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Author |
Cook, Deborah. |
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Title |
Open visiting: does this benefit adult patients in intensive care units |
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Year |
2006 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Pages |
32 pp |
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Abstract  |
A dissertation submitted in partial fulfilment of the requirements of the degree of Master of Nursing at Otago Polytechnic, Dunedin, New Zealand.
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. Analysis of the growing body of research can now be reviewed to enable existing visiting policies to be revised. |
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Call Number |
NZNO @ research @ |
Serial |
1332 |
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Author |
Isaac, D. |
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Title |
Passionate dedication: A qualitative descriptive study of nurses' and hospital play specialists' experiences on a children's burn ward |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Pages |
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Keywords |
Children; Nursing specialties; Mentoring; Job satisfaction |
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Abstract |
A qualitative descriptive approach was undertaken to explore the experience of eight registered nurses and two hospital play specialists who care for children hospitalised with burn injuries. The research participants were recruited from a paediatric ward that offers centralised specialty care to children with burns. Emerging out of the data was the over-arching theme of 'passionate dedication' that shows the nurses and hospital play specialists genuine compassion and commitment to meet the needs of the children with burns. The findings of the study reveal that the participant's dedication is shaped and determined by a dynamic process that involves having professional integrity and in-depth knowledge of caring for children and burn management. The nurses and the hospital play specialists have a common understanding of what their role entails and the skills required to provide quality care and support to the children and the children's family. On a personal and professional level the participants encounter several challenges in this care context that are physically and emotionally overwhelming. Despite becoming overwhelmed the participants are revealed as being resourceful and resilient in their aptitude to find ways that enable them to cope and get through. The author suggests that this study supports international literature that suggests that caring for children with burns is equally rewarding, as much as it is physically and emotionally demanding. The author identifies that the implication in this study for the organisation is to seriously consider issues regarding productivity and efficiency of the workforce with acknowledgement that nurses and hospital play specialists cannot do this emotional work without effective systems of support in place. |
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Call Number |
NRSNZNO @ research @ 577 |
Serial |
563 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse (PHCRN) interface with secondary care doctors |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Pages |
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Keywords |
Rural nursing; Rural health services; Relationships |
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Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors as a component of rural nursing practice and representative of the primary-secondary care interface. Crucial to patient centred care, the premise was that the quality of this interface would be variable due to multiple influences such as: the historical nurse/doctor relationship that has perpetuated medical dominance and nursing subordination; current policy direction encouraging greater inter-professional collaboration; and changing role boundaries threatening traditional professional positioning. A total of 11 nurses representing 10 separate rural areas participated in semi-structured interviews. Rural nurses typically interact with secondary care doctors for acute clinical presentations with two tiers of interaction identified. The first tier was presented as a default to secondary care doctors for assistance with managing primary care level clinical presentations in the absence of access to a general practitioner or an appropriate Standing Order enabling appropriate management. The second tier presented itself as situations where, in the professional judgement of the nurse, the client status indicated a need for secondary level expertise and/or referral to secondary care. The needs of the rural nurse in these interactions were identified as access to expertise in diagnosis, therapy and management, authorisation to act when intervention would exceed the nurse's scope of practice; the need to refer clients to secondary care; and the need for reassurance, encompassing emotional and professional issues. The quality of the interactions was found to be variable but predominantly positive. Professional outcomes of positive interactions included professional acknowledgement, support and continuing professional development. For the patient, the outcomes included appropriate, timely, safe intervention and patient centred care. The infrequent but less than ideal interactions between the participants and secondary care doctors led to professional outcomes of intraprofessional discord, a sense of invisibility for the nurse, increased professional risk and professional dissatisfaction; and for the client an increased potential for deleterious outcome and suffering. Instead of the proposition of variability arising from interprofessional discord and the current policy direction, the data suggested that variability arose from three interlinking factors; appropriate or inappropriate utilisation of secondary care doctors; familiarity among individuals with professional roles and issues of rurality; and acceptance by the primary care doctor of the sole on-call primary health care rural nurse role and the responsibility to assist with the provision of primary health care. Recommendations for improving interactions at the interface include national, regional and individual professional actions. |
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Call Number |
NRSNZNO @ research @ |
Serial |
493 |
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Author |
Turnwald, A.B. |
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Title |
Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department |
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Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Chronically ill; Clinical assessment; Emergency nursing |
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Abstract |
A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1210 |
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Author |
Howie, L. |
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Title |
Rural nursing practice in context |
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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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Issue |
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Pages |
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Keywords |
Rural nursing |
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Abstract |
