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Author |
Poot, Betty; Nelson, Katherine; Zonneveld, Rebecca; Weatherall, Mark |
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Title |
Potentially inappropriate medicine prescribing by nurse practitioners in New Zealand |
Type |
Journal Article |
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Year |
2020 |
Publication |
Journal of the American Association of Nurse Practitioners |
Abbreviated Journal |
JAANP |
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Volume |
32 |
Issue |
3 |
Pages |
220-228 |
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Keywords |
Nurse prescribing; Nurse practitioners; Potentially inappropriate medicines (PIM); Older people |
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Abstract |
Reports the prescribing of potentially-inappropriate medicines (PIM) to older adults (> 65 years). Undertakes a subset analysis of data from the Ministry of Health pharmaceutical collection for the years 2013-2015. Includes nurse practitioner (NP) registration number, medicines dispensed, patient age, gender and NZ Deprivation level. Uses the Beers 2015 criteria to identify PIM. Details the medicines most commonly inappropriately prescribed. |
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Call Number |
NZNO @ research @ |
Serial |
1768 |
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Author |
Ward, V C |
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Title |
Preoperative fluid management of the older adult patient with hip fracture |
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Year |
2013 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
162 pp |
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Keywords |
Older people --Medical care; Hip joint -- Fractures -- Treatment; Hip joint -- Fractures -- Patients -- Rehabilitation; Fluid therapy; Preoperative care; Postoperative care; Outcome assessment (Medical care) |
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Abstract |
Explores the relationships between pre-operative fluid management (PFM) and post-operative outcomes. Undertakes an observational study of 100 consecutive older adult patients admitted to a tertiary NZ hospital with traumatic hip fracture between March and Sept 2012. Gathers data regarding cohort demographics and in-hospital events, including surgical details, alongside PFM and post-operative outcomes. Itemises characteristics of the patients, predominantly female with a mean age of 85.2 years. Finds no statistically significant relationship between pre-operative fluid management and post-operative outcomes. |
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Call Number |
NZNO @ research @ |
Serial |
1395 |
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Author |
King, A.; Parsons, M. |
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Title |
An evaluation of two respite models for older people and their informal caregivers |
Type |
Journal Article |
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Year |
2005 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
118 |
Issue |
1214 |
Pages |
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Keywords |
Older people; Evaluation |
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Abstract |
The researchers evaluate two case-management models of respite relief care at Waitemata District Health Board. The evaluation consisted of semi-structured interviews and postal surveys for clients utilising respite care and staff members involved in both the North/West and Rodney models of respite care in Auckland. Across the two regions, a total of 2 older people and their informal caregivers, 2 respite coordinators, and the Needs Assessment Service Coordination (NASC) Manager were interviewed. In addition, postal surveys were received from 21 older people, 36 informal caregivers, 11 NASC workers, and 3 allied health professionals. Findings revealed there was generally high satisfaction with both the respite models. Caregivers believed the respite service did give them a break, although it was insufficient. Caregivers reported concerns regarding how respite facilities could improve and the older person's deterioration post respite. Staff identified improvements for each of the models. |
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Call Number |
NRSNZNO @ research @ 549 |
Serial |
535 |
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Author |
Hale, R. |
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Title |
Older patient perceptions of transitional care |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 147-152) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Older people; Rural health services; Community health nursing; Evaluation |
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Abstract |
The author describes transitional care as undertaken within the Waikato District Health Board health care environment. Transitional care supports people moving between acute health care (inpatient) and primary health care (home). It is a rehabilitative model based in smaller, predominantly rural communities to enable the older person to actively work towards recovery of functional ability within their own environment. Research indicates this rehabilitation model is applicable to the rural situation and satisfaction levels of the patients and caregivers tends to be positive. |
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Call Number |
NRSNZNO @ research @ 774 |
Serial |
758 |
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Author |
Challis-Morrison, S. |
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Title |
Caring for a community wanderer |
Type |
Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
11 |
Pages |
20-22 |
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Keywords |
Case studies; Older people; Community health nursing; Dementia |
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Abstract |
A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity. |
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Call Number |
NRSNZNO @ research @ |
Serial |
977 |
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Author |
Neville, S.J.; Alpass, F. |
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Title |
Older men and worries: The impact on well-being |
Type |
Journal Article |
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Year |
2006 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
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Volume |
14 |
Issue |
1 |
Pages |
4-7 |
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Keywords |
