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King, B. E., & Fletcher, M. P. (1981). The nursing workforce in New Zealand 1980. Ph.D. thesis, , .
Abstract: Factual information of the size and composition of the Nursing workforce in New Zealand as well as on the distribution of Nurses, their qualifications and their employment. Two basic factors affecting the workforce, external migration and long term absences, are also discussed. This is the first issue of a planned series, to be updated annually by the division of Nursing, Department of Health
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Ritchie, M. S. (2004). Process evaluation of an emergency department family violence intervention programme. Ph.D. thesis, , .
Abstract: Family violence is common and there are significant long-term negative health effects from victimisation. Health professionals are now recognised as key providers of family violence intervention. The Hawke's Bay District Health Board HBDHB) launched a Family Violence Intervention Programme in the emergency department in 2002, in accordance with national directives. The Family Violence Intervention Programme includes routine questioning for partner abuse within social history assessments for all women 16 years and over who seek healthcare services. Nurses assumed responsibility for implementing this programme into emergency department practice. Establishing partner abuse screening in practice requires an organisational and attitudinal change. Achieving and sustaining this change can be difficult. Evaluation was considered an essential aspect of the systems approach adopted within the HBDHB Family Violence Intervention Programme to support change. The aim of this study was to identify the enablers and barriers to routine questioning in the emergency department one year after the programme was launched and the strategies to address these barriers. The staff who have responsibility for routinely questioning women were considered well placed to provide this information. The methodology selected was evaluation research using semi-structured interviews. The design included member checking and triangulation of the findings. Eleven emergency department staff members participated in five (two group and three single) interviews. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department setting. Barriers to questioning exist and enablers can eliminate or minimise these. Enablers such as policy and training support routine questioning. Barriers identified included the lack of privacy and time. Participants suggested strategies to overcome these. These barriers, enablers and solutions were either personal or organisational in origin and all had a common theme of safety. An outcome of the study was the development of a model of barriers and enablers to ensure safety when routinely questioning women for partner abuse. This evaluation has utility within the HBDHB as it informs programme progression. However, the evaluation has wider implications. The experiences of the emergency department staff led to the emergence of key themes that may inform the development of comparable programmes. Introducing routine questioning requires a practice change; a multifaceted approach focusing on safety can assist staff to achieve that change.
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Margetts, M., Cuthbertson, S., & Streat, S. J. (1995). Bereavement follow-up service after fatal critical illness. Ph.D. thesis, , .
Abstract: Fatal illness is often short. Communication between patient and family is impaired and how to best meet family needs is unclear. We began a follow-up service to determine current next-of-kins outcomes and remedy service deficiencies. A critical care nurse identified deaths from our data base and completed a structured telephone interview with the next-of-kin. There were 374 admissions from 1/1/95 – 17/5/95, 55 died. Next- of-kin of 52 patients (M29, age 19-88 median 52) were contactable 16-70 (median 33)days later. All (defacto/wives 18, husbands 9, mothers 9, daughters 8, others 8) consented to interview (5 -80, median 15 minutes). Forty-nine had resumed normal home activities and 23/25 workers had returned to work. Thirty-three still had disturbed sleep, three were taking hypnotics. Twenty-four had had contact with their general practitioner because of the death (six were prescribed sedatives or hypnotics). Nineteen had financial problems. Forty-seven described DCCM care positively, 35 specifically (nursing care and compassion 15, communication 8, flexible visitors policy8) but 13 had particular difficulties (communication 4 , waiting 2, facilities 4) and 4 serious non-DCCM issues. Forty-six considered themselves well informed and understood well the sequence of events. Forty-eight identified family and friends as primary support. Three requested information about another agency (counseling), 9 asked us to contact as further relative. A telephone bereavement service is well received by next-of-kin. Most families members resolve their early grief without external agencies but sleep and money are problems. We have improved our facilities and are addressing communication and cultural issues
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Kapoor, S. D. (1978). Application of the process in the care of an alcohol dependent client. Ph.D. thesis, , .
Abstract: Feasibility for Nursing studies component of B.A. degree, Wellington Victoria University, Wellington 1978. With health workers and clients in 4 different health districts, an Industry, Health Centre, Intermediate School and University Health and Counselling
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Houliston, S. (2007). Flight nurse perceptions of factors inflencing clinical decision making in their practice environment. Master's thesis, , .
