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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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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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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Beaver, P. J. (2015). Contemporary patient safety and the challenges for New Zealand. Ph.D. thesis, University of Auckland, .
Abstract: Outlines the history, emergence, necessity, challenges, and strategies of the patient safety movement. Explores the challenges for staff working to reduce harm and implement safety improvement in NZ hospitals. Considers medical harm as a persistent and expensive threat to public health. Analyses health policy in the US, England and NZ using the theory of countervailing powers, and a shift from medical to managerial dominance. Reviews theories of accidents and risk, and the safety improvement literature. Provides staff perspectives from NZ by means of interviews with doctors, nurses and managers in two hospitals.
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Crogan, P. A. (2010). Nurses' perceptions of their role in quality improvement change. Master's thesis, University of Auckland, Auckland.
Abstract: Explores how nurses perceive quality improvement (QI) change, determines what is needed for nursing to further contribute to QI change and identifies the potential disconnect between the two. Undertakes a sequential, mixed-methods approach, using a questionnaire followed by a focus group representing 10 per cent of RNs at Middlemore Hospital.
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Mockford, A. (2009). The exploration of systems and technologies to enhance the healthcare of children under five. Margaret May Blackwell Travel Study Fellowship Reports. Waikato, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: The well known premise that 'healthy children grow into healthy adults' should reinforce the need for us to engage with parents and caregivers to ensure that we support them with meeting their child's health care needs. This scholarship enabled the author to see what the UK, Sweden, the US, and Canada were doing to strengthen and support children under five and their families across the continuum of care. Part of the Margaret May Blackwell Scholarship Reports series.
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Challis-Morrison, S. (2008). Management and guidance of patient resuscitations within secondary rural hospitals. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 111-122). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter firstly offers background information relating to the management and guidance of resuscitation within secondary rural hospitals. Secondly, it discusses the evidence related to issues concerning resuscitation and not-for-resuscitation, including issues involving medical and nursing staff, the patient experience, appropriate documentation, and cultural factors. Thirdly, it presents the findings through an implementation and evaluation plan.
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Barratt, R. (2008). Behind barriers: patients' perceptions of hospital isolation for methicillin-resistant Staphylococcus aureus (MRSA). Ph.D. thesis, , .
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.
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Davies, B. (2008). Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing. Ph.D. thesis, , .
Abstract: This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice.
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Haitana, J. (2007). Building relationships: A qualitative descriptive study reflective of the day-to-day experiences of one group of preceptors in a provincial hospital in New Zealand. Ph.D. thesis, , .
Abstract: Research suggests that the experience of being a preceptor can be rewarding, but there are challenges which may impact on their ability to fulfil the preceptorship role. In an effort to understand the experiences of being a preceptor and the factors that impact on that role, a qualitative descriptive study was undertaken in a small provincial hospital in New Zealand. A purposeful sample of five registered nurse preceptors completed semi-structured audio-taped interviews. Seven common categories were developed from the data – willingness to engage, building a relationship, letting go, support, workload, students in the clinical setting and making judgements. The author notes that this research has highlighted that preceptors need prior notice that they are going to be having student nurses so that they can be better prepared; preceptors and student nurses also need to be rostered together for the whole placement to allow a one-on-one relationship to develop. Preceptors would benefit from having a lighter workload during the first few days of preceptoring as then they can spend more time teaching the student. Schools of nursing and hospitals also need to have an ongoing collaborative relationship in planning and supporting the preceptorship program; this would further support preceptors in their role. The lecturer from the school of nursing needs to be contactable and available to both the preceptor and the student to clarify any misunderstandings and as a resource should any problems arise.
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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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Manning, J. (2007). Skin-to-skin care of the very low birth weight infant: Taking a risk and making it happen. Ph.D. thesis, , .
Abstract: Parent-infant skin-to-skin care has become an advocated aspect of care in neonatal intensive care units nationally within New Zealand and internationally. However the implementation of this care by nurses can be limited by a number of factors within the practice environment. This dissertation presents a critical analysis of literature alongside reflection on the author's own practice experience to explore factors that may be constraining the use of skin-to-skin care with the very low birth weight infant in the neonatal intensive care unit. These factors are examined through a lens of risk taking behaviour underpinned by the grounded theory work of Dobos (1992). The concept of risk is explored in order to develop an understanding of why, in the author's view, the practice of skin-to-skin care of very low birth weight infants may have declined in recent years. For neonatal nurses skin-to-skin care of the very low birth weight infant presents challenges related to the environment, physiological stability of the infant and changes over the past 10 years in the clinical management of very low birth weight infants. As progress is made toward the design, development and eventual move to a new unit in Dunedin recommendations pertaining to the change in physical space, the introduction of a structured model for nursing care and implications for nursing practice development in relation to skin-to-skin care are described.
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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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Payne, S. (2007). The nurse's role in promoting health of vulnerable children (0-5 yr olds) through coordinated care: Margaret May Blackwell Study Fellowship. Margaret May Blackwell Travel Study Fellowship Reports. Wellington, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: Explores the provision of emergency paediatric care internationally. Visits children's hospitals in the US, Canada, the UK and Australia. Part of the Margaret May Blackwell Scholarship Reports series.
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Marcinkowski, K., & McDonald, B. (2006). Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative. Nursing Praxis in New Zealand, 22(3), 15–21.
Abstract: This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
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