Abstract: The study outlined here explored outcomes from the provision of primary health care to children aged 5-13 years in a nurse-led clinic based in a primary school in Auckland. This multi-faceted study collected both qualitative and quantitative data, however it is the results of the quantitative arm of the study that are presented here. Data were collected from a variety of sources concerning conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage. Findings demonstrate that the provision of comprehensive primary health care by the nurse at the clinic impacts positively on hospital visitation by children from the area where the clinic is located.

Abstract: This project is a study of the barriers perceived by perioperative nurses to accessing and using research-based information. A survey questionnaire was distributed to 184 perioperative nurses working in five public and two private hospitals in the Auckland area. The number of completed questionnaires was 106 (57.6%). The results showed that the lack of time during work hours was ranked as the highest barrier. The results also showed that many nurses feel they do not have the skills to find and appraise research articles.

Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.

Abstract: This report presents an evaluation of the implementation of a best practice information sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa, based in Auckland, conducted a systematic review of the evidence and produced the best practice information sheet. A survey of 105 nurses was conducted at three sites, in New Zealand and Australia. Using a before/after design, data were collected at the time of release of the information sheet and then approximately 12 months later. The study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and the best practice information sheet.

Abstract: The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.

Abstract: This article discusses a child/adolescent-centred primary nocturnal enuresis program and service that is administered by a group of public health nurses in South Auckland. Enuresis is the involuntary passing of urine. Many children and adolescents who are nocturnal enuretics exhibit behaviours such as low self-esteem, withdrawal, less ambition and increased anxiety. These children are often low achievers within the school system and become a problem for their family and school.

Abstract: This study investigated nurse educators' conceptions of critical thinking used in making judgment related to nursing. Twelve nurse educators from a large nursing school in an urban environment in New Zealand participated in this qualitative study. A semistructured questionnaire was used to explore the nurse educators' conceptions of critical thinking. The study found that the participants viewed rational, logical thinking as a central focus of critical thinking. However, in addition to these traditional perspectives, the nurse educators also included in their conceptions views more commonly held by feminist writers. These aspects focused on attention to intuition, subjective knowing, attention to context, emotions, and caring.

Abstract: The authors discuss the usefulness of a generic tool to measure job stress in New Zealand workplaces, and report on a study using one such generic tool. The study involved sending questionnaires to all staff (193) who had worked at a regional women's health service for a minimum of six months. The mailed package contained the Job Stress Survey (JSS), the General Health Questionnaire (GHQ-12), demographic questions (including cultural safety), shift work questions, and a blank page for “qualitative comment”. Over 12,000 pieces of data were collected from the study but this article focuses only on the results of the JSS. The JSS can be used to determine a “job stress index” and can also be used to measure “job pressure” and “lack of organisational support”. For this study, job stress index scores were calculated and organised by occupational groupings. Midwives, nurses and doctors all cited inadequate or poor quality equipment, excessive paperwork, insufficient personal time, and frequent interruptions, as their top stressors. Three of these four stressors fall within the job pressure index. The results of the survey prompted organisational changes, including: extensive discussions; equipment being updated; management being made aware of the depth of concern felt by staff; the creation of a place for staff to have personal time; and coping intervention strategies were initiated. The authors suggest that no generic measure of job stress can fully evaluate stressors unique to a particular work setting. They support additional items being constructed and administered to assess stressors that are idiosyncratic to a particular occupational group.