Abstract: This literature review presents evidence on health professionals' practice in hand washing. The research was primarily quantitative and consistently showed that health professionals did not have a lack of knowledge, but that hand washing was not always done. More qualitative research is required to investigate reasons for this and possible interventions.

Abstract: Investigates nurses' catheter management practices, by means of an audit, as documented in a newly-introduced self-administered indwelling catheter-management checklist incorporating four components of catheter care in a catheter-associated urinary tract infection (CAUTI) prevention bundle. Identifies these components of the bundle of care as: minimisation of inappropriate catheter use, aseptic insertion of catheters, adherence to catheter maintenance guidelines, and ongoing review and evaluation of catheter necessity. Shows that implementation of care components decreases bacteriuria rates and CAUTI when used together in standardised clinical checklists and performed collectively by nurses. Employs a quantitative research design as part of a mixed-methods study conducted at two surgical wards in a public hospital in Auckland where 50 nurses completed 175 checklists.

Abstract: The nurse practitioner role is an important addition to nursing workforce development in New Zealand. At present there are relatively few nurse practitioners, however the number of nurses seeking Nursing Council endorsement continues to grow. These nurses are in a unique situation as pioneers having achieved the highest level of autonomous advanced nursing practice. This position will bring with it many challenges for those nurses who are among the first in the profession. Traditionally, nurses have always had formal and informal methods of support such as preceptors, role models and the hierarchy of nursing to help and guide them in their work. This network has generally been comprised of nurses more senior and qualified than the nurse needing support. Yet the nurse practitioner, considered to be the leading clinical nurse in New Zealand, may have very limited resources available for the clinical support needed to sustain their professional practice while keeping them refreshed, curious, creative and committed. The intent of this dissertation is to provide a framework of supportive mechanisms on which the emerging nurse practitioner can draw in their new professional domain throughout their career. The author explores the meaning of support, why there is a need for support for the nurse practitioner, the various methods of support noted in current literature and how these various methods can enhance the nurse practitioner's professional growth and development, maintain clinical safety, and foster job satisfaction.

Abstract: This thesis provides an interpretive critique of the way in which knowledge is viewed, transmitted and crystallized in the practice worlds experienced by four registered nurses working in acute care hospital settings. The theoretical assumptions of critical social theory underpin both the methodological approach (case study) and the analysis of data. In-depth unstructured interview, a critically reflexive dialogue between the investigator and participant focussed on the practice world experiences of the nurse, was the principle research method. A brief analysis of documentation was also undertaken.It is argued that previous studies related to nursing practice, and to the social worlds of nursing, have been limited by their failure to take account of the socio-political context in which nursing takes place. There has been a tendency to treat the transmission of knowledge in nursing and nursing practice process of information exchange. No account of socially generated constraints on personal and professional agency, or of systematic distortions in communication within the practice setting are therefore given.The analysis of data in this study demonstrates the way in which constraints on personal and professional agency were experienced by each of the four participants. In particular, practice expressing the participant's professional nursing knowledge and values ws often denied in the face of shared understandings reflective of the institutional ideology. These shared understandings included a belief in the legitimacy of medical domination over other social factors and the support of doctor, rather than nurse or patient, centered practices.This study demonstrates that the way that nurses and other social actors come to “know” and interpret their social worlds is dependent on the socio-political contest in which that knowledge in produced. It also shows how this knowledge may be treated ad though it were 'an object'. This tendency to treat existing social relationships and practices as 'natural' hence unchallengeable masks possibilities for transformative action within the practice of nursing.It is argued that a particular form of knowledge is required if nurses are to overcome the types of constraint experienced by these four nurses. This knowledge, emancipatory knowledge, is that developed in the process of shared, socially critical self-reflection rather than solitary, self-critical reflection

Abstract: In November 2005, the Oxford Community Health Centre (OCHC) introduced an innovative way of delivering primary health care to the residents of Oxford. This was in response to the difficulty with recruitment and retention of medical staff for the solo General Practitioner (GP) at OCHC. Primary health care services are now the shared responsibility of the Rural Nurse Specialists (RNS) and the GPs. This initiative is underpinned by a collaborative approach in sharing patient care between the GPs and RNSs to improve access to primary health care and foster staff retention. The team at OCHC is keen to consolidate and enhance the success of collaboration. Therefore, this dissertation has reviewed a range of literature in order to identify lessons that can be learned for the future. Two key factors that have implications for OCHC are the structural effects of the organisation and the interpersonal relationships between the GPs and RNSs. The structural effects include: the structure and philosophy at OCHC, and the social, cultural, and educational influences within the organisation. It is the nature of the interpersonal relationships that can affect the development and success of collaboration through a willingness to collaborate and the existence of mutual respect, trust, and effective communication between the RNSs and GPs. Strategies to foster collaboration at OCHC in the future include: staff participation in making collaboration visible within the philosophy at OCHC, a workshop for staff to further define roles and differentiate activities according to skill-mix; and the involvement of a nurse in decision-making at the organisational level. The author suggests that these strategies could also be beneficial to other rural practices that are striving to maintain a sustainable primary health care service.

Abstract: In 1991 a new labor relations regime was introduced which overturned a 100 year old pattern of 'historic compromise' between capital and labor. In a labor market structured by gender and race, this major change in bargaining arrangements has already widened the pay gap between men's and women's average earnings and reduced union coverage, particularly among women workers in low paid clerical, sales and service work. This study, documenting recent feminist struggle in the area of labor relations, provides a first look at the collective organisation of women under two different labor relations regimes.In the 1980s a particular conjunction of occupational unionism and feminism in New Zealand facilitated some significant improvements in the situation of women in paid employment. The thesis examines feminist strategies which led to a Working Women's Charter adopted by unions, an increase in women holding office in unions, complaints procedures for sexual harassment, standing committees to represent women and Maori in the union movement, and legislation to implement equal employment opportunity programmes and equal pay for work of equal value. It looks at how the institution-alisation of bargaining by occupation supported industrially weak workers and underpinned the unionisation of women, which occupational unions and women's own strategies of organisation provided the autonomous 'political space' to organise around issues specifically relevant to women.At the core of the thesis are three case studies of unions representing three of the occupations in which women are concentrated: clerical work, nursing and cleaning. It examines commonalities and contrasts in the industrial situations covered by these unions, and differences and similarities in the strategies they adopted. The focus of research, conducted between late 1990 and early1993, was the views of officials of these unions in the context of radical change in the regulation of wage bargaining. Particular attention was given to the way issues relating to women workers were prioritised in unions led by women or by men.These case studies are contextualised in chapters examining the position of women in the labor market, feminist organisation within the union movement, and corporatist change in labor relations legislation. In tracing the development of feminist unionism in the 1980s, the thesis considers the strategies of the NZ Council of Trade Unions and looks at what the radical change in bargaining structure will mean for collective organisation by women in paid employment