Records |
Author |
Neville, S.J.; Gilmour, J.A. |
Title |
Differentiating between delirium and dementia |
Type |
Journal Article |
Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
|
Volume |
13 |
Issue |
9 |
Pages |
22-25 |
Keywords |
Dementia; Psychiatric Nursing; Clinical assessment; Older people |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
983 |
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Author |
Macfie, B. |
Title |
Assessing health needs and identifying risk factors |
Type |
Journal Article |
Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
|
Volume |
12 |
Issue |
6 |
Pages |
16-18 |
Keywords |
Infants; Parents and caregivers; Clinical assessment; Risk factors; Plunket |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
974 |
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Author |
Pirret, A.M. |
Title |
A preoperative scoring system to identify patients requiring postoperative high dependency care |
Type |
Journal Article |
Year |
2003 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
|
Volume |
19 |
Issue |
5 |
Pages |
267-275 |
Keywords |
Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment |
Abstract |
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions. |
Call Number |
NRSNZNO @ research @ 904 |
Serial |
888 |
Permanent link to this record |
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Author |
Hamer, H.P.; McCallin, A. |
Title |
Cardiac pain or panic disorder? Managing uncertainty in the emergency department |
Type |
Journal Article |
Year |
2006 |
Publication |
Nursing & Health Sciences |
Abbreviated Journal |
|
Volume |
8 |
Issue |
4 |
Pages |
224-230 |
Keywords |
Emergency nursing; Clinical assessment; Diagnosis |
Abstract |
This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented. |
Call Number |
NRSNZNO @ research @ |
Serial |
689 |
Permanent link to this record |
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Author |
Pitama, S.; Robertson, P.; Cram, F.; Gillies, M.; Huria, T.; Dalla-Katoa, W. |
Title |
Meihana model: A clinical assessment framework |
Type |
Journal Article |
Year |
2007 |
Publication |
New Zealand Journal of Psychology |
Abbreviated Journal |
|
Volume |
36 |
Issue |
3 |
Pages |
118-125 |
Keywords |
Nursing models; Clinical assessment; Maori; Mental health |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
459 |
Permanent link to this record |
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Author |
Bishop, D.; Ford-Bruins, I. |
Title |
Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study |
Type |
Journal Article |
Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
|
Volume |
12 |
Issue |
3 |
Pages |
203-212 |
Keywords |
Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models |
Abstract |
This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed. |
Call Number |
NRSNZNO @ research @ 1082 |
Serial |
1067 |
Permanent link to this record |
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Author |
Lesa, R.; Dixon, D.A. |
Title |
Physical assessment: Implications for nurse educators and nursing practice |
Type |
Journal Article |
Year |
2007 |
Publication |
International Nursing Review |
Abbreviated Journal |
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Volume |
54 |
Issue |
2 |
Pages |
166-172 |
Keywords |
Advanced nursing practice; Clinical assessment; Cardiovascular diseases; Nursing; Education |
Abstract |
In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing. |
Call Number |
NRSNZNO @ research @ |
Serial |
786 |
Permanent link to this record |
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Author |
Holloway, K. T. |
Title |
The future for nursing education: UKCC review has relevance for New Zealand |
Type |
Journal Article |
Year |
2000 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
16 |
Issue |
2 |
Pages |
17-24 |
Keywords |
Nursing; Education; Recruitment and retention; Clinical assessment; Policy |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
848 |
Permanent link to this record |
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Author |
Neville, S.J.; Gillon, D.; Milligan, K. |
Title |
New Zealand registered nurses' use of physical assessment skills: A pilot study |
Type |
Journal Article |
Year |
2006 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
|
Issue |
14(1) |
Pages |
|
Keywords |
Clinical assessment; Nursing; Evaluation |
Abstract |
The objective of this project was to ascertain registered nurses' use of selected physical assessment skills before and after participation in a health assessment course. A pre- (also referred to as part I) and post- (part II) test design was used to investigate the research aim. Participants were obtained via a convenience sample. A questionnaire was completed at the beginning of the educational programme and then four to six weeks after completion of the assessment course. A two tailed t-test was used to identify any significant differences in the characteristics of participants from part I (N = 206) to part II (N = 145), with no differences identified. However, there was an overall mean percentage difference of 17.1% in the use of physical assessment skills after having completed the educational programme. In conclusion, the researchers found that four to six weeks after completion of a health assessment course, nurses were using the skills learned to improve their nursing practice more frequently than before the programme. |
Call Number |
NRSNZNO @ research @ 879 |
Serial |
863 |
Permanent link to this record |
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Author |
Richardson, S.; Ardagh, M.; Hider, P. |
Title |
New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department |
Type |
Journal Article |
Year |
2006 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
Volume |
119 |
Issue |
1232 |
Pages |
|
Keywords |
Hospitals; Clinical assessment; Interprofessional relations |
Abstract |
This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept. |
Call Number |
NRSNZNO @ research @ |
Serial |
526 |
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Author |
Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B. |
Title |
Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori |
Type |
Journal Article |
Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
Volume |
116 |
Issue |
1176 |
Pages |
|
Keywords |
Advanced nursing practice; Hospitals; Clinical assessment; Evaluation |
Abstract |
Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive. |
Call Number |
NRSNZNO @ research @ 625 |
Serial |
611 |
Permanent link to this record |
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Author |
Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P. |
Title |
Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial |
Type |
Journal Article |
Year |
2002 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
Volume |
115 |
Issue |
1157 |
Pages |
|
Keywords |
Emergency nursing; Time factors; Clinical assessment; Clinical decision making |
Abstract |
The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources. |
Call Number |
NRSNZNO @ research @ |
Serial |
617 |
Permanent link to this record |
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Author |
Hunt, M. |
Title |
Nurses can enhance the pre-operative assessment process |
Type |
Journal Article |
Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
10 |
Pages |
20-22 |
Keywords |
Nursing specialties; Clinical assessment; Hospitals; Surgery |
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. |
Call Number |
NRSNZNO @ research @ 1005 |
Serial |
989 |
Permanent link to this record |
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Author |
Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N. |
Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
Permanent link to this record |
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Author |
Palmer, S.G. |
Title |
Application of the cognitive therapy model to initial crisis assessment |
Type |
Journal Article |
Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
|
Volume |
12 |
Issue |
1 |
Pages |
30-38 |
Keywords |
Mental health; Clinical assessment; Psychiatric Nursing |
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. |
Call Number |
NRSNZNO @ research @ 1085 |
Serial |
1070 |
Permanent link to this record |