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Author |
Marshall, K. |
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Title |
Enteral nutrition within 72 hours after spinal chord injury: Complexities and complications |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Intensive care nursing |
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Abstract  |
Good nutrition is essential following acute spinal cord injury. Poor nutrition can lead to the deleterious effects of protein-calorie induced hypermetabolism and poor functional and rehabilitation outcomes. Nutritional management for patients with acute cervical or high thoracic spinal cord injury admitted to the Canterbury District Health Board's Burwood Spinal Unit and Christchurch Hospital's Department of Intensive Care Medicine (CHDICM) differ. The Burwood Spinal Unit has a delayed approach to nutritional management in contrast to the implementation of early enteral feeding by CHDICM. This prompted a literature review to critically consider the evidence underpinning clinical practice in this field. Literature revealed that nutritional management in the first 72 hours after spinal cord injury is a complex process. The complexities of when to commence, the method of delivering, and the target dose of enteral nutrition in the first 72 hours after spinal cord injury are due to the perceived risk of a spinal ileus and the ensuing, such as adverse effects on abdominal and respiratory function, resulting from enteral feeding intolerance. Literature revealed that delayed nutrition is largely based on expert opinion, while early enteral feeding has limited but stronger scientific research evidence. Nevertheless, it is desirable to use the best evidence currently available to develop, implement and evaluate an evidence-based, protocol driven, clinical pathway for nutritional management of patients within 72 hours of an acute cervical or high thoracic SCI. The author concludes that to ensure an acute spinal cord injury clinical pathway is based on scientific evidence, prospective, multi-centre, randomised controlled trials are needed to substantiate early enteral feeding and identification of the degree of and risk of complications from spinal ileus after acute cervical or high thoracic spinal cord injury. |
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Call Number |
NRSNZNO @ research @ |
Serial |
809 |
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Author |
Hall, J. |
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Title |
Building trust to work with a grounded theory study of paediatric acute care nurses work |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Issue |
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Pages |
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Keywords |
Nurse-family relations; Nurse-patient relations; Children; Paediatric nursing; Intensive care nursing |
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Abstract |
Grounded theory methodology has guided the grounded theory methods used to explore the acute care paediatric nurses' perspective of what they do when a child has had a severe accident. The research was initiated from the experience of nursing children in the context of a rehabilitation centre and wondering how acute care nurses promoted a child's recovery after a severe unintentional injury. Many avenues were used to search international and New Zealand literature but the scarcity of literature related to what acute care paediatric nurses do was evident. Nursing children in the acute care ward after a severe accident is complex. It encompasses nursing the family when they are experiencing a crisis. It is critical that the acute care nurse monitors and ensures the child's physiological needs are met, and the nurse “works with” the child to maintain and advance medical stability. Nursing interactions are an important part of “working with”, communication is the essence of nursing. This research has focussed on the nurses' social processes whilst caring for the physical needs of the child and interacting with the family and multidisciplinary team when appropriate. An effective working-relationship with a nurse and family is founded on trust. Grounded theory methods supported the process of exploring the social processes of “building trust” whilst “working with” families in a vulnerable position. Nurses rely on rapport to be invited into a family's space to “work with” and support the re-establishment of the parenting role. The “stepping in and out” of an effective working-relationship with a family is reliant on trust. Nurses build trust by spending time to “be with”, using chat to get to know each other, involving and supporting the family to parent a “different” child and reassuring and giving realistic hope to help the child and parents cope with their changed future. A substantive theory of the concept of “building trust to work with” has been developed using grounded theory methods. The theory has been conceptualised using the perspective of seven registered nurses working in paediatric acute care wards that admit children who have had a severe traumatic accident. |
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Call Number |
NRSNZNO @ research @ |
Serial |
597 |
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Author |
Bear, Rebecca |
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Title |
Kangaroo Mother Care: Participatory action research within a Neonatal Intensive Care Unit in Aotearoa New Zealand |
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Book Whole |
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Year |
2019 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
318 p. |
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Keywords |
Neonatal Intensive Care Units; Kangaroo Mother Care (KMC); Mother-infant attachment; Participatory Action Research |
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Abstract |
Illustrates the use of participatory action research (PAR) to assist in the improvement of Kangaroo Mother Care (KMC) in one Neonatal Intensive Care Unit (NICU) in a NZ hospital, by means of audit, observation and interview. Describes the unfolding processes of PAR, as well as the inclusion of a secondary discourse analysis and parental perspectives from local and global literature. |
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Call Number |
NZNO @ research @ |
Serial |
1692 |
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Author |
Yu, Shufen [Fiona] |
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Title |
Exploring resilience in Intensive Care Nurses in New Zealand |
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Book Whole |
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Year |
2021 |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
314 p. |
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Keywords |
Resilience; Intensive care nurses; Physical activity; 12-hour shifts |
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Abstract |
Investigates intensive care nurses' resilience levels and their association with personal factors and physical activity behaviour; physical work activity behaviour during a 12-hour shift; and clustered physical activity profiles and associations with resilience. Performs a cross-sectional study with intensive care nurses from four units at three hospitals in Auckland. Employs accelerometry to measure participants' physical activity during four days, two at work and two in their own time, and uses the Connor-Davidson Resilience Scale to measure resilience levels. |
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Call Number |
NZNO @ research @ |
Serial |
1767 |
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Author |
Mackle, Diane |
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Title |
Oxygen management in New Zealand and Australian intensive care units: A knowledge translation study |
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Book Whole |
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Year |
2021 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
299 p. |
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Keywords |
Oxygen therapy; Intensive Care Units (ICU); Intensive care nurses; ICU patients |
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Abstract |
Investigates the effects of participation in the Intensive Care Unit Randomised Trial Comparing Two Approaches to Oxygen therapy (ICU-ROX) randomised controlled trial, on attitudes and practices in relation to ICU oxygen therapy. Distributes a practitioner attitudes survey to 112 specialist doctors and 153 ICU nurses. Performs both inception and retrospective cohort studies using the Australian and NZ ICU adult patient database before, and post-publication of the ICU-ROX trial results. |
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Call Number |
NZNO @ research @ |
Serial |
1766 |
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Author |
Fielding, S. |
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Title |
