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Author |
Stojanovic, J.E.E. |
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Title |
Leaving your dignity at the door: Maternity in Wellington 1950 – 1970 |
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Year |
2002 |
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Abbreviated Journal  |
ResearchArchive@Victoria |
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Keywords |
Hospitals; Nursing specialties; Maternity care; Patient satisfaction |
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Abstract |
This thesis describes the maternity system in Wellington between 1950 and 1970 particularly from the perspectives of consumers and midwives. Four women consumers who experienced maternity in Wellington and two midwives who worked in Wellington's maternity hospitals during this period provided their oral testimonies as the main primary sources for this study. The author's experience of being a student nurse and a consumer in Wellington and other primary and secondary sources are used to substantiate, explore and explain the topic. The study traces the socio-political changes in New Zealand maternity from 1900 to 1970 creating a backdrop against which Wellington's maternity system, including the women, the hospitals, the workforce, maternity practices and the childbearing process are illuminated using the insights of women and midwives who experienced them. The oral testimonies of the six participants described positive and negative aspects of their maternity experiences, but the three strong themes that arose from their accounts included 'being alone', 'lack of autonomy' and 'uncaring attitudes'. |
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Call Number |
NRSNZNO @ research @ 1223 |
Serial |
1208 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
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Year |
2005 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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NRSNZNO @ research @ |
Serial |
1209 |
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Author |
Turnwald, A.B. |
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Title |
Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department |
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Year |
2006 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Chronically ill; Clinical assessment; Emergency nursing |
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Abstract |
A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. |
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NRSNZNO @ research @ |
Serial |
1210 |
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Author |
Mosley, B. |
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Title |
Seclusion management in an acute in-patient unit |
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Year |
2005 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Psychiatric Nursing; Patient rights; Hospitals; Workplace violence |
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Abstract |
This study was developed to explore the use of seclusion in an acute in-patient unit for people with mental illnesses. Investigation into this issue was considered important due to an identified large increase in seclusion use over the previous two years. The study used a qualitative research methodology with a descriptive and interpretive approach. Data collection included a retrospective file audit of patients who had been secluded over the past seven years, and one-to-one staff interviews. It also includes the author's personal reflections of seclusion events. The principle reason for using seclusion was violence and aggression in the context of mental illness. It was also used for people who were at risk of, or who had previously absconded from the unit. A recovery approach and the use of the strengths model was fundamental to nurses' way of working with patients in the unit. Nurses believed that the strengths process should be adapted to the person's level of acuity and to their ability to engage in this approach in a tangible way. Seclusion continues to be a clinical management option in the unit that is the subject of this study. However, in many circumstances there are other options that could be explored so that the utmost consideration is given to the dignity, privacy and safety of that person. |
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Call Number |
NRSNZNO @ research @ 1227 |
Serial |
1212 |
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Author |
Kuehl, S. |
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Title |
Emergency Department re-presentations following intentional self-harm |
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Year |
2008 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
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Abstract |
The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1214 |
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Author |
Hammond, S. |
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Title |
Parallel journeys: Perceptions of palliative care |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Palliative care; Policy; Geriatric nursing |
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Abstract |
The delivery of palliative care within contemporary New Zealand society is discussed, in the light of the recent publication of The New Zealand Palliative Care Strategy (2001). The viewpoint taken is largely descriptive rather than prescriptive, being based on a literature survey of international research and academic theory, which is also informed by the author's professionally gained knowledge. Four different perspectives, comprising a mix of providers and recipients of care are investigated: those of central government planning; specialist palliative care units; aged-care complexes; and patients, family and whanau. As an area of healthcare which current demographic projections indicate will become increasingly significant, the provision of palliative care to residents of and patients within aged-care complexes receives special attention. A metaphor of “parallel travellers” on “parallel journeys” is used to provide a thematic basis to the paper. The lived experiences and perceptions of each group of “parallel travellers” are explored. Difficulties in defining and evaluating palliative care, the implications of main-streaming, the scope of palliative care provision, the educative role of specialist palliative care providers and the current focus on mechanistic outcome measures are discussed. It is contended that the values and goals, both explicit and implicit, of the four specified groups may not at present be sufficiently congruent to optimise the effective provision of palliative care from the point of view of all concerned. While adequate resourcing and a genuinely collaborative approach among healthcare providers are both acknowledged to be critical, the potential for palliative care nurse practitioners to be appointed to the role of “care co-ordinator” alluded to within The New Zealand Palliative Care Strategy (2001), is also seen as pivotal. Insights from a postmodern perspective are offered as one possible way of achieving greater congruence. |
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NRSNZNO @ research @ |
Serial |
1215 |
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Author |
Watson, S. |
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Title |
Humane caring: Quality of life issues for those elderly people wanting to remain in their own environment |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Geriatric nursing; Older people; Home care |
