| Records |
| Author |
McCloskey, B.A.; Diers, D. |
| Title |
Effects of New Zealand's health reengineering on nursing and patient outcomes |
Type |
Journal Article |
| Year |
2005 |
Publication  |
Medical Care |
Abbreviated Journal |
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| Volume |
43 |
Issue |
11 |
Pages |
1140-1146 |
| Keywords |
Patient safety; Organisational change; Nursing; Hospitals |
| Abstract |
This study sought to examine the effects that hospital re-engineering may have on adverse patient outcomes and the nursing workforce. In 1993, New Zealand implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. All medical and surgical discharges from New Zealand's public hospitals (n=3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n=65,221 nurse responses) from 1993 through 2000 were examined. Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. The authors conclude that in the chaotic environment created by re-engineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organisational change plays in patient outcomes, the unintended consequences of health care re-engineering and market approaches in health care, and nursing's unique contribution to quality of care. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1052 |
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| Author |
Banks, J.; McArthur, J.; Gordon, G. |
| Title |
Flexible monitoring in the management of patient care process: A pilot study |
Type |
Journal Article |
| Year |
2000 |
Publication |
Lippincott's Case Management |
Abbreviated Journal |
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| Volume |
5 |
Issue |
3 |
Pages |
94-106 |
| Keywords |
Hospitals; Cardiovascular diseases; Nursing |
| Abstract |
This article describes a study conducted on the internal medicine, general surgical, and vascular wards of a large metropolitan hospital to assess the impact of a networked monitoring system and portable patient monitors. This pilot study was developed to address the needs of hospital patients who require continuous non-invasive vital signs monitoring (including heart rate, non-invasive blood pressure, pulse oximetry, cardiac waveform monitoring) with the addition of surveillance from a cardiac intensive care area. Data were collected from 114 patients over a three-month period to identify a patient group that could be managed appropriately under the new system and to determine the effect that flexible monitoring had on patient care management. Findings include identification of a specific patient group that can be managed successfully outside the cardiac intensive care area using this system. Other findings suggest a way to improve the management of patient monitoring in the general ward areas. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1091 |
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| Author |
Richardson, S. |
| Title |
Coping with outbreaks of the norovirus |
Type |
Journal Article |
| Year |
2005 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
11 |
Issue |
7 |
Pages |
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| Keywords |
Infection control; Risk management; Occupational health and safety; Hospitals |
| Abstract |
The author presents an overview of the impact and management of novovirus infections in New Zealand. The impact of this highly contagious virus on hospital settings is serious. With staff shortages already a problem, any outbreak of contagious disease has the potential to result in unsafe staffing, either through low numbers or poor skill mix. A report from New Zealand Environmental Science and Research (ESR) showed 35 reported norovirus outbreaks in New Zealand in the first quarter of 2004, resulting in 890 cases of the disease. Norovirus outbreaks are characterised by a rapid spread of infection, high uptake rate, and a high proportion of cases presenting with projectile vomiting. The author provides a definition of the novovirus, and looks at transmission, the management of hospital outbreaks, and the impact on emergency departments and hospital wards. Procedures include in-patient isolation. She notes there are no simple answers or “quick fixes” to the problem of norovirus outbreaks. While ongoing surveillance, recognition and isolation are key elements, there are wider structural and political implications that need to be acknowledged. These issues include overcrowding and staff shortages. |
| Call Number |
NRSNZNO @ research @ |
Serial |
981 |
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| Author |
Hunt, M. |
| Title |
Nurses can enhance the pre-operative assessment process |
Type |
Journal Article |
| Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
12 |
Issue |
10 |
Pages |
20-22 |
| Keywords |
Nursing specialties; Clinical assessment; Hospitals; Surgery |
| 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. |
| Call Number |
NRSNZNO @ research @ 1005 |
Serial |
989 |
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| Author |
Burrell, B. |
| Title |
Mixed-sex rooms: Invading patients' privacy? |
Type |
Journal Article |
| Year |
2003 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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| Volume |
9 |
Issue |
4 |
Pages |
26-28 |
| Keywords |
Cross-cultural comparison; Patient rights; Hospitals; Nursing; Gender |
| Abstract |
