|
|
Spence, D. (2004). Advancing nursing practice through postgraduate education, part two. Nursing Praxis in New Zealand, 20(3), 21–30.
Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.
|
|
|
|
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.
|
|
|
|
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.
|
|
|
|
Clendon, J., & Krothe, J. (2004). The nurse-managed clinic: An evaluative study. Nursing Praxis in New Zealand, 20(2), 15–23.
Abstract: Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.
|
|
|
|
Wilkinson, J. A., & Huntington, A. D. (2004). The personal safety of district nurses: A critical analysis. Nursing Praxis in New Zealand, 20(3), 31–44.
Abstract: A workplace safety study of district nurses in New Zealand was conducted to explore personal safety experiences. A qualitative methodology informed by Critical Social Theory was employed. This paper details the findings and implications derived from data collected from six district nurses in two urban New Zealand health services who recalled incidents in which they felt their personal safety was compromised. Data were collected through individual interviews and a focus group discussion with the participants. Data analysis revealed two-fold risks to nurse safety; these were associated with client behaviour as well as risks embedded in the organisational structure. The findings suggest a number of practical issues involving basic security measures require urgent attention. The complex power relationships that shape the experience of nursing in a community impinged on the ability of the nurses in this study to confidently and safely fulfil their role. An organisational commitment to a culture of safety would help address the powerlessness experienced by district nurses.
|
|
|
|
Jacobs, S. (2003). Advanced nursing practice: Time and meaning. Nursing Praxis in New Zealand, 19(3), 29–39.
Abstract: The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the nurse practitioner role at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001. Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. The focus is on clinical practice, research, teaching, consulting, higher education, and advancement of the profession. Historical aspects of advancement in New Zealand nursing are examined, including registration, unsupervised practice, technical specialisation, and career development.
|
|
|
|
Connor, M. (2003). Advancing nursing practice in New Zealand: A place for caring as a moral imperative. Nursing Praxis in New Zealand, 19(3), 13–21.
Abstract: The author argues that the framework of competencies required for advanced nursing practice should include a moral dimension in order to take account of relational as well as functional competencies. There is no recognition of the relational competencies required to practice caring as a moral imperative. The Nursing Council of New Zealand expects that nurses will practise 'in accord with values and moral principles'. The paper explores the history of two nursing discourses, that which sees nursing as a functional occupation and that which emphasises the relationship between nurse and patient. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies.
|
|
|
|
Vallance, E., & Scott, S. (2003). A critique of problem-based learning in nursing education and the contribution it can make toward beginning professional practice, part two. Nursing Praxis in New Zealand, 19(3), 40–49.
Abstract: In this article, the second of two, the literature is examined to determine the ability of problem-based learning to develop professional nursing practice. Professional practice depends on critical thinking for the development of both rational problem-solving skills and critical reflective thinking. This article proposes that problem-based learning has the potential to develop the critical thinking skills required for problem solving and decision-making. However problem-based learning is less likely to promote the critical reflective thinking without which the transformative practice needed to drive health gains in the 21st century is unlikely to emerge.
|
|
|
|
Vallance, E., & Scott, S. (2003). A critique of problem-based learning in nursing education and the contribution it can make toward beginning professional practice, part one. Nursing Praxis in New Zealand, 19(2), 41–51.
Abstract: Within New Zealand nursing education there appears to be a widespread acceptance of problem-based learning and an assumption that the strategies it uses are unproblematic. A review of the literature however, reveals that problem-based learning has drawbacks that may inhibit the achievement of desired graduate outcomes. It seems timely for nurse educators to exercise caution in uncritically accepting problem-based learning approaches and using them as the predominant approach to teaching and learning. To this end, a two-part critique of this teaching and learning method is presented. Part one critiques the methods of problem-based learning, discussing self-directed learning, the group process, self-assessment, and content knowledge. Part two explores the philosophical underpinnings of problem-based learning, and the so-called 'fit' within nursing.
|
|
|
|
Nicol, M. J. (2003). Genetics and nursing: Preparing for future health care development. Nursing Praxis in New Zealand, 19(2), 27–40.
