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Author  |
Paterson, J.E. |
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Title |
Nurses' clinical decision-making: The journey to advancing practice |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Pages |
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Keywords |
Clinical decision making; Mentoring; Nursing; Nurse practitioners |
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Abstract |
This dissertation reports on a scholarly journey to better understand the processes of clinical decision-making by nurses. It begins by identifying the various terms used to describe a clinical decision, its components and the contexts within which clinical decisions are made. Two philosophies of decision-making are summarised. Some insight into the history of the phenomenological and the rationalist theories of decision-making is offered. The author notes that it became evident that both of these theories are applicable to all nurses and their clinical decision making competencies. Four studies that were undertaken to analyse the decision-making methods of nurse practitioners are critiqued. Of the studies two are British, one is American and one is Australian. The author has summarised the combined findings that identified that the nurses were using a blend of decision-making processes that involved rational decision making as well as the use of intuition. The studies identified that sound clinical decision-making is determined by appropriate educational and clinical preparation and supported by a formal mentoring process and the use of critical reflective practice. In conclusion, the author reflects on her knowledge of decision making prior to embarking on the dissertation and states her intent to facilitate and support advanced decision-making by her colleagues. She goes on to say that uppermost is the need for an institutional and managerial environment that encourages advanced and independent decision-making by nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
681 |
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Author |
Paterson, M. |
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Title |
Dealing with life and death decisions |
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Journal Article |
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Year |
2000 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
6 |
Issue |
7 |
Pages |
14-16 |
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Keywords |
Ethics; Nursing; Patient rights; Clinical decision making; Euthanasia |
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Abstract |
This article examines the implications for nurses of not-for-resuscitation orders and orders to withdraw treatment. The rights of patients and correct procedure in the case of not-for-resuscitation or do-not-resuscitate orders are considered, as well as the ethical dilemma facing nurses in cases of the withdrawal of treatment. Guidelines are offered to assist nurses in reaching an ethical decision to withdraw treatment. Euthanasia is defined and case law decisions on not-for-resuscitation and treatment withdrawal are cited. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1017 |
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Author |
Paton, B.; Martin, S.; McClunie-Trust, P.; Weir, N. |
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Title |
Doing phenomenological research collaboratively |
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Journal Article |
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Year |
2004 |
Publication |
Journal of Continuing Education in Nursing |
Abbreviated Journal |
Wintec Research Archive |
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Volume |
35 |
Issue |
4 |
Pages |
176-181 |
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Keywords |
Qualiltative research; Nursing research; New graduate nurses |
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Abstract |
The purpose of this article is twofold. The first is to clarify some of the challenges experienced while conducting collaborative research and describe the steps taken to ensure consistency between the purpose of the research and the phenomenological research design used to explore the learning that nursing students acquire in their final clinical practicum. Second, it was thought that by illuminating this learning, registered nurses working as preceptors and those supporting new graduates could gain insight into the complexities of learning the skills of safe and competent practice from the student's perspective. This insight is essential in creating a strategy between education and practice to minimise the duplication of learning opportunities and lessen the cost of supporting newly registered nurses, which may be at the expense of investment in the professional development of experienced registered nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1202 |
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Author |
Paton, B.I. |
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Title |
Unready-to-hand as adventure: Knowing within the practice wisdom of clinical nurse educators |
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Year |
2003 |
Publication |
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Abbreviated Journal |
NZNO Library, Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Education |
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Abstract |
