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Author Nolan, M.; Featherston, J.; Nolan, J.
Title Palliative care: Palliative care philosophy in care homes: Lessons from New Zealand Type Journal Article
Year 2003 Publication British Journal of Nursing Abbreviated Journal
Volume 12 Issue 16 Pages (down) 974-979
Keywords Palliative care; Attitude of health personnel
Abstract Drawing on data from a large convenience sample of caregivers in New Zealand, this article argues for a reappraisal of the way in which care homes view death and dying and advocates the more widespread adoption of a palliative care philosophy. Increasing numbers of people are dying in care homes yet little is known about the nature and quality of their deaths. The limited research available suggests that there is a need to promote a philosophy of palliative care that is not confined to the terminal phase of life. However, adopting such an approach appears to be inhibited by a lack of understanding, education and training, as well as continuing reluctance to discuss issues of death and dying in an open and honest way.
Call Number NRSNZNO @ research @ 1081 Serial 1066
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Author O'Brien, A.P.; O'Brien, A.J.; Hardy, D.J.; Morrison-Ngatai, E.; Gaskin, C.J.; Boddy, J.M.; McNulty, N.; Ryan, T.; Skews, G.
Title The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study Type Journal Article
Year 2003 Publication International Journal of Nursing Studies Abbreviated Journal
Volume 40 Issue 8 Pages (down) 853-861
Keywords Biculturalism; Psychiatric Nursing; Professional competence; Evaluation
Abstract This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.
Call Number NRSNZNO @ research @ Serial 956
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Author Clendon, J.
Title Nurse-managed clinics: Issues in evaluation Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 44 Issue 6 Pages (down) 558-565
Keywords Evaluation research; Nurse managers; Qualiltative research; Patient satisfaction
Abstract This article explores the importance of evaluation of nurse-managed clinics using the Mana Health Clinic in Auckland, as an example. Fourth generation evaluation is offered as an appropriate methodology for undertaking evaluation of nurse-managed clinics. Fourth generation evaluation actively seeks involvement of clients in the process and outcome of the evaluation, resulting in participation and empowerment of stakeholders in the service – a precept often forgotten in traditional evaluation strategies and of vital importance in understanding why people use nurse-managed clinics. The method proposed here also incorporates the need for quantitative data. The main argument is that a combination of qualitative and quantitative data sources is likely to give the greatest understanding of nurse-managed clinics' utilisation.
Call Number NRSNZNO @ research @ Serial 949
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Author McCallin, A.
Title Interdisciplinary team leadership: A revisionist approach for an old problem? Type Journal Article
Year 2003 Publication Journal of Nursing Management Abbreviated Journal
Volume 11 Issue 6 Pages (down) 364-370
Keywords Leadership; Multidisciplinary care teams; Organisational change
Abstract In this paper the author argues that the term interdisciplinary team leadership should be embraced cautiously. Preliminary research suggests that interdisciplinary team leadership is a model of shared leadership that requires more development if it is to become the cornerstone of interdisciplinary team practice in a radically reforming health sector. Stewardship is proposed as a potential philosophy for interdisciplinary team leadership, and a new, shared leadership role of practice leader is suggested.
Call Number NRSNZNO @ research @ 724 Serial 710
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Author Polaschek, N.
Title Negotiated care: A model for nursing work in the renal setting Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 42 Issue 4 Pages (down) 355-363
Keywords Chronically ill; Nursing models; Nurse-patient relations; Communication
Abstract This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy.
Call Number NRSNZNO @ research @ Serial 1186
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Author Wepa, D.
Title An exploration of the experiences of cultural safety educators in New Zealand: An action research approach Type Journal Article
Year 2003 Publication Journal of Transcultural Nursing Abbreviated Journal
Volume 14 Issue 4 Pages (down) 339-348
Keywords Cultural safety; Nursing; Education; Teaching methods; Organisational culture; Maori
Abstract This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
Call Number NRSNZNO @ research @ Serial 887
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Author Surtees, R.
Title Midwifery as Feminist Praxis in Aotearoa/New Zealand Type
Year 2003 Publication Abbreviated Journal NZNO Library
Volume Issue Pages (down) 323 pp
Keywords
Abstract A thesis submitted in fulfilment of the requirements for the Degree

of DOCTOR OF PHILOSOPHY IN EDUCATION, UNIVERSITY OF CANTERBURY 2003.

