Abstract: Investigates the logistics and acceptability of an electronic medication dispenser (EMD) within a home-based medication management service as a substitute for face-to-face home visiting, as a means of reminding elderly clients to take their medication on time. Uses a qualitative usability study methodology to conduct the study, centred on a small group of clients receiving the service from a small group of clients receiving the service from a community nursing organisation in Christchurch. Involves patients, pharmacists, nurses and managers of the community nursing service. Identifies critical processes and protocols required to safely support a wider roll-out of the product within the service.

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.

Abstract: This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice.

Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.

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.

Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.

Abstract: Considers whether an educational intervention in which mental illness and addiction sufferers share their personal experience with nursing students results in the development of empathy and compassion among nursing students. Incorporates five workshops into the bachelor of nursing curriculum, in which students listen to the stories told by mental health/addiction patients. Gathers accounts from students of their reactions afterwards.