Abstract: Flight nurse perceptions of factors inflencing clinical decision making in their practice environment: a thesis presented in partial fulfilment of the requirements for the Degree of Master of Nursing at the Eastern Institute of Technology, Taradale, New Zealand
The research project sought to describe the flight nurses perceptions about the factors that influence clinical decision making in their flight nursing practice, using a descriptive survey methodology. Themes emerged as factors which participants perceived influenced clinical decision making in their flight nursing role and in the aeromedical role. These themes included pre-flight preparation, patient status, experience and education of the nurse, and the challenges associated with the physical and atmospheric environments.
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Golding, C. (2012). Clinical supervision for general nurses in NZ: the imperative of finding a way forward -- nurses perceptions of professional/clinical supervision. Master's thesis, Auckland University of Technology, .
Abstract: Focuses on two broad themes: perceptions and attitudes of general nurses in in-patient hospital settings towards clinical supervision and how they have found such support to be of benefit to themselves or their practice; organisational documentation policies and procedures available to nurses in order to understand their contribution to, and valuing of, clinical supervision. Seeks to discover whether there is evidence of other factors influencing the provision of, or access to, clinical supervision by general nurses, which influences attitudes and perceptions.
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Casey, H. (2000). Empowerment: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area. Ph.D. thesis, , .
Abstract: For nurses to have control over their practice they need to have input into policy development. Nurses having control over their practice has been linked to nursing empowerment. Therefore the question explored in this research project is: What can nurse leaders do to encourage an empowering environment for nurses working in the mental health area? The literature reviewed for this project includes empowerment, power, the history of nursing in relation to women's role in society, oppression and resistance, and literature on Critical Social Theory as the underlying theoretical and philosophical position which informs the research process. In order to answer the research question a single focus group was used to gather data from a group of registered nurses practising in mental health. Focus groups as a data collection method produce data and insights that would be less accessible without the interaction found in the group. The key themes to emerge from the data analysis were: power is an important component of empowerment and power relationships; and at a systems level, professional, organisational, and political influences impact on feelings of empowerment and/or disempowerment. These key themes are discussed in relation to the literature and the broader social and cultural context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations for nurse leaders who aim to provide an empowering environment for nurses practising in mental health.
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McKenna, B., Poole, S., Smith, N. A., Coverdale, J., & Gale, C. (2003). A survey of threats and violent behaviour by patients against registered nurses in their first year of practice (Vol. 12).
Abstract: For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes.
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McKenna, B., & Poole, S. (2001). Debating forensic mental health nursing [corrected] (Vol. 7).
Abstract: Forensic mental health nursing roles have developed along different lines in the United States and the United Kingdom. The authors suggest that New Zealand nurses consider the evolution of such roles here.
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Marshall, K. (2007). Enteral nutrition within 72 hours after spinal chord injury: Complexities and complications. Ph.D. thesis, , .
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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Hall, J. (2004). Building trust to work with a grounded theory study of paediatric acute care nurses work. Ph.D. thesis, , .
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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Sherrard, I. M. (1996). Living with a damaged body. Ph.D. thesis, , .
Abstract: Grounded theory was used to investigate the lives of quadriplegic people living in the community. The model indicates that people move between dependence and independence according to several factors
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Hand, K. (1984). Nursing, alcohol and the social model: a study of nurse attitudes. Ph.D. thesis, , .
Abstract: Health professionals, as well as clients, appear to often miss, ignore or avoid alcohol as a health problem. Changes in role for Nurses as well as changes in concepts of alcoholism, alcohol and alcohol control especially in sociological terms led to this study of Nurse's attitudes to alcohol as a social issue. Aim was to shed light on the adequacy of Nurses to function in the community and in the application of sociologically oriented programs of alcohol control. 44 Student Nurses on the point of entering clinical practise were questioned on 21 attitude items. Their responses were compared to those of 100 respondents selected as comparable demographically from 10,000 New Zealanders surveyed in 1978-79 by A.L.A.C. Differences were found, but no strong profile of distinctive 'nurse' views could be identified with confidence. No real extra concern for alcohol issues could be established giving some doubts about the efficiency of Nurses in the workplace. Nurses did differ in some areas of social viewpoints from the general New Zealand population but further studies are needed to more exactly define dimensions of these differences
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Rayat, P. (2001). The relationship between job satisfaction and professional development in nursing: A socio critical outlook.
Abstract: Health reforms, reviews and restructuring are not new to New Zealand nursing. The author notes that changes in the environment have created many pressures on nursing as a profession. The profession is trying to deal with this turmoil in a responsible fashion. It is also trying to grow and develop at the same time. This research is focused on finding the relationship between job and professional development. It also highlights the factors that affect job satisfaction and professional development.
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Elliott, M. M. (2006). Model of care development: Moving between liaison and complex care coordination in the community health setting.
Abstract: Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services.
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