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Author Clunie, S. url  openurl
  Title The current trend and importance of postgraduate education for nurses Type Journal Article
  Year 2006 Publication Nursing Journal Northland Polytechnic Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector  
  Volume 10 Issue (up) Pages 18-23  
  Keywords Nursing; Education; Professional development; Leadership; Policy  
  Abstract The purpose of this essay is to examine why postgraduate education has become so important, to examine some of the issues around mandatory continuing education and the practical effect of this on a nursing career. Four strategies from the Ministry of Health, designed to facilitate changing nurse education, are discussed. The importance of Professional Development Recognition programmes is discussed along with the need for strong nursing leadership.  
  Call Number NRSNZNO @ research @ Serial 1207  
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Author Rudd, J. url  openurl
  Title From triage to treatment: An exploration of patient flow systems in emergency departments Type
  Year 2005 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Emergency nursing; Hospitals; Risk management; Patient safety  
  Abstract To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room.  
  Call Number NRSNZNO @ research @ Serial 1209  
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Author Turnwald, A.B. url  openurl
  Title Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department Type
  Year 2006 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Chronically ill; Clinical assessment; Emergency nursing  
  Abstract A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home.  
  Call Number NRSNZNO @ research @ Serial 1210  
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Author Kuehl, S. url  openurl
  Title Emergency Department re-presentations following intentional self-harm Type
  Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Emergency nursing; Psychiatric Nursing; Mental health; Clinical assessment  
  Abstract The aim of this research was to describe what factors contribute to people re-presenting to the emergency department (ED) within one week of a previous visit for intentional self-harm. Objectives identified were to describe the people using demographic and clinical features; describe and evaluate ED management; and identify possible personal or system reasons as to why people re-present to ED within one week. A retrospective observational design was selected for a period of one year. The data was collected from electronic clinical case notes. The sample consisted of 48 people with 73 presentations and re-presentations. Missing data limited the number of inferential analyses. Outcome measures were divided into information regarding the person and the presentation. This study made several discoveries: many representations (55%) occurred within one day; the exact number of people who represented many times to ED is unknown, but is far higher than reported in other studies; fewer support people were present for the second presentation; the documentation of triage and assessments by ED staff was often minimal, though frequently portrayed immense distress of this population; cultural input for Maori was missing; physical health complaints and psychosis were found with some intentional self-harm presentations; challenging behaviours occurred in at least a quarter of presentations; and the medical and mental health inpatient admission rates were approximately 50% higher for second presentations. Recommendations in regard to the use of a triage assessment tool, the practice of reviewing peoples' past presentations and the need for a mental health consultation liaison nurse in ED are made. Staff education, collaboration between services with consumer involvement and further research of this group are required. This study supports the need for holistic and expert care for people who present at emergency departments with intentional self-harm.  
  Call Number NRSNZNO @ research @ Serial 1214  
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Author Hammond, S. url  openurl
  Title Parallel journeys: Perceptions of palliative care Type
  Year 2001 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Palliative care; Policy; Geriatric nursing  
  Abstract The delivery of palliative care within contemporary New Zealand society is discussed, in the light of the recent publication of The New Zealand Palliative Care Strategy (2001). The viewpoint taken is largely descriptive rather than prescriptive, being based on a literature survey of international research and academic theory, which is also informed by the author's professionally gained knowledge. Four different perspectives, comprising a mix of providers and recipients of care are investigated: those of central government planning; specialist palliative care units; aged-care complexes; and patients, family and whanau. As an area of healthcare which current demographic projections indicate will become increasingly significant, the provision of palliative care to residents of and patients within aged-care complexes receives special attention. A metaphor of “parallel travellers” on “parallel journeys” is used to provide a thematic basis to the paper. The lived experiences and perceptions of each group of “parallel travellers” are explored. Difficulties in defining and evaluating palliative care, the implications of main-streaming, the scope of palliative care provision, the educative role of specialist palliative care providers and the current focus on mechanistic outcome measures are discussed. It is contended that the values and goals, both explicit and implicit, of the four specified groups may not at present be sufficiently congruent to optimise the effective provision of palliative care from the point of view of all concerned. While adequate resourcing and a genuinely collaborative approach among healthcare providers are both acknowledged to be critical, the potential for palliative care nurse practitioners to be appointed to the role of “care co-ordinator” alluded to within The New Zealand Palliative Care Strategy (2001), is also seen as pivotal. Insights from a postmodern perspective are offered as one possible way of achieving greater congruence.  
