|
|
Lienert-Brown, M. F. (2013). Exploring undergraduate nursing students' experiences of their first clinical placement in an acute adult mental health inpatient service. Master's thesis, University of Otago, .
Abstract: Seeks to develop a better understanding of the undergraduate nursing students' experience of their clinical placement in mental health, and to identify the influences on student learning in an acute adult mental health service. Enrols a cohort of 13 nursing students to analyse their lived experiences through their written reflections on practice, which offered important insights into the students' experience of their first mental health clinical placement. Identifies six themes by means of thematic analysis.
|
|
|
|
Harvey, G. (2022). 'Thank you for telling our story...': An exploration of the needs of migrant nurses undergoing competence assessment for New Zealand registration. Master's thesis, Otago Polytechnic, Dunedin. Retrieved July 3, 2024, from https://hdl.handle.net/10652/5972
Abstract: Seeks to give voice to migrant nurses, using case-study methodology to highlight their experience of the competence assessment process. Distributes a questionnaire to a group of 22 newly-arrived IQNs, and conducts interviews with 10 IQNs who had been working in NZ for several years. Uncovers the motivations among the first group and reflections on the Competence Assessment Programme (CAP) among the second. Makes recommendations for CAP training based on the results of the study.
|
|
|
|
Brown, J. (2019). Thorn in the flesh: the experience of women living with surgical mesh complications. Master's thesis, University of Otago, Dunedin. Retrieved July 3, 2024, from https://www.nzno.org.nz/resources/library/theses
Abstract: Sheds light on the experiences of seven women who have suffered pelvic surgical mesh complications as a result of surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Emphasises the existential impacts arising from disruption to the embodied self as experienced by the study participants. Discusses problems with biomedical research on pelvic surgical mesh, highlighting two key clinical studies, and a NZ study. Employs hermeneutic phenomenology and a questionnaire to survey the participants.
|
|
|
|
Hardy, D. J., O'Brien, A. P., Gaskin, C. J., O'Brien, A. J., Morrison-Ngatai, E., Skews, G., et al. (2004). Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand. Journal of Advanced Nursing, 46(1), 95–109.
Abstract: The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
|
|
|
|
Kuehl, S. (2008). Emergency Department re-presentations following intentional self-harm. Ph.D. thesis, , .
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.
|
|
|
|
Kiata, L., Kerse, N., & Dixon, R. (2005). Residential care workers and residents: The New Zealand story. Access is free to articles older than 6 months, and abstracts., 118(1214).
Abstract: The aim of this study was to describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand was undertaken, with completed surveys received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The authors conclude that the age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.
|
|
|
|
Crowe, M., O'Malley, J., & Gordon, S. (2001). Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand. Journal of Advanced Nursing, 35(1), 88–96.
Abstract: The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
|
|
|
|
Honey, M. (2007). Teaching and learning with technology as enabler: A case study on flexible learning for postgraduate nurses. Ph.D. thesis, , .
Abstract: The aim of this study was to explore the practice of flexible learning for postgraduate nurses. Flexible learning is a contemporary approach to learning that utilises the benefits of technology. Flexible learning can be understood as a continuum, from fully on-line or web-based courses, to those that are on-campus and supported by technology. Internationally, the rise of flexible learning has been influenced by increased demand for higher education and competition among providers within the context of reduced education funding. The study population, New Zealand postgraduate nurses, are accessing higher education in increasing numbers to advance their practice and to position themselves for new roles and opportunities. These are often experienced nurses yet inexperienced in higher university education, who combine study, work and other commitments. The study employed a qualitative case study design because it enabled multiple perspectives to be gained. Data included documentation, participant observation, survey, students' assessed work and interviews with key stakeholders: student, teacher and the organisation. Thematic analysis was conducted on reviewed documentation, participant observation and interviews. The study identifies the elements that contribute to flexible learning and the interconnectedness between the elements within the dynamic context of a university to illustrate that effective flexible learning can be provided by using a student centred approach to ensure the learning needs of postgraduate nurses are met. The author concludes that flexible learning improved access, choice, and provided an emphasis on the student as central to learning. In response to these findings the weighting of recommendations are toward the organisation as, the author suggests, it is at this level where greater change can be made to improve support for flexible learning provision.
|
|
|
|
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.
|
|
|
|
Crowe, M., & Carlyle, D. (2003). Deconstructing risk assessment and management in mental health nursing. Journal of Advanced Nursing, 43(1), 19–27.
Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
|
|
|
|
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.
|
|
|
|
Minto, R. (2006). The future of practice nursing. New Zealand Family Physician, 33(3), 169–172.
Abstract: The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery.
|
|
|
|
Evans, S. (2003). Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes. Pediatric Intensive Care Nursing, 4(2), 7.
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.
|
|
|
|
Kyle, W. (2002). Dementia specific nursing in New Zealand: History and practice today. Vision: A Journal of Nursing, 8(14), 3–9.
Abstract: The author examines influences on contemporary dementia specific nursing practice. She addresses the current situation and future developments in this area.
|
|
|
|
Murrell-McMillan, K. A. (2006). Why nurses in New Zealand stay working in rural areas. New Zealand Family Physician, 33(3), 173–175.
Abstract: The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues.
|
|