Learning to do, learning to be: The transition to competence in critical care nursing |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Preceptorship; Nursing specialties |
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Abstract |
Making the transition to an area of specialist nursing practice is challenging for both the learner and staff who are responsible for education and skill development. This study uses grounded theory methodology to explore the question: “How do nurses learn critical care nursing?” The eight registered nurses who participated in this study were recruited from a range of intensive care settings. The criteria for inclusion in the study included the participant having attained competency within the critical care setting. Data was collected from individual interviews. This study found that nurses focus on two main areas during their orientation and induction into critical care nursing practice. These are learning to do (skill acquisition) and learning to be (professional socialisation). The process of transition involves two stages: that of learning to do the tasks related to critical care nursing practice, and the ongoing development of competence and confidence in practice ability. The relationship of the learner with the critical care team is a vital part of the transition to competency within the specialist area. This study identifies factors that influence the learner during transition and also provides an understanding of the strategies used by the learners to attain competency. These findings are applicable to educators and leaders responsible for the education and ongoing learning of nurses within critical care practice. The use of strategies such as simulated learning and repetition are significant in skill acquisition. However attention must also be paid to issues that influence the professional socialisation process, such as the quality of preceptor input during orientation and the use of ongoing mentoring of the learner. |
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Call Number |
NRSNZNO @ research @ |
Serial |
509 |
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Author |
Evans, S. |
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Title |
Silence kills: Communication around adverse events in ICU |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Communication; Interprofessional relations |
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Abstract |
The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety. |
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Call Number |
NRSNZNO @ research @ |
Serial |
741 |
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Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
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Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
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Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
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Keywords |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
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Abstract |
The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU. |
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Call Number |
NRSNZNO @ research @ |
Serial |
962 |
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Author |
Tweed, C.; Tweed, M. |
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Title |
Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program |
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Journal Article |
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Year |
2008 |
Publication |
American Journal of Critical Care |
Abbreviated Journal |
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Volume |
17 |
Issue |
4 |
Pages |
338-347 |
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Keywords |
Intensive care nursing; Training; Evaluation |
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Abstract |
The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline. |
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Call Number |
NRSNZNO @ research @ |
Serial |
958 |
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Author |
Evans, S. |
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Title |
Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes |
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Journal Article |
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Year |
2003 |
Publication |
Pediatric Intensive Care Nursing |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
7 |
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Keywords |
Nursing specialties; Intensive care nursing; Equipment and Supplies |
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Abstract |
The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
926 |
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Author |
Ho, T. |
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Title |
Ethical dilemmas in neonatal care |
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Journal Article |
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Year |
2000 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
6 |
Issue |
7 |
Pages |
17-19 |
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Keywords |
Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making |
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Abstract |
The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment. |
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Call Number |
NRSNZNO @ research @ 1035 |
Serial |
1019 |
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Author |
Powell, J. |
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Title |
Caring for patients after an ICU admission |
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Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
7 |
Pages |
24-25 |
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Keywords |
Intensive care nursing; Nurse-patient relations; Trauma; Communication |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
954 |
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Author |
Morrison, M. |
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Title |
Posthuman pathology: A postmodern art project located in critical care |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Nursing philosophy; Culture; Technology |
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Abstract |
The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care. |
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Call Number |
NRSNZNO @ research @ 580 |
Serial |
566 |
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Author |
Fahey, M. |
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Title |
Family centred care in the newborn intensive care unit: Creating a supportive environment |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Infants; Nurse-family relations |
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Abstract |
The environment of the Newborn Intensive Care Unit (NICU) is a stressful one for families and is often designed to provide technical care for the infant rather than facilities that would enable and support parental and family participation in infant care. Furthermore, the author notes that the environment of the NICU emerged in literature as an obstacle to meaningful family involvement in care. However, she goes on to say that a philosophy of Family Centred Care in the NICU can offer a framework of care that supports family involvement in the infant's care and family presence in the NICU. It also promotes parental participation in decision-making for the infant and gives recognition to the importance of perspectives provided by the family. This dissertation explores the difficulties associated with the practice of Family Centred Care in the environment of the NICU. It offers recommendations for features of unit design that can promote Family Centred Care by supporting and sustaining the presence of families in the NICU and therefore facilitating their involvement in the care of their infant. |
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Call Number |
NRSNZNO @ research @ |
Serial |
592 |
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Author |
Pirret, A.M. |
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Title |
The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making |
Type |
Journal Article |
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Year |
2007 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
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Volume |
23 |
Issue |
3 |
Pages |
145-155 |
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Keywords |
Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education |
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Abstract |
The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved. |
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Call Number |
NRSNZNO @ research @ |
Serial |
933 |
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