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Author |
Blair, K.M. |
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Title |
Recognising the sick patient: An emergency nurses view: A research paper |
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Year |
2006 |
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 |
Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making |
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Abstract |
This paper reports on a literature review that examines how health professionals (mainly nurses) recognise the signs of physical deterioration in their patients. It includes discussion of how nurses' clinical decision making skills influence how physical deterioration is identified and determines what changes in the delivery of care could have an impact on emergency department patients at risk of life threatening deterioration. |
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Call Number |
NRSNZNO @ research @ |
Serial |
467 |
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Author |
Stokes, G. |
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Title |
Who cares? Accountability for public safety in nurse education |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Online at Research Space @ Auckland University |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education; Accountability; Patient safety |
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Abstract |
The focus of this study is the management of unsafe nursing students within the tertiary education context. The moral dilemmas experienced by nurse educators, specifically linked to the issue of accountability for public safety, are explored. The theoretical framework for the thesis is informed by the two moral voices of justice and care identified by Gilligan and further developed using the work of Hekman and Lyotard. Case study methodology was used and data were collected from three schools of nursing and their respective educational organisations. Interviews were conducted with nurse educators and education administrators who had managed unsafe nursing students. Interviews were also conducted with representatives from the Nursing Council of New Zealand and the New Zealand Nurses Organisation to gain professional perspectives regarding public safety, nurse education and unsafe students. Transcripts were analysed using the strategies of categorical aggregation and direct interpretation. Issues identified in each of the three case studies were examined using philosophical and theoretical analyses. This thesis explores how students come to be identified as unsafe and the challenges this posed within three educational contexts. The justice and care moral voices of nurse educators and administrators and the ways in which these produced different ways of caring are made visible. Different competing and conflicting discourses of nursing and education are revealed, including the discourse of safety – one of the language games of nursing. The way in which participants positioned themselves and positioned others within these discourses are identified. Overall, education administrators considered accountability for public safety to be a specific professional, nursing responsibility and not a concern of education per se. This thesis provides an account of how nurse educators attempted to make the educational world safe for patients, students, and themselves. Participants experienced different tensions and moral dilemmas in the management of unsafe students, depending upon the moral language games they employed and the dominant discourse of the educational organisation. Nurse educators were expected to use the discourses of education to make their case and manage unsafe students. However, the discourses of nursing and education were found to be incommensurable and so the moral dilemmas experienced by nurse educators were detected as differends. This study bears witness to these differends. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1106 |
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Author |
Whitehead, N. |
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Title |
Quality and staffing: Is there a relationship in aged residential care |
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Year |
2007 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Rest homes; Patient safety; Older people; Nursing specialties |
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Abstract |
This thesis reports a mixed methods study, longitudinal in nature, of consenting Age Related Residential Care (ARRC) hospitals in the upper half of the North Island, which was conducted to examine several factors, including AARC hospital efficiency at producing adverse event free days for residents. An interpretativist approach examined what best practice strategies were implemented by the ARRC hospitals that were identified to be most successful at producing adverse event free days for the residents. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1159 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
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Year |
2005 |
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 |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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Author |
Fairhall, M. |
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Title |
An observational study of Peripherally Inserted Central Cather(PICC)-related complications amongst oncology patients |
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Year |
2008 |
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 |
Patient safety; Equipment and Supplies; Nursing specialties; Cancer; Oncology |
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Abstract |
