| Records |
| 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 |
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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 |
Tweed, C.; Tweed, M. |
| Title |
Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program |
Type |
Journal Article |
| Year |
2008 |
Publication |
American Journal of Critical Care |
Abbreviated Journal |
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| Volume |
17 |
Issue |
4 |
Pages |
338-347 |
| Keywords |
Intensive care nursing; Training; Evaluation |
| Abstract |
The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline. |
| Call Number |
NRSNZNO @ research @ |
Serial |
958 |
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| 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 |
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| 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 |
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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 |
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| 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 |
Lui, D.M.K. |
| Title |
Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 2. Survey results |
Type |
Journal Article |
| Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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| Volume |
9 |
Issue |
3 |
Pages |
91-96 |
| Keywords |
Intensive care nursing; Paediatric nursing; Ethics; Attitude of health personnel |
| Abstract |
Discontinuation of life support measures for an extremely low birthweight or very premature baby is controversial and difficult for both the parents and the healthcare professional involved in caring for the infant. This study seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Part 1 reviewed the literature on this subject. Part 2 reports the results of a survey carried out in a New Zealand NICU. |
| Call Number |
NRSNZNO @ research @ 966 |
Serial |
950 |
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| Author |
Powell, J. |
| Title |
Caring for patients after an ICU admission |
Type |
Journal Article |
| Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
8 |
Issue |
7 |
Pages |
24-25 |
| Keywords |
Intensive care nursing; Nurse-patient relations; Trauma; Communication |
| Abstract |
The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education. |
| Call Number |
NRSNZNO @ research @ |
Serial |
954 |
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| Author |
Hansen, G. |
| Title |
The role of massage in the care of the critically ill |
Type |
Journal Article |
| Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
8 |
Issue |
7 |
Pages |
14-16 |
| Keywords |
Nursing; Alternative therapies; Intensive care nursing |
| Abstract |
This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1010 |
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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 |
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| 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 |
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| Author |
Ho, T. |
| Title |
Ethical dilemmas in neonatal care |
Type |
Journal Article |
| Year |
2000 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
6 |
Issue |
7 |
Pages |
17-19 |
| Keywords |
Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making |
| Abstract |
The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment. |
| Call Number |
NRSNZNO @ research @ 1035 |
Serial |
1019 |
| Permanent link to this record |
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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 |
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| 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 |
Evans, S. |
| Title |
Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes |
Type |
Journal Article |
| Year |
2003 |
Publication |
Pediatric Intensive Care Nursing |
Abbreviated Journal |
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| Volume |
4 |
Issue |
2 |
Pages |
7 |
| Keywords |
Nursing specialties; Intensive care nursing; Equipment and Supplies |
| Abstract |
The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation. |
| Call Number |
NRSNZNO @ research @ |
Serial |
926 |
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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 |
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Issue |
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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 |
Roberts, C. |
| Title |
The influence of nursing culture on family visiting in adult intensive care units |
Type |
|
| Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| 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 |
Patel, R. |
| Title |
Evaluation and assessment of the online postgraduate intensive care nursing course |
Type |
|
| Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
| Volume |
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Issue |
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Pages |
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| Keywords |
Education; Intensive care nursing; Nursing specialties |
| Abstract |
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| Call Number |
NRSNZNO @ research @ 519 |
Serial |
505 |
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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 |
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Issue |
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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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