The author considers the issue of mixed-sex rooming (MSR) in New Zealand hospitals. A review of the literature is presented, with a focus on the attitudes and experiences of patients in the UK, where the issue has been most practised and studied. Findings of a survey of a group of New Zealand female patients are presented. The patients feelings of embarrassment and loss of dignity and privacy are discussed. The legal issues are explored, with the practice evaluated against the patient's rights detailed in the Code of Health and Disability Services and the Privacy Act 1993. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1000 |
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| Author |
Challis-Morrison, S. |
| Title |
Management and guidance of patient resuscitations within secondary rural hospitals |
Type |
Book Chapter |
| Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 111-122) |
Abbreviated Journal |
Ministry of Health publications page |
| Volume |
|
Issue |
|
Pages |
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| Keywords |
Hospitals; Rural health services; Resuscitation |
| Abstract |
This chapter firstly offers background information relating to the management and guidance of resuscitation within secondary rural hospitals. Secondly, it discusses the evidence related to issues concerning resuscitation and not-for-resuscitation, including issues involving medical and nursing staff, the patient experience, appropriate documentation, and cultural factors. Thirdly, it presents the findings through an implementation and evaluation plan. |
| Call Number |
NRSNZNO @ research @ 771 |
Serial |
755 |
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| Author |
Carter, H.; McKinlay, E.M.; Scott, I.; Wise, D.; MacLeod, R. |
| Title |
Impact of a hospital palliative care service: Perspective of the hospital staff |
Type |
Journal Article |
| Year |
2002 |
Publication |
JBI Reports |
Abbreviated Journal |
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| Volume |
18 |
Issue |
3 |
Pages |
160-167 |
| Keywords |
Palliative care; Hospitals; Attitude of health personnel; Cancer |
| Abstract |
The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1075 |
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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 |
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| Volume |
19 |
Issue |
5 |
Pages |
267-275 |
| Keywords |
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 |
Wassner, A. |
| Title |
Labour of love: Childbirth at Dunedin Hospital, 1862-1972 |
Type |
Book Whole |
| Year |
1999 |
Publication |
Dissector |
Abbreviated Journal |
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| Volume |
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Issue |
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Pages |
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| Keywords |
Hospitals; History of nursing; Maternity care; Registered nurses; Nursing; Education |
| Abstract |
This book covers obstetrical care from a nursing perspective at the Dunedin Hospital's Maternity Units. The researcher found little information on the two lying-in (maternity) wards of the first two Dunedin Hospitals. The book presents historical records outlining obstetric nursing procedures and maternity culture at the Dunedin Hospitals, The Benevolent Institution, The Batchelor Maternity Hospital, and Queen Mary Hospital. It covers cultural, social and legislative changes over the period, and examines conditions and pay for nursing staff across this time. A chapter on the evolution of baby care looks at changes in acceptable practices around nursery care, breast and bottle feeding, and medical procedures. The book has an extensive list of appendices, including staff lists, training notes for staff, duty lists, and interviews with staff and patients. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1049 |
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| Author |
Hardcastle, J. |
| Title |
The meaning of effective education for critical care nursing practice: A thematic analysis |
Type |
Journal Article |
| Year |
2004 |
Publication |
Australian Critical Care |
Abbreviated Journal |
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| Volume |
17 |
Issue |
3 |
Pages |
114, 116-2 |
| Keywords |
Hospitals; Nursing; Education; Nursing specialties |
| Abstract |
Using thematic analysis, this study explored the phenomenon of effective education for critical care nursing practice by asking: What does effective education for critical care nursing practice mean to nurses currently practising in the specialty? Eighty eight critical care nurses from the South Island provided written descriptions of what effective education for critical care nursing practice meant to them. Descriptive statements were analysed to reveal constituents, themes and essences of meaning. Four core themes of personal quality, practice quality, the learning process and learning needs emerged. Appropriateness or relevance for individual learning needs is further identified as an essential theme within the meaning of effective education for critical care nursing practice. Shared experiences of the phenomenon are made explicit and discussed with reference to education and practice development in the specialty. The study results lend support to education that focuses on individual learning needs, and identifies work based learning as a potential strategy for learning and practice development in critical care nursing. |
| Call Number |
NRSNZNO @ research @ |
Serial |
873 |
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| Author |
Chadwick, A.; Hope, A. |
| Title |
In pursuit of the named nurse |
Type |
Journal Article |
| Year |
2000 |
Publication |
Australasian Journal of Neuroscience |
Abbreviated Journal |
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| Volume |
13 |
Issue |
4 |
Pages |
6-9 |
| Keywords |
