Hardcastle, J. (2004). The meaning of effective education for critical care nursing practice: A thematic analysis. Australian Critical Care, 17(3), 114, 116–2.
Abstract: Using thematic analysis, this study explored the phenomenon of effective education for critical care nursing practice by asking: What does effective education for critical care nursing practice mean to nurses currently practising in the specialty? Eighty eight critical care nurses from the South Island provided written descriptions of what effective education for critical care nursing practice meant to them. Descriptive statements were analysed to reveal constituents, themes and essences of meaning. Four core themes of personal quality, practice quality, the learning process and learning needs emerged. Appropriateness or relevance for individual learning needs is further identified as an essential theme within the meaning of effective education for critical care nursing practice. Shared experiences of the phenomenon are made explicit and discussed with reference to education and practice development in the specialty. The study results lend support to education that focuses on individual learning needs, and identifies work based learning as a potential strategy for learning and practice development in critical care nursing.
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Chadwick, A., & Hope, A. (2000). In pursuit of the named nurse. Australasian Journal of Neuroscience, 13(4), 6–9.
Abstract: This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
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Richardson, S. (2005). Coping with outbreaks of the norovirus. Kai Tiaki: Nursing New Zealand, 11(7).
Abstract: The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages.
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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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Wassner, A. (1999). Labour of love: Childbirth at Dunedin Hospital, 1862-1972. Dunedin: A Wassner.
Abstract: This book covers obstetrical care from a nursing perspective at the Dunedin Hospital's Maternity Units. The researcher found little information on the two lying-in (maternity) wards of the first two Dunedin Hospitals. The book presents historical records outlining obstetric nursing procedures and maternity culture at the Dunedin Hospitals, The Benevolent Institution, The Batchelor Maternity Hospital, and Queen Mary Hospital. It covers cultural, social and legislative changes over the period, and examines conditions and pay for nursing staff across this time. A chapter on the evolution of baby care looks at changes in acceptable practices around nursery care, breast and bottle feeding, and medical procedures. The book has an extensive list of appendices, including staff lists, training notes for staff, duty lists, and interviews with staff and patients.
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McCloskey, B. A., & Diers, D. (2005). Effects of New Zealand's health reengineering on nursing and patient outcomes. Medical Care, 43(11), 1140–1146.
Abstract: This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care.
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Carter, H., McKinlay, E. M., Scott, I., Wise, D., & MacLeod, R. (2002). Impact of a hospital palliative care service: Perspective of the hospital staff. JBI Reports, 18(3), 160–167.
Abstract: The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.
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Kirkham, S., Smye, V., Tang, S., Anderson, J., Blue, C., Browne, A., et al. (2002). Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research. Research in Nursing & Health, 25(3), 222–232.
Abstract: The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations.
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Banks, J., McArthur, J., & Gordon, G. (2000). Flexible monitoring in the management of patient care process: A pilot study. Lippincott's Case Management, 5(3), 94–106.
Abstract: This article describes a study conducted on the internal medicine, general surgical, and vascular wards of a large metropolitan hospital to assess the impact of a networked monitoring system and portable patient monitors. This pilot study was developed to address the needs of hospital patients who require continuous non-invasive vital signs monitoring (including heart rate, non-invasive blood pressure, pulse oximetry, cardiac waveform monitoring) with the addition of surveillance from a cardiac intensive care area. Data were collected from 114 patients over a three-month period to identify a patient group that could be managed appropriately under the new system and to determine the effect that flexible monitoring had on patient care management. Findings include identification of a specific patient group that can be managed successfully outside the cardiac intensive care area using this system. Other findings suggest a way to improve the management of patient monitoring in the general ward areas.
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Bickley, J. (2002). A study of medical, nursing, and institutional not-for-resuscitation (NFR) discourses. Ph.D. thesis, , .
Abstract: This study investigates the way that medical, nursing and institutional discourses construct knowledge in the specific context of Not-for-resuscitation (NFR)in a New Zealand general hospital where NFR guidelines are available in the wards and from the regional ethics committee. The thesis argues that there are ranges of techniques that staff use to construct NFR knowledge, enacted through various forms of speech and silence, which result in orderly and disorderly experiences for patients nearing death. The study was conducted through a critical analysis of the talk of health professionals and the Chairperson of the Regional Ethics Committee.
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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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Barratt, R. (2008). Behind barriers: patients' perceptions of hospital isolation for methicillin-resistant Staphylococcus aureus (MRSA). Ph.D. thesis, , .
Abstract: This study explored the experiences of hospitalised patients in methicillin resistant Staphylococcus aureus (MRSA) isolation in New Zealand and the meaning that those patients made of those experiences. The research question of this study was 'What is the lived experience of patients in MRSA isolation?' An interpretive phenomenological approach was undertaken for this research, informed by the philosophical hermeneutic tenets of Heidegger (1927/1962). Audio-taped, semi-structured interviews were used to collect data from a purposive sample of ten adults who were in MRSA isolation in various wards in a large acute care hospital in the central North Island. Three salient themes emerged from the data. The first, 'being MRSA positive', summarises the meaning of having an identity of being MRSA positive. The second theme, 'being with others', is concerned with the effect that being in isolation for MRSA has on interpersonal relations. 'Living within four walls' is the third theme and reveals the significance that the physical environment of the MRSA isolation room has on the experience of MRSA isolation. Within the discussion of these themes, excerpts from the interviews are provided to illuminate the meanings and interpretations made. Recommendations are made for nursing practice and education.
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Payne, S. (2007). The nurse's role in promoting health of vulnerable children (0-5 yr olds) through coordinated care: Margaret May Blackwell Study Fellowship. Margaret May Blackwell Travel Study Fellowship Reports. Wellington, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: Explores the provision of emergency paediatric care internationally. Visits children's hospitals in the US, Canada, the UK and Australia. Part of the Margaret May Blackwell Scholarship Reports series.
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Mockford, A. (2009). The exploration of systems and technologies to enhance the healthcare of children under five. Margaret May Blackwell Travel Study Fellowship Reports. Waikato, N.Z.: Nursing Education and Research Foundation (NERF).
Abstract: The well known premise that 'healthy children grow into healthy adults' should reinforce the need for us to engage with parents and caregivers to ensure that we support them with meeting their child's health care needs. This scholarship enabled the author to see what the UK, Sweden, the US, and Canada were doing to strengthen and support children under five and their families across the continuum of care. Part of the Margaret May Blackwell Scholarship Reports series.
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Moore, J. (2005). Breaking down barriers in child healthcare (0-5) years. Margaret May Blackwell Travelling Fellowship 2005. Margaret May Blackwell Travel Study Fellowship Reports. Christchurch: Nursing Education and Research Foundation (NERF).
Abstract: Travels to Australia, Canada, the US and the UK to investigate various methods of procedural sedation for 0-5-year-olds in paediatric Emergency Departments. Describes the types of sedation used and the recovery periods. Transcribes the interviews he conducted with Emergency Department staff in each country. Part of the Margaret May Blackwell Scholarship Reports series.
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