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Crowe, M., & Carlyle, D. (2003). Deconstructing risk assessment and management in mental health nursing. Journal of Advanced Nursing, 43(1), 19–27.
Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
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Hernandez, M., King, A., & Stewart, L. (2019). Catheter-associated urinary tract infection (CAUTI) prevention and nurses' checklist documentation of their indwelling catheter management practices. Nursing Praxis in New Zealand, 35(1). Retrieved May 19, 2024, from www.nursingpraxis.org
Abstract: Investigates nurses' catheter management practices, by means of an audit, as documented in a newly-introduced self-administered indwelling catheter-management checklist incorporating four components of catheter care in a catheter-associated urinary tract infection (CAUTI) prevention bundle. Identifies these components of the bundle of care as: minimisation of inappropriate catheter use, aseptic insertion of catheters, adherence to catheter maintenance guidelines, and ongoing review and evaluation of catheter necessity. Shows that implementation of care components decreases bacteriuria rates and CAUTI when used together in standardised clinical checklists and performed collectively by nurses. Employs a quantitative research design as part of a mixed-methods study conducted at two surgical wards in a public hospital in Auckland where 50 nurses completed 175 checklists.
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Francis, H., Carryer, J., & Cram, F. (2019). Consulting with Maori experts to ensure mainstream health research is inclusive of Maori. Nursing Praxis in Aotearoa New Zealand, 35(3). Retrieved May 19, 2024, from http://dx.doi.org/10.36951/NgPxNZ.2019.010
Abstract: Advocates for the inclusion of Maori participants in research on long-term conditions (LTC). Presents research with 16 participants, including 6 Maori, into how they managed their conditions, and describes the role of consultation with Maori experts to support the cultural responsiveness of such research.
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Haufe, B., & Honey, M. (2019). Role of whanau in self-management for adults receiving haemodialysis in Aotearoa New Zealand: a qualitative study. Nursing Praxis in Aotearoa New Zealand, 35(3), www.nursingpraxis.org. Retrieved May 19, 2024, from http://dx.doi.org/10.36951/NgPxNZ.2019.011
Abstract: Explores the role of family/whanau on self-management of end-stage renal disease (ESRD). Conducts semi-structured interviews with 7 haemodialysis patients, of which 5 were Maori, about their perspectives on whanau's role. Highlights 3 themes: whanau support, whanau importance and whanau hindrance.
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Fitzgerald, S., Tripp, H., & Halksworth-Smith, G. (2017). Assessment and management of acute pain in older people: barriers and facilitators to nursing practice. Australian Journal of Advanced Nursing, 35(1). Retrieved May 19, 2024, from https://www.ajan.com.au/
Abstract: Examines the pain management practices of nurses, and identifies barriers and facilitators to the assessment and management of pain for older people, within the acute hospital setting.
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Garcia, A., Whitehead, D., & Winter, H. S. (2015). Oncology nurses' perception of cancer pain: a qualitative exploratory study. Nursing Praxis in New Zealand, 31(1), 27–33.
Abstract: Undertakes research to explore how oncology nurses perceive cancer pain in patients. Presents the findings of semi-structured interviews with a sample of 5 registered nurses working in a NZ oncology ward, who reported their responses to under-treatment of cancer pain. Highlights the need to explore cancer pain management with patients.
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Slight, C., Marsden, J., & Raynel, S. (2009). The impact of a glaucoma nurse specialist role on glaucoma waiting lists. Nursing Praxis in New Zealand, 25(1), 38–47.
Abstract: Reports on the effect of a 'nurse-led' glaucoma clinic at a large metropolitan hospital, in which patients were recruited from specific categories of glaucoma patients on the waiting list. Audits the impact on the waiting list over a two-year period.
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Spence, D., & Wood, E. E. (2007). Registered nurse participation in performance appraisal interviews. Journal of Professional Nursing, 23(1), 55–59.
Abstract: This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice.
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Smillie, A. (2006). Historical investigations: Risk management in a New Zealand hospital, 1888-1904. Nursing Praxis in New Zealand, 22(2), 33–38.
Abstract: This article examines historical events within one hospital and compares them with contemporary risk management practices. The examples involve a nurse sustaining injury in the course of her work, a fire in the hospital and two instances of patient complaints – one concerning nursing care and the other relating to a time lag between admission to hospital and receiving medical attention. Analysis of the processes followed in investigating these occurrences reveals that these historic investigations were small in scale and less bureaucratic than contemporary practice, and were based on a culture of blame. This is contrasted with modern risk management practices which are more focused on understanding what can be learned from the incident with respect to preventing recurrence.
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Drake, M., & Stokes, G. (2004). Managing pre-registration student risk: A professional and legislative minefield. Nursing Praxis in New Zealand, 20(1), 15–27.
Abstract: This article reports data from 15 schools of nursing, surveyed to identify difficulties experienced by nurse educators with respect to entry, progression and programme completion of undergraduate nursing students. Risk assessment, along with a lack of clear policy and procedures were found to be the main problem areas. Difficulties were exacerbated for educators when there were challenges to their professional judgement, either from the Nursing Council of New Zealand or from within their own institution. The authors argue for more recognition of the dual role of nurse educators, and greater clarification of the Nursing Council of New Zealand role in regulating the student's programme entry and progression, and ultimate admission to the Register. It is suggested that the recently passed Health Practitioners Competence Assurance Act (2003) provides nursing with an opportunity to address some of these issues.
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McKenna, B. (2002). Risk assessment of violence to others: Time for action. Nursing Praxis in New Zealand, 18(1), 36–43.
Abstract: The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.
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King, S. L. J., & Walsh, K. (2007). 'I think PCA is great, but . . .'- Surgical nurses' perceptions of patient-controlled analgesia. International Journal of Nursing Practice, 13(5), 276–283.
Abstract: This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semi-structured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being `I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education.
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Chiyesu, W., & Rasmussen, S. (2021). Influence of a pulmonary rehabilitation education programme on health outcimes for chronic obstructive pulmonary disease (COPD). Kai Tiaki Nursing Research, 12(1), 49–59.
Abstract: Considers whether the education component in a pulmonary rehabilitation programme (PRP) influences health outcomes for patients with chronic obstructive pulmonary disease (COPD) patients. Performs an integrative review of literature to integrate results from qualitative, quantitative and mixed-methods articles. Highlights the following concepts: disease knowledge, knowledge in relation to self-management, and the relationship between knowledge and education.
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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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