  Call Number NRSNZNO @ research @ Serial 1215  
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Author Watson, S. url  openurl
  Title Humane caring: Quality of life issues for those elderly people wanting to remain in their own environment Type
  Year 2001 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Geriatric nursing; Older people; Home care  
  Abstract This thesis explores the issues surrounding the elderly remaining in their own environment and why remaining 'at home' becomes so essential for them. There are many elderly people who have moved to residential care settings on the advice of others. The author explores the implications of such moves through the stories of several elderly persons, and her own experiences as a nurse working with the elderly in institutional care.  
  Call Number NRSNZNO @ research @ Serial 1217  
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Author Mackay, B. url  openurl
  Title Using SMS mobile technology to M-Support nursing students in clinical placements Type Conference Article
  Year 2007 Publication NorthTec Nursing & Health Conference Papers Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector  
  Volume Paper presented at eFest Conference 27th-29th Sept Issue (up) Pages  
  Keywords Technology; Nursing; Education  
  Abstract M-Learning compliments and supports E-Learning and incorporates technologies such as the use of mobile phones, PDAs and pod casting. A sub function of M-Learning is M-Support which is the provision of support for the mobile student. This paper describes a pilot project using short message service – mobile technology -to M-support nursing students in primary health care clinical placements. Forty one students took part in a mixed methods study to assess the project against a pre determined set of criteria. The results indicated that students did feel supported by the messages, cost was not prohibitive, flexibility in communication was appreciated, and the acceptance was high.  
  Call Number NRSNZNO @ research @ Serial 1218  
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Author Fairhall, M. url  openurl
  Title An observational study of Peripherally Inserted Central Cather(PICC)-related complications amongst oncology patients Type
  Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Patient safety; Equipment and Supplies; Nursing specialties; Cancer; Oncology  
  Abstract This thesis reports on a retrospective observational study that examined the complication rate of peripherally inserted central catheters (PICCs) within a regional cancer centre. PICCs are increasingly used for delivery of chemotherapy and other intravenous therapies in oncology patients. A literature review revealed that almost all published research on PICC complications reported on silicone (Groshong(TM)) catheter use, rather than the polyurethane (Arrow(TM)) PICCs used at Christchurch Hospital. Also, much literature referred to PICCs being inserted by non-nurses, whereas the Christchurch service uses specially-trained nurses to insert them. The purpose of the study was to identify the nature, incidence and rates of polyurethane (Arrow(TM)) PICC complications in an adult oncology cohort. Ethics Committee approval was gained to retrospectively follow all PICCs inserted in adult oncology patients at Christchurch Hospital over a 13-month period from 1st March 2006 until 31st March 2007. Data collected were analysed utilising the statistical computer package SPSS. One hundred and sixty-four PICCs were inserted into 156 individual oncology patients over this period. The median dwell time was 68 days for a total of 14,276 catheter-days. Complications occurred in 25 (15%) out of 164 PICC lines, in 22 (15%) of the 156 patients for an overall complication rate of 1.75 per 1000 catheter-days. However, only 16 of the 25 PICCs with complications required early removal (9.75% of the cohort) for a favourably low serious complication rate of 1.12 per 1000 catheter-days. The three commonest complications were infection at 4.3% (7/164) or 0.49 infection complications/1000 PICC-days, PICC migration at 3% (5/164) or 0.35/1000 catheter days, and thrombosis at 2.4% (4/164) or 0.28/1000 catheter days. The median time to complication was 41 days. Those with complications were more likely to have a gastro-intestinal or an ovarian cancer diagnosis, and less likely to have colorectal cancer. These findings provide support for the safe and effective use of polyurethane (Arrow(TM)) PICCs for venous access within the adult oncology context. Furthermore, it suggests that cost effective nurse-led (Arrow(TM)) PICC insertions can contribute to a low complication rate.  
