Abstract: International nursing literature indicates nursing shortages are widely recognised; however efforts to remedy poor recruitment and retention of nurses have been largely unsuccessful. This paper presents the predominant factors influencing poor recruitment and retention of nurses, such as: the image of nursing as a career, pay and conditions of employment, educational opportunities, management and decision making, and low morale and then explores how Magnet hospitals address these factors. During the 1980s, several hospitals in the United States were identified as being able to attract nursing staff when others could not, they became known as 'Magnet' hospitals. The American Nurse Credentialing Centre developed the Magnet Recognition programme to accredit hospitals that meet comprehensive criteria to support and develop excellence in nursing services. Magnet hospitals not only attract and retain satisfied nursing staff, but also have improved patient outcomes compared to non-Magnet hospitals, such as decreased patient morbidity and mortality and increased patient satisfaction. The successes of the Magnet Recognition programme in recruitment and retention of nurses is discussed in relation to its transferability outside of the United States, particularly to New Zealand as a way of improving recruitment and retention of nurses here.

Abstract: Evaluates the SIP/PIP process to illuminate the views of the nurse managers and preceptors on the effectiveness of the SIP/PIP programme in ensuring competent practice and provides recommendations for improvement and strengthening of the framework. Uses a qualitative approach with data collected through individual semi-structured interviews with preceptors and nurse managers. Due to lack of participation in the quantitative arm a mixed-method study was not completed using an anonymous survey. Undertakes thematic data analysis utilising NVIVO 10 software. Draws four major themes from the qualitative data: (1) Feedback- insight loop, (2) Process clarity, (3) Relationships, commitment & reflective response to participation in the SIP/PIP process, (4) Barriers and enablers to the SIP/PIP process.

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.

Abstract: Interviews 9 nurses in their first year of clinical practice to investigate how newly-qualified nurses recognise and develop those skills relating to clinical risk and patient safety. Identifies workplace culture, clinical role models, exposure to the clinical environment, experiential learning, narrative sharing, debriefing and simulation as contributing to learning and understanding clinical risk and safe patient care. Considers strategies to facilitate professional development.

Abstract: Interviews thirteen registered nurses and one enrolled nurse working in different nursing positions within the Southern District Health Board -- Mental Health Services. Codes data into 24 sub-themes related to the sequence and impact of assaults on the participants. Discusses the nature and impact of assaults and the supportive strategies associated with violence against mental health nurses.

Abstract: Investigates the neonatal intensive care unit (NICU) nurse-infant relationship, with a focus on vocal soothing. Undertakes two observational studies to record the use of voice by NICU nurses during painful and non-painful procedures. Develops a model of vocal soothing and tests it for its ability to provide comfort to pre-term infants undergoing painful procedures. Measures pain using the Premature Infant Pain Profile Revised.

Abstract: An essential part of nursing practice for the nurse on the surgical floor is to relieve the discomfort of post operative pain for patients in their care. Post operative pain management encompasses a series of processes from assessing pain, providing relief, assessment of measures used to relieve pain through to documentation in the patient record. Yet literature, both internationally and from Australia and New Zealand, suggests that post operative pain continues to be poorly managed despite having the means to provide more than adequate relief. Events leading up to the commencement of this study indicated that locally, post operative pain assessment, including documentation in the patient record may be substandard. The objective of this study was to develop and test an audit tool; undertake a retrospective audit of nursing records, including nursing notes and the nursing care plan, in respect of what postoperative pain assessments nurses document in the patient record; evaluate data and make recommendations for practice. Methodology: A five part, 23 question Likert scale audit tool, designed specifically for this study was used to collect data over a period of two months. In total 40 patient records that met the inclusion criteria were audited.The results indicate that local practice reflects poor documentation standards found in other studies. The most complete recordings were those entered on specifically designed charts such as the Patient Controlled Analgesia and Epidural charts (N 28) but this did not carry over into the patient record. Despite that fact that the patient's self reports of pain is said to be the single most reliable indicator of pain, there was only four occasions when the patient's verbal response to pain was recorded. None of those responses were according to any type of pain rating scale. Evidence of evaluation following measures used to relieve pain was more likely to be recorded if pain was poorly controlled or when side effects such as nausea were experienced by the patient. The author concludes that overall the audit has highlighted many gaps in what is or is not recorded in the patient record in respect of post operative pain assessment and has highlighted the need to develop standards of practice that will improve post operative pain management practices.

Abstract: The objective of this paper is to establish if there is any documented research and literature evidence that describe what the presenting clinical symptoms of Mai Aitu is, and also to explore an alternative frame-work to assess Pacific Islanders who present to mental health in crisis. As a community mental health nurse in the Crisis Assessment and Treatment Team (CATT), the author reports being confronted almost every day with an increasing number of Pacific Islanders presenting in crisis with symptoms consistent with the well documented signs of psychosis. For instance, symptoms like hallucinations, delusion and paranoid ideation which are also well known for describing schizophrenia. Her concern is that mental health nurses may be compromising their practice, the safety of the Pacific Island population and possibly the credibility of the profession with what appears like a lack of knowledge and awareness regarding the clinical symptoms of some Pacific Island mental illness. In Tonga it is called Avea Avanga, in Fiji it is referred to as Lialia, in Samoa it is known as Mai Aitu. The author notes that the issue becomes apparent when Samoan clients present in crisis with what appears to be psychosis but the fanau believe their love one is not mentally unwell, that he or she is simply suffering a traditional Samoan illness. Therefore they insist he or she be treated at home, instead of through admission to the psychiatric hospital, and also that they be seen by a Samoan healer instead of a psychiatrist.