Older people; Male; Geriatric nursing |
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Abstract |
The aim of this research was to investigate the relationship between worries and psychological well-being, and self-rated health in older men. A cross-sectional survey method was used to investigate the research aim. A group of men aged 65 years and over (n = 217), who lived in a small New Zealand city, participated in this study. Results from this research revealed that worries about physical abilities and health were significantly related to a decrease in psychological well-being and self-rated health. Gerontological nurses are challenged to be cognisant of older men's concerns about their health and physical ability. |
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Call Number |
NRSNZNO @ research @ 1323 |
Serial |
1307 |
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Author |
McKenzie-Green, B. |
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Title |
Shifting focus: How registered nurses in residential aged care organise their work: A grounded theory study |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Older people; Registered nurses; Nurse-patient relations |
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Abstract |
Registered nurses in residential aged care work with older people who have complex care needs. Besides providing direct care, these nurses have a wide range of responsibilities which include supervising staff and attending to the smooth running of the care facility. This grounded theory study using dimensional analysis was aimed at answering the question: How do registered nurses organise their work? Indepth interviews were conducted with 10 registered nurses who worked in a range of positions in aged care facilities. Theoretical sampling and constant comparative analysis was used to guide both ongoing data collectiona and data analysis. Categories were examined for their relationships and dimensions to arrive at a substantive grounded theory which the author has named 'shifting focus'. Individual and institutional philosophies of care were core elements in the registered nurses' focus of work. There was a relationship between staffing adequacy, individual and institutional philosophies of care, and the focus of registered nurse work. These relationships created conditions where the registered nurse would focus on ensuring the delivery of individualised resident care or focus on getting through the routine of care. The relationship between staffing adequacy, philosophies of care and the registered nurses' focus of work remained consistent when staffing adequacy changed. In instances of decreased staffing adequacy, the participants' focus shifted to either maintaining individualised care or focusing on safety. When the registered nurse aimed to change the philosophy of care, an increase in staffing adequacy enabled some aspects of cultural change to commence. The relationships between residents, family and staff were significant contrasting elements within an individualised philosophy of care, and an institutional philosophy of care. In the former, relationships were valued and developed. In the latter, they were benevolent, functional or conflicted. The significance of this study is that it reveals how registered nurses and management personnel in aged care facilities, can create conditions where the relationships between residents, their families and staff, are valued and developed to result in positive care outcomes. It is recommended that future research be conducted to examine the resources required to maintain an individualised approach to the nursing care of residents in aged care facilities. |
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Call Number |
NRSNZNO @ research @ 912 |
Serial |
896 |
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Author |
Mearns, G. |
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Title |
Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Geriatric nursing; Older people; Registered nurses |
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Abstract |
The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner. |
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Call Number |
NRSNZNO @ research @ |
Serial |
585 |
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Author |
Neville, S.J. |
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Title |
Delirium in the older adult: A critical gerontological approach |
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Year |
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Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Geriatric nursing; Older people |
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Abstract |
The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor. Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk. Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people. |
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Call Number |
NRSNZNO @ research @ 598 |
Serial |
584 |
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Author |
Brown, J.A. |
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Title |
“Let my spirit always sing”: A descriptive study of how four elderly rest home residents view spirituality and spiritual care at the end of life |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Older people; Rest homes; Spirituality; Nursing |
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Abstract |
This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. Four rest home residents were recruited, to talk about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi's analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants' satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured. Recommendations are made for improving the spiritual dimension of care, and for further research. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1228 |
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Author |
Lidiard, B. |
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Title |
Implementing the Rating Scale for Aggressive Behaviours in the elderly: Can it make a difference to nursing management of aggressive behaviours in elderly patients with dementia? |
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Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Geriatric nursing; Dementia; Workplace violence; Older people |
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Abstract |
