Ardagh, M., Wells, E., Cooper, K., Lyons, R., Patterson, R., & O'Donovan, P. (2002). Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial. Access is free to articles older than 6 months, and abstracts., 115(1157).
Abstract: The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources.
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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.
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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.
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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.
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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.
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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.
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Mackay, B. (2002). Leadership development: Supporting nursing in a changing primary health care environment. Nursing Praxis in New Zealand, 18(2), 24–32.
Abstract: The author argues that the involvement of nurses in the decision-making of health organisations is essential to maximise the contribution of nurses and promote positive outcomes for patients. She suggests that development of leadership skills will make nurses aware of power structures in the health system and allow them to become interdependent health professionals in primary health organisations (PHO). The particular competencies discussed are those proposed by Van Maurik (1997), namely ability to understand and manage organisational politics, work facilitatively with people and circumstances, and build a feeling of purpose.
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McKenna, B. (2002). Risk assessment of violence to others: Time for action. Nursing Praxis in New Zealand, 18(1), 36–43.
Abstract: The author performs a literature search on the topics of risk assessment, dangerousness, aggression, and violence in order to determine an evidence-based approach to risk assessment of patient violence towards others. This is set in the context of possible expansion in the scope of practice of mental health nurses, and the prevalence of nurses being assaulted by patients. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to adapt evidence to specific clinical settings.
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Horsburgh, M., Smith, V. A., & Kivell, D. (2002). South Auckland community paediatric nursing service: A framework for evaluation. Nursing Praxis in New Zealand, 18(3), 40–49.
Abstract: This paper describes the Kidz First paediatric community homecare nursing team in South Auckland. While the service was not initially planned as an integrated approach to child health, its evolution reflects the move to more community based care delivery and the expansion of nurse-led initiatives in New Zealand. The components of a community paediatric home nursing team as described by Eaton (2000) are used to provide the framework with which to describe the service. A focus group held with the Kidz First paediatric community homecare nurses has enabled definition of the key nursing components provided to children and their families living in South Auckland.
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Farrow, T., McKenna, B., & O'Brien, A. J. (2002). Advanced 'prescribing' of nurses' emergency holding powers under New Zealand mental health legislation. International Journal of Mental Health Nursing, 11(3), 164–169.
Abstract: A new approach to mental health legislation has seen the involvement of a range of health professionals in legislated mental health roles, including the power of registered nurses to detain patients in hospital under Section 111 of the New Zealand Mental Health (Compulsory Assessment and Treatment) Act (1992). Under this Section, a nurse who believes that a voluntary patient meets the legal criteria of the Act can independently detain the patient for a period of up to six hours, pending further assessment by a medical practitioner. However, anecdotal evidence and a clinical audit undertaken by the authors suggest some doctors 'prescribe' Section 111 at the time of admission. This practice instructs nurses to initiate Section 111 if particular voluntary patients choose to leave hospital. This study outlines practice issues resulting from 'prescribing' Section 111; provides a legal critique of medical practitioners' involvement in this practice; and makes recommendations for guidelines toward a more constructive use of Section 111.
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Nicol, M. J., Manoharan, H., Marfell-Jones, M., Meha-Hoerara, K., Milne, R., O'Connell, M., et al. (2002). Issues in adolescent health: A challenge for nursing. Contemporary Nurse, 12(2), 155–163.
Abstract: This review provides an overview of the health issues for adolescents, and the implications for nursing practice, particularly around health promotion. It looks at the social context of adolescents including peer pressure, along with health issues such as suicide, mental health, sexual health, and smoking.
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Farrow, T. (2002). Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments. International Journal of Mental Health Nursing, 11(4), 214–219.
Abstract: 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
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Spence, D., & Fielding, S. (2002). Win-win-win: Collaboration advances critical care practice. Contemporary Nurse, 13(2/3), 223–228.
Abstract: This paper provides an overview of the structure and processes of an eighteen month, distance education course focused on developing advanced practice in the context of critical care nursing. Within the framework of a Master of Health Science, the postgraduate certificate (critical care nursing) was developed as a collaboration between Auckland University of Technology and two regional health providers. Students enrol in science and knowledge papers concurrently then, in the second half of the course, are supported within their practice environment to acquire advanced clinical skills and to analyse, critique and develop practice within their specialty. This course is set against a background of increasing interest in education post registration. The acquisition of highly developed clinical capabilities requires a combination of nursing experience and education. This requires collaboration between clinicians and nurse educators, and approaches to address accessibility of relevant educational opportunities for nurses outside the country's main centres.
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Bland, M. F. (2002). Patient observation in nursing home research: Who was that masked woman? [corrected] [published erratum appears in Contemporary Nurse 2002 Apr; 12(2): 135]. Contemporary Nurse, 12(1), 42–48.
Abstract: This article discusses the issues that one nurse researcher faced during participant observation in three New Zealand nursing homes. These include the complexity of the nurse researcher role, the blurring of role boundaries, and various ethical concerns that arose, including the difficulties of ensuring that all those who were involved in the study were kept informed as to the researcher's role and purpose. Strategies used to maintain ethical and role integrity are outlined, with further debate and discussion around fieldwork issues and experiences for nurse researchers called for.
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Powell, J. (2002). Caring for patients after an ICU admission. Kai Tiaki: Nursing New Zealand, 8(7), 24–25.
Abstract: The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education.
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