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Author Walsh, K.; Moss, C.; Lawless, J.; McKelvie, R.; Duncan, L.
Title Puzzling practice: A strategy for working with clinical practice issues Type Journal Article
Year 2008 Publication International Journal of Law and Psychiatry Abbreviated Journal (up)
Volume 14 Issue 2 Pages 94-100
Keywords Nursing philosophy; Clinical decision making; Problem solving
Abstract The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
Call Number NRSNZNO @ research @ Serial 838
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Author Koorey, R.
Title Is there a place for clinical supervision in perioperative nursing? Type Journal Article
Year 2008 Publication Dissector Abbreviated Journal (up)
Volume 35 Issue 4 Pages 15-17
Keywords Nursing models; Clinical supervision; Nursing specialties
Abstract This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided.
Call Number NRSNZNO @ research @ Serial 928
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Author Tweed, C.; Tweed, M.
Title Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program Type Journal Article
Year 2008 Publication American Journal of Critical Care Abbreviated Journal (up)
Volume 17 Issue 4 Pages 338-347
Keywords Intensive care nursing; Training; Evaluation
Abstract The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.
Call Number NRSNZNO @ research @ Serial 958
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Author Harding, T.S.; North, N.; Perkins, R.
Title Sexualizing men's touch: Male nurses and the use of intimate touch in clinical practice Type Journal Article
Year 2008 Publication Research & Theory for Nursing Practice Abbreviated Journal (up)
Volume 22 Issue 2 Pages 88-102
Keywords Male nurses; Nurse-patient relations; Gender
Abstract Drawn from a larger study, this article reports the experiences of a group of male nurses regarding the use of intimate physical touch. Using discourse analysis, interview data from 18 male nurses were analysed and related to existing text on men as nurses. The analysis reveals that although touch is important in nursing care, it is problematic for men because discourses have normalised women's use of touch as a caring behaviour and have sexualised men's touch. Participants described their vulnerability, how they protected themselves from risk, and the resulting stress. The complicity of nurses in sexualising men's touch and the neglect of educators in preparing men for providing intimate care are revealed. A paradox emerged whereby the very measures employed to protect both patients and men as nurses exacerbate the perceived risk posed by men carrying out intimate care. The authors suggest that deconstructing and reframing prevailing discourses around nursing, gender, and caring involving touch can help to legitimise men's involvement in physical caring.
Call Number NRSNZNO @ research @ Serial 960
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Author Kent, B.
Title Surgeon assistant's role within the New Zealand health care setting Type Journal Article
Year 2008 Publication Dissector Abbreviated Journal (up)
Volume 36 Issue 1 Pages 20-27
Keywords
Abstract This article examines the role of the surgeon assistant, identifying and discussing the factors that have stimulated the development globally and the present situation within the New Zealand health care setting. This article offers thought-provoking material that aims to provide the perioperative nurse with a clearer direction and purpose to practice, and to what the future may hold.
Call Number NRSNZNO @ research @ Serial 961
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Author Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J.
Title Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units Type Journal Article
Year 2008 Publication Journal of Clinical Nursing Abbreviated Journal (up)
Volume 17 Issue 8 Pages 1035-1043
Keywords Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison
Abstract The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.
Call Number NRSNZNO @ research @ Serial 962
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Author Kool, B.; Thomas, D.; Moore, D.; Anderson, A.; Bennetts, P.; Earp, K.
Title Innovation and effectiveness: Changing the scope of school nurses in New Zealand secondary schools Type Journal Article
Year 2008 Publication Australian & New Zealand Journal of Public Health Abbreviated Journal (up)
Volume 32 Issue 2 Pages 177-180
Keywords School nursing; Maori; Pacific peoples; Socioeconomic factors; Evaluation; Scope of practice
Abstract The aim of this research was to describe the changing role of school nurses in eight New Zealand secondary schools from low socio-economic areas with high Pacific Island and Maori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland(2002-05) was made. Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. The researchers conclude that school nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. The researchers go on to say that co-ordination of school nurses either at a regional or national level is required.
Call Number NRSNZNO @ research @ Serial 963
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Author Curtis, K.; Donoghue, J.
Title The trauma nurse coordinator in Australia and New Zealand: A progress survey of demographics, role function, and resources Type Journal Article
Year 2008 Publication Journal of Trauma Nursing Abbreviated Journal (up)
Volume 15 Issue 2 Pages 34-42
Keywords Emergency nursing; Personnel; Nurse managers; Economics
Abstract An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective
Call Number NRSNZNO @ research @ Serial 964
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Author Diers, D.
Title “Noses and eyes”: Nurse practitioners in New Zealand Type Journal Article
Year 2008 Publication Nursing Praxis in New Zealand Abbreviated Journal (up)
Volume 24 Issue 1 (Mar) Pages 4-10
Keywords Cross-cultural comparison; Nurse practitioners; History of nursing
Abstract Principles for understanding and evolving nurse practitioner practice, politics and policy are distilled from 40 years of experience in the United States and Australia. The issues in all countries are remarkably similar. The author suggests that some historical and conceptual grounding may assist the continuing development of this expanded role for nursing in New Zealand.
