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Author |
Litchfield, M. |
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Title |
A framework of complementary models of nursing practice: A study of nursing roles and practice for a new era of healthcare provision in New Zealand |
Type |
Report |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Pages |
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Keywords |
Nursing models; Rural nursing; Policy; Scope of practice |
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Abstract |
This is the second of a series of research projects undertaken to present the contemporary picture of the nurse workforce and their work in rural settings to inform policy for development of rural healthcare. The document presents the findings of telephone interviews with nurses in different work rural work settings around the country discussing their practice. The analysis identified a framework of four models of nursing practice: two traditional models defined by the institutions employing nurses, and two emerging models defined by the new positions requiring nurses to respond directly to health need. |
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Call Number |
NRSNZNO @ research @ |
Serial  |
1176 |
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Author |
Litchfield, M. |
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Title |
The successful design and delivery of rural health services: The meaning of success |
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Report |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Issue |
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Pages |
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Keywords |
Evaluation; Rural health services; Primary health care |
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Abstract |
This is the report of the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of “successful design and delivery of rural health services” as a step towards a measurement tool. Participants were grouped as general practitioners, nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1177 |
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Author |
Litchfield, M. |
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Title |
Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 |
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Manuscript |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Held by the Ministry of Health, publication pending |
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Issue |
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Pages |
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Keywords |
Evaluation; Community health nursing; Nursing models; Interprofessional relations |
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Abstract |
This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1178 |
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Author |
Smart, S. |
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Title |
Post-operative pain management knowledge and attitude of paediatric nurses: A New Zealand regional view |
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Year |
2005 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
Pain management; Paediatric nursing; Hospitals; Pharmacology |
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Abstract |
This research explored the knowledge and attitudes towards paediatric post-operative pain, within the New Zealand context of small regional hospitals. It established how nurses working in these areas obtain and update their paediatric pain management knowledge, and what is it that influences their paediatric post-operative pain management practices. A questionnaire survey of registered nurses working in three small paediatric units (5 to 12 beds), in regional secondary service hospitals was undertaken. The survey had a 79% (n=33) response rate. Findings corroborate many findings in previously published literature including that nurses do well in questions related to assessment. However pharmacological knowledge continues to be lacking. Results also indicated that while nurses have a good understanding about who is the best person to rate pain, this wasn't carried through in the clinical scenarios provided. Education is clearly an important factor in improving the knowledge and attitudes needed in clinical practice. While this survey was somewhat limited, both in size and in that a clear correlation between the results and actual clinical practice could not be made, results are significant for the areas surveyed and for the development of pain education for nurses. |
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Call Number |
NRSNZNO @ research @ 1194 |
Serial |
1179 |
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Author |
Davies, B. |
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Title |
Same person different nurse: A study of the relationship between nurse and patient based on the experience of shifting from secondary care to home-based nursing |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Research Archive at Wintec |
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Pages |
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Keywords |
Nurse-patient relations; Communication; Hospitals; Home care |
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Abstract |
This study focuses on power themes in the nurse-patient relationship. The study is a critical reflection of the author's practice using a humanistic perspective from Hartrick Doane and Varcoe's (2005) model of relational family practice. It reviews the literature relating to power relationships in communication between nurses and patients and compares the ability to provide relational care in the home with hospital care. Practice examples demonstrate the shift in power relationships that the author had noticed since changing roles from hospital based to home care nursing. This is related to cultural, socio-environmental, historical and traditional influences on power in communication. The study is based on her reflection of the paradigm shift in her practice. Her practice moved from a problem solving approach to an empowerment, strengths based approach within partnership. The ethical challenges of discussing her practice in relation to clients has been managed by scrambling patient data so that it is not related to a single person and is focused on the author's nursing practice. |
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Call Number |
NRSNZNO @ research @ 1195 |
Serial |
1180 |
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Author |
Kingsbury, K. |
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Title |
The illlusion of separateness, a philosophical study of nursing and naturopathic practice: Healing connections between people |
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Year |
