Abstract: This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being.

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.

Abstract: The authors discuss the usefulness of a generic tool to measure job stress in New Zealand workplaces, and report on a study using one such generic tool. The study involved sending questionnaires to all staff (193) who had worked at a regional women's health service for a minimum of six months. The mailed package contained the Job Stress Survey (JSS), the General Health Questionnaire (GHQ-12), demographic questions (including cultural safety), shift work questions, and a blank page for “qualitative comment”. Over 12,000 pieces of data were collected from the study but this article focuses only on the results of the JSS. The JSS can be used to determine a “job stress index” and can also be used to measure “job pressure” and “lack of organisational support”. For this study, job stress index scores were calculated and organised by occupational groupings. Midwives, nurses and doctors all cited inadequate or poor quality equipment, excessive paperwork, insufficient personal time, and frequent interruptions, as their top stressors. Three of these four stressors fall within the job pressure index. The results of the survey prompted organisational changes, including: extensive discussions; equipment being updated; management being made aware of the depth of concern felt by staff; the creation of a place for staff to have personal time; and coping intervention strategies were initiated. The authors suggest that no generic measure of job stress can fully evaluate stressors unique to a particular work setting. They support additional items being constructed and administered to assess stressors that are idiosyncratic to a particular occupational group.

Abstract: Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.

Abstract: The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.

Abstract: The authors defines health assessment and argue that it is a tool nurses should be using as a means of improving health outcomes for clients. The skills involved in health assessments are analysed, and four levels of data gathering are identified. The authors present an historical perspective, tracing the development of these skills as they have been incorporated in nursing practice in North America and Australia.

Abstract: Assesses the impact of a patient safety leadership walk-rounds (PSLWR) programme in an Auckland hospital to provide recommendations for programme improvement. Involves senior leaders and other departmental representatives visiting wards to conduct staff and patient interviews to capture their experiences, and to assess the environment. Proposes recommendations for organisations intending to or currently implementing a PSLWR programme.