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Author Tuitea, I.
Title Solution focused nursing: An alternative model for assessing psychosis and mai aitu in mental health Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Pacific peoples; Mental health; Psychiatric Nursing; Culture
Abstract (down) The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.
Call Number NRSNZNO @ research @ 753 Serial 739
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Author Jull, A.
Title Oral Pentoxifylline in the treatment of venous leg ulcers: A meta-analysis Type
Year 1999 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Pharmacology; Evidence-based medicine; Nursing
Abstract (down) The objective of this meta-analysis was to assess the effectiveness of pentoxifylline as an adjunct to compression bandaging in the treatment of venous leg ulcers. The CENTRAL registers of the Cochrane Peripheral Vascular Diseases and Wounds Groups were searched – each register is routinely updated by extensive searches of electronic databases, handsearching of relevant journals and conference proceedings, and contact with product companies and experts in the field. The drug's manufacturer was contacted and the references of review articles and all obtained trials were scrutinised for further citations. Randomised controlled trials published in any language comparing pentoxifylline and compression with placebo in adult participants with venous ulceration were included. Trials must have reported a meaningful objective outcome (rates of healing, proportions healed, time to healing). Details from eligible trials (independently selected by two reviewers) were extracted and summarised by one reviewer. A second reviewer independently verified extracted data. Eleven clinical trials were identified. Five trials compared pentoxifylline with placebo (compression standard therapy). Six trials were excluded. Pentoxifylline and compression was more effective than placebo and compression (RR 1.30, 95% C1 1.10-1.54) and was robust to sensitivity analyses. The greater number of adverse effects (46 reports) occurred in the pentoxifylline group, although this was not significant (RR 1.12, 95% C1 0.77-1.62); 34 percent of adverse effects were gastro-intestinal. Seven of 21 reported withdrawals were for adverse effects. In conclusion, pentoxifylline appears an effective adjunct to compression bandaging in the treatment of venous ulcers. The absence of cost-effectiveness data suggests it not be employed as a routine adjunct, but it could be considered as for those patients not responding to compression therapy alone. The majority of adverse effects are likely to be tolerated by patients.
Call Number NRSNZNO @ research @ 1244 Serial 1229
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Author Brinkman, A.
Title Collating for collaboration: Tertiary education funding structures Type Report
Year 2008 Publication Abbreviated Journal Available from http://www.nzno.org.nz
Volume Issue Pages
Keywords Nursing; Education; Policy
Abstract (down) The nursing education environment is complex and varied, and is affected by both the education and health systems. This report backgrounds the funding systems that underwrite the Tertiary Education Commission (TEC) processes. The two primary objectives that have guided this collation are: to stimulate awareness and discussion of the issues around funding nursing education in New Zealand; and to promote understanding of the complex funding structures currently in place in New Zealand by students, nurses, nurse educators and nurse managers.
Call Number NZNO @ research @ Serial 1330
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Author Thompson, C.M.M.
Title Caring for people with mental health problems who present at the emergency department: A nurse educator's journey Type
Year 2005 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Mental health; Emergency nursing; Education
Abstract (down) The New Zealand emergency department (ED) nurse is faced daily with the challenge of caring for patients of all ages with a wide variety of presenting complaints. Courses are available for ED specialty work such as trauma and paediatric assessment. However, this thesis argues, it is difficult to access updated and ongoing education in relation to caring for people with mental health problems who present to the emergency department. In addition to this education deficit, are the challenges of providing care in an overcrowded ED environment. The author goes on to say that such factors contribute to a perceived lack of confidence and sometimes ambivalence or frustration on the part of nursing staff in caring for this group. This may result in an inconsistent standard of care for the person with a mental health problem unless such issues are addressed. The aim of this research paper was to explore the education needs of ED nurses when caring for people with mental health problems. A literature review was undertaken to investigate the broad education strategies available to overcome these challenges. Diverse approaches were identified such as workshops, clinical guidelines, and mental health consultation-liaison roles. Research was also identified that examined ED nursing attitudes and their learning needs in relation to mental health. This paper concludes with a discussion of recommendations for the New Zealand setting with the intention of developing a more confident and competent nursing workforce, who are better prepared to care for the person with a mental health problem.
Call Number NRSNZNO @ research @ Serial 575
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Author Kempthorne, A.
Title Why do nurse graduates choose to work in the area of mental health? Type
Year 2006 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Careers in nursing; Psychiatric Nursing; Mental health
Abstract (down) The low numbers of nurses attracted to work in mental health is a concern particularly with the increased demand for mental health services. Strategies are required to increase recruitment to this less popular area of nursing to ensure that a high quality of care is provided for people suffering from mental illness. The World Health Organisation is aware that this area of health has been neglected and that it is time to promote mental health. This study aimed to examine the influences involved in nurses choosing to work in this area. A descriptive survey using a questionnaire was given to seven groups of new graduates enrolled in the New Graduate Mental Health Nursing programme through five educational institutes. At the time of writing there were no published studies around this topic in New Zealand. This study will attempt to inform nurses, the Nursing Council of New Zealand, tertiary institutions and the government of New Zealand that there is evidence of a need to develop and change practices to address the predicted workforce decline.
