| Records |
| Author |
Key, R.; Habashi, S.; Baber, C.; Cuthbertson, S.; Streat, S.J. |
| Title |
Long-term follow-up after Bjork flap tracheostomy |
Type |
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| Year |
1994 |
Publication |
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Abbreviated Journal  |
DCCM, Private Bag 92024, Auckland |
| Volume |
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Issue |
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Pages |
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| Keywords |
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| Abstract |
Because of concern about long-term complications of bjork flap tracheostomy we followed-up 136 intensive care patients who had Bjork flap tracheotomy in 1992 a median of 117 (range 5-402) hours after intubation. Twenty died in hospital, none as a result of tracheostomy. Twenty- six patients were lost to follow-up and eleven declined. The remaining 79 had measures of health status, a quality of life questionnaire, respiratory function testing and physical examination of the neck and upper airway 9-27 months (median 14) later. Various health status measures deteriorated in 9 to 51 of 77 patients. Forty-two of 77 patients were taking prescription medication and 15/32 smokers had stopped smoking. FEV1, FVC and FEV1/FVC were significantly reduced from predicted normal (n=70, 2.8+ 1.1 vs 3.2 +0.9 p<.0001, 3.7 + 1.3 vs 4.0 + 1.0 p<.0001, 76 +11vs 79 +3 p= 0.035 respectively). Pulse oximetry was normal (>92%) in 73/74 patients tested. The median horizontal scar dimension was 45mm (range 20 to 75 mm). Nine had a median vertical scar dimension 15mm (range 8 to 25mm). Nineteen scars were hypertrophic, 56 were tethered. Two patients had already undergone tracheal scar revision at follow-up and further 13 accepted scar revision. Ten patients had abnormal voice examination, four abnormal cough, two stridor, three vocal cord lesions, three tracheal polyps and fourteen asymptomatic tracheal narrowing from 10-60% (median 25%) of the tracheal luminal diameter. Patients surviving critical illness with bjork flap tracheostomy have reduced quality of life and respiratory function and poor cosmetic result but a low incidence of important airway problems |
| Call Number |
NRSNZNO @ research @ 201 |
Serial |
201 |
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| Author |
Key, R.; Cuthbertson, S.; Streat, S.J. |
| Title |
Feasibility of a nurse-based critical care follow-up clinic |
Type |
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| Year |
1994 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital Private Bag 92024 Aucklan |
| Volume |
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Issue |
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Pages |
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| Keywords |
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| Abstract |
We are about to implement a nurse-based critical care follow-up service and used a follow-up study of tracheostomy to determine the feasibility of such a service. Nine to 27 months median 14 after intensive care admission we attempted to follow-up 116 of our most severely ill survivors. Twenty six could not be found, 11 declined follow-up. A questionnaire, interview and limited examination were used to determine health status. Ten patients unable to come to a clinic were seen at home. Interview time varied between patients but 79 patients took 100 nurse-hours. Ninety percent of patients co-operated with respiratory function testing. Pulse oximetry identified one with severe chronic respiratory failure. In this highly selected group of patients with on going problems (perceived poor health, dependency, disability, changes in appearance, deterioration in personal relationships, poor sleep, pain, altered diet, unaddressed chronic health problems, poor access to health services, and continuing prescription medication) were common, and addressed to some extent by appropriate referral. Approximately 20% of patients reported improvement in their health and personal relationships after critical illness and half of the smokers had given up. Factors contributing to follow-up difficulty included distance, delay in initial contact, change of address (255 of this group), disability and poverty. A nurse-run critical care follow-up clinic is feasible, time consuming but productive. A register of current addresses and phone numbers is recommended. The optimal time for follow-up will vary with patients conditions but early follow-up with protocol- based lines of referral is recommended to reduce persistent health problems |
| Call Number |
NRSNZNO @ research @ 205 |
Serial |
205 |
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| Author |
Litchfield, M.; McCombie, M.-L. |
| Title |
The introduction of an advanced nurse practitioner role in mental health: report of the evaluation research undertaken for the Mental Health Service of Capital Coast Health Ltd |
Type |
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| Year |
1994 |
Publication |
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Abbreviated Journal |
Chief Nurse Advisor, Ministry of Health, PO Box 50 |
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Issue |
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Pages |
