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Author |
Jonsdottir, H.; Litchfield, M.; Pharris, M. |
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Title |
Partnership in practice |
Type |
Journal Article |
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Year |
2003 |
Publication |
Research & Theory for Nursing Practice |
Abbreviated Journal |
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Volume |
17 |
Issue |
1 |
Pages |
51-63 |
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Keywords |
Nurse-patient relations; Nursing philosophy; Nursing research |
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Abstract |
This article presents a reconsideration of partnership between nurse and client as the core of the nursing discipline. It points to the significance of the relational nature of partnership, differentiating its features and form from the prevalent understanding associated with prescriptive interventions to achieve predetermined goals and outcomes. The meaning of partnership is presented within the nursing process where the caring presence of the nurse becomes integral to the health experience of the client as the potential for action. Exemplars provide illustration of this emerging view in practice and research. This is the first of a series of articles written as a partnership between nurse scholars from Iceland, New Zealand and the USA. The series draws on research projects that explored the philosophical, theoretical, ethical and practical nature of nursing practice and its significance for health and healthcare in a world of changing need. |
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Call Number |
NRSNZNO @ research @ |
Serial  |
1172 |
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Author |
Jonsdottir, H.; Litchfield, M.; Pharris, M. |
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Title |
The relational core of nursing practice as partnership |
Type |
Journal Article |
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Year |
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Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
47 |
Issue |
3 |
Pages |
241-250 |
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Keywords |
Nurse-patient relations; Nursing philosophy; Nursing research |
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Abstract |
This article elaborates the meaning of partnership in practice for nurses practising in different and complementary way to nurses in specialist roles and medical practitioners. It positions partnership as the relational core of nursing practice. Partnership is presented as an evolving dialogue between nurse and patient, which is characterised by open, caring, mutually responsive and non-directive approaches. This partnership occurs within a health system that is dominated by technologically-driven, prescriptive, and outcome-oriented approaches. It is the second of a series of articles written as a partnership between nurse scholars from Iceland, NZ and USA. |
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Call Number |
NRSNZNO @ research @ 1188 |
Serial |
1173 |
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Author |
Litchfield, M.; Jonsdottir, H. |
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Title |
A practice discipline that's here and now |
Type |
Journal Article |
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Year |
2008 |
Publication |
Advances in Nursing Science |
Abbreviated Journal |
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Volume |
31 |
Issue |
1 |
Pages |
79-92 |
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Keywords |
Nursing research; Policy; Nursing philosophy |
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Abstract |
The article is a collaborative writing venture drawing on research findings from New Zealand and Iceland to contribute to the international scholarship on the status and future direction of the nursing discipline. It takes an overview of the international historical trends in nursing knowledge development and proposes a framework for contemporary nursing research that accommodates the past efforts and paradigms of nurse scholars and reflects the changing thinking around the humanness of the health circumstance as the focus of the nursing discipline. It addresses contemporary challenges facing nurses as practitioners and researchers for advancement of practice and delivery of health services, and for influencing health policy. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1174 |
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Author |
Litchfield, M.; Ross, J. |
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Title |
The role of rural nurses: National survey |
Type |
Report |
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Year |
2000 |
Publication |
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Abbreviated Journal |
Online on the Ministry of Health's Centre for Rural Health pages |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural nursing; Personnel; Nursing specialties; Primary health care |
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Abstract |
A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1175 |
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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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Volume |
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Issue |
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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 |
Type |
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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Volume |
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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 |
Type |
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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Volume |
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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 |
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 |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Research Archive at Wintec |
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Volume |
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Issue |
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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 |
Anderson, P.R. |
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Title |
Determining competency for entry to nursing practice: A grounded theory study |
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 |
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 |
McEldowney, R.A. |
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Title |
Shape-shifting: Stories of teaching for social change in nursing |
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 |
Nursing philosophy; Teaching methods; Feminist critique; Qualiltative research |
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Abstract |
This research explores why and how nurse educators teach for social change. Critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity. Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women's health, community development and cultural safety. All teach in counter-hegemonic ways, opening students' eyes to the unseen and unspoken. Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced. The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1193 |
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Author |
Clissold, C. |
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Title |
How discourses stifle the Primary Health Care Strategy's intent to reduce health inequalities |
Type |
