Richardson, S. (2005). Coping with outbreaks of the norovirus. Kai Tiaki: Nursing New Zealand, 11(7).
Abstract: The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
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Richardson, S. (2005). Incorporation of research into clinical practice: The development of a clinical nurse researcher position. Nursing Praxis in New Zealand, 21(1), 33–42.
Abstract: The author backgrounds the development of the role of an innovative Nurse Researcher (Emergency Medicine) role at Christchurch Hospital. She describes the emergency department and the factors leading to the creation of the role. Specific nursing research projects are reviewed, and the nature of nursing in relation to research is discussed. The author argues that the nurse researcher is integral to the expansion of evidence-based nursing, and that the role of Clinical Nurse Researcher in the emergency department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance.
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Richardson, S., Ardagh, M., & Hider, P. (2006). New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department. Access is free to articles older than 6 months, and abstracts., 119(1232).
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.
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Rudd, J. (2005). From triage to treatment: An exploration of patient flow systems in emergency departments. Ph.D. thesis, , .
Abstract: To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room.
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Schroyen, B., & Finlayson, M. (2004). Clinical teaching and learning: An action research study. Nursing Praxis in New Zealand, 20(2), 36–45.
Abstract: Using an educational action research model, a nursing lecturer based in a polytechnic and ten students formed a research group to address one issue that was important to them. The research group chose to plan, implement and evaluate a practical change strategy aimed at improving the teaching and learning relationship between students and staff nurses in clinical settings. A sample of five staff nurses working closely with five students in the group was invited to join the study in order to gain their perspectives on the issues. The findings were that contract learning provides a strategy which, under certain conditions, offers both students and staff nurses an opportunity to improve the effectiveness of their interactions.
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Scott, S., Johnson, Y., & Caughley, B. (2003). An evaluation of the new graduate orientation programme: Introduced at Capital Coast District Health Board's Wellington Hospital in March 1998. [Wellington]: Massey University.
Abstract: This report presents a longitudinal research study which evaluated the effectiveness of the twelve months New Graduate Orientation Programme introduced at Capital Coast District Health Board's Wellington Hospital in March 1998. The programme was implemented to assist new nursing graduate's transition into the role of registered nurse. The evaluation project took place over a three-year period. Three annual intakes of new graduates enrolled in the New Graduate Orientation Programme were surveyed by questionnaire on their completion of the programme.
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Seldon, L. A. (2017). Non-pharmacological Methods in Relieving Children's Pain in Hospital: a pilot study. Master's thesis, University of Canterbury, .
Abstract: Adapts the questionnaire used in three international studies of the utilisation of non-pharmacological methods of post-operative pain management for paediatric surgical patients, and distributes it to registered nurses working in a paediatric surgical ward in one district health board (DHB) hospital. Discusses the non-pharmacological methods used and how they correlate with international literature.
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Sheward, K. A. (2005). Exploring the juxtaposition of end of life care in the acute setting and the integrated care pathway for the care of the dying.
Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.
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Smart, S. (2005). Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view. Ph.D. thesis, , .
Abstract: This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses.
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Stodart, J. (2017). Infection prevention and control clinical governance in New Zealand District Health Boards. Master's thesis, University of Otago, Dunedin.
Abstract: Explores the current climate of infection prevention control (IPC) clinical governance in NZ. Audits IPC management plans in NZ District Health Boards (DHB) to evaluate which clinical governance factors facilitate or hinder IPC best practice. Employs a mixed-method, exploratory, qualitative study design to conduct semi-structured interviews with ten IPC nurses across NZ. Seeks to understand their perceptions of the IPC Standard, how it is implemented in their DHB, how the IPC risks are managed, and which barriers hinder IPC engagement. Analyses IPC documentation from all 20 DHBs to examine IPC clinical governance in each DHB.
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Stojanovic, J. E. E. (2002). Leaving your dignity at the door: Maternity in Wellington 1950 – 1970. Ph.D. thesis, , .
Abstract: This thesis describes the maternity system in Wellington between 1950 and 1970 particularly from the perspectives of consumers and midwives. Four women consumers who experienced maternity in Wellington and two midwives who worked in Wellington's maternity hospitals during this period provided their oral testimonies as the main primary sources for this study. The author's experience of being a student nurse and a consumer in Wellington and other primary and secondary sources are used to substantiate, explore and explain the topic. The study traces the socio-political changes in New Zealand maternity from 1900 to 1970 creating a backdrop against which Wellington's maternity system, including the women, the hospitals, the workforce, maternity practices and the childbearing process are illuminated using the insights of women and midwives who experienced them. The oral testimonies of the six participants described positive and negative aspects of their maternity experiences, but the three strong themes that arose from their accounts included 'being alone', 'lack of autonomy' and 'uncaring attitudes'.
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Tewin, M. H. (2015). Exploring the impact of the lung cancer Clinical Nurse Specialist role on patient care in a regional hospital in New Zealand. Master's thesis, University of Otago, .
Abstract: Distributes a questionnaire to 50 members of the multidisciplinary team within a regional lung cancer service to investigate the impact of an advanced nursing role within the team. Performs an audit of five months of clinical data relating to patients cared for by the lung cancer Clinical Nurse Specialist as judged against the MOH Standards of Service Provision for Lung Cancer Patients in New Zealand .
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Truscott, J. M., Townsend, J. M., & Arnold, E. P. (2007). A successful nurse-led model in the elective orthopaedic admissions process. NZ Medical Association website. Access free to articles older than 6 months., 120(1265).
Abstract: This paper documents a successful nurse-led admissions process for same day orthopaedic surgery, on relatively fit patients under 70 years of age. During the 6-month study, 31 patients with a median age of 38 years were categorised into 3 streams. 252 patients (76%) underwent a nursing-admission process without the need for further consultation with a junior medical officer or an anaesthetist. The remaining patients not included in the study were admitted and clerked by a house officer. No safety issues arose and the surgeons and anaesthetists were satisfied with the process. The junior medical officers described improved job satisfaction by being able to attend theatre, other educational opportunities, and working more closely with the consultant. The process has now been incorporated into elective orthopaedic admissions at Burwood Hospital.
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Vermeulen, J. (2002). “And there's the likes of me”: A phenomenological study of the experience of four women inpatients at a mental health unit. Ph.D. thesis, , .
Abstract: This research draws on the experiences of four women whilst they were inpatients at the Mental Health Unit in Southland. The Husserlian path of phenomenology was followed and in-depth interviewing used to collect data. Colaizzi's method of analysis enabled accurate interpretation of transcripts. The overall goal of this research was to provide health professionals with an opportunity to inform their practice, based on what consumers were saying about their experience of hospitalisation. Themes emerged through participants relating their experience by using comparisons with either their outside world or previous episodes of hospitalisation. Through analysis, two fundamental structures became evident within the findings. These were 'the environment as containment' and 'the road to recovery'. The author concludes that this study raises significant issues surrounding the experience of hospitalisation at the Mental Health Unit that have implications for future research and for future service delivery.
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Walsh, C., Boyd, L., Baker, P., Gavriel, A., McClusky, N., Puckey, T. C., et al. (2001). It was time for me to leave: A participatory action research study into discharge planning from an acute mental health setting. Wellington: Victoria University of Wellington.
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