| Records |
| Author |
Haji Vahabzadeh, Ali |
| Title |
Optimal Allocation of Intensive Care Unit nurses to Patient-At-Risk-Team |
Type |
Book Whole |
Year  |
2018 |
Publication |
|
Abbreviated Journal |
|
| Volume |
|
Issue |
|
Pages |
224 p. |
| Keywords |
Intensive Care Units; Intensive care nursing; Patients; Mortality; Health economics |
| Abstract |
Explains the need for nurse-led Patient-at-Risk-Teams(PART) to prevent unnecessary ICU admissions. Investigates which nurse allocation policy between PART and ICU would result in the best outcomes for patients and hospitals. Provides econometric models to estimate the impact of critical care nurses on hospital length of stay. Proposes queueing and simulation models to obtain the optimal nurse allocation policy for minimising the ICU mortality rate. Validates proposed models at Middlemore Hospital from 2015 to 2016. Estimates the financial and mortality impact of allocating another nurse to PART per shift. |
| Call Number |
NZNO @ research @ |
Serial |
1647 |
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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 |
| Permanent link to this record |
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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 |
|
| 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 |
|
| 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 |
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 |
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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 |
|
| Call Number |
NRSNZNO @ research @ 824 |
Serial |
808 |
| Permanent link to this record |
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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 |
|
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 |
| Permanent link to this record |
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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 |
| Permanent link to this record |
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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 |
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 |
|
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 |
|
Pages |
|
| Keywords |
Education; Intensive care nursing; Nursing specialties |
| Abstract |
|
| Call Number |
NRSNZNO @ research @ 519 |
Serial |
505 |
| Permanent link to this record |
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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 |
|
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 |
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 |
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 |
|
| 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 |
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 |