Call Number NRSNZNO @ research @ Serial 733
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Author Bleach, A.
Title Nurses talk the walk: An exploration of nurses' perception of advanced nursing practice on acute mental health inpatient units in New Zealand Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Mental health; Nursing; Policy; Registered nurses; Advanced nursing practice; Psychiatric Nursing
Abstract (down) The last twenty years, particularly the early 1990s, ushered in major mental health sector reforms inclusive of deinstitutionalisation policies and subsequent development of community services. Concurrent changes to student nurses' education left registered nurses as the workforce mainstay on inpatient units. However, the author suggests, an emerging global shortage of nurses and implementation of the Employment Contracts Act (1991) negatively impacted on recruitment and retention of registered nurses. Inpatient nurses either left nursing or moved to community positions for better money and increased job status. The author suggests that, as a consequence, the 'critical mass' of experienced and skilled nurses who traditionally provided nursing leadership disappeared resulting in compromised standards of care for patients. As the manager of an inpatient unit, the author proposed the establishment of advanced nursing practice roles as one initiative to provide nursing leadership in order to attract and retain nurses. This study explored five inpatient nurses' perceptions of advanced practice and whether these roles could assist to provide leadership and improve standards of care. The research was a qualitative exploratory descriptive study using a focus group interview as the data collection method. A thematic analysis of the group discussion transcription revealed three key themes: 1) the 'makeup' of advanced nursing practice, 2) moving forwards: establishing roles, 3) moving sideways: barriers to role development. The themes are critically discussed in relation to selected literature. The thesis includes recommendations that could be used by nurses responsible for planning and implementing advanced practice roles on inpatient units.
Call Number NRSNZNO @ research @ Serial 663
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Author Farmer, D.
Title Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication Type
Year 2008 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Primary health care; Nursing
Abstract (down) The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community.
Call Number NRSNZNO @ research @ Serial 913
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Author Mearns, G.
Title Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice Type
Year 2005 Publication Abbreviated Journal Auckland University of Technology Library
Volume Issue Pages
Keywords Nurse practitioners; Geriatric nursing; Older people; Registered nurses
Abstract (down) The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner.
Call Number NRSNZNO @ research @ Serial 585
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Author Bridgen, A.F.
Title A heuristic journey of discovery: Exploring the positive influence of the natural environment on the human spirit Type
Year 2007 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Spirituality; Nursing; Nursing philosophy
Abstract (down) The intention of this heuristic study was to explore and discover the essence of the positive influence of the natural environment on the human spirit. The study quest was identified as a central concern that evolved from the author's personal experience of spiritual awakening in the natural environment and an interest in the concept of connectedness in nursing care and practice. The study also focused on the self of the nurse and the qualities of holistic nursing care. Guided by heuristic methodology developed by Moustakas (1990) the thesis traces a journey of discovery. Using conversational interviews, six nurses were asked to describe their experiences of their spirit being positively influenced in the natural environment. These nurses were also asked if these beneficial experiences had any flow-on effect to their nursing practice. From these interviews various commonalities of experience were identified as well as some experiences unique to the individual participants. The participant knowing was articulated using Reed's (1992) dimensions of relatedness in spirituality as a framework. Reed describes these dimensions as being able to be experienced intrapersonally, interpersonally and transpersonally. A substantive body of nursing and non-nursing literature was explored to support the participant knowing and provide strength to the discussion. The study discovered that the human spirit is positively influenced in the natural environment. The three actions of personal healing and wellbeing in the natural environment, knowing self – knowing others and sustaining self in nursing practice were valued by the participants as contributing to the quality of their nursing care. In bringing together spirituality, the natural environment and nursing, holism was discovered to be the significant and connecting constituent. The study has some implications for the discipline of nursing that are also discussed by the author.
Call Number NRSNZNO @ research @ 831 Serial 815
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Author Corbett, A.
Title Cultural safety: A New Zealand experience Type Journal Article
Year 2004 Publication Journal of the Australasian Rehabilitation Nurses Association Abbreviated Journal
Volume 7 Issue 1 Pages 14-17
Keywords Cross-cultural comparison; Cultural safety; Transcultural nursing
Abstract (down) The Indigenous Nursing Education Working Group report “Gettin em n keepin em”, was presented at the Australasian Nurse Educators Conference held in Rotorua, New Zealand. The practicalities of the implementation of this report were challenged in light of the experiences of New Zealand nurse educators in implementing the concepts of cultural safety into undergraduate nurse education in New Zealand. The experiences of one Maori family with the Australian health system is given to illustrate the points made.