This thesis highlights the ways in which the practices of contemporary midwives in

Aotearoa/New Zealand are caught within the intersection of an array of competing discourses. The context for this is the reconstruction of midwifery in Aotearoa/New Zealand as an autonomous feminist profession founded on partnership with women. Interviews and participant observation with midwives, based mainly in one New Zealand city, are the basis of an analysis of the complexity of midwives? praxis as professionals. The analysis draws on insights from critical and feminist approaches to Foucault?s theories of discourse, power and the subject. It includes discussion of the conditions which came to produce and authorise the concept of ?partnership?. Which subjects can speak about partnership, and when? What claims

are made about it? What challenges it?
Call Number NZNO @ research @ Serial 1403
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Author Wilson, H.V.
Title Paradoxical pursuits in child health nursing practice: Discourses of scientific mothercraft Type Journal Article
Year 2003 Publication Critical Public Health Abbreviated Journal
Volume 13 Issue 3 Pages (down) 281-293
Keywords Plunket; Nurse-family relations; Paediatric nursing; Nursing philosophy
Abstract The purpose of this paper is to examine the discourses of scientific mothercraft and their implications for the nurse-mother relationship, drawing on the author's recent research into surveillance and the exercise of power in the child health nursing context. The application of Foucauldian discourse analysis to the texts generated by interviews with five New Zealand child health nurses confirms that this paradoxical role has never been fully resolved. Plunket nurses primarily work in the community with the parents of new babies and preschool children. Their work, child health surveillance, is considered to involve routine and unproblematic practices generally carried out in the context of a relationship between the nurse and the mother. However, there are suggestions in the literature that historically the nurse's surveillance role has conflicting objectives, as she is at the same time an inspector and family friend.
Call Number NRSNZNO @ research @ 1116 Serial 1101
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Author Pirret, A.M.
Title A preoperative scoring system to identify patients requiring postoperative high dependency care Type Journal Article
Year 2003 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 19 Issue 5 Pages (down) 267-275
Keywords Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment
Abstract The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number NRSNZNO @ research @ 904 Serial 888
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Author Budge, C.; Carryer, J.B.; Wood, S.
Title Health correlates of autonomy, control and professional relationships in the nursing work environment Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 42 Issue 3 Pages (down) 260-268
Keywords Workplace; Occupational health and safety; Registered nurses
Abstract The aim of this study was to examine nursing in New Zealand and to see whether aspects of the work environment are associated with health status. A total of 225 registered nurses in a general hospital completed the Revised Nursing Work Index (NWI-R) and Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36). Ratings indicated that the New Zealand hospital environment was characterized by less autonomy and control and better nurse-physician relations than in USA hospitals. Results of correlations demonstrated that more positive ratings of the three workplace attributes were associated with better health status amongst the nurses. The results of regression analyses were indicative either of a confounding relationship or of a mediating relationship such that nurses' relations with physicians, administration and other departments mediate the associations between autonomy, control and health status.
Call Number NRSNZNO @ research @ Serial 703
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Author Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J.
Title The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 4 Pages (down) 259-270
Keywords Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research
Abstract This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
Call Number NRSNZNO @ research @ Serial 1064
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Author MacGeorge, J.M.; Nelson, K.
Title The experience of the nurse at triage influences the timing of CPAP intervention Type Journal Article
Year 2003 Publication Accident & Emergency Nursing Abbreviated Journal
Volume 11 Issue 4 Pages (down) 234-238
Keywords Emergency nursing; Clinical decision making; Hospitals; Quality of health care
Abstract This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
Call Number NRSNZNO @ research @ Serial 847
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Author Wilson, D.
Title The nurse's role in improving indigenous health Type Journal Article
Year 2003 Publication Contemporary Nurse Abbreviated Journal
Volume 15 Issue 3 Pages (down) 232-240
Keywords Transcultural nursing; Maori; Health status
Abstract The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.
Call Number NRSNZNO @ research @ Serial 1065
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Author Spence, D.
Title Nursing people from cultures other than one's own: A perspective from New Zealand Type Journal Article
Year 2003 Publication Contemporary Nurse Abbreviated Journal
Volume 15 Issue 3 Pages (down) 222-231
Keywords Transcultural nursing; Maori; Psychiatric Nursing
Abstract This paper provides an overview of the evolving meaning of 'culture' in New Zealand nursing. Then, drawing upon the findings of research that used hermeneutic phenomenology to explore the experience of nursing people from cultures other than one's own, a description of the constituent parts is of this phenomenon is briefly outlined and followed by an exemplar that describes the coalescent and contradictory nature of the phenomenon as a whole. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, interplay of the notions of prejudice, paradox and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses.
Call Number NRSNZNO @ research @ 798 Serial 782
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Author Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 3 Pages (down) 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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