This research aims to clarify the knowing and wisdom that inform clinical nurse educators' responses through unpredictable situations. The author referred to philosophical literature on the notions of tacit knowledge, practical wisdom, smooth activity and the Unready-to-Hand experience. She created an explanatory framework and utilised this in a thought experiment by reflecting on personal experiences. To add clarity to these reflections, two layers of interviewing with nurse educators teaching in practice were carried out. The first layer was an interview with eight clinical nurse educators who in their role experienced Unready-to-Hand situations. The second layer consisted of four clinical nurse educators who volunteered to be involved in more in-depth interviews. An interpretive analysis of these clinical nurse educators stories illuminated the “Unready-to Hand as Adventure”, highlighting the uncertainty and energy associated with opening in the adventure, not knowing what will unfold, yet committed to remaining engaged and doing the best they can. Through the process of attuning to difference, accessing and deciphering knowing, nurse educators create meanings of situational complexities. By preserving the ideals of good practice and engaged caring, nurse educators salvage learning by creating opportunities for learning and teaching. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1134 |
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Author |
Patrick, S. |
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Title |
A nursing role in rural adolescent sexual health |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Sexual health; Adolescents; Nursing; Rural health services |
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Abstract |
This dissertation explores the nurse's role in addressing the sexual health needs of a rural adolescent community in New Zealand. The increasing incidence of adolescent sexual activity is widely recognised and it is acknowledged that youth face unique barriers to health care. These barriers are particularly apparent in access to contraception with a resulting increase in the rates of sexually transmitted infections, unintended pregnancies and termination of pregnancies. These deteriorating adolescent sexual health statistics are of particular concern within New Zealand's health sector. A review of national and international literature examined the potential nursing role in adolescent sexual health. Results provide strong evidence that experienced nurses can competently and confidently assist in meeting the needs of this population group, especially in rural areas. Literature consistently concluded that nurses could provide care that is as effective as that provided by a doctor. School-based health clinics are identified as a viable way to improve access to adolescent sexual health services. In conclusion, the author suggests that nurses are in a key position to provide an alternative model of health care delivery that can improve adolescent sexual health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
821 |
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Author |
Payne, D.; Goedeke, S. |
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Title |
Holding together: Caring for clients undergoing assisted reproductive technologies |
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Journal Article |
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Year |
2007 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
60 |
Issue |
6 |
Pages |
645-653 |
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Keywords |
Nursing specialties; Sexual and reproductive health; Communication; Multidisciplinary care teams |
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Abstract |
This paper reports a study to investigate the roles and experiences of nurses caring for clients undergoing assisted reproductive technologies (ART). Nurses are in a potentially unique position in the assisted reproductive technology environment as they maintain a more constant contact with the client. A qualitative approach was taken and a convenience sample of 15 nurses from New Zealand was interviewed in 2005. Data were analysed using interpretive description. The overarching theme identified was that of the potential role of the nurse to 'hold together' multiple components of the assisted reproductive technology process: holding together clients' emotional and physical experiences of assisted reproductive technologies; holding together the roles of different specialist team members; and holding together personal own emotions. It encompasses practices such as information-giving, interpreting, supporting and advocating. The researchers note that recognition of and support for the complexity of the role of ART nurses may positively contribute to clients' experiences. |
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Call Number |
NRSNZNO @ research @ 985 |
Serial |
969 |
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Author |
Payne, Sharon |
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Title |
The nurse's role in promoting health of vulnerable children (0-5 yr olds) through coordinated care: Margaret May Blackwell Study Fellowship |
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Report |
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Year |
2007 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
50 p. |
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Keywords |
Child health services; Hospitals; Emergency services; Reports |
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Abstract |
Explores the provision of emergency paediatric care internationally. Visits children's hospitals in the US, Canada, the UK and Australia. Part of the Margaret May Blackwell Scholarship Reports series. |
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Call Number |
NZNO @ research @ |
Serial |
1416 |
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Author |
