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Farrow, T., & O'Brien, A. J. (2005). Discourse analysis of newspaper coverage of the 2001/2002 Canterbury, New Zealand mental health nurses' strike. International Journal of Mental Health Nursing, 14(3), 187–195.
Abstract: This paper reports on research into print media representations of industrial disputes in Canterbury in 2001, when mental health nurses undertook a variety of strike actions after stalled negotiations with the local district health board. One response to these actions was the temporary reduction of many of the regions' mental health services. The researchers identified themes of juxtaposed but largely deprecatory images of both mental health nursing and of consumers of services. Some professional nursing voices were given print space during the strike; however, these were largely incorporated into existing discourses rather than offering a nursing viewpoint on the strike. The researchers suggest organisational efforts to focus on ways of ensuring that mental health nurses are seen as a legitimate authority by the media.
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Crowe, M., Ward, N., Dunnachie, B., & Roberts, M. H. (2006). Characteristics of adolescent depression. International Journal of Mental Health Nursing, 15(1), 10–18.
Abstract: This is a descriptive study of the characteristics of depression in a sample of 121 adolescents attending an outpatient specialist adolescent mental health service in New Zealand. The adolescents were required to complete two self-report measures to assess presence of depressive symptoms, severity of depression, and particular characteristics of the depression. The findings revealed that irritability was the most common characteristic along with other interpersonal and thought processing symptoms. It is important that mental health nurses are able to identify the specific characteristics of adolescent depression that may differ from adult depression in order to manage this patient population effectively.
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O'Brien, A. P., Boddy, J. M., Hardy, D. J., & O'Brien, A. J. (2004). Clinical indicators as measures of mental health nursing standards of practice in New Zealand. International Journal of Mental Health Nursing, 13(2), 778–788.
Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
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Bishop, D., & Ford-Bruins, I. (2003). Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study. International Journal of Mental Health Nursing, 12(3), 203–212.
Abstract: This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
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Palmer, S. G. (2003). Application of the cognitive therapy model to initial crisis assessment. International Journal of Mental Health Nursing, 12(1), 30–38.
Abstract: This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
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King, S. L. J., & Walsh, K. (2007). 'I think PCA is great, but . . .'- Surgical nurses' perceptions of patient-controlled analgesia. International Journal of Nursing Practice, 13(5), 276–283.
Abstract: This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semi-structured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being `I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education.
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Lesa, R., & Dixon, D. A. (2007). Physical assessment: Implications for nurse educators and nursing practice. International Nursing Review, 54(2), 166–172.
Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.
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Hennephof, R. (2005). Preceptorship and mentoring. In J. McDrury (Ed.), Nursing matters: A reader for teaching and learning in the clinical setting (pp. 27-45). Dunedin: Otago Polytechnic.
Abstract: This paper reviews international and local nursing literature on preceptorship and mentoring. This includes an exploration of ways in which these two terms are defined, a discussion of the essential qualities needed to undertake such roles, and an examination of appropriate preparation and exploration of the ways in which registered nurses can be supported when engaged in providing these roles. At the end of the chapter, discussion questions are provided by Joc Parkes.
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Hardy, D. J., O'Brien, A. P., Gaskin, C. J., O'Brien, A. J., Morrison-Ngatai, E., Skews, G., et al. (2004). Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand. Journal of Advanced Nursing, 46(1), 95–109.
Abstract: The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
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Crowe, M., & Carlyle, D. (2003). Deconstructing risk assessment and management in mental health nursing. Journal of Advanced Nursing, 43(1), 19–27.
Abstract: The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
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Crowe, M., O'Malley, J., & Gordon, S. (2001). Meeting the needs of consumers in the community: A working partnership in mental health in New Zealand. Journal of Advanced Nursing, 35(1), 88–96.
Abstract: The aim of this study was to evaluate whether the services that community mental health nurses provide are meeting the needs of consumers in the community. This was a joint project between nurses and consumers. It was a service-specific descriptive research project utilising qualitative methods of data collection and analysis that provides a model for working in partnership. The results of this research identify collaboration in planning care and sharing information as two areas of concern but generally the consumers were very satisfied with the care provided by community mental health nurses. The analysis of the data suggests that consumers value nursing care because nurses provide support in their own home; they help consumers develop strategies for coping with their illness and their life; they provide practical assistance when it is required; they are vigilant about any deterioration or improvement; and they are available and accessible. The results of this study have demonstrated that nurses will remain critical to the success of community-based care because of their ability and willingness to be flexible to the demands of their own organisation and the users of services.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.
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Ho, T., & Mok, J. (2003). Condensate clearance from CPAP circuit: An examination of two methods of draining condensate from the inspiratory tubing. Journal of Neonatal Nursing, 9(4), 117–120.
Abstract: Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate.
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Spence, D., & Wood, E. E. (2007). Registered nurse participation in performance appraisal interviews. Journal of Professional Nursing, 23(1), 55–59.
Abstract: This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice.
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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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