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Year |
2006 |
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 |
Community health nursing; Policy; Primary health care |
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Abstract |
The Primary Health Care Strategy (PHCS) has a stated commitment to defined populations who suffer disproportionately from ill health. This thesis examines whether some prevailing discourses actually decrease the focus on health inequalities. A study of the nursing and medical media found that it focused predominantly on professional and industrial issues, leaving health workers focused mainly on their own professional interests, rather than considering the effects on health inequalities. She goes on to suggest that current Ministry of Health discourse values decentralised community health decision making. This may gloss over factors in community health which are affected by Government policy such as employment policy, and thus should be dealt with centrally by legislation. These factors have been found to be the most pertinent in health inequalities. So while models of community partnerships may seem to place communities as agents in their own health, this downplays the determinants of health which are beyond their control. Having shown that discourse can decrease the focus on health inequalities due to other professional and political drivers, the author then looked at health initiative concepts which are effective, efficient and equitable given the current set up of PHOs and nursing innovations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1196 |
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Author |
Ryder-Lewis, M. |
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Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
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 |
Intensive care nursing; Interprofessional relations |
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Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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Author |
Rudd, J. |
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Title |
From triage to treatment: An exploration of patient flow systems in emergency departments |
Type |
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Year |
2005 |
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 |
Emergency nursing; Hospitals; Risk management; Patient safety |
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Abstract |
To find an effective approach to managing or reducing waiting times for lower triage category patients processed through one particular metropolitan emergency department, an extensive search of the literature revealed several different patient flow processes. These approaches are discussed, in relation to suitability for the particular emergency department. The history of triage, including how and why it evolved, plus the realities of triage today are explored. Included are case examples of two patients on a journey through the department the way it is presently, and how it could be if particular approaches are introduced. Extending nursing practice by introducing nurse-initiated x-rays at triage and the introduction of a separate stream for minor category patients in a dedicated ambulatory care area is one approach that could improve waiting times for these patients. There would be the added advantage of improving triage compliance figures for category three patients. The additional costs involved in such a process could be offset by improved efficiency in terms of waiting times, improved triage compliance figures, happier patients and clinical staff, and an emptier waiting room. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1209 |
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Author |
Turnwald, A.B. |
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Title |
Acute Hypercarbia in Chronic Obstructive Pulmonary Disease (COPD): Presentations to a New Zealand emergency department |
Type |
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Year |
2006 |
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 |
Chronically ill; Clinical assessment; Emergency nursing |
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Abstract |
A retrospective descriptive design was used to examine the records of all presentations to the emergency department of patients with COPD over a 3-month period to determine whether there is a subset group of people who present with hypercarbia. There were 114 presentations, amongst those there were 71 individuals, a number presenting more than once within the three months. 80% of the 71 individuals had a smoking history of which 53% were female. Of the 114 presentations, 76 had arterial blood gases taken during their emergency department presentation. Of these 76 presentations 30 had hypercarbia and 46 were non-hypercarbia. These 76 presentations involved 58 individuals, with some individuals presenting five times over the three-month period. Three groups emerged, some who were only hypercarbia (n= 18), some in the non-hypercarbia group (n=35) and 5 individuals who had presentations in both the hypercarbia and non-hypercarbia groups. Data showed that there was no definable subset group of hypercarbia patients within acute exacerbations of COPD presenting to the emergency department according to the variables. However the sample of presentations (with a blood gas) found within the study suffering hypercarbia was much higher (31.1%) than anticipated. Further analysis showed that the hypercarbia group had a significant lower forced expiratory volume in one second (FEV1) and a combination diagnosis of emphysema or asthma and congestive heart failure. An implication to the clinician is that identification of hypercarbia within COPD exacerbation is problematically difficult until the late signs are shown with the individual. By that time effective treatment patterns may have changed from the initial presenting problem. The author concludes that future areas of research within this field needs to lie within the community, and look at when these people start the exacerbation, what leads them to progression presentation to the emergency department, and whether these people are chronic sufferers of hypercarbia or presenting after a period of days exacerbation within their own home. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1210 |
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Author |
Dobbs, L. |
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Title |
Can evidence improve nursing practice? |
Type |
Journal Article |
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Year |
2006 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
10 |
Issue |
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Pages |
27-32 |
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Keywords |
Evidence-based medicine; Nursing; Professional development |
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Abstract |
Evidenced Based Practice is aimed at providing safe, effective and cost-appropriate health care. The utilisation of EBP in nursing has proved to be valuable not only for patients and nurses, but also for other health professionals and the wider community. However, despite the recognised benefits of EBP, a significant gap between theory and practice exists. This paper explores some of the issues behind not implementing EBP, such as comfort with traditional practices, lack of engagement with EBP, and time constraints. |
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Call Number |
NRSNZNO @ research @ 1226 |
Serial |
1211 |
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