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Scrymgeour, G. (2005). Using diagnostic reasoning in nursing practice: Ectopic pregnancy: A case study approach. Available online at Eastern Institute of Technology, 13(1), 13–17.
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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Macfie, B. (2006). Assessing health needs and identifying risk factors. Kai Tiaki: Nursing New Zealand, 12(6), 16–18.
Abstract: In 2004, Plunket nurses from eight areas around New Zealand participated in collecting data for a research project on health needs assessment practices. This project aimed to examine risk factors identified by Plunket nurses, what areas of health need considered to be priorities; grading of health needs; and how closely the results of health need assessment aligned with the individual clients' deprivation score. The researchers examine the assessment of health needs against the use of the Deprivation Index, which indicates a specific population in a specific area, as a funding model. This study appeared to show there are two distinct groups of clients assessed as high needs: those with risk factors such as family violence and severe parental mental illness, and who may live in an area of 1-7 deprivation; and those with multiple risk factors which include poverty, low education, and/or reluctance to access services and support, and who usually live in dep 8-10 areas. This research supports the anecdotal evidence that significant health needs exist outside the lower deprivation areas.
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Holloway, K. T. (2000). The future for nursing education: UKCC review has relevance for New Zealand. Nursing Praxis in New Zealand, 16(2), 17–24.
Abstract: The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation.
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Hunt, M. (2006). Nurses can enhance the pre-operative assessment process. Kai Tiaki: Nursing New Zealand, 12(10), 20–22.
Abstract: This reports on an initiative at Whakatane Hospital, where a Nurse-Led pre-assessment (NLPA) was delivered at an outpatients clinic. NLPA involves taking a comprehensive medical history, a nursing assessment, physical examination, airway assessment, ordering appropriate investigations and carefully documenting the process and results. More valuably, it provides an opportunity for the patient to participate in planning their care. The aim of this initative was to short circuit delays and congestion in existing pre-assessment clinics, streamline the pre-assessment process and reduce the number of patient visits to hospital. Reducing cancellations of surgery (often on the day of surgery) and “did not appear” (DNA) numbers were also objectives. After a small pilot, a six-month trial was funded by the Ministry of Health. Over the six-month trial, 373 patients attended NLPA; 178 patients required anaesthetist review before surgery, and 198 could proceed directly to surgery following NLPA. An anonymous postal survey was made of patients, who indicated satisfaction with the service. Other outcomes are discussed, and the trial was deemed successful. Follow up plans have been disrupted by restructuring at the hospital and the clinic has yet to be implemented.
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Neville, S. J., & Gilmour, J. A. (2007). Differentiating between delirium and dementia. Kai Tiaki: Nursing New Zealand, 13(9), 22–25.
Abstract: Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources.
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Garcia, A., Whitehead, D., & Winter, H. S. (2015). Oncology nurses' perception of cancer pain: a qualitative exploratory study. Nursing Praxis in New Zealand, 31(1), 27–33.
Abstract: Undertakes research to explore how oncology nurses perceive cancer pain in patients. Presents the findings of semi-structured interviews with a sample of 5 registered nurses working in a NZ oncology ward, who reported their responses to under-treatment of cancer pain. Highlights the need to explore cancer pain management with patients.
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Palmer, S. G. (2003). Application of the cognitive therapy model to initial crisis assessment. International Journal of Mental Health Nursing, 12(1), 30–38.
Abstract: This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
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Fitzgerald, S., Tripp, H., & Halksworth-Smith, G. (2017). Assessment and management of acute pain in older people: barriers and facilitators to nursing practice. Australian Journal of Advanced Nursing, 35(1). Retrieved June 28, 2024, from https://www.ajan.com.au/
Abstract: Examines the pain management practices of nurses, and identifies barriers and facilitators to the assessment and management of pain for older people, within the acute hospital setting.
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Moana, B., Crawford, R., & Isaac, D. (2017). Discussing sexual health with older clients: are primary health care nurses sufficiently prepared? Whitireia Nursing and Health Journal, (24), 63–67.
