Abstract: This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.

Abstract: This paper looks broadly at issues to do with quality monitoring in higher education and considers the role and focus of the Nursing Council of New Zealand in the approval of and ongoing monitoring of undergraduate nursing degree programmes. It is suggested that the approach taken by the Nursing Council is accountability led where minimal attention is given to teaching and learning and actual graduate outcomes. This may lead to a mistaken belief that Nursing Council's monitoring focuses on quality or that the outcomes of their monitoring might contribute to programme enhancement. A shift to emphasise learning processes, students and continual improvement in order to enhance programme quality is proposed.

Abstract: This article explores the incorporation of western knowledge with kaupapa Maori in the delivery of health care. It presents a fictional kaupapa Maori service, as a tool to explore the change process and influence that organisational culture and leadership styles have on a process of integrating a kaupapa Maori nursing service. The importance of continual evaluation through quality assurance measures was also conveyed.

Abstract: This thesis looks at the prospect of developing and implementing case management as a model of care for complex patients in an acute medical setting. An extensive literature review was conducted to explore the concept of case management and to identify the role of the case manager, including the qualities and qualifications required for the position. Clinical pathways are a tool used in case management so these are also included in the literature review. As the author had been involved in the development of the first clinical pathway for Hutt Valley Health, this is used as an example to clarify how case management and clinical pathways can be used in conjunction. A discussion chapter examines the advantages and disadvantages of case management which shows that it can be an effective and efficient model of care through the development of clinical pathways. The ethical implications of case management are also considered. The thesis concludes with recommendations for the continued development of case management as a model of care to improve the quality of care for both patients and the organisation. During the course of the thesis, other areas that are worth further investigation have also been identified, such as the relevance of case management to different cultures. The thesis suggests that a proposal for case management for complex patients in the acute care setting is developed along with a job description for the role of the case manager.