Although it is accepted in rural nursing literature that the context shapes nursing practice there is limited opportunity to gain an understanding of how this occurs. This dissertation addresses this issue. Firstly, by employing a social geographical lens to define and examine the dynamic, evolving rural context and secondly, by considering the nursing concepts that arise from those contextual factors that relate directly to rural societal health needs. Defining 'rural' is essential when describing or debating rural nursing practice in context. However, there remains no universally accepted definition of 'rural'. Despite this and even though each location is individually specific, there are socio-cultural, occupational, ecological and health aspects that are common and bespeak rural society. These aspects have been developed into a Rural Framework Wheel as a visual reference to demonstrate the substantial influences which impact on nursing practice within the rural context. The framework encapsulates the distinctive dimensions that are hallmarks of rural nursing practice. Nurses can therefore use the framework to express concisely their individualised practice and competence by employing the two broad themes that have emerged from the literature; that of 'nursing per se' and 'partnership'. The Rural Framework Wheel is recommended as a paradigm to critique the practice of rural nurses from an educational, employment, research and political perspective. It is advocated that this framework be used by rural nurses to describe their practice and therefore to express the distinctiveness of the rural nursing identity. |
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Call Number |
NRSNZNO @ research @ |
Serial |
744 |
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Author |
Cook, D. |
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Title |
Open visiting: Does this benefit adult patients in intensive care units? |
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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 |
Hospitals; Intensive care nursing |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
680 |
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Author |
Thompson, L.E. |
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Title |
Profession and place: Contesting professional boundaries at the margins |
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Year |
2006 |
Publication |
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Abbreviated Journal |
UC Research Repository |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
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Abstract |
Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural. |
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Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
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Author |
Trimmer, W.C. |
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Title |
The way things are done around here: Perceptions of clinical leadership in mental health nursing |
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Journal Article |
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Year |
2006 |
Publication |
Whitireia Nursing Journal |
Abbreviated Journal |
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Volume |
13 |
Issue |
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Pages |
68-69 |
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Keywords |
Psychiatric Nursing; Leadership; Clinical supervision |
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Abstract |
Based on the author's thesis, this research project explored nurses' perceptions of clinical leadership in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. |
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Call Number |
NRSNZNO @ research @ 1057 |
Serial |
1041 |
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Author |
Johnstone, S. |
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Title |
Undergraduate nursing and death education |
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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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Issue |
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Pages |
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Keywords |
Terminal care; Nursing; Education |
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Abstract |
Death education encompasses many complex realities, for both the students and lecturers involved. This quantitative research explored the experiential and didactic preparation of nursing students through a content analysis, of one New Zealand, three year Bachelor of Nursing programme, in relation to death education. The Otago Polytechnic Bachelor of Nursing programme incorporates compulsory and optional courses, with the courses taught as an integrated programme with a progressive, sequential approach. This approach builds on content, deepening understanding from year to year, as well as providing opportunities for experiential learning and broadening of understanding. The literature review discusses three dominant themes of undergraduate death education: education, death, and transition. The data collection tool incorporates eighteen key terms, ten teaching methods and ten assessment methods. The programme and individual course documents, which define course content, teaching and assessment were scanned and analysed. The findings initially showed limited evidence of death education in course documents, however deeper analysis of the documents showed further evidence over the three year programme. The existence of death education is implied rather than overt throughout many course documents, through the use of broad practice statements. Content analysis is one way of shedding light on programme content in relation to death education. Limitations of the content analysis approach mean measuring experiential and didactic learning is not fully achievable from documentation analysis only. Further development of Bachelor of Nursing death education is an ongoing challenge, with current programmes very full and possibly lacking the capacity to increase content. Bachelor of Nursing programmes are discussed, highlighting the need for student focused learning with emphasis on acquiring and processing information, rather than mastery of content. |
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Call Number |
NRSNZNO @ research @ |
Serial |
735 |
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Author |
Manning, J. |
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Title |
Building trust with families in neonatal intensive care units |
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Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
6 |
Pages |
18-20 |
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Keywords |
Paediatric nursing; Neonatal nursing; Parents and caregivers; Communication |
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Abstract |
Establishing a trusting relationship is a key therapeutic intervention for nurses working with families of hospitalised children. This article is an exploration of the definition of trust. Specifically, it considers how parents come to trust (or not) nurses in neonatal intensive care unit (NICU) helps to reveal the meaning of parent-nurse trust and how this affects nursing practice. Understanding and meeting parental needs is important in developing and sustaining trust. The medical model of care often dominates in NICU. This is a deficit model that focuses on illness and treatment. However, the use of a nursing framework, such as developmentally supportive family centred care, focuses on recognising and building on the strengths of the family, by fostering trust to equip the family with the capacity to manage their infant's health care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