2000 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Alternative therapies; Nurse practitioners; Nursing models |
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Abstract |
This thesis describes the journey of a practicing independent nurse practitioner and naturopath through the stories of five clients. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of nursing and naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1181 |
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Author |
Anderson, P.R. |
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Title |
Determining competency for entry to nursing practice: A grounded theory study |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional competence; Clinical supervision; Nursing; Education |
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Abstract |
Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented, the author suggests could further enhance the validity and reliability of assessment outcomes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1182 |
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Author |
Tustin-Payne, W. |
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Title |
Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Wintec Research Archive |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional competence; Nursing; Psychology; Quality of health care; Feminist critique |
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Abstract |
The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection. |
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Call Number |
NRSNZNO @ research @ 1198 |
Serial |
1183 |
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Author |
Pearson, J.R. |
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Title |
Health promotion in one New Zealand primary school: A case study |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Health promotion; Evaluation; Students; Maori; Pacific peoples; Health education |
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Abstract |
The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1184 |
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Author |
Joyce, M. |
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Title |
The Strengths Perspective: Relevance and application to mental health nursing and crisis resolution work |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Nursing models; Evidence-based medicine |
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Abstract |
This research paper aims to explore the contribution of the Strengths Perspective to mental health nursing practice. The Strengths Perspective emerged from the area of social work and is primarily concerned with emphasising the strengths and resources of the person, as they define them. The premise is that if a person is able to identify and call on those strengths then he or she is able to improve the quality of their life. The paper outlines the historical, philosophical and moral foundations of the Strengths Perspective and discusses the humanistic approach to mental health nursing. The aim is to demonstrate that the Strengths Perspective and mental health nursing have a strong alignment, particularly with regard to a person-centred approach to care. The influence and constraints of the biomedical model on both mental health nursing and strengths based practice is a theme of the paper. The contention is that the biomedical or pathological approach to care can often disable, not enable consumers of health care, whereas an approach that centres on a person and their strengths is more likely to empower and liberate. The paper concludes with a discussion of themes that emerged from reflection on the literature and propositions are then made about how mental health nurses might orientate their thinking and practice to utilise the Strengths Perspective to augment their clinical work. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1185 |
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Author |
Polaschek, N. |
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Title |
Negotiated care: A model for nursing work in the renal setting |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
42 |
Issue |
4 |
Pages |
355-363 |
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Keywords |
Chronically ill; Nursing models; Nurse-patient relations; Communication |
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Abstract |
This article outlines a model for the nursing role in the chronic health care context of renal replacement therapy. Materials from several streams of literature are used to conceptualise the potential for nursing work in the renal setting as negotiated care. In order to present the role of the renal nurse in this way it is contextualised by viewing the renal setting as a specialised social context constituted by a dominant professional discourse and a contrasting client discourse. While performing specific therapeutic activities in accord with the dominant discourse, renal nurses can develop a relationship with the person living on dialysis, based on responsiveness to their subjective experience reflecting the renal client discourse. In contrast to the language of noncompliance prevalent in the renal setting, nurses can, through their relationship with renal clients, facilitate their attempts to negotiate the requirements of the therapeutic regime into their own personal life situation. Nurses can mediate between the dominant and client discourses for the person living on dialysis. Care describes the quality that nurses actively seek to create in their relationships with clients, through negotiation, in order to support them to live as fully as possible while using renal replacement therapy. The author concludes that within chronic health care contexts, shaped by the acute curative paradigm of biomedicine, the model of nursing work as negotiated care has the potential to humanise contemporary medical technologies by responding to clients' experiences of illness and therapy. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1186 |
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Author |
Narbey, N. |
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Title |
Cognitive Behaviour Therapy in psychosis: Relevance to mental health nurses |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Psychiatric Nursing; Psychology; Evidence-based medicine |
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Abstract |
