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Marshall, K. (2007). Enteral nutrition within 72 hours after spinal chord injury: Complexities and complications. Ph.D. thesis, , .
Abstract: Good nutrition is essential following acute spinal cord injury. Poor nutrition can lead to the deleterious effects of protein-calorie induced hypermetabolism and poor functional and rehabilitation outcomes. Nutritional management for patients with acute cervical or high thoracic spinal cord injury admitted to the Canterbury District Health Board's Burwood Spinal Unit and Christchurch Hospital's Department of Intensive Care Medicine (CHDICM) differ. The Burwood Spinal Unit has a delayed approach to nutritional management in contrast to the implementation of early enteral feeding by CHDICM. This prompted a literature review to critically consider the evidence underpinning clinical practice in this field. Literature revealed that nutritional management in the first 72 hours after spinal cord injury is a complex process. The complexities of when to commence, the method of delivering, and the target dose of enteral nutrition in the first 72 hours after spinal cord injury are due to the perceived risk of a spinal ileus and the ensuing, such as adverse effects on abdominal and respiratory function, resulting from enteral feeding intolerance. Literature revealed that delayed nutrition is largely based on expert opinion, while early enteral feeding has limited but stronger scientific research evidence. Nevertheless, it is desirable to use the best evidence currently available to develop, implement and evaluate an evidence-based, protocol driven, clinical pathway for nutritional management of patients within 72 hours of an acute cervical or high thoracic SCI. The author concludes that to ensure an acute spinal cord injury clinical pathway is based on scientific evidence, prospective, multi-centre, randomised controlled trials are needed to substantiate early enteral feeding and identification of the degree of and risk of complications from spinal ileus after acute cervical or high thoracic spinal cord injury.
Keywords: Nursing; Intensive care nursing
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Seccombe, J. (2007). Attitudes towards disability in an undergraduate nursing curriculum: A literature review. Nurse Education Today, (27(5)).
Abstract: In the process of introducing a new disability unit into an undergraduate nursing curriculum in a New Zealand educational setting, the opportunity arose to conduct a small study comparing the attitudes of students nurses to people with disabilities. This paper discusses the literature review, which formed the basis for the study. A range of perspectives and research was identified that explored societal and nurses' attitudes, disability studies in undergraduate nursing curricula, the impact of nurses' attitudes on patient care, and interventions for changing those attitudes. Effective nursing care can be severely compromised through negative attitudes, and concerns are expressed at the lack of attention given to this issue in nursing curricula generally. The literature showed that combining educational approaches with opportunities for student nurses to interact with disabled people provides the most effective means for student nurses to develop positive attitudes towards disabled people. The goal for nurse educators is to ensure the inclusion of disability studies as a core component in undergraduate nursing education.
Keywords: Nursing; Education; Students; People with disabilities
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McDonald, S., Willis, G., Fourie, W., & Hedgecock, B. (2007). Graduate nurses and their experience of postgraduate education within a Graduate Nurse programme (Vol. (Monograph Series 2/2007)). Manukau: Manukau Institute of Technology.
Abstract: The authors note that the literature identifies that the transition from tertiary based training to the realities of industry expectations can be a stressful period for graduates. Various District Health Boards offer postgraduate papers within their graduate nursing programmes, resulting in graduates being expected to perform the role of a beginning practitioner as well as embark on postgraduate education during this first year. As yet, the authors note, there is little evidence available to substantiate the efficacy and impact of such papers. The purpose of this study was to explore graduate nurse's experience of postgraduate education within the Graduate Nurse Programme. The report contains the results of a survey of nurses within the Programme. This report details the results of that survey and make recommendations for consideration.
Keywords: Nursing; Education; New graduate nurses; Teaching methods; Students
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Gallagher, P. (2007). Preconceptions and learning to be a nurse. Nurse Education Today, 27(8), 878–884.
Abstract: This article discusses the important role that preconceptions play in the process by which students learn to be nurses. The importance of preconceptions emerged from the analysis of data in a grounded theory study that sought to gain a greater understanding of how undergraduate student nurses in New Zealand experienced and responded to differences they perceived between the theory and the practice of nursing. It became clear that the preconceptions each student nurse held about the nature of nurses and nursing care were the standards against which the worth of the formal, practical and personal theories to which students were exposed during their nursing degree was evaluated. It was clear that preconceptions functioned as the mediator between the intentions of nursing education and the learning that eventuated for each student from practicum experiences. The implications for nursing education, for which preconceptions are not generally highly valued as a basis for learning about professional nursing, are that the individual experience and personal characteristics of each student receive significant focus when a nursing programme is planned. This means that the orthodox principles that underpin the design of nursing curricula should be reviewed and an overtly constructivist perspective adopted for nursing education for which the prior experiences of the student are the starting point.
Keywords: Nursing; Education; Attitude of health personnel; Theory
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Wilkinson, A. (2007). New age informatics & the management of perioperative nursing documentation. Dissector, 35(1), 20–23.
Abstract: Investigates the requirements for documentation by nurses. Research by Millar & Araquiza (1999) suggests that nurses spend an estimated 30% of their time documenting patient care.
Keywords: Nursing; Administration
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Payne, D., & Goedeke, S. (2007). Holding together: Caring for clients undergoing assisted reproductive technologies. Journal of Advanced Nursing, 60(6), 645–653.
Abstract: This paper reports a study to investigate the roles and experiences of nurses caring for clients undergoing assisted reproductive technologies (ART). Nurses are in a potentially unique position in the assisted reproductive technology environment as they maintain a more constant contact with the client. A qualitative approach was taken and a convenience sample of 15 nurses from New Zealand was interviewed in 2005. Data were analysed using interpretive description. The overarching theme identified was that of the potential role of the nurse to 'hold together' multiple components of the assisted reproductive technology process: holding together clients' emotional and physical experiences of assisted reproductive technologies; holding together the roles of different specialist team members; and holding together personal own emotions. It encompasses practices such as information-giving, interpreting, supporting and advocating. The researchers note that recognition of and support for the complexity of the role of ART nurses may positively contribute to clients' experiences.