976 |
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Author |
Dobbs, L. |
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Title |
Can evidence improve nursing practice? |
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Journal Article |
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Year |
2006 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
10 |
Issue |
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Pages |
27-32 |
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Keywords |
Evidence-based medicine; Nursing; Professional development |
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Abstract |
Evidenced Based Practice is aimed at providing safe, effective and cost-appropriate health care. The utilisation of EBP in nursing has proved to be valuable not only for patients and nurses, but also for other health professionals and the wider community. However, despite the recognised benefits of EBP, a significant gap between theory and practice exists. This paper explores some of the issues behind not implementing EBP, such as comfort with traditional practices, lack of engagement with EBP, and time constraints. |
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Call Number |
NRSNZNO @ research @ 1226 |
Serial |
1211 |
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Author |
Elliott, M.M. |
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Title |
Model of care development: Moving between liaison and complex care coordination in the community health setting |
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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 |
Community health nursing; Nursing models |
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Abstract |
Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services. |
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Call Number |
NRSNZNO @ research @ |
Serial |
684 |
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Author |
Mulcahy, D.M. |
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Title |
Journeys cross divides: Nurses and midwives' experiences of choosing a path following separation of the professions |
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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 |
Midwifery; Nursing; Policy; Careers in nursing |
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Abstract |
In 2003 the Health Practitioners Competence Assurance Act was introduced and established separate regulatory authorities for nursing and midwifery. This study is designed to explore the experiences of dually registered practitioners affected by this divide, as now there are two separate and possible paths, and two corresponding sets of competencies to fulfil. The design for this qualitative descriptive study utilised the written and oral narratives of three practitioners affected by this professional regulation and demonstrated its impact on their career development. Individual storytelling, as narrative, provided a theoretical lens aiding insight into their experience and pattern of decision making. In addition, symbolic consideration of the study data was provided by collective storytelling via the perennial myth of the hero journey. Shifting professional ground following the Health Practitioners Competence Act 2003 generated a focus for the inquiry into practitioners' modes of adjustment. For the practitioners in the study, transition between the occupational roles of nursing and midwifery comprised the possible career trajectories. A status passage, as the process of change from one social status to another, is described and includes the transitional experience of anticipation, expectation, contrast, and change. The author suggests that the findings from this research provide illumination of the nuances of professional decision making as a lived experience, and highlight how these practitioners dealt with shifting meaning, values, awareness, choices, and relationships. Aspects of group agency and identity, change management, and professional role transition were revealed. Life pattern, revealed through narrative, was an important research construct for exposing the ways in which the participants negotiated change, and displayed the function of their thinking and reasoning through dilemmas. Perception of individual and group identity revealed attitudes of esteem to the dominant discourse, and exposed dynamic tension between work patterns and life stage. Renegotiating arrangements of personal and professional commitment resulted from this dynamic interplay, and the relationship to stress and burnout was explored. |
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Call Number |
NRSNZNO @ research @ 700 |
Serial |
686 |
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Author |
Macfie, B. |
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Title |
Assessing health needs and identifying risk factors |
Type |
Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
6 |
Pages |
16-18 |
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Keywords |
Infants; Parents and caregivers; Clinical assessment; Risk factors; Plunket |
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Abstract |
In 2004, Plunket nurses from eight areas around New Zealand participated in collecting data for a research project on health needs assessment practices. This project aimed to examine risk factors identified by Plunket nurses, what areas of health need considered to be priorities; grading of health needs; and how closely the results of health need assessment aligned with the individual clients' deprivation score. The researchers examine the assessment of health needs against the use of the Deprivation Index, which indicates a specific population in a specific area, as a funding model. This study appeared to show there are two distinct groups of clients assessed as high needs: those with risk factors such as family violence and severe parental mental illness, and who may live in an area of 1-7 deprivation; and those with multiple risk factors which include poverty, low education, and/or reluctance to access services and support, and who usually live in dep 8-10 areas. This research supports the anecdotal evidence that significant health needs exist outside the lower deprivation areas. |
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Call Number |
NRSNZNO @ research @ |
Serial |
974 |
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Author |
Arcus, K.J.; Wilson, D. |
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Title |
Choosing Whitireia as a political act: Celebrating 20 years of a nurse education at Whitireia Community Polytechnic 1986-2006 |
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Journal Article |
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Year |
2006 |
Publication |
Whitireia Nursing Journal |
Abbreviated Journal |
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Volume |
13 |
Issue |
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Pages |
12-24 |
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Keywords |
Cultural safety; Curriculum; Nursing; Education |
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Abstract |
In 2006, Whitireia Community Polytechnic celebrates 20 years of tertiary education. Nursing was one of the first courses to start at the new Parumoana Community College in February 1986. Oral histories, gathered from the women who have been the leaders of the undergraduate nursing programme throughout these two decades, form the basis of this article. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1038 |
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