The author uses his personal and professional experience to explore the application of Cognitive Behavioural Therapy in caring for people who experience psychosis. Psychosis can be a life-threatening illness; about one in ten young men with psychosis will take their own lives. Much of the progress in treatment has been predicated on a biological explanation of psychosis. The late 1990s have seen increasing interest in psychological approaches in the treatment of psychosis; not withstanding that this treatment does not work for all people. The first aim of this research report is to develop understanding about Cognitive Behavioural Therapy, through exploration of its origins and examining the theoretical basis and reviewing the evidence that may support its use. The second aim is to explore the evidence around mental health nurses' training and use of Cognitive Behavioural Therapy, by critically examining some of the major UK and Australian reports. The author considers that Cognitive Behavioural Therapy is theoretically and pragmatically compatible with contemporary nursing practice, and will have increasing prominence for New Zealand mental health nurses. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1187 |
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Author |
Clayton, J.R. |
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Title |
Exploring transitions: Working in “the space between the no longer and the not yet” |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Communication; Nurse-patient relations; Case studies |
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Abstract |
This thesis uncovers a personal journey of reflective practice, focusing on the author's emerging role as a nurse facilitating transitions using a dialectical approach in the context of a private nursing practice. Transitions encompass: life changes, loss, and adjustment to changes in function. Dialectical nurse facilitation of transition (DNFT) is a way of exploring self in the transitional space between “the no longer and the not yet”. In this facilitated process people potentially discover paradoxes, tensions, and creative energy, as they search for a way forward. The research design details a dialectical heuristic quest through journaling and reflecting on practice supervision and peer review, over a two year period. Exemplars written after reflecting on case notes reveal the lived experiences of participants. These case reviews show the complexity of patterns for people undergoing transitions and nurse facilitation. A relational pattern for DNFT encompasses compassionate engagement, catalytic mirroring, and interconnectedness. An exploration of literature encompasses nursing theories, facilitation, dialogue, loss, grief, spirituality and transition. This thesis provides a basis for evaluative research on the effectiveness of DNFT in health care settings in the future. Discussions regarding the expansion of these reflective and praxis genres are included which may be of interest to nursing education and practice contexts. |
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Call Number |
NRSNZNO @ research @ 1203 |
Serial |
1188 |
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Author |
Lally, E.J. |
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Title |
An exploration of language and nursing practice to improve communication in the context of ear syringing |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Communication; Practice nurses; Economics |
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Abstract |
This action research inquiry explores communication and nursing practice in an effort to improve practice and enhance patient care. Action research is a critical reflective process that involves spirals or cycles of planning, acting, reflecting/evaluating and replanning the next cycle. Using ear syringing as a procedure, in the general practice setting and at two separate surgeries, the author and another practice nurse co-researched this study during working hours. Twelve people consented to participate in the research that involved the audiotaping of each ear syringing interaction. Following each transcription of the recording, the researchers read their own and then each other's transcripts, and listened to the recordings. They discussed and reflected on their findings and planned the next cycle. Throughout the process, the researchers found a number of areas of practice to change or enhance. Changes included the use of technical language such as “contraindications” and “auditory meatus”, the side effects of syringing, improvements in communicating situations where ear syringing is not recommended and the options available, and post procedure information. These changes became a significant challenge, for example when both researchers forgot the changes, thus repeating previous errors and omissions. This factor highlighted the need to practise any changes prior to interactions, and to have a cue card on hand to facilitate recollection and to cement improvements into practice. Although time constraints limited this inquiry to three cycles, at the final meeting the researchers agreed to continue the reflective process they had begun to explore their practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1189 |
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Author |
McLoughlin, N. |
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Title |
Dying to know: Advancing palliative care nursing competence with education in elderly health settings |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Professional development; Nursing specialties; Palliative care; Nursing; Education |
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Abstract |
This paper explores the benefits of using education as one means to advance palliative care competence for nurses. A literature search was conducted revealing numerous educational initiatives and approaches have been developed to improve palliative care. Benefits include improved nursing knowledge, confidence and competence which directly correlate with improved patient outcomes. Accompanying the shift of palliative care from hospices to varied health care providers globally, are disparities in care provision. The literature suggests that reasons for such disparities include insufficient specialised palliative care knowledge and skills of nurses to effectively deliver this care within generalist health settings and lack of information for caregivers. In response, approaches aimed at improving palliative care include reviewing, redefining and implementing nursing roles, education courses, and theoretical frameworks to inform practice and improve outcomes. This paper focuses on the benefits of offering tailored palliative care education in work settings to improve patient care. One entrepreneurial education initiative aimed at advancing palliative nursing and which is currently being implemented in aged care contexts is shared. Careful strategic planning and working more collaboratively between all stakeholders, is strongly recommended in order to manage current and future challenges. Advancing palliative nursing care using appropriate education is achievable and beneficial but is fraught with complexities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1190 |
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