Abstract: This paper reports a study to explore Well Child nurses' perceptions of outcomes resulting from the use of solution-focused conversations in their telephone consultations with clients. The standard problem-solving approach used to address physical issues is less effective for various non-physical concerns, where different communication strategies may be helpful. In this qualitative, action-oriented study, a small group of Well Child telenurses in New Zealand was introduced to a specific communication strategy, called 'solution-focused conversations', during 2005. They applied this approach in their practice and then reflected together on their experiences in focus groups. The nurses considered that the solution-focused conversations enabled clients to: recognise the nature of the parenting issue of concern that had motivated their call; identify more effective parenting practices to address specific issues with their child; increase their confidence in their own parenting capabilities. This study suggested the value of learning a specific communication strategy for the practice of a group of Well Child telenurses.

Abstract: The aim of this study was to examine and compare Australian and New Zealand nurses' experience of workplace stress, coping strategies and health status. A postal survey was administered to 328 New South Wales (Australia) and 190 New Zealand volunteer acute care hospital nurses (response rate 41%) from randomly sampled nurses. The survey consisted of a demographic questionnaire, the Nursing Stress Scale, the WAYS of Coping Questionnaire and the SF-36 Health Survey Version 2. More frequent workplace stress predicted lower physical and mental health. Problem-focused coping was associated with better mental health. Emotion-focused coping was associated with reduced mental health. Coping styles did not predict physical health. New South Wales and New Zealand scored effectively the same on sources of workplace stress, stress coping methods, and physical and mental health when controlling for relevant variables. Results suggest mental health benefits for nurses who use problem-solving to cope with stress by addressing the external source of the stress, rather than emotion-focused coping in which nurses try to control or manage their internal response to stress. Cultural similarities and similar hospital environments could account for equivalent findings for New South Wales and New Zealand.

Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.

Abstract: The aim of this study was to obtain a 2005 snapshot of the New Zealand rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. A postal questionnaire was distributed to rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists in November 2005. The self-reported data included information on demographics, country of training, years in practice, business ownership, hours worked including on-call, and intention to leave rural practice.

Abstract: An initial profile of the demographics and current practice of Australian trauma nurse coordinators (TNCs) was conducted in 2003. The study identified common and differing role components, provided information to assist with establishing national parameters for the role, and identified the resources perceived necessary to enable the role to be performed effectively. This article compares the findings of the 2003 study with a 2007 survey, expanded to include New Zealand trauma coordinators. Forty-nine people, identified as working in a TNC capacity in Australia and New Zealand, were invited to participate in February 2007. Participation in the research enabled an update of the previously compiled Australia/New Zealand trauma network list. Thirty-six surveys (71.5% response rate) were returned. Descriptive statistics were undertaken for each item, and comparisons were made among states, territories, and countries. Participants reported that most of their time was spent fulfilling the trauma registry component of the role (27% of total hours), followed by quality and clinical activities (19% of total hours), education, and administration. The component associated with the least amount of time was outreach (3% of total hours). Although the proportion of time has almost halved since 2003, TNCs still spend the most time maintaining trauma registries. Compared to the 2003 survey, Australian and New Zealand TNCs are working more unpaid overtime, spending more time performing quality and clinical activities and less time doing data entry. Despite where one works, the role components identified are fulfilled to a certain extent. However, the authors conclude that trauma centres need to provide the TNC with adequate resources if trauma care systems are to be optimally effective

Abstract: The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.

Abstract: The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.

Abstract: This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.