Peach, J. |
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Title |
The contribution of nursing to the health of New Zealand |
Type |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Health status |
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Abstract |
Nursing in New Zealand has been a recognised profession for one hundred years. Throughout this time the profession has made a significant contribution to the health of communities, nationally and internationally. Despite the obvious effort and achievement, the author suggests that the evidence of this contribution is not well known. She goes on to say that nurses, now as never before, are challenged to show how they 'add value' and to explain why nursing expertise is essential to safe service delivery. Finding a way to communicate this contribution has been identified as one of the most important issues facing the profession. This thesis explores the concept of contribution and presents a model, the 'Contribution Model', to show how nursing can articulate the action and achievements that show how nursing professionals have and will continue to contribute to health gain in New Zealand. Through the application of the 'Contribution Model' and framework presented in this thesis, nursing is shown to have made a contribution to health gain by using the broad range of knowledge, skills and experiences in a wide range of settings, to provide care wherever and whenever required. Case studies and scenarios from history, observation and prediction are used to show how the actions and achievements of nursing meet the expectations of individuals, the community and society: past, present and future. |
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Call Number |
NRSNZNO @ research @ 501 |
Serial |
487 |
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Author |
Peach, J. |
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Title |
The Professional Development Programme: Achievements and outcomes |
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Journal Article |
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Year |
1999 |
Publication |
Professional Leader |
Abbreviated Journal |
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Volume |
5 |
Issue |
1 |
Pages |
6-9 |
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Keywords |
Professional development; Evaluation; Nursing |
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Abstract |
This article backgrounds the professional development programme instigated at Auckland Hospital in 1988, and reviews the achievements of the past 10 years. It describes PDP and distinguishes it from a clinical career pathway. Specific indicators were used to assess the achievement of the programme, and these are presented. Overall the programme achieved it's outcomes and at a reasonable cost. |
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Call Number |
NRSNZNO @ research @ 1289 |
Serial |
1274 |
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Author |
Peach, J.; Hall, B. |
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Title |
Professional boundaries: Being in relationship 'with' yet remaining separate |
Type |
Journal Article |
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Year |
1999 |
Publication |
Professional Leader |
Abbreviated Journal |
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Volume |
5 |
Issue |
1 |
Pages |
16-18 |
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Keywords |
Nurse-patient relations; Professional competence |
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Abstract |
This article describes the management of the therapeutic relationship, that is set up between nurses or midwives and those in their care. It reviews the responsibilities of the health practitioner, and looks at issues around boundaries, confidentiality and accountability. It also looks at the role senior colleagues can play in ensuring this intentional relationship is managed professionally. |
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Call Number |
NRSNZNO @ research @ 1288 |
Serial |
1273 |
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Author |
Pearce, K. |
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Title |
Orientation: Reading the nurses map; what new Plunket Nurses need in an orientation programme |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Plunket; Training; New graduate nurses; Curriculum; Community health nursing |
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Abstract |
The Plunket orientation programme, first implemented in 1994, aims to prepare new Plunket Nurses for autonomous practice within the complexity of community based nursing. This study seeks to identify what new Plunket Nurses feel are their orientation needs. An evaluation research approach was used. An examination of the literature explored how orientation is conducted and the needs of nurses in orientation. Key aspects in relation to orientation were identified as including socialisation, job change, new graduates, preceptorship, orientation frameworks and retention. A focus group followed by a postal survey were utilised to collect data from new Plunket Nurses nationwide to ascertain what they thought their orientation needs were. Data analysis was completed using descriptive statistics and thematic analysis. The results of the study identified key orientation needs for new Plunket Nurses. These were an orientation programme, preceptorship, clinical skills teaching, time in own area and beginning autonomous practice, administration needs and support needs. The participants recommended quality preceptorship and early clinical teaching from the Clinical Educator. There was a general dissatisfaction with orientation as it stands in preparing them for their role as a Plunket Nurse. Recommendations to the Plunket Management Team were made based on the results of this study. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1240 |