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Abstract |
This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1217 |
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Author |
Hughes, H.M. |
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Title |
Whakaohonga na Kahungatanga: Awakening from addiction |
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Year |
2007 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Culture; Maori; Substance abuse; Alcoholism |
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Abstract |
This thesis explores the shared experiential journeys of four Pukorero (participants) who successfully completed detoxification and recovery programmes from AOD addiction. Three questions were used to guide the research process to enable the Pukorero to identify positive aspects of their individual detoxification and recovery programmes, surface any barriers and issues they experienced, and clarify the support they received throughout the process. Kaupapa Maori and narrative inquiry was adapted to undertake this study to capture the essence of Maori thinking and reality regarding AOD. Through the use of thematic analysis the data findings of the study reflect the views from each Pukorero of Wairua, Whakapapa and Whanau as key to their successful recovery. This supports the notion that a pathway of detoxification, recovery and hope exists to enable Maori and others to take the journey to reclaim their own health and well-being, and the health and well-being of whanau, hapu, iwi, and Maori community. In honour of these Pukorero, kaumatua, tipuna, whanau, hapu, iwi, Maori katoa, and to celebrate kaupapa Maori and narrative inquiry [as the preferred methodological approach], the use of our tino ataahua reo integrated with English throughout the thesis demonstrates the interwoven connections between the two cultures enshrined in Te Tiriti o Waitangi that comprise the nation of Aotearoa me Te Waipounamu of New Zealand. |
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NRSNZNO @ research @ |
Serial |
1219 |
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Author |
Gare, L. |
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Title |
Patient experience of joint replacement education: A joint venture |
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Year |
2006 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Nurse-patient relations; Health education; Communication |
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Abstract |
The aim of this research was to explore patients' educational experiences and the usefulness and benefits of this health education in the rehabilitation period, when undertaking a total joint replacement. An exploratory, qualitative descriptive study method was used to describing patients' experiences of health education. Five participants, convenience sampled, were interviewed eight to twelve weeks post surgery following unilateral total joint replacement in a tertiary hospital. Participants valued the education they received pre operatively, which included written material, video and individual interaction with varied health professionals. Although this was provided in a timely manner, evidence showed limited post operative reinforcement and follow up of given education and preparation for discharge. Three 'partnership' themes were identified from data, Communicative, Subservient and Knowledge. 'Communicative Partnership' conceptualised the participants' experiences of the nurse-patient relationship, whilst 'Subservient Partnership' captured the participants' experiences of 'being' patients. 'Knowledge Partnership' combined the participants' ideas about knowledge and their retention of this knowledge to assist with their rehabilitation post surgery. The needs and experiences of patients after total joint replacement reflect on transitional change – changes in roles, behaviour, abilities and relationships. Educational contents need to reflect a realistic recovery process to assist with this transitional period, delivered by health care professionals in a manner best suited for patients. |
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Call Number |
NRSNZNO @ research @ 1235 |
Serial |
1220 |
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Author |
Lowe, P. |
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Title |
A descriptive research study on factors that impact upon the quality of life of elderly women with comorbid chronic illnesses: Three women's perspectives |
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Year |
2007 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Older people; Female; Chronically ill; Quality of life |
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Abstract |
The aim of this research study is to explore factors that older women living with comorbid chronic illnesses identify as key to maintaining or improving their quality of life. This study uses a qualitative approach, with a descriptive methodology. Face-to-face interviews were conducted with three women over the age of 80 who had been diagnosed with more than one chronic illness. These interviews were audiotaped, and the data analysed using thematic analysis. What emerged from this analysis of older women was the need for them to create meaning in their life, which is further explicated through three main themes: (1) coping with changing health, (2) the impact of family, and (3) attitude. Attitude to life and having a positive outlook were all factors these participants expressed as being essential to maintaining their quality of life. The quality of life of these participants is enhanced by the ability of these women to create meaning in their life. They do this by integrating their wealth of past experience into their present, reflecting back on their lives, but still gaining enjoyment from the here and now. |
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Call Number |
NRSNZNO @ research @ 1236 |
Serial |
1221 |
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Author |
Fairhall, M. |
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Title |
An observational study of Peripherally Inserted Central Cather(PICC)-related complications amongst oncology patients |
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Year |
2008 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Patient safety; Equipment and Supplies; Nursing specialties; Cancer; Oncology |
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Abstract |