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| Abstract |
The study was commissioned to define the role of Advanced Nurses Practitioner to inform the establishment of a clinical career pathway. Four new, loosely defined ANP positions were created and the role evolution over three months was described. The impact on the multidisciplinary team functioning was to be given particular attention. The research design was developed in collaboration with the ANP Project Team of the service. Data were derived from surveys of nurses in the units and other staff before and at the end of the 3 months period; interviews with the ANPs and official client advocates; daily journals and weekly logs kept by the ANPs; statistical records of patient loads and staffing. The findings presented the role as the interface of unit management and direct client care, with the ANPs orchestrating the activities of the unit. The ANPs developed the role differently according to quite distinct conceptualisations of nursing which influenced whether direct client care was pivotal or peripheral to the role. This had an effect on whether the strains of the service were seen as inhibitory of focal to the development of the ANP practice. There was little change in unit staff satisfaction. Attempts to incorporate client advocacy to determine change in client satisfaction were unsuccessful. The ANPs used the research as a process of role development |
| Call Number |
NRSNZNO @ research @ 386 |
Serial |
386 |
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| Author |
Litchfield, M.; Connor, M.; Eathorne, T.; Laws, M.; McCombie, M.-L.; Smith, S. |
| Title |
Family nurse practice in a nurse management scheme: a pilot service study for the health reforms |
Type |
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| Year |
1994 |
Publication |
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Abbreviated Journal |
Centre for Initiative in Nursing & Health Care, P. |
| Volume |
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Issue |
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Pages |
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| Abstract |
The independently funded 10 month pilot project demonstrated the autonomy of nursing practice for a new role family nurse. The findings were presented as the health experience of families in strife with complex health circumstances, a description of a beginning model for the nursing practice that addressed the needs of these families as their circumstances changed over time, and its cost-effectiveness. A caseload of nineteen families was found to be optimum. The evaluation research continued throughout as a form of praxis expressed as health patterning, a methodology developed in previous research (Litchfield, 1993). The family nurse'spractice demonstrated qualities common to all nurses: the caring relationship and fiscal responsibility. The unique practice was characterised by a professional partnership of limited duration: the families referred to the service in a predicament of strife, trapped in the immediate present, gained a view to a future, moved towards assuming control over health circumstances, seeking and using services with discernment, and increasing community as family/group members and citizens. Cost containment was achieved through: a) development of a co-operative approach amongst family members, between families and professionals, and amongst all health workers, and b) the families discerning use of services by anticipating a future. Through one family case, cost of saving over the 7 months with the family nurse was estimated as $4000, a possible saving of $16000 over 13 months if the family nurse had been involved earlier, and projected savings in the long term of over a million dollars. The satisfaction of clients, nurses and professionals was shown. The service was positioned within the new health system of health reforms |
| Call Number |
NRSNZNO @ research @ 389 |
Serial |
389 |
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| Author |
Stevenson, A.F. |
| Title |
In search of New Zealand nursing history: a literature review |
Type |
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| Year |
1994 |
Publication |
Occasional Paper |
Abbreviated Journal |
Author, Wellington Polytechnic Library, |
| Volume |
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Issue |
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Pages |
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| Keywords |
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| Abstract |
This paper examines some of the contributions to nursing history up to 1993, and also surveys published social and women's history in New Zealand for references to nursing work |
| Call Number |
NRSNZNO @ research @ 117 |
Serial |
117 |
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| Author |
Watson, P.B. |
| Title |
A study of cardiac inpatient participation in Canterbury Health's cardiac rehabilitation programme |
Type |
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| Year |
1994 |
Publication |
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Abbreviated Journal |
Author |
| Volume |
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Issue |
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Pages |