The Rating Scale for Aggressive Behaviours in the Elderly (RAGE) is a twenty-one item rating scale, designed specifically to measure aggressive behaviours in the elderly in the psychogeriatric inpatient setting. The purpose of the scale is to qualify the aggressive behaviour, note any changes in the behaviour, and record intervention and/or treatments. This study combines both qualitative and quantitative methods with exploratory and descriptive designs to explore nurses' experiences of using a consistent tool for monitoring, measuring and managing aggressive behaviours. Data gathered over a three month period of implementing RAGE aimed to provide a 'snapshot' of the prevalence, extent and type of aggressive behaviours within the inpatient setting, providing evidence to nurses in developing strategies for the management of aggression. Focus group interviews were used to enable nurses to discuss their experiences of utilising a clinically validated tool in their practice and how this made a difference to their practice. Findings from this research indicate that nurses within the setting found that RAGE is a consistent tool with which nurses can record, measure and monitor aggressive behaviours. Responses from nurses' experiences of utilising RAGE in their practice were varied, with some being unable to articulate how RAGE had made a difference to their practice. Despite this there was an overwhelming positive response for the continued use of RAGE within the setting as a clinically validated tool by which to measure, record and manage aggressive behaviours. |
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Call Number |
NRSNZNO @ research @ |
Serial |
798 |
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Author |
Lowe, P. |
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Title |
A descriptive research study on factors that impact upon the quality of life of elderly women with comorbid chronic illnesses: Three women's perspectives |
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Year |
2007 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Older people; Female; Chronically ill; Quality of life |
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Abstract |
The aim of this research study is to explore factors that older women living with comorbid chronic illnesses identify as key to maintaining or improving their quality of life. This study uses a qualitative approach, with a descriptive methodology. Face-to-face interviews were conducted with three women over the age of 80 who had been diagnosed with more than one chronic illness. These interviews were audiotaped, and the data analysed using thematic analysis. What emerged from this analysis of older women was the need for them to create meaning in their life, which is further explicated through three main themes: (1) coping with changing health, (2) the impact of family, and (3) attitude. Attitude to life and having a positive outlook were all factors these participants expressed as being essential to maintaining their quality of life. The quality of life of these participants is enhanced by the ability of these women to create meaning in their life. They do this by integrating their wealth of past experience into their present, reflecting back on their lives, but still gaining enjoyment from the here and now. |
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Call Number |
NRSNZNO @ research @ 1236 |
Serial |
1221 |
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Author |
Watson, S. |
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Title |
Humane caring: Quality of life issues for those elderly people wanting to remain in their own environment |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Geriatric nursing; Older people; Home care |
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Abstract |
This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1217 |
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Author |
Dulieu, F. |
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Title |
Collaborative practice: A study in bridging the gap to transform the delivery of specialist palliative nursing care in residential aged care facilities |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Palliative care; Older people; Nursing; Advanced nursing practice; Terminal care; Geriatric nursing |
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Abstract |
This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau. The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education programme while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
580 |
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Author |
Clark, P.N. |
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Title |
The potential for nurse-led clinics on oncology at Southland District Health Board |
Type |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Older people; Scope of practice; Nursing; Oncology; Cancer |
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Abstract |
The author points to a “waiting list crisis” occurring in ambulatory oncology services at Southland District Health Board (SDHB), and notes that the literature suggests this is occurring both nationally and globally. This is due to factors such as an increase in the number of people aged 65 years and over, many of whom will develop cancer. Furthermore new drug therapies and indications for treatment have led to increased numbers of patients referred for oncological assessment in the out-patient clinics. The author notes that, at SDHB, this delay for patients to be seen at a first specialist assessment appointment is causing concern for patients, managers and the medical and nursing staff involved. This dissertation analyses relevant literature in order to explore the nature and outcomes of nurse-led clinics. A range of studies indicate that effective care can be provided by nurses working in a variety of nurse-led clinics settings. These studies reveal ways in which a nurse-led clinic might be established and delivered in oncology services and, the author suggests, this will go some way to provide a solution for SDHB. These clinics would assess and monitor the follow-up of selected patients with stable disease and established care plans such as patients receiving adjuvant chemotherapy for bowel and breast cancer. This would allow medical oncologists to see more new patients at first assessment and the follow-up of complex cases, and could go some way in relieving the current waiting lists. The educational preparation and competency of nurses leading such a clinic are considered. |
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Call Number |
NRSNZNO @ research @ |
Serial |
677 |
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