Call Number NRSNZNO @ research @ 964 Serial 948
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Author Pirret, A.M.
Title A preoperative scoring system to identify patients requiring postoperative high dependency care Type Journal Article
Year 2003 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 19 Issue 5 Pages 267-275
Keywords Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment
Abstract (down) The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number NRSNZNO @ research @ 904 Serial 888
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Author Wilson, D.
Title The nurse's role in improving indigenous health Type Journal Article
Year 2003 Publication Contemporary Nurse Abbreviated Journal
Volume 15 Issue 3 Pages 232-240
Keywords Transcultural nursing; Maori; Health status
Abstract (down) The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.
Call Number NRSNZNO @ research @ Serial 1065
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Author Tustin-Payne, W.
Title Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? Type
Year 2008 Publication Abbreviated Journal Wintec Research Archive
Volume Issue Pages
Keywords Professional competence; Nursing; Psychology; Quality of health care; Feminist critique
Abstract (down) The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.
Call Number NRSNZNO @ research @ 1198 Serial 1183
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Author Dobson, J.
Title Nurses' experiences of parental informed consent in the neonatal intensive care unit Type
Year 2004 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Neonatal nursing; Parents and caregivers
Abstract (down) The Guthrie Test has become the standard screening test for early detection of congenital metabolic disorders for newborn babies in New Zealand and is an accepted part of neonatal care. In neonatal care, decisions are made on behalf of babies usually by their parents and, for the Guthrie Test there is a requirement that health professionals obtain informed consent. This qualitative research utilised focus group methodology to discover what neonatal nurses in clinical practice consider when obtaining informed consent from parents for newborn screening, the Guthrie Test. The convenience sample consisted of seven registered nurses who volunteered to participate in the study. They all practice in the Neonatal Intensive Care Unit at Dunedin Public Hospital that provides Level 3 intensive care to neonates in the Otago/Southland regions. There are proven benefits of the current newborn screening programme and in the experience of this focus group not many parents choose to refuse. These neonatal nurses identified the rights of parents to have that choice and to make an informed decision. The findings from this research indicate the importance neonatal nurses place on patients' rights and the information provided to ensure that their rights are respected. However, the results indicated that there is a need for clarification of the purpose and process of informed consent for the Guthrie Test in the Neonatal Intensive Care Unit. Therefore providing sufficient, relevant information at an appropriate time and manner is considered necessary. The findings will be used to inform discussion related to the provision of best practice.
Call Number NRSNZNO @ research @ Serial 921
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Author Stokes, G.
Title Who cares? Accountability for public safety in nurse education Type
Year 2005 Publication Abbreviated Journal Online at Research Space @ Auckland University
Volume Issue Pages
Keywords Nursing; Education; Accountability; Patient safety
Abstract (down) The focus of this study is the management of unsafe nursing students within the tertiary education context. The moral dilemmas experienced by nurse educators, specifically linked to the issue of accountability for public safety, are explored. The theoretical framework for the thesis is informed by the two moral voices of justice and care identified by Gilligan and further developed using the work of Hekman and Lyotard. Case study methodology was used and data were collected from three schools of nursing and their respective educational organisations. Interviews were conducted with nurse educators and education administrators who had managed unsafe nursing students. Interviews were also conducted with representatives from the Nursing Council of New Zealand and the New Zealand Nurses Organisation to gain professional perspectives regarding public safety, nurse education and unsafe students. Transcripts were analysed using the strategies of categorical aggregation and direct interpretation. Issues identified in each of the three case studies were examined using philosophical and theoretical analyses. This thesis explores how students come to be identified as unsafe and the challenges this posed within three educational contexts. The justice and care moral voices of nurse educators and administrators and the ways in which these produced different ways of caring are made visible. Different competing and conflicting discourses of nursing and education are revealed, including the discourse of safety – one of the language games of nursing. The way in which participants positioned themselves and positioned others within these discourses are identified. Overall, education administrators considered accountability for public safety to be a specific professional, nursing responsibility and not a concern of education per se. This thesis provides an account of how nurse educators attempted to make the educational world safe for patients, students, and themselves. Participants experienced different tensions and moral dilemmas in the management of unsafe students, depending upon the moral language games they employed and the dominant discourse of the educational organisation. Nurse educators were expected to use the discourses of education to make their case and manage unsafe students. However, the discourses of nursing and education were found to be incommensurable and so the moral dilemmas experienced by nurse educators were detected as differends. This study bears witness to these differends.
Call Number NRSNZNO @ research @ Serial 1106
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