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| Abstract |
A telephone survey was conducted with 61 randomly selected patients who had been admitted to the cardiology service with an Myocardial infarction but did not attend the cardiac rehabilitation programme. Findings show that many patients who would benefit from cardiac rehabilitation are denied access because it is only open to patients who have Myocardial Infarctions. Only a small percentage of MI admissions attend rehabilitation the main reason being patients are not informed the service is available. Women are under represented among rehabilitation participants and lack of transport is a major factor inhibiting women from attending. Improvements in referral systems and follow up are recommended |
| Call Number |
NRSNZNO @ research @ 155 |
Serial |
155 |
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| Author |
Fleming, Valerie E M |
| Title |
Partnership, power and politics: feminist perceptions of midwifery practice |
Type |
Book Whole |
| Year |
1994 |
Publication |
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Abbreviated Journal |
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| Volume |
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Issue |
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Pages |
237 p |
| Keywords |
Midwifery; Feminism; Power |
| Abstract |
Provides an interpretative critique of the partnership of a group of independent midwives and their clients in urban NZ. Uses a theoretical basis grounded in the principles of feminism, incorporating aspects of critical social science and post-modernism, to underpin both the methodological approach and the data analysis. Utilises the concepts of subjectivity, power/knowledge and praxis as tools for analysis of data which is collected through semi-structured interviews. |
| Call Number |
NRSNZNO @ research @ |
Serial |
253 |
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| Author |
Litchfield, M. |
| Title |
Viewpoint: Telling nursing stories |
Type |
Journal Article |
| Year |
1994 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
2 |
Issue |
4 |
Pages |
28 |
| Keywords |
Nursing research; Ethics; Patient rights |
| Abstract |
A brief critique and comment on the ethical implications of nurse researchers using methodology that involves soliciting personal experiences of patients and subsequently publishing them as stories. |
| Call Number |
NZNO @ research @ |
Serial |
1321 |
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| Author |
Wagener, Sally |
| Title |
The nursing management of the acutely ill child in communities without readily available specialist paediatric services |
Type |
Report |
| Year |
1994 |
Publication |
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Abbreviated Journal |
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| Volume |
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Issue |
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Pages |
22 p. |
| Keywords |
Chronically ill children; Pediatric nursing -- Australia; Child health services -- Australia; Reports |
| Abstract |
Observes how acutely ill children in remote areas of Australia are managed in the absence of specialist paediatric nursing services. Visits remote nursing stations, rural hospitals, and the Royal Flying Doctor Service. Part of the Margaret May Blackwell Scholarship Reports series. |
| Call Number |
NZNO @ research @ |
Serial |
1415 |
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| Author |
Wheeler, C. |
| Title |
The diagnosis of schizophrenia and its impact on the primary caregiver |
Type |
Journal Article |
| Year |
1994 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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| Volume |
9 |
Issue |
3 |
Pages |
15-23 |
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| Abstract |
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| Call Number |
NRSNZNO @ research @ 265 |
Serial |
265 |
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| Author |
van Wissen, K.A.; Woodman, K. |
| Title |
Nurses' attitudes and concerns to HIV/AIDS: a focus group approach |
Type |
Journal Article |
| Year |
1994 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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| Volume |
20 |
Issue |
6 |
Pages |
1141-1147 |
| Keywords |
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| Abstract |
An exploratory qualitative study was investigated to further identify nurses'' attitudes to the care of people with human immunodeficiency virus (HIV) and acquired immunodefiency syndrome (AIDS). This follows as a sequel to a study using questionnaire. Data collected from nine focus groups attended by a total of 29 nurses at a hospital within a new Zealand regional health authority. The principal findings suggest that nurses' attitudes to this patient group are varied and depend on social influences, personal experiences and the extent of knowledge regarding HIV/AIDS. Other concerns raised included nurses' rights to choose to care for HIV-positive patients and the issue of universal precautions. Theses findings may have implications for further educational initiatives and information of hospital policy |
| Call Number |
NRSNZNO @ research @ 356 |
Serial |
356 |
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