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Sutton, D. M. (2007). An analysis of the application of Christensen's Nursing Partnership Model in vascular nursing: A case study approach. Ph.D. thesis, , .
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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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Fisher, M. (2007). Resuscitation guidelines: Managing change in practice. Pediatric Intensive Care Nursing, 8(1), 7–10.
Abstract: This article describes the effect of an education programme for Paediatric Intensive Care Unit (PICU) staff, developed as part of the roll out of revised clinical guidelines. In 2005, the International Liaison Committee on Resuscitation released advisory statements and a revised universal algorithm for Infant, Child and Adult Cardiopulmonary Resuscitation (CPR). Subsequently the New Zealand Resuscitation Council developed and disseminated revised guidelines for use within the New Zealand Healthcare System. Within the PICU the challenge of integrating new practice standards whilst ensuring compliance with CPR guidelines, was how to disseminate information to over 80 staff nurses working 12 hour shifts. Following implementation of an education programme, a survey completed by 20 staff members demonstrated that staff felt well supported with the introduction of the new CPR guidelines (90%) and confident that they understood the changes to the resuscitation guidelines (90%). Staff identified that the poster display (95%) and the mail sleeve “flyer” (80%) helped them understand the changes to CPR.
Keywords: Nursing specialties; Guidelines; Training
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Blake-Palmer, E. (2007). Seeing the world through orthopaedic eyes: The experience of being an orthopaedic nurse: A hermeneutic study. Ph.D. thesis, , .
Abstract: This study explores the experience of being an orthopaedic nurse. As an orthopaedic nurse the author had concerns that the validity of orthopaedic nursing as a unique scope of practice was being questioned. In this thesis, the case for orthopaedic nursing is argued, by showing it as a specialty in its own right. A qualitative approach informed by the author's interpretation of philosophical hermeneutics as articulated by Heidegger (1927/1962) and Gadamer (1976; 1989) was undertaken. Phenomenology seeks to uncover 'taken-for granted' meanings in everyday experience and hermeneutic research recognises that the historical and cultural horizons of participants and researcher influence the interpretation. Eight nurses working in various orthopaedic settings were interviewed. Data was analysed using the interpretive thematic approach described by van Manen (1990). The nurses' stories from practice yielded two essential themes, 'being part', and 'gaining and maintaining integrity'. The author concludes that these themes interrelate and together reveal meanings and insights about being an orthopaedic nurse. 'Being part', shows the essential nature of relationships between orthopaedic nurses and others. 'Gaining and maintaining integrity' describes the embodied nature of the phenomenon. The overall thematic finding 'seeing the world through orthopaedic eyes' reveals the nature of orthopaedic nursing as a unique scope of practice.
Keywords: Nursing specialties
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Giddings, D. L. S., & Grant, B. M. (2007). A Trojan Horse for positivism? A critique of mixed methods research. Advances in Nursing Science, 30(1), 52–60.
Abstract: This paper presents an analysis of mixed methods research, which the authors suggest is captured by a pragmatically inflected form of post-positivism. Although it passes for an alternative methodological movement that purports to breach the divide between qualitative and quantitative research, most mixed methods studies favour the forms of analysis and truth finding associated with positivism. The authors anticipate a move away from exploring more philosophical questions or undertaking modes of enquiry that challenge the status quo. At the same time, they recognise that mixed methods research offers particular strengths and that, although it serves as a Trojan Horse for positivism, it may productively carry other paradigmatic passengers.
Keywords: Nursing research; Methodology; Evaluation
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Grainger, P. C. (2007). Nursing documentation in the emergency department: nurses' perspectives. Master's thesis, Victoria University of Wellington, Wellington.
Abstract: Explores emergency nurses? perspectives and practices about the quality, importance and value of emergency nursing documentation in relation to their personal beliefs, past experiences and preferred systems of documentation; the practical and contextual factors that influence documentation practices within an emergency department (ED); their interests in documentation tools or systems; and their interests in relation to further development of documentation practices and systems. Conducts a qualitative descriptive study in which ten emergency nurses from one ED in New Zealand were interviewed using interactive interview methods, and asked to complete a Likert scale to identify the relevance of internationally- recognised general influences on documentation to their own practices in the context of an ED. Includes recommended routes to development through partnership, participation and process engagement, and strategies including document development, knowledge advancement and support.
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Phillips, B. N. (2007). Nursing care and understanding the experiences of others: A Gadamerian perspective. Nursing Inquiry, 14(1), 89–94.
Abstract: This article investigates the process where nurses attempt to understand the experience of patients. The author argues that this transcends particular models of ill-health. Gadamerian hermeneutics, which has been used in nursing research to articulate the process of understanding, is elaborated on. Gadamer's exposition of understanding shows that practitioners need to be aware that understanding of other people is developed through a fusion of one's own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which practitioners put their ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process. In this way, the experience of nurses seeking to understanding those they nurse increases self-awareness, as well as enhancing their ability to further understand others.
Keywords: Nursing philosophy; Nurse-patient relations
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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.
Keywords: Nursing models; Obesity; Cultural safety
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Pitama, S., Robertson, P., Cram, F., Gillies, M., Huria, T., & Dalla-Katoa, W. (2007). Meihana model: A clinical assessment framework. New Zealand Journal of Psychology, 36(3), 118–125.
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.
Keywords: Nursing models; Clinical assessment; Maori; Mental health
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