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Author Kuehl, S.
Title Emergency Department re-presentations following intentional self-harm Type
Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 1214
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Author Wilson, H.V.
Title Power and partnership: A critical analysis of the surveillance discourses of child health nurses Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 36 Issue 2 Pages 294-301
Keywords Paediatric nursing; Nurse-family relations; Nursing philosophy; Plunket
Abstract (up) The aim of this research was to explore surveillance discourses within New Zealand child health nursing and to identify whether surveillance practices have implications in this context for power relations. Five experienced and practising Plunket nurses were each interviewed twice. The texts generated by these semi-structured interviews were analysed using a Foucauldian approach to critical discourse analysis. In contrast with the conventional view of power as held and wielded by one party, this study revealed that, in the Plunket nursing context, power is exercised in various and unexpected ways. Although the relationship between the mother and the nurse cannot be said to operate as a partnership, it is constituted in the nurses' discourses as a dynamic relationship in which the mother is actively engaged on her own terms. The effect of this is that it is presented by the nurses as a precarious relationship that has significant implications for the success of their work.
Call Number NRSNZNO @ research @ Serial 1085
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Author Neville, S.J.; Alpass, F.
Title Older men and worries: The impact on well-being Type Journal Article
Year 2006 Publication Vision: A Journal of Nursing Abbreviated Journal Available online from Eastern Institute of Technology
Volume 14 Issue 1 Pages 4-7
Keywords Older people; Male; Geriatric nursing
Abstract (up) The aim of this research was to investigate the relationship between worries and psychological well-being, and self-rated health in older men. A cross-sectional survey method was used to investigate the research aim. A group of men aged 65 years and over (n = 217), who lived in a small New Zealand city, participated in this study. Results from this research revealed that worries about physical abilities and health were significantly related to a decrease in psychological well-being and self-rated health. Gerontological nurses are challenged to be cognisant of older men's concerns about their health and physical ability.
Call Number NRSNZNO @ research @ 1323 Serial 1307
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Author Henty, C.; Dickinson, A.R.
Title Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study Type Journal Article
Year 2007 Publication New Zealand Family Physician Abbreviated Journal The Royal New Zealand College of General Practitioners website
Volume 34 Issue 5 Pages 335-338
Keywords Primary health care; Chronic diseases; Nursing; Evaluation
Abstract (up) The aim of this small qualitative descriptive pilot study was to describe the experiences of practice nurses delivering the Care Plus programme within the general practice setting. Care Plus was introduced into Primary Health Organisations (PHOs) in 2004. This programme encourages more involvement from practice nurses in chronic care management. For many New Zealand practice nurses this is a new role. This study, carried out prior to the larger Care Plus implementation review (2006), provides an insight into the nursing experience of implementing Care Plus and provides a basis for future studies with regard to the nurse's role within the Care Plus programme.
Call Number NRSNZNO @ research @ 468 Serial 454
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Author Sye, J.
Title A fine balance Type
Year 2008 Publication Abbreviated Journal AUT University Library
Volume Issue Pages
Keywords Paediatric nursing; Community health nursing; Nurse-patient relations; Children; Patient rights
Abstract (up) The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children's rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children's rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society's interest in children's rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children's health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children's health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children's rights whilst respecting the role of parents and families. The author argues that children's rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. She proposes that children's community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children's rights advocates.
Call Number NRSNZNO @ research @ 911 Serial 895
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Author Tweed, C.; Tweed, M.
Title Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program Type Journal Article
Year 2008 Publication American Journal of Critical Care Abbreviated Journal
Volume 17 Issue 4 Pages 338-347
Keywords Intensive care nursing; Training; Evaluation
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 958
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Author Peri, K.; Kerse, N.; Kiata, L.; Wilkinson, T.; Robinson, E.; Parsons, J.; Willingale, J.; Parsons, M.; Brown, P.; Pearson, J.R.; von Randow, M.; Arroll, B.
Title Promoting independence in residential care: Successful recruitment for a randomized controlled trial Type Journal Article
Year 2008 Publication Journal of the American Medical Directors Association Abbreviated Journal
Volume 9 Issue 4 Pages 251-256
Keywords Research; Geriatric nursing; Rest homes; Evaluation; Attitude of health personnel
Abstract (up) The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.
