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Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
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McKenna, B., O'Brien, A. J., Dal Din, A., & Them, K. (2006). Responsible clinician role offers opportunities for nurses. Kai Tiaki: Nursing New Zealand, 12(11), 12–14.
Abstract: The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation.
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Smith, M. C. (2008). Reviewing the role of a mental health nurse practitioner. Kai Tiaki: Nursing New Zealand, 14(3), 20–22.
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.
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Evans, S. (2007). Silence kills: Challenging unsafe practice. Kai Tiaki: Nursing New Zealand, 13(3), 16–19.
Abstract: The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals.
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Warren, B. L. (2007). Using paracetamol before immunisation: Does it work? Kai Tiaki: Nursing New Zealand, 13(5), 24–26.
Abstract: The author presents a review of evidence on the prophylactic use of paracetamol prior to infant and child immunisation. The research was prompted when the Otago District Health Board was planning its Meningococcal B strategy. The evidence suggests that it was appropriate when the whole cell pertussis vaccine was used, but it was not recommended since the introduction of better vaccines such as acellular pertussis with fewer antigens and fewer side effects. Paracetamol may still be given orally to treat pain and fever that occasionally follows vaccination. Paracetamol pharmacology is presented, along with alternatives to paracetamol.
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Harding, T. S. (2004). Male nurses: The struggle for acceptance. Kai Tiaki: Nursing New Zealand, 9(4), 17–19.
Abstract: This article describes the role of men in the nursing profession in New Zealand from colonial times to the 1970s. It considers attitudes towards male nurses, the provision of training for men and the various laws and regulations dealing with the issue.
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Burrell, B. (2003). Mixed-sex rooms: Invading patients' privacy? Kai Tiaki: Nursing New Zealand, 9(4), 26–28.
Abstract: The author considers the issue of mixed-sex rooming (MSR) in New Zealand hospitals. A review of the literature is presented, with a focus on the attitudes and experiences of patients in the UK, where the issue has been most practised and studied. Findings of a survey of a group of New Zealand female patients are presented. The patients feelings of embarrassment and loss of dignity and privacy are discussed. The legal issues are explored, with the practice evaluated against the patient's rights detailed in the Code of Health and Disability Services and the Privacy Act 1993.
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Wilkinson, J. A. (2002). Creating a culture of workplace safety. Kai Tiaki: Nursing New Zealand, 8(6), 14–15.
Abstract: This study investigated the safety of working environments of a group of urban district nurses. Six district nurses were interviewed and participated in a focus group. The findings focus on the risks associated with client behaviour and with the organisational structure in which district nurses work. Recommendations for primary, secondary and tertiary prevention of harm to nurses working in isolation in the community are presented. The author describes her personal background in district nursing, which prompted the study.
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Woods, M. (2002). Dissecting a brave new nursing world. Kai Tiaki: Nursing New Zealand, 8(10), 20–22, 36.
Abstract: This article critiques the 'Strategic Review of Undergraduate Education' commissioned by the Nursing Council. The premise of the review is examined, along with the foundations of nursing practice and the role of nursing education.
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Christie, J. (2002). Managing febrile children: When and how to treat. Kai Tiaki: Nursing New Zealand, 8(4), 15–17.
Abstract: The author describes the nursing of febrile children in a general paediatric ward at Tauranga Hospital. She focuses on the cooling methods used and their efficacy. Ward practice is compared with clinical trials and the literature to determine best practice and evidence-based guidelines. Also discussed are fans and clothes removal, tepid sponging, paracetamol, and brufen.
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Hales, A., & Dignam, D. (2002). Nurse prescribing lessons from the US. Kai Tiaki: Nursing New Zealand, 8(10), 12–15.
Abstract: The researchers present a survey of a sample population of 32 advanced practice nurses (APN) in the US about their experiences of acquiring and implementing prescriptive authority. The issues relevant to nurse practitioners in New Zealand are discussed, around acquiring knowledge and education, relationships with other professionals, establishing the role, and retaining the nursing role. The intent and scope of APN prescribing in the US is also discussed.
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Hansen, G. (2002). The role of massage in the care of the critically ill. Kai Tiaki: Nursing New Zealand, 8(7), 14–16.
Abstract: This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated.
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Johnstone, C. (2001). Linking diet and respiratory distress. Kai Tiaki: Nursing New Zealand, 7(5), 22–23.
Abstract: The author, a district nurse, describes the experiences of a patient with chronic obstructive pulmonary disease requiring long-term oxygen therapy and characterised as a carbon dioxide retainer whose overall health was improved by a carbohydrate restricted diet. The literature on carbohydrate intake and respiratory disease is briefly reviewed.
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Wright, R. (2001). Linking theory with practice. Kai Tiaki: Nursing New Zealand, 7(2), 14–15.
Abstract: This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family.
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Skadiang, K. (2001). Researching post-tonsillectomy bleeding. Kai Tiaki: Nursing New Zealand, 7(4), 22–23.
Abstract: This article reports findings from an audit of post-tonsillectomy haemorrhage among patients at South Auckland Health from October 1998 to April 1999. All patients who underwent tonsillectomy or adenotonsillectomy were contacted by telephone, after the 14th day and before the 21st day following surgery.
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