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Author Hamer, H.P.; McCallin, A.
Title Cardiac pain or panic disorder? Managing uncertainty in the emergency department Type Journal Article
Year 2006 Publication Nursing & Health Sciences Abbreviated Journal
Volume 8 Issue 4 Pages 224-230
Keywords (up) Emergency nursing; Clinical assessment; Diagnosis
Abstract This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented.
Call Number NRSNZNO @ research @ Serial 689
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Author Blair, K.M.
Title Recognising the sick patient: An emergency nurses view: A research paper Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords (up) Emergency nursing; Patient safety; Diagnosis; Training; Clinical decision making
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.
Call Number NRSNZNO @ research @ Serial 467
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Author Litchfield, M.
Title Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 Type Manuscript
Year 2006 Publication Abbreviated Journal Held by the Ministry of Health, publication pending
Volume Issue Pages
Keywords (up) Evaluation; Community health nursing; Nursing models; Interprofessional relations
Abstract This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice.
Call Number NRSNZNO @ research @ Serial 1178
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Author Harding, T.S.
Title New strategies in evidence based practice Type Journal Article
Year 2006 Publication Klinisk sygepleje Abbreviated Journal
Volume 20 Issue 3 Pages 4-11
Keywords (up) Evidence-based medicine; Nursing; Education; Curriculum
Abstract This article considers wider organisational issues that impact on the implementation of evidence based practice. It describes the strategies adopted by the Auckland Area Health Board and Unitec New Zealand to implement the principles of evidence based practice in New Zealand. This has resulted in a collaboration with Auckland University and the Joanna Briggs Institute for Evidence Based Nursing and Midwifery to form the Centre for Evidence Based Nursing – Aotearoa. Evidence based nursing is a vital part of nursing education. Unitec New Zealand has developed and incorporated evidence based nursing into all courses in their undergraduate programme. Central to this is the use of evidence based practice in patient care and the integration of technology with evidence based nursing in clinical practice.
Call Number NRSNZNO @ research @ Serial 778
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Author Dobbs, L.
Title Can evidence improve nursing practice? Type Journal Article
Year 2006 Publication Nursing Journal Northland Polytechnic Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector
Volume 10 Issue Pages 27-32
Keywords (up) Evidence-based medicine; Nursing; Professional development
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.
Call Number NRSNZNO @ research @ 1226 Serial 1211
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Author Williams, H.
Title One for the boys: An evaluative study of primary health care access by men in Tairawhiti Type
Year 2006 Publication Abbreviated Journal NZNO Library
Volume Issue Pages
Keywords (up) Gender; Primary health care; Access; Male
Abstract
Call Number NRSNZNO @ research @ Serial 1138
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Author Lidiard, B.
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? Type
Year 2006 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords (up) Geriatric nursing; Dementia; Workplace violence; Older people
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.
Call Number NRSNZNO @ research @ Serial 798
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Author Janssen, J.
Title Fat simple: A nursing tool for client education Type Journal Article
Year 2006 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 22 Issue 2 Pages 21-32
Keywords (up) Health education; Nursing; Diet
Abstract This article summarises the current level of knowledge regarding dietary effects on serum cholesterol. Information from a literature review was used to design a table that identifies how changes in diet and activity can alter components of a person's lipid profile. Nurses can use the resulting table as a simple tool to give clients targeted education based on their individual cholesterol results. This tool illustrates that not all dietary recommendations to the public are beneficial to serum cholesterol levels and it also explains why popular diets such as the Atkins, Mediterranean, and glycaemic index / load can produce more cardio-protective profiles than the traditional low fat diet.
Call Number NRSNZNO @ research @ 536 Serial 522
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Author Richardson, S.; Ardagh, M.; Hider, P.
Title New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department Type Journal Article
Year 2006 Publication New Zealand Medical Journal Abbreviated Journal Access is free to articles older than 6 months, and abstracts.
Volume 119 Issue 1232 Pages
Keywords (up) Hospitals; Clinical assessment; Interprofessional relations
Abstract This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept.
Call Number NRSNZNO @ research @ Serial 526
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Author Cook, D.