Advanced nursing practice; Hospitals; Evaluation; Nurse-family relations; Nurse-patient relations |
| Abstract |
This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required. |
| Call Number |
NRSNZNO @ research @ |
Serial |
924 |
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| Author |
MacGeorge, J.M.; Nelson, K. |
| Title |
The experience of the nurse at triage influences the timing of CPAP intervention |
Type |
Journal Article |
| Year |
2003 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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| Volume |
11 |
Issue |
4 |
Pages |
234-238 |
| Keywords |
Emergency nursing; Clinical decision making; Hospitals; Quality of health care |
| Abstract |
This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. |
| Call Number |
NRSNZNO @ research @ |
Serial |
847 |
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| Author |
Haitana, J. |
| Title |
Building relationships: A qualitative descriptive study reflective of the day-to-day experiences of one group of preceptors in a provincial hospital in New Zealand |
Type |
|
| Year |
2007 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Hospitals; Preceptorship; Education; Professional development; Mentoring; Training; Nursing |
| Abstract |
Research suggests that the experience of being a preceptor can be rewarding, but there are challenges which may impact on their ability to fulfil the preceptorship role. In an effort to understand the experiences of being a preceptor and the factors that impact on that role, a qualitative descriptive study was undertaken in a small provincial hospital in New Zealand. A purposeful sample of five registered nurse preceptors completed semi-structured audio-taped interviews. Seven common categories were developed from the data – willingness to engage, building a relationship, letting go, support, workload, students in the clinical setting and making judgements. The author notes that this research has highlighted that preceptors need prior notice that they are going to be having student nurses so that they can be better prepared; preceptors and student nurses also need to be rostered together for the whole placement to allow a one-on-one relationship to develop. Preceptors would benefit from having a lighter workload during the first few days of preceptoring as then they can spend more time teaching the student. Schools of nursing and hospitals also need to have an ongoing collaborative relationship in planning and supporting the preceptorship program; this would further support preceptors in their role. The lecturer from the school of nursing needs to be contactable and available to both the preceptor and the student to clarify any misunderstandings and as a resource should any problems arise. |
| Call Number |
NRSNZNO @ research @ |
Serial |
476 |
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| Author |
Becker, F. |
| Title |
Recruitment & retention: Magnet hospitals |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
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Issue |
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Pages |
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| Keywords |
Personnel; Hospitals; Recruitment and retention; Nursing |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
567 |
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| Author |
Cook, D. |
| Title |
Open visiting: Does this benefit adult patients in intensive care units? |
Type |
|
| Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
| Volume |
|
Issue |
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Pages |
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| Keywords |
Hospitals; Intensive care nursing |
| Abstract |
As the healthcare system moves toward a consumer-driven paradigm, visiting hours for family and significant others of the intensive care unit patient have become a topic of interest and discussion. Research since the 1970s has generated controversy and speculation over the ideal visiting practices in the adult intensive care unit. The aim of this dissertation was to examine the benefits for the patient, family members and nurses of appropriate visiting practices within intensive care areas in order to establish if open visiting is the best regime for patients in the adult intensive care unit (ICU). This dissertation explores visiting practices in adult critical care unit settings. Specifically, the benefits of visiting for patients, and the factors that may impede or facilitate visiting practices within the ICU were critically discussed. These factors included the benefits and disadvantages of open visiting, and the nurse as an influential factor in visiting. These areas linked together to form the basis for consideration of visiting in the ICU. Review of existing literature pertaining to visiting in the ICU indicated that patients wanted open visiting hours yet also indicated that they would like some visiting restrictions. Nurses appeared to value family input into care and were aware of patient and family needs, even though they may restrict visiting to suit their own work practices. Family members can provide the patient with psychological support, provide important historical data, assist the nurse with selected aspects of physical care, and actively encourage the patient's efforts to recover. The outcome of this exploration is the recommendation of an open visiting policy tailored to individual patients, as, the author suggests, this would foster nursing practice and ultimately benefit patients and their families. |
| Call Number |
NRSNZNO @ research @ |
Serial |
680 |
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