Call Number NRSNZNO @ research @ 803 Serial 787
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Author Clendon, J.; White, G.E.
Title The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 34 Issue 2 Pages 171-178
Keywords Primary health care; Nurse managers; Advanced nursing practice; Community health nursing; School nursing
Abstract (up) The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.
Call Number NRSNZNO @ research @ Serial 952
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Author Flynn, L.; Carryer, J.B.; Budge, C.
Title Organisational attributes valued by hospital, home care, and district nurses in the United States and New Zealand Type Journal Article
Year 2005 Publication Journal of Nursing Scholarship Abbreviated Journal
Volume 37 Issue 1 Pages 67-72
Keywords Organisational culture; Cross-cultural comparison; Nursing
Abstract (up) The aim of this study was to determine whether hospital-based, home care, and district nurses identify a core set of organisational attributes in the nursing work environment that they value as important to the support of professional practice. Survey data, collected in 2002 2003 from 403 home care nurses in the United States and 320 district nurses in New Zealand, were pooled with an existing data set of 669 hospital-based nurses to conduct this descriptive, nonexperimental study. The importance of organisational attributes in the nursing work environment was measured using the Nursing Work Index-Revised (NWI-R). The authors found that at least 80% of hospital-based, home care, and district nurses either agreed or strongly agreed that 47 of the 49 items comprising the NWI-R represented organisational attributes they considered important to the support of their professional nursing practice. Mean importance scores among home care nurses, however, were significantly lower than were those of the other two groups. The authors conclude that the overall, hospital-based, home care, and district nurses had a high level of agreement regarding the importance of organisational traits to the support of their professional practice. The intensity of the attributes' importance was less among home care nurses. Further research is needed to determine whether this set of organisational traits, measured using the NWI-R, is associated with positive nurse and patient outcomes in home care and district nursing practice, as has been shown in acute care settings.
Call Number NRSNZNO @ research @ Serial 886
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Author Crowe, M.; O'Malley, J.; Gordon, S.
Title Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 35 Issue 1 Pages 88-96
Keywords Community health nursing; Psychiatric Nursing; Patient satisfaction; Mental health
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 1087
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Author Chang, E.M.; Bidewell, J.W.; Huntington, A.D.; Daly, J.; Johnson, A.; Wilson, H.; Lambert, V.; Lambert, C.E.
Title A survey of role stress, coping and health in Australian and New Zealand hospital nurses Type Journal Article
Year 2008 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 44 Issue 8 Pages 1354-1362
Keywords Stress; Psychology; Cross-cultural comparison; Nursing
Abstract (up) The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.
Call Number NRSNZNO @ research @ Serial 970
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Author Honey, M.
Title Teaching and learning with technology as enabler: A case study on flexible learning for postgraduate nurses Type
Year 2007 Publication Abbreviated Journal
Volume Issue Pages
Keywords Education; Technology; Nursing; Professional development; Teaching methods
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 473
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Author Goodyear-Smith, F.; Janes, R.
Title New Zealand rural primary health care workforce in 2005: More than just a doctor shortage Type Journal Article
Year 2008 Publication Australian Journal of Rural Health Abbreviated Journal
Volume 16 Issue 1 Pages 40-46
Keywords Personnel; Physicians; Rural health services; Nursing; Primary health care; Pharmacists
Abstract (up) The aim of this study was to obtain a 2005 snapshot of the New Zealand rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. A postal questionnaire was distributed to rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists in November 2005. The self-reported data included information on demographics, country of training, years in practice, business ownership, hours worked including on-call, and intention to leave rural practice.
Call Number NRSNZNO @ research @ Serial 966
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Author Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P.
Title 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 Type Journal Article
Year 2002 Publication New Zealand Medical Journal Abbreviated Journal Access is free to articles older than 6 months, and abstracts.
Volume 115 Issue 1157 Pages
Keywords Emergency nursing; Time factors; Clinical assessment; Clinical decision making
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 617
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract (up) 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.
Call Number NRSNZNO @ research @ Serial 1069
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