Abstract: The author discusses the impact of 'new genetic knowledge' on society and how molecular and clinical genetics are having an increasing influence on routine health care. Increasingly, nurses will be exposed to this new genetic knowledge and challenged to integrate it into their clinical practice in order to ensure that patients and families receive the best health care available. The paper reports the percentage of undergraduate nursing curricula devoted to teaching about genetics and considers how the fundamental principles of molecular genetics and the clinically relevant areas of genetics can be incorporated into pre- or post-registration education.
|
|
|
|
Brasell-Brian, R., & Vallance, E. (2002). Clinical practice/education exchange: Bridging the theory-practice gap. Nursing Praxis in New Zealand, 18(1), 17–26.
Abstract: This article positions clinical practice/education exchange (CPEE) within nursing literature and presents narrative accounts from a nurse educator and clinician who exchanged jobs for one year. This type of exchange, between education institutes and service areas where students are placed, is a new concept. The aim is to enhance student learning and facilitating meaningful links between theory and practice for them.
|
|
|
|
Fourie, W., & Oliver, J. D. (2002). Defining currency of practice for nurse educators. Nursing Praxis in New Zealand, 18(3), 30–39.
Abstract: Recent Nursing Council of New Zealand guidelines for competence-based practising certificates and the fact that all nurse educators must have a current practising certificate prompted the Nursing Schools within the Tertiary Accord of New Zealand (TANZ) to explore issues surrounding current competency in practice and how this can be maintained by nurse educators. The authors note that discussions related to competence-based practising certificates generally refer to competence only in terms of direct patient care. They set out to clarify the issue with specific reference to nurse educators who, by the nature of their scope of practice, often do not carry a patient caseload. They review the literature relating to currency of practice and draw on the findings of a survey of TANZ Nursing Schools and provide a position on how currency of practice applies to nurses working in an educational setting. They present strategies to maintain clinical, teaching and scholarly currency and make some suggestions for providing evidence that currency of practice is maintained.
|
|
|
|
Finlayson, M., & Gower, S. E. (2002). Hospital restructuring: Identifying the impact on patients and nurses. Nursing Praxis in New Zealand, 18(2), 27–35.
Abstract: The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.
|
|
|
|
Warren, B. L. (2002). Intramuscular injection angle: Evidence for practice? (Vol. 18).
Abstract: This article presents the findings of a search for evidence to support the 45-60 degree angle of insertion for intramuscular injection of vaccine which is recommended in New Zealand. With the objective of discovering the evidence base for an intramuscular injection angle which differs from that recommended by the World Health Organisation and the accepted practice experienced by the author in the UK, Canada, Malawi and the USA, a comprehensive library and internet literature search was undertaken. Information was also sought by personal correspondence and contact with a range of immunisation specialists. Both the literature specifically on needle angle and that which includes needle angle within a wider investigation of technique is included. Overwhelmingly the evidence supports a 90 degree angle of needle insertion for intramuscular injection as being most effective in terms of patient comfort, safety and efficacy of vaccine.
|
|
|
|
Farrow, T., McKenna, B., & O'Brien, A. J. (2002). Initiating committal proceedings 'just in case' with voluntary patients: A critique of nursing practice. Nursing Praxis in New Zealand, 18(2), 15–23.
Abstract: The authors report a clinical audit that, combined with anecdotal evidence, verifies the practice of putting section 8B medical certificates on the files of voluntary mental health patients at the time of admission. This is seen as a strategy to balance the requirement to support and promote the autonomy of voluntary patients with the need to protect those patients or other people. A conceptual analysis of these issues indicates that such a practice is both legally questionable and ethically inappropriate. The authors suggest an alternative framework for practice that is legally and ethically preferable for both nurses and patients.
|
|