Abstract: Reports some findings of a study which examined primary health care (PHC) nurses' preparedness for engaging older adults in conversation about sexual health research. Examines the experiences and beliefs of PHC nurses working with older clients. Conducts three focus groups with 16 participants who discussed their experiences, values and perceptions of conversations on sexual health with older clients.
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Quiding, J. (2021). Improving assessment inter-rater reliability of a nursing ePortfolio: An Integrative Review. Master's thesis, Auckland University of Technology, Auckland. Retrieved June 28, 2024, from http://hdl.handle.net/10292/13959
Abstract: Analyses 13 articles using an integrative review methodology framework and thematic analysis to support the data analysis process, seeking to clarify the inter-rater reliability of nursing ePortfolio assessment. Identifies two themes emerging from the data: the subjective nature of the assessor, and external factors due to the nature of nursing portfolio requirements. Considers how to minimise assessment variability due to subjective factors.
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Hardy, D. J., O'Brien, A. P., Gaskin, C. J., O'Brien, A. J., Morrison-Ngatai, E., Skews, G., et al. (2004). Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand. Journal of Advanced Nursing, 46(1), 95–109.
Abstract: The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
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Kennedy, W. L. (2008). How do Registered Nurses utilise self assessment and performance appraisal to inform their professional practice? Master's thesis, Eastern Institute of Technology, Taradale. Retrieved June 28, 2024, from https://www.nzno.org.nz/resources/library/theses
Abstract: Describes an exploratory study of Registered Nurses (RNs) within a local District Health Board which pursued the question of 'if' and 'how' professional practice frameworks assisted nurses in their individual professional practice, specifically self-assessment and performance appraisal. Utilises a qualitative descriptive framework to explore the experiences of RNs in inpatient settings, via questionnaire. Identifies 8 themes related to self-assessment, performance appraisal, and professional practice.
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Harvey, G. (2022). 'Thank you for telling our story...': An exploration of the needs of migrant nurses undergoing competence assessment for New Zealand registration. Master's thesis, Otago Polytechnic, Dunedin. Retrieved June 28, 2024, from https://hdl.handle.net/10652/5972
Abstract: Seeks to give voice to migrant nurses, using case-study methodology to highlight their experience of the competence assessment process. Distributes a questionnaire to a group of 22 newly-arrived IQNs, and conducts interviews with 10 IQNs who had been working in NZ for several years. Uncovers the motivations among the first group and reflections on the Competence Assessment Programme (CAP) among the second. Makes recommendations for CAP training based on the results of the study.
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Pitama, S., Robertson, P., Cram, F., Gillies, M., Huria, T., & Dalla-Katoa, W. (2007). Meihana model: A clinical assessment framework. New Zealand Journal of Psychology, 36(3), 118–125.
Abstract: In 1984 Mason Durie documented a framework for understanding Maori health, Te Whare Tapa Wha, which has subsequently become embedded in Maori health policy. This article presents a specific assessment framework, the Meihana Model, which encompasses the four original cornerstones of Te Whare Tapa Wha, and inserts two additional elements. These form a practice model (alongside Maori beliefs, values and experiences) to guide clinical assessment and intervention with Maori clients and whanau accessing mental health services. This paper outlines the rationale for and background of the Meihana Model and then describes each dimension: whanau, wairua, tinana, hinengaro, taiao and iwi katoa. The model provides a basis for a more comprehensive assessment of clients/whanau to underpin appropriate treatment decisions.
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Sharma, M. (2020). An exploration of the experiences of registered nurses working in aged residential care facilities regarding interRAI: A qualitative research design. Master's thesis, University of Otago, Dunedin. Retrieved June 28, 2024, from http://hdl.handle.net/10523/10009
Abstract: Assesses the experiences of registered nurses (RNs)working in aged residential care facilities in Christchurch, in performing interRAI assessments using interRAI MOMENTUM software. Explores the positive and negative aspects of their experiences and the factors affecting performance of interRAI-based comprehensive health assessments. Identifies the aids and barriers faced by RNs in applying and using interRAI. Conducts focus-group interviews with 7 RNs. Highlights the need for a unified standard assessment system.
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