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Author |
McLoughlin, N. |
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Title |
Dying to know: Advancing palliative care nursing competence with education in elderly health settings |
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Year |
2007 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Professional development; Nursing specialties; Palliative care; Nursing; Education |
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Abstract |
This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities. |
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Call Number  |
NRSNZNO @ research @ |
Serial |
1190 |
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Author |
Holloway, K. T.; Pearson, J.R. |
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Title |
Trailblazers: Primary health care programme evaluation |
Type |
Conference Article |
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Year |
2005 |
Publication |
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Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
Paper presented June 2004 at Royal New Zealand Plu |
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Keywords |
New graduate nurses; Primary health care; Evaluation research; Professional development |
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Abstract |
This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1200 |
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Author |
Clunie, S. |
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Title |
The current trend and importance of postgraduate education for nurses |
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Journal Article |
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Year |
2006 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
10 |
Issue |
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Pages |
18-23 |
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Keywords |
Nursing; Education; Professional development; Leadership; Policy |
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Abstract |
The purpose of this essay is to examine why postgraduate education has become so important, to examine some of the issues around mandatory continuing education and the practical effect of this on a nursing career. Four strategies from the Ministry of Health, designed to facilitate changing nurse education, are discussed. The importance of Professional Development Recognition programmes is discussed along with the need for strong nursing leadership. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1207 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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Author |
Turnwald, A.B. |
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Title |
Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department |
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Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Issue |
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Pages |
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Keywords |
Chronically ill; Clinical assessment; Emergency nursing |
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Abstract |
A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1210 |
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Author |
Kuehl, S. |
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Title |
Emergency Department re-presentations following intentional self-harm |
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Year |
2008 |
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 |
Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment |
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Abstract |
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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1214 |
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Author |
Fairhall, M. |
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Title |
An observational study of Peripherally Inserted Central Cather(PICC)-related complications amongst oncology patients |
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Year |
2008 |
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 |
Patient safety; Equipment and Supplies; Nursing specialties; Cancer; Oncology |
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Abstract |
This thesis reports on a retrospective observational study that examined the complication rate of peripherally inserted central catheters (PICCs) within a regional cancer centre. PICCs are increasingly used for delivery of chemotherapy and other intravenous therapies in oncology patients. A literature review revealed that almost all published research on PICC complications reported on silicone (Groshong(TM)) catheter use, rather than the polyurethane (Arrow(TM)) PICCs used at Christchurch Hospital. Also, much literature referred to PICCs being inserted by non-nurses, whereas the Christchurch service uses specially-trained nurses to insert them. The purpose of the study was to identify the nature, incidence and rates of polyurethane (Arrow(TM)) PICC complications in an adult oncology cohort. Ethics Committee approval was gained to retrospectively follow all PICCs inserted in adult oncology patients at Christchurch Hospital over a 13-month period from 1st March 2006 until 31st March 2007. Data collected were analysed utilising the statistical computer package SPSS. One hundred and sixty-four PICCs were inserted into 156 individual oncology patients over this period. The median dwell time was 68 days for a total of 14,276 catheter-days. Complications occurred in 25 (15%) out of 164 PICC lines, in 22 (15%) of the 156 patients for an overall complication rate of 1.75 per 1000 catheter-days. However, only 16 of the 25 PICCs with complications required early removal (9.75% of the cohort) for a favourably low serious complication rate of 1.12 per 1000 catheter-days. The three commonest complications were infection at 4.3% (7/164) or 0.49 infection complications/1000 PICC-days, PICC migration at 3% (5/164) or 0.35/1000 catheter days, and thrombosis at 2.4% (4/164) or 0.28/1000 catheter days. The median time to complication was 41 days. Those with complications were more likely to have a gastro-intestinal or an ovarian cancer diagnosis, and less likely to have colorectal cancer. These findings provide support for the safe and effective use of polyurethane (Arrow(TM)) PICCs for venous access within the adult oncology context. Furthermore, it suggests that cost effective nurse-led (Arrow(TM)) PICC insertions can contribute to a low complication rate. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1222 |
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Author |
Lewis, T. |
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Title |
Euthanasia: A Foucauldian analysis |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ScholarlyCommons@AUT |
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Volume |
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Issue |
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Pages |
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Keywords |
Law and legislation; Euthanasia; Ethics; Pain management; Terminal care; Nursing; Palliative care |
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Abstract |
This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the “right-to-die”. It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what the author termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of “truth” regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. These findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing profession's lack of preparation to deal with euthanasia if it becomes a legal option in end of life care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1226 |
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Author |
Esera, F.I. |
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Title |
If a client is operating from a Samoan world view how can s/he be holistically and appropriately treated under the western medical model? |
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 |
Mental health; Psychiatric Nursing; Cultural safety; Cross-cultural comparison; Pacific peoples |
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Abstract |
This paper is an analysis of the cultural and traditional factors that the author presents as essential considerations in the treatment of Samoan people who have been diagnosed with a mental illness. Just as important to any clinical diagnosis, is the spiritual nature of Samoan culture and traditions, which inform belief systems. A full understanding of these will explain how the traditional beliefs and cultural values of Samoan people have an impact on their perception of mental illness, its causes and cures. The thesis places emphasis on 'ma'i -aitu', the Samoan term for most ailments pertaining to the mind or psyche. The focus is on defining 'ma'i -aitu' as part of a Samoan world view and likewise a description of a similar type of manifestation in the Papalagi (western) context of a psychiatric disorder and how treatment and management is usually undertaken. The issues addressed in this paper aim to highlight the Samoan client's world view from a Samoan perspective of mental illness which then poses the question of how they can be managed holistically and appropriately under the Papalagi medical system. Furthermore, it questions if the traditional belief system of Samoans run deeper than originally thought and can the replacement thereof by a foreign culture be responsible for the increased mental problems in Samoans living in New Zealand? This paper emphasises the importance of integrating the western medical model and Samoan health models, for appropriate mental health service delivery to Samoan people. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1231 |