Call Number NRSNZNO @ research @ Serial 965
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Author Goodyear-Smith, F.; Janes, R.
Title New Zealand rural primary health care workforce in 2005: More than just a doctor shortage Type Journal Article
Year 2008 Publication Australian Journal of Rural Health Abbreviated Journal (up)
Volume 16 Issue 1 Pages 40-46
Keywords Personnel; Physicians; Rural health services; Nursing; Primary health care; Pharmacists
Abstract The aim of this study was to obtain a 2005 snapshot of the New Zealand rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. A postal questionnaire was distributed to rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists in November 2005. The self-reported data included information on demographics, country of training, years in practice, business ownership, hours worked including on-call, and intention to leave rural practice.
Call Number NRSNZNO @ research @ Serial 966
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Author Darbyshire, P.
Title 'Never mind the quality, feel the width': The nonsense of 'quality', 'excellence', and 'audit' in education, health and research Type Journal Article
Year 2008 Publication Collegian: Journal of the Royal College of Nursing Australia Abbreviated Journal (up)
Volume 15 Issue 1 Pages 35-41
Keywords Accountability; Quality assurance; Organisational change; Nursing research; Nursing; Education
Abstract The author contends that health care and education have been colonised by 'The Audit Society' and managerialism. It is argued that under the benign guise of 'improving quality' and 'ensuring value for money' a more Orwellian purpose operates. Academics had to be transformed into a workforce of 'docile bodies', willing to scrutinise and survey themselves and their 'performance' as outcome deliverers and disciples of the new 'Qualispeak'. This paper critiques the current obsession with audit and performativity, and the constant and often pointless 'change' that is held to be so self-evidently 'a good thing' and identifies policy discussion as a linguistic wasteland.
Call Number NRSNZNO @ research @ Serial 967
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Author Chang, E.M.; Bidewell, J.W.; Huntington, A.D.; Daly, J.; Johnson, A.; Wilson, H.; Lambert, V.; Lambert, C.E.
Title A survey of role stress, coping and health in Australian and New Zealand hospital nurses Type Journal Article
Year 2008 Publication Intensive & Critical Care Nursing Abbreviated Journal (up)
Volume 44 Issue 8 Pages 1354-1362
Keywords Stress; Psychology; Cross-cultural comparison; Nursing
Abstract The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.
Call Number NRSNZNO @ research @ Serial 970
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Author Tielemans, W.
Title Encouraging young women to have regular smear tests Type Journal Article
Year 2008 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal (up)
Volume 14 Issue 7 Pages 16-18
Keywords Nursing research; Sexual and reproductive health; Screening; Attitude to health; Cancer
Abstract The author presents the results of a study carried out as part of a research project with two nurse researchers from Maastricht University in the Netherlands. The aim of this study was to examine awareness among female students aged 18 to 25 about cervical cancer and to identify factors associated with their decision or intention to enter the cervical screening programme. Students aged 18-25 were recruited from four tertiary institutions in the Wellington region. A questionnaire was available online and distributed by student health centres and the researchers. Questions covered the following areas: intentions, attitude, knowledge, awareness, modelling, and support systems and efficacy. Data was analysed using descriptive statistics, multiple regression and independent t-tests. The findings are presented, and factors associated with intention and participation in cervical screening are discussed. The results indicate that the information concerning the national screening programme needs to be adjusted for the different age groups.
Call Number NRSNZNO @ research @ Serial 984
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Author Smith, M.C.
Title Reviewing the role of a mental health nurse practitioner Type Journal Article
Year 2008 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal (up)
Volume 14 Issue 3 Pages 20-22
Keywords Psychiatric Nursing; Nurse practitioners; Evaluation research; Professional competence
Abstract The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.
Call Number NRSNZNO @ research @ Serial 993
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Author Barratt, Ruth
Title Behind barriers: patients' perceptions of hospital isolation for methicillin-resistant Staphylococcus aureus (MRSA) Type
Year 2008 Publication Abbreviated Journal (up)
Volume Issue Pages
Keywords Infection control; Patient satisfaction; Nursing specialties; Hospitals
Abstract This study explored the experiences of hospitalised patients in methicillin resistant Staphylococcus aureus (MRSA) isolation in New Zealand and the meaning that those patients made of those experiences. The research question of this study was 'What is the lived experience of patients in MRSA isolation?' An interpretive phenomenological approach was undertaken for this research, informed by the philosophical hermeneutic tenets of Heidegger (1927/1962). Audio-taped, semi-structured interviews were used to collect data from a purposive sample of ten adults who were in MRSA isolation in various wards in a large acute care hospital in the central North Island. Three salient themes emerged from the data. The first, 'being MRSA positive', summarises the meaning of having an identity of being MRSA positive. The second theme, 'being with others', is concerned with the effect that being in isolation for MRSA has on interpersonal relations. 'Living within four walls' is the third theme and reveals the significance that the physical environment of the MRSA isolation room has on the experience of MRSA isolation. Within the discussion of these themes, excerpts from the interviews are provided to illuminate the meanings and interpretations made. Recommendations are made for nursing practice and education.
Call Number NRSNZNO @ research @ Serial 1167
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