This thesis reports on a retrospective observational study that examined the complication rate of peripherally inserted central catheters (PICCs) within a regional cancer centre. PICCs are increasingly used for delivery of chemotherapy and other intravenous therapies in oncology patients. A literature review revealed that almost all published research on PICC complications reported on silicone (Groshong(TM)) catheter use, rather than the polyurethane (Arrow(TM)) PICCs used at Christchurch Hospital. Also, much literature referred to PICCs being inserted by non-nurses, whereas the Christchurch service uses specially-trained nurses to insert them. The purpose of the study was to identify the nature, incidence and rates of polyurethane (Arrow(TM)) PICC complications in an adult oncology cohort. Ethics Committee approval was gained to retrospectively follow all PICCs inserted in adult oncology patients at Christchurch Hospital over a 13-month period from 1st March 2006 until 31st March 2007. Data collected were analysed utilising the statistical computer package SPSS. One hundred and sixty-four PICCs were inserted into 156 individual oncology patients over this period. The median dwell time was 68 days for a total of 14,276 catheter-days. Complications occurred in 25 (15%) out of 164 PICC lines, in 22 (15%) of the 156 patients for an overall complication rate of 1.75 per 1000 catheter-days. However, only 16 of the 25 PICCs with complications required early removal (9.75% of the cohort) for a favourably low serious complication rate of 1.12 per 1000 catheter-days. The three commonest complications were infection at 4.3% (7/164) or 0.49 infection complications/1000 PICC-days, PICC migration at 3% (5/164) or 0.35/1000 catheter days, and thrombosis at 2.4% (4/164) or 0.28/1000 catheter days. The median time to complication was 41 days. Those with complications were more likely to have a gastro-intestinal or an ovarian cancer diagnosis, and less likely to have colorectal cancer. These findings provide support for the safe and effective use of polyurethane (Arrow(TM)) PICCs for venous access within the adult oncology context. Furthermore, it suggests that cost effective nurse-led (Arrow(TM)) PICC insertions can contribute to a low complication rate. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1222 |
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Author |
Mitchell, K. |
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Title |
Childbirth: A momentous occasion. Muslim women's childbirth experiences |
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Year |
2001 |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Childbirth; Cultural safety; Nurse-patient relations |
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Abstract |
This thesis explores three Muslim women's experience of childbirth, in a setting surrounded by health professionals who largely have little understanding of their culture. Various forms of narrative such as a letter, excerpts from conversations, and interviews, have been used in presenting this research. The women's stories reveal that giving birth in a cross-cultural setting is stressful. The women had to adjust to an environment which challenged their beliefs and values, in one case with no extended family or cultural support. This stress is long lasting as evidenced in the women's stories. Given the opportunity to tell their story, all the women highlighted both the positive and negative aspects of their birth experiences. This thesis identifies situations that heightened the vulnerability of the women, and highlights the uniqueness of each woman. It concludes by identifying recommendations and reading material for nurses and midwives in education or practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1223 |
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Author |
Börner, Heidi.E |
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Title |
Evaluating safe patient handling systems: Is there a better way? |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Patient safety; Evaluation research; Occupational health and safety |
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Abstract |
This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1224 |
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Author |
Gibson, C. |
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Title |
Hearing the adolescents' voice: A study evaluating the use of conjoint analysis for use with adolescents to determine preferences for inpatient hospital facilities |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Adolescents; Hospitals; Patient satisfaction; Cancer |
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Abstract |
This research used the economic technique of conjoint analysis and an informal discussion to canvas opinions regarding ideal combination of inpatient facilities and the use of cell phones in hospital. The content of the conjoint analysis was, with the exception of the inclusion of the question regarding the use of cell phones, derived from the literature. Because conjoint analysis does not appear to have been used with adolescents one of the questions to be answered was whether this was a method of research that could be used with adolescents. The research was undertaken with 29 young people, most of who were from CanTeen (the adolescent cancer support group) in Wellington. The conjoint analysis, and discussion with the adolescents supported the general findings from the literature that adolescents do not want to be nursed in either overtly paediatric or, in their words, 'dull adult wards', as they enjoy bright lively surrounds. Ideally they would like to be nursed with their peer group and so have the opportunity to interact with young people of their age. The research demonstrated that adolescents are able to understand the concept of conjoint analysis and also supported findings from overseas that these healthcare consumers value having their opinions canvassed and are well able to give constructive and well thought out opinions. A report on the findings of this research will be presented to Capital and Coast District Health Board with the expectation that it will be considered when the final decisions are made regarding the upgrading of Wellington Hospital's present facilities as it is anticipated that these facilities will contain dedicated adolescent beds within the paediatric unit. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1225 |
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Author |
Murphy, S.E.E. |
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Title |
Through mothers' eyes: The lived experience of caring for a child who has undergone and recovered from a liver transplantation |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Keywords |
Parents and caregivers; Paediatric nursing; Children; Surgery |
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Abstract |
Mothers, whose children had undergone a liver transplant more than one year ago at time of interview and whose children were outpatients of Starship Children's Hospital, were invited to participate in this research. A Heideggerian hermeneutic phenomenological approach, informed by the work of van Manen (1990) was used. Three mothers of children who had received a liver transplant were interviewed to reveal the meanings of the phenomenon – what is the meaning of lived experience of mothers in caring for their child who has undergone and recovered following liver transplantation? Little previous study regarding mothers' lived experience of caring for their child, who had recovered from a liver transplant, was found in the literature. The emerging themes were punctuated with stress being a consistent feature. Utilising Ruddick's (1983) concepts of maternal thinking, the emerging themes were merged within the three interests governing maternal practice; preservation, growth and acceptability. The absolute capacity for attentive love draws the experience together. An essential theme identified out of the analysis was the concept of survival relating to the unique features of liver transplantation and the consequences of liver rejection and failure. The findings contribute to the understanding of the phenomenon, emphasising the need for good support systems for families of children who have undergone transplantation; assistance in the establishment of maternal coping strategies and regular feedback on the children's progress acknowledging the role and care provided by mothers. |
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Call Number |
NRSNZNO @ research @ 1242 |
Serial |
1227 |
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