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Author Harvey, Geoffrey
Title 'Thank you for telling our story...': An exploration of the needs of migrant nurses undergoing competence assessment for New Zealand registration Type Book Whole
Year 2022 Publication Abbreviated Journal
Volume Issue Pages 108 p.
Keywords (down) Internationally qualified nurses (IQN); Migrant nurses; Competency assessment; Nursing registration; Surveys
Abstract Seeks to give voice to migrant nurses, using case-study methodology to highlight their experience of the competence assessment process. Distributes a questionnaire to a group of 22 newly-arrived IQNs, and conducts interviews with 10 IQNs who had been working in NZ for several years. Uncovers the motivations among the first group and reflections on the Competence Assessment Programme (CAP) among the second. Makes recommendations for CAP training based on the results of the study.
Call Number NZNO @ research @ Serial 1836
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Author Fogarty, K.
Title The assessment of competence in the novice nurse in the adult intensive care unit Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords (down) Intensive care nursing; Nursing specialties; Clinical assessment
Abstract This dissertation explores the assessment of nurses' clinical competence in the adult ICU setting. Specifically, methods for the assessment of competence are critiqued for their practical application to the novice nurse with less than six months experience in ICU. The assessment methods considered are continuous clinical assessment, self-assessment, peer review, objective structured clinical examination (OSCE), portfolio and computer assisted assessment. Several criteria are applied to the methods including the ability of each method to assess skills, knowledge and attitudes or values. Each method is critiqued for its implications in terms of cost and staffing resource, benefits and barriers to implementation. In addition, reliability and validity issues are considered for each method. The outcome of this exploration is the recommendation of a combination of methods; namely, portfolio and OSCE, for the assessment of competence in the ICU novice. The author concludes that this finding enhances current understanding within the ICU specialty of the multidimensional nature of competence assessment.
Call Number NRSNZNO @ research @ Serial 574
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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 (down) 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 (down) 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
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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 (down) 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 Harris, C.; Crozier, I.; Smyth, J.; Elliot, J.; Watson, P.B.; Sands, J.; Cuddihy, R.
Title An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI Type Manuscript
Year 2007 Publication Abbreviated Journal
Volume Issue Pages
Keywords (down) Hospitals; Clinical assessment; Cardiovascular diseases; Guidelines; Teaching methods
Abstract This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
Call Number NRSNZNO @ research @ Serial 1157
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Author Quiding, Janine
Title Improving assessment inter-rater reliability of a nursing ePortfolio: An Integrative Review Type Book Whole
Year 2021 Publication Abbreviated Journal
Volume Issue Pages 66 p.
Keywords (down) ePortfolios; Professional Development and Recognition Programmes (PDRP); Nursing assessment
Abstract Analyses 13 articles using an integrative review methodology framework and thematic analysis to support the data analysis process, seeking to clarify the inter-rater reliability of nursing ePortfolio assessment. Identifies two themes emerging from the data: the subjective nature of the assessor, and external factors due to the nature of nursing portfolio requirements. Considers how to minimise assessment variability due to subjective factors.
Call Number NZNO @ research @ Serial 1749
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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 (down) 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
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Author Kuehl, S.
Title Emergency Department re-presentations following intentional self-harm Type
Year 2008 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords (down) 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 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 (down) 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
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Author Yip, Jacqueline Chi Yan
Title Development of a brief heart healthy eating assessment tool for use by practice nurses in New Zealand Type Book Whole
Year 2014 Publication Abbreviated Journal
Volume Issue Pages 1v
Keywords (down) Dietary assessment; Practice nurses; Heart healthy eating; Nutrition counselling; Cardiovascular disease
Abstract Aims to determine how a brief dietary assessment tool should be designed for use by practice nurses in New Zealand with the intention of providing individualised nutrition advice to reduce individuals' risk of cardiovascular disease (heart healthy eating counselling). Recruits 11 practice nurses from the Auckland region for interview and analyses data from the 2008/2009 NZ adult nutrition survey. Uses an action research approach as the underlying strategy of inquiry for the study.
Call Number NZNO @ research @ Serial 1568
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Author Hinvest, Kate
Title The meaning of nurses' caring for clinically-deteriorating patients Type Book Whole
Year 2020 Publication Abbreviated Journal
Volume Issue Pages 166 p.
Keywords (down) Deterioration; Patients; Acute Assessment Unit; Phenomenology; Registered Nurses
Abstract Reveals and explores the stories of ten Registered Nurses working in Acute Assessment Units caring for clinically-deteriorating patients. Uses the perspectives of hermeneutic phenomenology to explore the meaning of nurses caring for such patients. Conducts semi-structured interviews with the RNs identifying three main themes.
Call Number NZNO @ research @ Serial 1746
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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 (down) 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 Christensen, Martin
Title Nurses' knowledge of delirium: a survey of theoretical knowing Type Journal Article
Year 2016 Publication Kai Tiaki Nursing Research Abbreviated Journal
Volume 7 Issue 1 Pages 11-18
Keywords (down) Delirium; Delirium assessment; ICU psychosis; ICU syndrome
Abstract Conducts an exploratory study to assess whether nurses at a regional base hospital have sufficient theoretical knowledge to assess and manage delirium in the clinical setting. Uses a self-administered survey based on a true/false questionnaire, and a Likert scale to assess nurses' perceived levels of confidence in detecting and managing the delirious patient. Administers the questionnaire to 130 nurses from acute adult wards.
Call Number NZNO @ research @ Serial 1526
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Author Macfarlane, K.
Title Communicating changes in a patient's condition: A critical incident approach Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords (down) Communication; Clinical assessment; Physicians; Nursing; Relationships
Abstract This study explores how registered nurses working within the acute surgical ward environment of a New Zealand hospital communicate changes in a patient's condition. The purpose of this research study was to examine the processes, communication techniques and behaviours that nurses use, in order to determine the critical requirements for registered nurses to effectively communicate changes in patients' conditions to doctors. The critical incident technique developed by Flanagan (1954) was adapted and used to explore incidents that occurred when six registered nurses working in acute surgical wards communicated a change in a patient's condition to a doctor. Communication is an integral part of everyday activity. This study has shown an assessment process occurs before communication can take place. A nurse's concern for a patient's condition initiates the assessment process. A judgement is formed from the nurse's concern that a patient's condition has changed. Judgements take into account multiple ways of knowing including pattern recognition, empirical knowing and intuition. Institutional protocols also affect judgements and the ability of a nurse to ensure support is received for the patient's well being. The communication process is initiated for two reasons, to support the patient, and to support the nurse in providing care for the patient. Significant in determining the need for support is the action required that might be outside the nurse's scope of practice. The response should address the nurse's concern and take into account the importance of the relationship, trust between all parties, respect of each other's positions and knowing team members and their capabilities. Understanding these aspects of the communication process should enhance nurses and doctors abilities to effectively communicate regarding a change in a patient's condition.
Call Number NRSNZNO @ research @ Serial 724
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