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Author |
Lyall, C. |
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Title |
Therapeutic relationships: What are inpatient registered nurses perceptions of the factors which influence therapeutic relationship development? |
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Year |
2003 |
Publication |
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Abbreviated Journal |
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 |
Psychiatric Nursing; Registered nurses; Nurse-patient relations; Mental health |
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Abstract |
The question explored in this research project is: What are inpatient registered nurses' perceptions of the factors which influence therapeutic relationship development? The literature reviewed for this project includes the history of interpersonal relationships in nursing; therapeutic relationships; what constitutes these relationships. Also discussed is literature about phenomenology as the underlying theoretical and philosophical position that informs the research method. To answer the research question a single focus group was used to gather data from a group of registered nurses practising in inpatient mental health units. Focus groups as a data collection method produce data and insights that would not be accessible without the group interaction. The key themes to emerge from the data analysis were; time, environment, knowing / self-awareness, compassion and power imbalance / empowerment. These key themes are discussed in relation to the literature and the wider context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations to nurses, nurse leaders and managers who aim to provide therapeutic mental health unit environments. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1245 |
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Author |
Wilson, L.J. |
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Title |
Futurist planning, not a shortage stopgap: Recruitment and retention of registered nurses in New Zealand |
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Year |
2001 |
Publication |
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Abbreviated Journal |
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 |
Recruitment and retention; Registered nurses; Policy; Careers in nursing |
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Abstract |
This literature review critically examines contributing factors to the current nursing shortage in New Zealand, centering on recruitment and retention of registered nurses. There is a dramatic widening between the supply of registered nurses and the demand for their services. All regions in New Zealand are reporting difficulty in hiring experienced and specialty nurses, and recruiting time is lengthening. This report suggests that the shortage is closely linked to factors in the nursing care environment. As a result of multiple factors during the centralising, cost-containing, acuity-increasing decade of the 1990s, the care environment has driven practising nurses out of acute care settings and discouraged new students from entering the profession. The availability of numerous alternative career opportunities has heightened the effect. Continuing causes to the non-selection of nursing as a profession are the influences of wage compression and limited career progression over the lifetime of the nurse, and insufficient orientation and mentoring of new nurses. Recent changes in the health care system have gone unevaluated and without oversight by nursing regulatory agencies – a situation not in the best interests of patients or nurses. A number of both literature-supported and resourceful approaches, including recommendations towards addressing the nursing shortage are proposed in this review. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1258 |
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Author |
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Title |
Dementia care: A literature review |
Type |
Journal Article |
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Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
13 |
Pages |
33-36 |
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Keywords |
Dementia; Nurse-patient relations; Quality of health care; Nursing; Education |
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Abstract |
This article defines dementia, and explores recent trends in relation to why it is such a misunderstood condition in the health care setting. Within a theoretical framework of literature development, nurse client relationships, and quality of care and attitudes are analysed. Gaps, inconsistencies and consistencies are outlined, with the implications for nursing practice and education explored. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1279 |
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Author |
MacDonald, R. |
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Title |
Mammography screening for breast cancer: Does it reduce the mortality rate? |
Type |
Journal Article |
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Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
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Volume |
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Issue |
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Pages |
8-12 |
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Keywords |
Breast cancer; Screening; Risk management; Health education; Cancer |
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Abstract |
This paper critically examines the literature on mammography as a breast cancer screening modality. It looks at what the New Zealand consumer is being told about the scientific uncertainties about the effectiveness of mammography and the substantial risks involved with it. This literature review raises concerns about the lack of information available for healthy women to make a fully informed decision about mammography screening. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1304 |
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Author |
Scrymgeour, G. |
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Title |
Using diagnostic reasoning in nursing practice: Ectopic pregnancy: A case study approach |
Type |
Journal Article |
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Year |
2005 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online at Eastern Institute of Technology |
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Volume |
13 |
Issue |
1 |
Pages |
13-17 |
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Keywords |
Nursing; Pregnancy; Clinical assessment |
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Abstract |
This paper explores, through the use of a case study, an evidence-based diagnostic reasoning process utilising the framework followed by Dains, Baumann and Scheibel (1998). This framework, as described by these authors, involves an inductive process of reasoning, which leads to formulation of a hypothesis that is then analysed using an evidence-based approach. From this analysis, a likely diagnosis can be made and appropriate therapeutic intervention initiated. This research demonstrates that although an evidence-based approach is the ideal, sometimes clinical intuition is equally important to the clinical outcome. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1305 |
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Author |
Wiffin, L. |
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Title |
Treating depression during pregnancy: Cognitive behavioural therapy as a treatment option |
Type |
Journal Article |
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Year |
2006 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
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Volume |
14 |
Issue |
1 |
Pages |
8-12 |
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Keywords |
Pregnancy; Mental health; Stress |
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Abstract |
This article reviews the use of cognitive behavioural therapy (CBT) for pregnant women suffering from depressive symptoms. CBT provides a structured, short-term, collaborative process between clinician and client, using strategies and techniques to identify dysfunctional thinking and beliefs, challenge and change these beliefs, then implement new rational beliefs and behaviours. A process of engagement, assessment and conceptualisation is followed by treatment planning and implementation, and modification of dysfunctional thinking and behaviours. Use of CBT to treat depression in women during pregnancy is supported by the literature, especially where pharmacological intervention is declined or contraindicated. Pregnancy can bring stressors that combine with biological factors and core beliefs to contribute to depressive symptoms. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1308 |
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