McKillop, A. M. (2004). Evaluation of the implementation of a best practice information sheet: Tracheal suctioning of adults with an artificial airway. JBI Reports, 2(9), 293–308.
Abstract: This report presents an evaluation of the implementation of a best practice information sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa, based in Auckland, conducted a systematic review of the evidence and produced the best practice information sheet. A survey of 105 nurses was conducted at three sites, in New Zealand and Australia. Using a before/after design, data were collected at the time of release of the information sheet and then approximately 12 months later. The study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and the best practice information sheet.
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O'Brien, A. P., O'Brien, A. J., Hardy, D. J., Morrison-Ngatai, E., Gaskin, C. J., Boddy, J. M., et al. (2003). The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study. International Journal of Nursing Studies, 40(8), 853–861.
Abstract: This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.
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Brinkman, A., & Caughley, B. (2004). Measuring on-the-job stress accurately. Kai Tiaki: Nursing New Zealand, 18(8), 12–15.
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.
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van Rooyen, P., Dixon, D. A., Dixon, G., & Wells, C. C. (2006). Entry criteria as predictor of performance in an undergraduate nursing degree programme. Nurse Education Today, 27(7), 593–600.
Abstract: This research explored the relationship between entry criteria and academic performance in the first and second year bioscience papers at Otago Polytechnic School of Nursing. The School's inclusion of a bioscience requirement varies from the Nursing Council criteria for acceptance into undergraduate nursing programmes. Six hundred and nineteen academic records of 1994-2002 graduates were sampled. Chi-square and correlational analyses found a relationship between entry qualifications and students' academic performance in the two papers. The entry criteria had a stronger relationship with the students' performance in the first year bioscience paper than the second year paper. Performance in the first year was predicative of second year performance. Age was also found to be a useful predictor of grades. These findings support the School's Bioscience entry criteria and provide important information for admission committees.
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Clendon, J. (2003). Nurse-managed clinics: Issues in evaluation. Journal of Advanced Nursing, 44(6), 558–565.
Abstract: This article explores the importance of evaluation of nurse-managed clinics using the Mana Health Clinic in Auckland, as an example. Fourth generation evaluation is offered as an appropriate methodology for undertaking evaluation of nurse-managed clinics. Fourth generation evaluation actively seeks involvement of clients in the process and outcome of the evaluation, resulting in participation and empowerment of stakeholders in the service – a precept often forgotten in traditional evaluation strategies and of vital importance in understanding why people use nurse-managed clinics. The method proposed here also incorporates the need for quantitative data. The main argument is that a combination of qualitative and quantitative data sources is likely to give the greatest understanding of nurse-managed clinics' utilisation.
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Henty, C., & Dickinson, A. R. (2007). Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study. The Royal New Zealand College of General Practitioners website, 34(5), 335–338.
Abstract: The aim of this small qualitative descriptive pilot study was to describe the experiences of practice nurses delivering the Care Plus programme within the general practice setting. Care Plus was introduced into Primary Health Organisations (PHOs) in 2004. This programme encourages more involvement from practice nurses in chronic care management. For many New Zealand practice nurses this is a new role. This study, carried out prior to the larger Care Plus implementation review (2006), provides an insight into the nursing experience of implementing Care Plus and provides a basis for future studies with regard to the nurse's role within the Care Plus programme.
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Cook, N., Phillips, B. N., & Sadler, D. (2005). The Tidal Model as experienced by patients and nurses in a regional forensic unit. Journal of Psychiatric & Mental Health Nursing, 15(5), 536–540.
Abstract: This study looks at the effect of implementing the Tidal Model at Rangipapa, a regional secure mental health forensic unit. A phenomenological study was undertaken to obtain reflective description of the nursing care experience from the perspective's of four registered nurses and four “special patients”. Five major themes were identified that appeared to capture the experiences of the participants. The themes show changes to the unit's unique culture and values following implementation of the model. These changes engendered a sense of hope, where nurses felt they were making a difference and patients were able to communicate in their own words their feelings of hope and optimism. Levelling was experienced as an effect emerging from individual and group processes whereby a shift in power enhanced a sense of self and connectedness in their relationships. These interpersonal transactions were noted by the special patients as being positive for their recovery. This enabled effective nurse-patient collaboration expressed simply as working together. The participants reported a feeling of humanity, so that there was a human face to a potentially objectifying forensic setting. Implications arising from this study are that the use of the model enables a synergistic interpersonal process wherein nurses are professionally satisfied and patients are validated in their experience supporting their recovery.
