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Surtees, R. (2007). Developing a therapeutic alliance in an eating disorders unit. Kai Tiaki: Nursing New Zealand, 13(10), 14–16.
Abstract: The author presents the approach of a nursing team at Christchurch's Princess Margaret Hospital, in the regional specialist service for people with anorexia nervosa. This unit provides the only specialist inpatient unit in the country, consisting of a six or seven-bed facility that shares a unit with a mother and baby unit. A multidisciplinary team of psychiatric nurses, dietitians, occupational therapists, psychiatrists, psychologists and social workers all make significant contributions. The Christchurch unit uses a cognitive-behavioural therapy model (CBT) across the disciplines, a multidimensional approach incorporating psychotherapeutic, psychoeducational, biomedical and behaviourist paradigms. This occurs within a “lenient flexible approach”. Within the Unit, the eight nurses constitute what could be seen as an “intra”-disciplinary team within the wider “inter”-disciplinary or MDT team. They apply an evidence-based nursing approach with a commitment to partnership and advocacy with their patients. They use collaborative techniques for defining shared goals, and the careful management of the introduction of food. As one of the team members, the author envisages that the job of specialised nurses is to form a therapeutic alliance with patients, which takes account of the dynamic ways that patients may negotiate their own complex understandings of health, care, and recovery.
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Hunt, M. (2006). Nurses can enhance the pre-operative assessment process. Kai Tiaki: Nursing New Zealand, 12(10), 20–22.
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.
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Tielemans, W. (2008). Encouraging young women to have regular smear tests. Kai Tiaki: Nursing New Zealand, 14(7), 16–18.
Abstract: The author presents the results of a study carried out as part of a research project with two nurse researchers from Maastricht University in the Netherlands. The aim of this study was to examine awareness among female students aged 18 to 25 about cervical cancer and to identify factors associated with their decision or intention to enter the cervical screening programme. Students aged 18-25 were recruited from four tertiary institutions in the Wellington region. A questionnaire was available online and distributed by student health centres and the researchers. Questions covered the following areas: intentions, attitude, knowledge, awareness, modelling, and support systems and efficacy. Data was analysed using descriptive statistics, multiple regression and independent t-tests. The findings are presented, and factors associated with intention and participation in cervical screening are discussed. The results indicate that the information concerning the national screening programme needs to be adjusted for the different age groups.
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Litchfield, M. (1994). Viewpoint: Telling nursing stories. Kai Tiaki: Nursing New Zealand, 2(4), 28.
Abstract: A brief critique and comment on the ethical implications of nurse researchers using methodology that involves soliciting personal experiences of patients and subsequently publishing them as stories.
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Litchfield, M. (1989). Knowledge embedded in practice. Kai Tiaki: Nursing New Zealand, 82(10), 24–25.
Abstract: A statement of the nature of research needed to distinguish the knowledge of nursing practice from knowledge developed by other disciplines. It orients to the interrelationship of practice and research as the foundation of the discipline of nursing.
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Litchfield, M. (1993). Priorities for research. kai Tiaki: Nursing New Zealand, 1(8), 28–30.
Abstract: An article adapted from the author's contribution as an invited member of the International Panel of Nurse Researchers leading the Special Research Seminar of the 1993 International Council of Nurses Quadrennial Congress, Madrid, Spain. The priorities of nursing research in New Zealand were derived from the findings of a semi-structured survey of the opinions of nurses in academic settings.
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Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
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Litchfield, M. (1998). Professional development: Developing a new model of integrated care. Kai Tiaki: Nursing New Zealand, 4(9), 23–25.
Abstract: An overview of the model of nursing practice and nurse roles derived through a programme of nursing research in the context of the policy and strategies directing developments in the New Zealand health system. The emphsis was on the health service configuration model presented diagrammatically to show the position of a new role of family nurse with a distinct form of practice forming the hub.
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Litchfield, M. (1991). Nursing education: Direction with purpose. Kai Tiaki: Nursing New Zealand, 84(7), 22–24.
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Hales, A., & Dignam, D. (2002). Nurse prescribing lessons from the US. Kai Tiaki: Nursing New Zealand, 8(10), 12–15.
Abstract: The researchers present a survey of a sample population of 32 advanced practice nurses (APN) in the US about their experiences of acquiring and implementing prescriptive authority. The issues relevant to nurse practitioners in New Zealand are discussed, around acquiring knowledge and education, relationships with other professionals, establishing the role, and retaining the nursing role. The intent and scope of APN prescribing in the US is also discussed.
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Evans, S. (2007). Silence kills: Challenging unsafe practice. Kai Tiaki: Nursing New Zealand, 13(3), 16–19.
Abstract: The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals.
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Webby, A. (2001). Developing safe nursing practice for Maori. Kai Tiaki: Nursing New Zealand, 7(1), 16–17.
Abstract: A safe mental health nursing practice for Maori is defined as one that includes Maori ways of knowing. The author also notes that Maori mental health nurses must be given the ability to create their own practice to best meet their clients' needs.
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Webby, A. (2008). Should non-Maori research and write about Maori? Kai Tiaki: Nursing New Zealand, 14(5), 20–21.
Abstract: The author examines the complexities surrounding non-Maori nurse researchers working on Maori issues. She suggests that as long as respect and observation of Maori processes is shown, and work is undertaken collaboratively with Maori, then such a role is appropriate.
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Ho, T. (2000). Ethical dilemmas in neonatal care. Kai Tiaki: Nursing New Zealand, 6(7), 17–19.
Abstract: The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment.
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Powell, J. (2002). Caring for patients after an ICU admission. Kai Tiaki: Nursing New Zealand, 8(7), 24–25.
Abstract: The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education.
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