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Author |
Pearce, L.; Cuthbertson, S.; Streat, S.J.; Hay, D. |
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Title |
Dental hygiene in the critically ill: a randomised controlled trial of three methods |
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Year |
1996 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital, Private Bag 92024, Auck |
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Pages |
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Abstract |
Introduction Critically ill patients cannot clean their own teeth. A variety of methods are used but as the best method is unknown we performed a prospective randomised double-blind controlled trial of three methods.Method Of 359 consecutive admissions to the Department of Critical Care Medicine between 31/01/97 and 25/05/97, 222 were excluded (62 edentulous, 6 unexaminable, 142 transferred alive and 12 dead or dying at 24 hours). The remaining 137 patients had quantitative (picture-linked, ordinal score) assessment of caries, peridontal status and plaque (in 12 segments of teeth) before randomisation (to the use of either toothbrush, jumbo swab or sonic toothbrush) by pre-assigned sealed envelopes. All teeth were cleaned (prescribed four hourly) with 0.2% chlorhexidine solution. Daily plaque scores were obtained (by an assessor (SC) blind to treatment allocation) until withdrawal, death or transfer.Results Toothbrush Jumboswab SonicPatients assigned 50 48 39Withdrawn within 24hrs. 9 3 5Patients remaining 41 45 34Percentage of teeth segments thatare pristine: pre treatment 45 50 51 after 2 days 74 57 90 F(2.63) = 5.00 p = 0.0097 More withdrawals for patient noncompliance after randomisation occurred in the sonic group (5/34 versus 3/86). Conclusion. By the second day the sonic toothbrush was the most effective in plaque removal with the toothbrush the next most effective method |
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Call Number |
NRSNZNO @ research @ 203 |
Serial |
203 |
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Author |
Pearce, L.; Kirkham, S.; Cuthbertson, S. |
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Title |
Quality of follow-up for self-poisoning patients after discharge from intensive care: 1996, one year later |
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Year |
1996 |
Publication |
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Abbreviated Journal |
DCCM, Auckland Hospital, P.O.Box 92024, Auckland |
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Pages |
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Abstract |
In 1995 we conducted a retrospective audit on a prospectively collated database to find out which intensive care patients missed out on psychiatric care after self poisoning. Our results showed that 57 patients in 1995 may not have received psychiatric follow-up assessment. Department of Critical Care Medicine (DCCM) follow-up was also less successful for this particular group. It was recommended that on admission to intensive care, all self poisoning patients would be referred to the Liaison Psychiatry Service (LPS).In 1996 we reviewed the databases of DCCM and LPS to determine if the quality of psychiatric follow-up had improved after the initial 1995 audit. In 1996 124 patients had 149 admissions (85F, age range 14.6-85.3, median 35, median GCS 9, 99 ventilated, 3 deaths). Thirteen patients had 25 admissions within 6 months of their index admission , 7/13 had a major psychiatric disorder. Mixed poisoning remained common. Forty-five admissions took cyclic antidepressants, 21 sedatives, 52 other medications, 25 ethanol (median 43 mmol/l ), 30 carbon monoxide and 5 took various non-prescription poisons.Thirteen went home, 32 to other hospitals, 4 to psychiatric hospitals and 97 were transferred to wards within Auckland Hospital. Psychiatric follow-up assessment was successful in 96/97 patients prior to discharge from Auckland Hospital. Those discharged to other hospitals or home were referred and followed up by LPS teams or other Mental Health Services.DCCM follow-up 4-6 weeks post discharge was more successful for 1996 with 120/146 contacted of which 33/120 were receiving ongoing psychiatric care. |
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Call Number |
NRSNZNO @ research @ 207 |
Serial |
207 |
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Author |
Pearson, J.R. |
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Title |
A discussion of the principles of health promotion and their application to nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Whitireia Nursing Journal |
Abbreviated Journal |
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Volume |
10 |
Issue |
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Pages |
23-34 |
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Keywords |
Health promotion; Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1088 |
Serial |
1073 |
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Author |
Pearson, J.R. |
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Title |
Health promotion in one New Zealand primary school: A case study |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Health promotion; Evaluation; Students; Maori; Pacific peoples; Health education |
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Abstract |
The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1184 |
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