  Call Number NRSNZNO @ research @ Serial 1222  
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Author Lewis, T. url  openurl
  Title Euthanasia: A Foucauldian analysis Type
  Year 2005 Publication Abbreviated Journal ScholarlyCommons@AUT  
  Volume Issue (up) Pages  
  Keywords Law and legislation; Euthanasia; Ethics; Pain management; Terminal care; Nursing; Palliative care  
  Abstract This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the “right-to-die”. It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what the author termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of “truth” regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. These findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing profession's lack of preparation to deal with euthanasia if it becomes a legal option in end of life care.  
  Call Number NRSNZNO @ research @ Serial 1226  
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Author Brown, J.A. url  openurl
  Title “Let my spirit always sing”: A descriptive study of how four elderly rest home residents view spirituality and spiritual care at the end of life Type
  Year 2004 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Older people; Rest homes; Spirituality; Nursing  
  Abstract This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. Four rest home residents were recruited, to talk about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed. The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi's analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants' satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured. Recommendations are made for improving the spiritual dimension of care, and for further research.  
  Call Number NRSNZNO @ research @ Serial 1228  
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Author Esera, F.I. url  openurl
  Title If a client is operating from a Samoan world view how can s/he be holistically and appropriately treated under the western medical model? Type
  Year 2001 Publication Abbreviated Journal ResearchArchive@Victoria  
  Volume Issue (up) Pages  
  Keywords Mental health; Psychiatric Nursing; Cultural safety; Cross-cultural comparison; Pacific peoples  
  Abstract This paper is an analysis of the cultural and traditional factors that the author presents as essential considerations in the treatment of Samoan people who have been diagnosed with a mental illness. Just as important to any clinical diagnosis, is the spiritual nature of Samoan culture and traditions, which inform belief systems. A full understanding of these will explain how the traditional beliefs and cultural values of Samoan people have an impact on their perception of mental illness, its causes and cures. The thesis places emphasis on 'ma'i -aitu', the Samoan term for most ailments pertaining to the mind or psyche. The focus is on defining 'ma'i -aitu' as part of a Samoan world view and likewise a description of a similar type of manifestation in the Papalagi (western) context of a psychiatric disorder and how treatment and management is usually undertaken. The issues addressed in this paper aim to highlight the Samoan client's world view from a Samoan perspective of mental illness which then poses the question of how they can be managed holistically and appropriately under the Papalagi medical system. Furthermore, it questions if the traditional belief system of Samoans run deeper than originally thought and can the replacement thereof by a foreign culture be responsible for the increased mental problems in Samoans living in New Zealand? This paper emphasises the importance of integrating the western medical model and Samoan health models, for appropriate mental health service delivery to Samoan people.  
  Call Number NRSNZNO @ research @ Serial 1231  
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Author Water, T. url  openurl
  Title The meaning of being in dilemma in paediatric practice: A phenomenological study Type
  Year 2008 Publication Abbreviated Journal NZNO Library  
  Volume Issue (up) Pages 259 pp  
  Keywords Psychology; Paediatric nursing; Paedetric practice; Problem solving  
  Abstract This study explores the phenomenon of dilemma in paediatric practice. Using a hermeneutic phenomenological method informed by the writings of Heidegger [1889-1976] and Gadamer [1900-2002] this study provides an understanding of the meaning of 'being in dilemma' from the perspective of predominantly paediatric health care professionals but also families in New Zealand. Study participants include four families who had a child requiring health care and fifteen health care practitioners from the disciplines of medicine, nursing, physiotherapy, play specialist and occupational therapy who work with families and children requiring health care. Participants' narratives of their experiences of 'being in dilemma' were captured via audio taped interviewing. These stories uncover the everyday realities facing health professionals and families and provide an ontological understanding for the notion of dilemma. The findings of this study suggest that experience of dilemma for health professionals reveals a world that is uncertain and questionable where they are thrown into having to make uncomfortable choices and must live with the painful consequences of their actions. The consequences of being in such dilemma are having to find ways of living with the angst, or risk becoming too sensitive or desensitizing. For families the experience of dilemma reveals a similar phenomenon most evident in circumstances where they feel totalized by the impact of heath care encounters. This study has uncovered that the perspectives that health professionals and families bring to the experience of dilemma reveal different concerns and commitments and may be hidden from each other. This thesis proposes that health professionals and families need support in living with their own personal encounters of enduring experiences of dilemma.  