This thesis reports on a retrospective observational study that examined the complication rate of peripherally inserted central catheters (PICCs) within a regional cancer centre. PICCs are increasingly used for delivery of chemotherapy and other intravenous therapies in oncology patients. A literature review revealed that almost all published research on PICC complications reported on silicone (Groshong(TM)) catheter use, rather than the polyurethane (Arrow(TM)) PICCs used at Christchurch Hospital. Also, much literature referred to PICCs being inserted by non-nurses, whereas the Christchurch service uses specially-trained nurses to insert them. The purpose of the study was to identify the nature, incidence and rates of polyurethane (Arrow(TM)) PICC complications in an adult oncology cohort. Ethics Committee approval was gained to retrospectively follow all PICCs inserted in adult oncology patients at Christchurch Hospital over a 13-month period from 1st March 2006 until 31st March 2007. Data collected were analysed utilising the statistical computer package SPSS. One hundred and sixty-four PICCs were inserted into 156 individual oncology patients over this period. The median dwell time was 68 days for a total of 14,276 catheter-days. Complications occurred in 25 (15%) out of 164 PICC lines, in 22 (15%) of the 156 patients for an overall complication rate of 1.75 per 1000 catheter-days. However, only 16 of the 25 PICCs with complications required early removal (9.75% of the cohort) for a favourably low serious complication rate of 1.12 per 1000 catheter-days. The three commonest complications were infection at 4.3% (7/164) or 0.49 infection complications/1000 PICC-days, PICC migration at 3% (5/164) or 0.35/1000 catheter days, and thrombosis at 2.4% (4/164) or 0.28/1000 catheter days. The median time to complication was 41 days. Those with complications were more likely to have a gastro-intestinal or an ovarian cancer diagnosis, and less likely to have colorectal cancer. These findings provide support for the safe and effective use of polyurethane (Arrow(TM)) PICCs for venous access within the adult oncology context. Furthermore, it suggests that cost effective nurse-led (Arrow(TM)) PICC insertions can contribute to a low complication rate. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1222 |
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Author |
Börner, Heidi.E |
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Title |
Evaluating safe patient handling systems: Is there a better way? |
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Year |
2008 |
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 |
Patient safety; Evaluation research; Occupational health and safety |
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Abstract |
This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1224 |
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Author |
Hughes, M.; Farrow, T. |
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Title |
Invisible borders: Sexual misconduct in nursing |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
2 |
Pages |
15-25 |
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Keywords |
Patient safety; Nursing; Guidelines |
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Abstract |
This paper identifies the issue of sexual misconduct by nurses in New Zealand. There is evidence that some nurses have been involved in sexual misconduct, resulting in disciplinary proceedings against them. Despite this, there is an absence of guidelines and discussion for New Zealand nurses to prevent such occurrences. This article identifies difficulties in naming and defining sexual misconduct, and discusses sexual misconduct as an abuse of power by nurses. New Zealand and international literature about sexual misconduct by nurses and other health professionals is described, as are guidelines designed to prevent sexual misconduct. Finally, the authors make recommendations for actions needed to facilitate New Zealand nurses in identifying and avoiding sexual misconduct in practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
537 |
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Author |
Evans, S. |
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Title |
Silence kills: Challenging unsafe practice |
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Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
3 |
Pages |
16-19 |
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Keywords |
Medical errors; Organisational change; Organisational culture; Patient safety; Interprofessional relations |
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Abstract |
The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals. |
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Call Number |
NRSNZNO @ research @ |
Serial |
994 |
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Author |
Lim, Anecita Gigi; North, Nicola; Shaw, John |
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Title |
Nurse prescribing : the New Zealand context |
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Journal Article |
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Year |
2014 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
30 |
Issue |
2 |
Pages |
18-27 |
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Keywords |
Nurse prescribing; Authorised prescribing; Nurse practitioner; Patient safety; Prescribing education |
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Abstract |
Examines the introduction of nurse prescribing in NZ with respect to the level of knowledge and skills required of practitioners for safe prescribing. Compares experiences in NZ with those in the US, UK, and Canada. Critiques the higher educational model as the standard for preparation to prescribe, while supporting alternative models for extending prescribing rights. |
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Call Number |
NZNO @ research @ |
Serial |
1493 |
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Author |
Winters, Rosie; Neville, Stephen |
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Title |
Registered nurse perspectives on delayed or missed nursing cares in a New Zealand hospital |
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Journal Article |
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Year |
2012 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
28 |
Issue |
1 |
Pages |
19-28 |
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Keywords |
Missed care; Rationing nursing care; Patient care outcomes; Patient safety |
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Abstract |
