| Records |
| Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
| Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
Type |
Journal Article |
| Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
|
| Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
Keywords  |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
962 |
| Permanent link to this record |
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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 |
|
Pages |
|
| Keywords |
Education; Intensive care nursing; Nursing specialties |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 519 |
Serial |
505 |
| Permanent link to this record |
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| Author |
Johnson, H. |
| Title |
Clinical trials in the intensive care setting: A nursing perspective |
Type |
|
| Year |
2008 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Evaluation; Intensive care nursing |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
923 |
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| Author |
Pirret, A.M. |
| Title |
The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making |
Type |
Journal Article |
| Year |
2007 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
|
| Volume |
23 |
Issue |
3 |
Pages |
145-155 |
| Keywords |
Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education |
| Abstract |
The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved. |
| Call Number |
NRSNZNO @ research @ |
Serial |
933 |
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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 |
|
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 |
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 |
|
Pages |
|
| Keywords |
Intensive care nursing |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 824 |
Serial |
808 |
| Permanent link to this record |
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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 |
|
Pages |
|
| Keywords |
Intensive care nursing; Clinical decision making |
| Abstract |
|
| Call Number |
NRSNZNO @ research @ 686 |
Serial |
672 |
| Permanent link to this record |
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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 |
|
Pages |
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| 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 |
| Permanent link to this record |
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| Author |
Evans-Murray, A. |
| Title |
Meeting the needs of grieving relatives |
Type |
Journal Article |
| Year |
2004 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
|
| Volume |
10 |
Issue |
9 |
Pages |
18-20 |
| Keywords |
Intensive care nursing; Grief; Communication |
| Abstract |
This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters. |
| Call Number |
NRSNZNO @ research @ 1004 |
Serial |
988 |
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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 |
|
Pages |
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| 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 |
Ryder-Lewis, M. |
| Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
Type |
|
| Year |
2004 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Intensive care nursing; Interprofessional relations |
| Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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| Author |
Dredge, A. |
| Title |
An insider's view of professional nursing and care management of the critically ill patient |
Type |
Journal Article |
| Year |
1999 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
|
| Volume |
5 |
Issue |
8 |
Pages |
13-16 |
| Keywords |
Intensive care nursing; Interprofessional relations; Registered nurses |
| Abstract |
This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care. |
| Call Number |
NRSNZNO @ research @ 1302 |
Serial |
1287 |
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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 |
|
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 |
| Permanent link to this record |
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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 |
|
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 |
| Permanent link to this record |
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| Author |
Wright, R. |
| Title |
Linking theory with practice |
Type |
Journal Article |
| Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
|
| Volume |
7 |
Issue |
2 |
Pages |
14-15 |
| Keywords |
Intensive care nursing; Nurse-family relations; Nursing models |
| Abstract |
This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1012 |
| Permanent link to this record |