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Chenery, K. (2007). Building child health nurses' confidence and competence. Kai Tiaki: Nursing New Zealand, 13(5), 26–38.
Abstract: This article describes the development of the Generic Orientation Programme, Child Health Nursing and its perceived impact on practice after ten months, through two simultaneous evaluation surveys, seeking the views of programme participants and their nurse managers. The programme aims to equip the newly appointed RN in the child health cluster or the nurse working in a non-designated children's area with the knowledge and skills to safely care for children. These include basic anatomical and physiological differences; fluid and electrolyte management; safe administration of medication; pain management; recognition of the seriously ill child; and building partnerships with children and their families. A survey instrument eliciting qualitative and quantitative responses was used. The majority of nurse respondents believed they had gained new knowledge and described how they were incorporating it into everyday practice. Similarly, several nurse managers observed that nurses' clinical knowledge and skills had improved since attending the programme. In particular, responses from those working in non-designated children's areas suggested the programme had provided them with greater insight into the care of children.
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Peri, K., Kerse, N., Kiata, L., Wilkinson, T., Robinson, E., Parsons, J., et al. (2008). Promoting independence in residential care: Successful recruitment for a randomized controlled trial. Journal of the American Medical Directors Association, 9(4), 251–256.
Abstract: The aim of this study was to describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. A global impression of staff willingness to facilitate research was gauged by research nurses, facility characteristics were measured by staff interview. Forty-one (85%) facilities and 682 (83%) residents participated, median age was 85 years (range 65-101), and 74% were women. Participants had complex health problems. Recruitment rates were associated (but did not increase linearly) with the perceived willingness of staff, and were not associated with facility size. Design effects from the cluster recruitment differed according to outcome. The recruitment strategy was successful in recruiting a large sample of people with complex comorbidities and high levels of functional disability despite perceptions of staff reluctance. Staff willingness was related to recruitment success.
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Chadwick, A., & Hope, A. (2000). In pursuit of the named nurse. Australasian Journal of Neuroscience, 13(4), 6–9.
Abstract: This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required.
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Tweed, C., & Tweed, M. (2008). Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program. American Journal of Critical Care, 17(4), 338–347.
Abstract: The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.
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Horsburgh, M., Smith, V. A., & Kivell, D. (2002). South Auckland community paediatric nursing service: A framework for evaluation. Nursing Praxis in New Zealand, 18(3), 40–49.
Abstract: This paper describes the Kidz First paediatric community homecare nursing team in South Auckland. While the service was not initially planned as an integrated approach to child health, its evolution reflects the move to more community based care delivery and the expansion of nurse-led initiatives in New Zealand. The components of a community paediatric home nursing team as described by Eaton (2000) are used to provide the framework with which to describe the service. A focus group held with the Kidz First paediatric community homecare nurses has enabled definition of the key nursing components provided to children and their families living in South Auckland.
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Gallagher, P. (2000). An evaluation of a standards based portfolio [Corrected and republished article printed in NURSE EDUC TODAY 2001 Apr; 21(3): 197-200]. Nurse Education Today, 20(3), 218–226.
Abstract: This study is an evaluation of student perceptions of a standards based portfolio, which is a is a series of student work that seeks to address pre-determined learning outcomes. Of interest to the study was the relationship between theory and practice, the availability of resources to complete the assignment and the contribution the portfolio made to the process of learning. For a particular unit of learning, 'Nursing Business', second year undergraduate students in the Bachelor of Nursing programme were required to complete a portfolio. The assessment directed the students to meet specific criteria which in turn reflected the learning outcomes.
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Kaviani, N., & Stillwell, Y. (2000). An evaluative study of clinical preceptorship. Nurse Education Today, 20(3), 218–226.
Abstract: A preceptorship programme of 100 hours duration was developed and delivered by a nurse education institute, in consultation with a health care organisation. The purpose of the study was to examine preceptors, preceptees, and nurse managers' preceptions of the preceptor role and factors which influenced the performance of preceptors. Using focus groups, participants were each asked to identify the outcomes of the programme in practice. Study findings highlighted the importance of formal preceptor preparation, personal and professional development of the preceptors, and the promotion of positive partnerships between nurse educators and nurse practitioners. The need for formal recognition of the preceptor role in practice, particularly in relation to the provision of adequate time and resources, emerged from the study. The research findings enabled the development of an evaluative model of preceptorship, which highlights the intrinsic and extrinsic factors impacting on the preceptor role
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Pirret, A. M. (2007). The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making. Intensive & Critical Care Nursing, 23(3), 145–155.
Abstract: The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.
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