  Call Number NRSNZNO @ research @ Serial 1234  
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Author Litchfield, M. openurl 
  Title The nation's health and our response Type Conference Article
  Year 1992 Publication Abbreviated Journal  
  Volume Keynote address at the 1992 NERF/NZNZ National Nur Issue (up) Pages  
  Keywords Nursing; Health reforms; Nurse-family relations  
  Abstract An analysis of the challenges for the nursing profession of the Government's health reforms. The findings of the 10-month Wellington Nurse Case Management Project 1991-1992, including the description of family nursing practice, what it achieved for health and the service delivery model that would position family nurses in the health reforms were used to provide an exemplar for the nuyrising contribution to health policy for the health reforms. The paper identified a vacum for the reorientating of health care provision to patients/clients and health need and the call to nursesw to take leadership in goving direction to the reorientation.  
  Call Number NZNO @ research @ Serial 1319  
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Author Pearce, K. openurl 
  Title Orientation: Reading the nurses map; what new Plunket Nurses need in an orientation programme Type
  Year 2003 Publication Abbreviated Journal Victoria University Library  
  Volume Issue (up) Pages  
  Keywords Plunket; Training; New graduate nurses; Curriculum; Community health nursing  
  Abstract The Plunket orientation programme, first implemented in 1994, aims to prepare new Plunket Nurses for autonomous practice within the complexity of community based nursing. This study seeks to identify what new Plunket Nurses feel are their orientation needs. An evaluation research approach was used. An examination of the literature explored how orientation is conducted and the needs of nurses in orientation. Key aspects in relation to orientation were identified as including socialisation, job change, new graduates, preceptorship, orientation frameworks and retention. A focus group followed by a postal survey were utilised to collect data from new Plunket Nurses nationwide to ascertain what they thought their orientation needs were. Data analysis was completed using descriptive statistics and thematic analysis. The results of the study identified key orientation needs for new Plunket Nurses. These were an orientation programme, preceptorship, clinical skills teaching, time in own area and beginning autonomous practice, administration needs and support needs. The participants recommended quality preceptorship and early clinical teaching from the Clinical Educator. There was a general dissatisfaction with orientation as it stands in preparing them for their role as a Plunket Nurse. Recommendations to the Plunket Management Team were made based on the results of this study.  
  Call Number NRSNZNO @ research @ Serial 1240  
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Author Lyall, C. openurl 
  Title Therapeutic relationships: What are inpatient registered nurses perceptions of the factors which influence therapeutic relationship development? Type
  Year 2003 Publication Abbreviated Journal Victoria University of Wellington Library  
  Volume Issue (up) Pages  
  Keywords Psychiatric Nursing; Registered nurses; Nurse-patient relations; Mental health  
  Abstract The question explored in this research project is: What are inpatient registered nurses' perceptions of the factors which influence therapeutic relationship development? The literature reviewed for this project includes the history of interpersonal relationships in nursing; therapeutic relationships; what constitutes these relationships. Also discussed is literature about phenomenology as the underlying theoretical and philosophical position that informs the research method. To answer the research question a single focus group was used to gather data from a group of registered nurses practising in inpatient mental health units. Focus groups as a data collection method produce data and insights that would not be accessible without the group interaction. The key themes to emerge from the data analysis were; time, environment, knowing / self-awareness, compassion and power imbalance / empowerment. These key themes are discussed in relation to the literature and the wider context of the mental health care environment. The contribution this research makes to nursing includes a list of recommendations to nurses, nurse leaders and managers who aim to provide therapeutic mental health unit environments.  
  Call Number NRSNZNO @ research @ Serial 1245  
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