Explores the concept of 'missed care' using a qualitative descriptive approach. Interviews 5 registered nurses within a NZ hospital about fluctuations in nursing-skill mix and staffing levels, inconsistent availability of equipment and supplies, and higher patient acuity. Identifies two main categories of missed care and nurses' resulting moral distress |
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Call Number |
NZNO @ research @ |
Serial |
1471 |
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Author |
Moir, Chris; Taylor, Peta; Seaton, Philippa; Snell, Helen; Wood, Susan |
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Title |
Changes noticed following a pressure-injury link-nurse programme |
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Journal Article |
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Year |
2023 |
Publication |
Kaitiaki Nursing Research |
Abbreviated Journal |
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Volume |
14 |
Issue |
1 |
Pages |
19-24 |
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Keywords |
Pressure injuries; Link nurses; Patient safety; Quality improvement |
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Abstract |
Identifies changes that link nurses noticed in their practice areas as a result of participating in a pressure-injury prevention programme. Uses three nurse focus groups to collect data about changes in pressure-injury prevention within their practice areas following implementation of a link-nurse programme. Talks to 22 nurses about increasing awareness of pressure injury prevention, use of assessment tools and documentation, and acquisition of injury prevention equipment. |
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Call Number |
NZNO @ research @ |
Serial |
1848 |
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Author |
Koorey, R. |
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Title |
Documentation of the surgical count |
Type |
Journal Article |
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Year |
2007 |
Publication |
Dissector |
Abbreviated Journal |
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Volume |
34 |
Issue |
4 |
Pages |
23-6,28,30 |
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Keywords |
Law and legislation; Patient safety; Surgery; Nursing specialties |
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Abstract |
The author examines the current practices around the surgical counts of sponges, sharps and instruments, which is an integral component of safe perioperative nursing practice. Current practice, legislative requirements are reviewed, and the guidelines from the Perioperative Nurses College of New Zealand are reproduced. Case studies of errors in counts are used to illustrate the legal standards of practice. |
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Call Number |
NRSNZNO @ research @ 1048 |
Serial |
1032 |
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Author |
Wynne-Jones, Jacqui; Martin-Babin, Margot; Hayward, Brooke; Villa, Luis |
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Title |
Patient safety leadership walk-rounds: lessons learrned from a mixed-methods evaluaion |
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Journal Article |
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Year |
2020 |
Publication |
Kai Tiaki Nursing Research |
Abbreviated Journal |
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Volume |
11 |
Issue |
1 |
Pages |
24-33 |
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Keywords |
Patient safety; Nurse leaders; Walk-round; Evaluation |
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Abstract |
Assesses the impact of a patient safety leadership walk-rounds (PSLWR) programme in an Auckland hospital to provide recommendations for programme improvement. Involves senior leaders and other departmental representatives visiting wards to conduct staff and patient interviews to capture their experiences, and to assess the environment. Proposes recommendations for organisations intending to or currently implementing a PSLWR programme. |
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Call Number |
NZNO @ research @ |
Serial |
1658 |
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Author |
Smillie, A. |
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Title |
Historical investigations: Risk management in a New Zealand hospital, 1888-1904 |
Type |
Journal Article |
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Year |
2006 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
22 |
Issue |
2 |
Pages |
33-38 |
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Keywords |
Risk management; History; Patient safety |
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Abstract |
This article examines historical events within one hospital and compares them with contemporary risk management practices. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints – one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. Analysis of the processes followed in investigating these occurrences reveals that these historic investigations were small in scale and less bureaucratic than contemporary practice, and were based on a culture of blame. This is contrasted with modern risk management practices which are more focused on understanding what can be learned from the incident with respect to preventing recurrence. |
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Call Number |
NRSNZNO @ research @ 539 |
Serial |
525 |
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Author |
McBride-Henry, K.; Foureur, M. |
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Title |
Medication administration errors: Understanding the issues |
Type |
Journal Article |
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Year |
2006 |
Publication |
Australian Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
23 |
Issue |
3 |
Pages |
33-41 |
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Keywords |
Nursing; Patient safety; Medical errors; Drug administration; Quality assurance |
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Abstract |
This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety. |
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Call Number |
NRSNZNO @ research @ |
Serial |
715 |
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