Abstract: Explores and identifies factors associated with nurse concern when patient deterioration is recognised in the absence of an emergency activation score such as early warning scoring (EWS) or the physiologically-unstable patient (PUP) tool. Describes the two phases of the multi-site and mixed-methods study: retrospective chart review of 19,326 referrals for emergency assistance; and seven focus group discussions with 29 nurses about what they do when concerned about patient deterioration in the absence of an EWS. Highlights the role of nurse expertise, knowledge and skill in identifying patient deterioration prior to the activation score on an EWS.

Abstract: Aims to understand the factors that encourage motivation and engagement of caregivers who are relatively poorly paid, with limited training, but who are required to provide personal care to an increasingly frail population. Undertakes an initial exploratory study, with participants from four rural aged-residential care (ARC) facilities, to identify three key themes that influence caregiver motivation. Subsequently develops these initial themes, within a 42-bed facility, to explore how to encourage caregiver motivation. Bases the four-step process on Lewin’s cycle: plan, act, observe, and reflect. Establishes an advisory group of caregivers who develop a nine-point action plan, accepted by management and implemented in the facility.

Abstract: The aim of this research was to describe the changing role of school nurses in eight New Zealand secondary schools from low socio-economic areas with high Pacific Island and Maori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland(2002-05) was made. Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. The researchers conclude that school nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. The researchers go on to say that co-ordination of school nurses either at a regional or national level is required.

Abstract: The purpose of this article is twofold. The first is to clarify some of the challenges experienced while conducting collaborative research and describe the steps taken to ensure consistency between the purpose of the research and the phenomenological research design used to explore the learning that nursing students acquire in their final clinical practicum. Second, it was thought that by illuminating this learning, registered nurses working as preceptors and those supporting new graduates could gain insight into the complexities of learning the skills of safe and competent practice from the student's perspective. This insight is essential in creating a strategy between education and practice to minimise the duplication of learning opportunities and lessen the cost of supporting newly registered nurses, which may be at the expense of investment in the professional development of experienced registered nurses.

Abstract: Develops a daily measure of job satisfaction in the operating room (OR) setting in the form of a tool called the Morale-o-Meter. Trials and evaluates the tool between 2018-2019, inviting all OR staff to participate using the tool to measure their job satisfaction once each shift. Follows up the trial with an online feedback survey. Proves that overall job satisfaction is positively related to daily job satisfaction and affective commitment, and negatively related to emotional exhaustion. Suggests the Morale-o-Meter has the potential to increase the voice of OR nurses.

Abstract: The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues.

Abstract: The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.

Abstract: Explores how patient safety is described from the perspective of clinicians and organisational managers in a NZ acute-care hospital, using embedded case study design. Conducts three interviews with health-care managers and 6 focus groups, comprising 19 doctors and 19 nurses. Develops the theoretical concept of safety capability: the ability to provide safe patient care based on resilient culture, anticipation and vigilance, along a continuum of safety levels.