currently available to develop, implement and evaluate an evidence-based, protocol driven, clinical pathway for nutritional management of patients within 72 hours of an acute cervical or high thoracic SCI. The author concludes that to ensure an acute spinal cord injury clinical pathway is based on scientific evidence, prospective, multi-centre, randomised controlled trials are needed to substantiate early enteral feeding and identification of the degree of and risk of complications from spinal ileus after acute cervical or high thoracic spinal cord injury.
Call Number NRSNZNO @ research @ Serial 809
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