Title Open visiting: Does this benefit adult patients in intensive care units? Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords (up) Hospitals; Intensive care nursing
Abstract As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. The aim of this dissertation was to examine the benefits for the patient, family members and nurses of appropriate visiting practices within intensive care areas in order to establish if open visiting is the best regime for patients in the adult intensive care unit (ICU). This dissertation explores visiting practices in adult critical care unit settings. Specifically, the benefits of visiting for patients, and the factors that may impede or facilitate visiting practices within the ICU were critically discussed. These factors included the benefits and disadvantages of open visiting, and the nurse as an influential factor in visiting. These areas linked together to form the basis for consideration of visiting in the ICU. Review of existing literature pertaining to visiting in the ICU indicated that patients wanted open visiting hours yet also indicated that they would like some visiting restrictions. Nurses appeared to value family input into care and were aware of patient and family needs, even though they may restrict visiting to suit their own work practices. Family members can provide the patient with psychological support, provide important historical data, assist the nurse with selected aspects of physical care, and actively encourage the patient's efforts to recover. The outcome of this exploration is the recommendation of an open visiting policy tailored to individual patients, as, the author suggests, this would foster nursing practice and ultimately benefit patients and their families.
Call Number NRSNZNO @ research @ Serial 680
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Author Morton, J.; Williams, Y.; Philpott, M.
Title New Zealand's Christchurch Hospital at night: An audit of medical activity from 2230 to 0800 hours Type Journal Article
Year 2006 Publication New Zealand Medical Journal Abbreviated Journal
Volume 119 Issue 1231 Pages
Keywords (up) Hospitals; Teamwork; Administration; Shiftwork; Organisational culture
Abstract The authors conduct an audit of medical activity at Christchurch Hospital, a 650 bed tertiary centre, between 2230 and 0800 hours. They measured the volumes of tasks requiring completion overnight and identified the competencies required for this as well as the level of teamwork that existed. They found several organisational areas of concern, that indicate new approaches are required to staff the “hospital at night,” and an Out of Hours Multidisciplinary Team is recommended. Specific issues included the lack of teamwork from the Resident Medical Officers (RMOs), with some overextended while others were inactive. House officer tasks were largely generic rather than specialty specific; there was no formal handover from the afternoon or day shifts and the level of hospital medical staffing did not reflect the activity levels over the time period studied. The researchers also recommend an urgent review of the beep policy. A third of the admissions were to General Medicine, and basic medical activities (including admitting, reviewing, and prescribing drugs and fluids) for patients admitted under all specialties represented the majority of the night workload. Medical registrars had reduced some of the traditional multiple clerking by admitting patients themselves.
Call Number NRSNZNO @ research @ Serial 528
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Author Macfie, B.
Title Assessing health needs and identifying risk factors Type Journal Article
Year 2006 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 12 Issue 6 Pages 16-18
Keywords (up) Infants; Parents and caregivers; Clinical assessment; Risk factors; Plunket
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.
Call Number NRSNZNO @ research @ Serial 974
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Author Evans, S.
Title Silence kills: Communication around adverse events in ICU Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords (up) Intensive care nursing; Communication; Interprofessional relations
Abstract The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety.
Call Number NRSNZNO @ research @ Serial 741
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Author Fielding, S.
Title Learning to do, learning to be: The transition to competence in critical care nursing Type
Year 2006 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue Pages
Keywords (up) Intensive care nursing; Preceptorship; Nursing specialties
Abstract Making the transition to an area of specialist nursing practice is challenging for both the learner and staff who are responsible for education and skill development. This study uses grounded theory methodology to explore the question: “How do nurses learn critical care nursing?” The eight registered nurses who participated in this study were recruited from a range of intensive care settings. The criteria for inclusion in the study included the participant having attained competency within the critical care setting. Data was collected from individual interviews. This study found that nurses focus on two main areas during their orientation and induction into critical care nursing practice. These are learning to do (skill acquisition) and learning to be (professional socialisation). The process of transition involves two stages: that of learning to do the tasks related to critical care nursing practice, and the ongoing development of competence and confidence in practice ability. The relationship of the learner with the critical care team is a vital part of the transition to competency within the specialist area. This study identifies factors that influence the learner during transition and also provides an understanding of the strategies used by the learners to attain competency. These findings are applicable to educators and leaders responsible for the education and ongoing learning of nurses within critical care practice. The use of strategies such as simulated learning and repetition are significant in skill acquisition. However attention must also be paid to issues that influence the professional socialisation process, such as the quality of preceptor input during orientation and the use of ongoing mentoring of the learner.
Call Number NRSNZNO @ research @ Serial 509
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Author Horsburgh, M.; Perkins, R.; Coyle, B.; Degeling, P.
Title The professional subcultures of students entering medicine, nursing and pharmacy programmes Type Journal Article
Year 2006 Publication Journal of Interprofessional Care Abbreviated Journal
Volume 20 Issue 4 Pages 425-431
Keywords (up) Interprofessional relations; Attitude of health personnel; Nurse managers; Nursing; Education; Organisational culture
Abstract This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.
Call Number NRSNZNO @ research @ Serial 937
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