Records |
Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
Type |
Journal Article |
Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
|
Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
Keywords |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
962 |
Permanent link to this record |
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|
Author |
Hardcastle, J. |
Title |
What is the potential of distance education for learning and practice development in critical care nursing in the South Island of New Zealand? |
Type |
|
Year |
2003 |
Publication |
|
Abbreviated Journal |
Massey University Library |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Nursing; Education |
Abstract |
|
Call Number |
NRSNZNO @ research @ |
Serial |
1116 |
Permanent link to this record |
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|
Author |
Pirret, A.M. |
Title |
The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making |
Type |
|
Year |
2005 |
Publication |
|
Abbreviated Journal |
Massey University Library |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Clinical decision making |
Abstract |
|
Call Number |
NRSNZNO @ research @ 686 |
Serial |
672 |
Permanent link to this record |
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|
Author |
Hansen, G. |
Title |
The role of massage in the care of the critically ill |
Type |
Journal Article |
Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
|
Volume |
8 |
Issue |
7 |
Pages |
14-16 |
Keywords |
Nursing; Alternative therapies; Intensive care nursing |
Abstract |
This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated. |
Call Number |
NRSNZNO @ research @ |
Serial |
1010 |
Permanent link to this record |
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Author |
McNamara, N. |
Title |
The meaning of the experience for ICU nurses when a family member is critically ill: A hermeneutic phenomenologcial study |
Type |
|
Year |
2007 |
Publication |
|
Abbreviated Journal |
NZNO Library |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Nurse-family relations |
Abstract |
This study provides insight into the experience of being an ICU nurse and relative of a critically ill patient. Analysis of data from interviews of four ICU nurses who had experienced having a family member admitted to ICU brought up several themes. These included: a nurses' nightmare, knowing and not knowing, feeling torn, and gaining deeper insight and new meaning. Recommendations for organisational support for ICU nurse/relatives, and education for staff are made, based on the findings. |
Call Number |
NRSNZNO @ research @ 1312 |
Serial |
1296 |
Permanent link to this record |
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|
Author |
Pirret, A.M. |
Title |
The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making |
Type |
Journal Article |
Year |
2007 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
|
Volume |
23 |
Issue |
3 |
Pages |
145-155 |
Keywords |
Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education |
Abstract |
The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved. |
Call Number |
NRSNZNO @ research @ |
Serial |
933 |
Permanent link to this record |
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Author |
Roberts, C. |
Title |
The influence of nursing culture on family visiting in adult intensive care units |
Type |
|
Year |
2007 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Nurse-family relations; Culture; Nursing |
Abstract |
This dissertation considers the implications of the relationship between nurses and the patient's family, when family members visit intensive care units (ICUs) following the acute admission of a relative there. In particular it explores the issues of power and control, nurses might have in this setting, the culture that supports that, and the implications this has for practice in the New Zealand context. A comprehensive literature review on the perspective of nurses in relation to relatives visiting adult intensive care units was conducted. The author concludes that nurses modify policies related to visiting access for family members to suit themselves, and the needs of their patient. Nurses use a variety of tactics to maintain a position of power and control by looking out for themselves first, their patient second, and relatives third. The need of the patient and their families is not well understood by nurses, and nurses feel they have inadequate skills to cope with the needs and stresses of visiting relatives. The author suggests that for nurses to provide family focused care in ICU they must develop a therapeutic relationship with all concerned. ICU nursing culture affects nurses ability to focus on caring for their patients and their families. Nurses in ICU appear to need to maintain power and control over their environment but further research is needed to identify the current situation in New Zealand ICUs. |
Call Number |
NRSNZNO @ research @ |
Serial |
502 |
Permanent link to this record |
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|
Author |
Fogarty, K. |
Title |
The assessment of competence in the novice nurse in the adult intensive care unit |
Type |
|
Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Nursing specialties; Clinical assessment |
Abstract |
This dissertation explores the assessment of nurses' clinical competence in the adult ICU setting. Specifically, methods for the assessment of competence are critiqued for their practical application to the novice nurse with less than six months experience in ICU. The assessment methods considered are continuous clinical assessment, self-assessment, peer review, objective structured clinical examination (OSCE), portfolio and computer assisted assessment. Several criteria are applied to the methods including the ability of each method to assess skills, knowledge and attitudes or values. Each method is critiqued for its implications in terms of cost and staffing resource, benefits and barriers to implementation. In addition, reliability and validity issues are considered for each method. The outcome of this exploration is the recommendation of a combination of methods; namely, portfolio and OSCE, for the assessment of competence in the ICU novice. The author concludes that this finding enhances current understanding within the ICU specialty of the multidimensional nature of competence assessment. |
Call Number |
NRSNZNO @ research @ |
Serial |
574 |
Permanent link to this record |
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|
Author |
Evans, S. |
Title |
Silence kills: Communication around adverse events in ICU |
Type |
|
Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Communication; Interprofessional relations |
Abstract |
The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety. |
Call Number |
NRSNZNO @ research @ |
Serial |
741 |
Permanent link to this record |
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|
|
Author |
Rummel, L. |
Title |
Safeguarding the practices of nursing: The lived experience of being-as preceptor to undergraduate student nurses in acute care settings |
Type |
|
Year |
2001 |
Publication |
|
Abbreviated Journal |
Massey University, Albany, Library |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Preceptorship; Nursing; Education; Identity; Intensive care nursing |
Abstract |
This thesis used a Heideggerian Hermeneutic approach to explore the experiences of registered nurses who act as preceptors to undergraduate student nurses. The researcher interviewed fifteen volunteer registered nurses twice as preceptors to investigate their experience. The data generated was audio-taped and analysed. Four dominant themes emerged. The first, 'Becoming attuned – the call', related to registered nurses responding to the call to be preceptors to students in their clinical placement. The second, “The emerging identity of being-as preceptor: keeping the student in mind”, related to preceptors cultivating their own identity as preceptors as they worked with students in the world of nursing practice. The third, 'Assessing where the student is at: the preceptor and preceptee working and growing together', related to a constant evaluation by preceptors of students' knowledge, readiness to learn, and the provision of learning opportunities. The fourth, 'Preceptors as builders of nursing practice through teaching reality nursing', facilitated the preceptee's experience of the real world of nursing practice. An overall constitutive theme: 'Preceptors as the safeguarders of the practices of nursing', emerged as the essence of the experience. |
Call Number |
NRSNZNO @ research @ |
Serial |
1263 |
Permanent link to this record |
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|
Author |
Ryder-Lewis, M. |
Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
Type |
|
Year |
2004 |
Publication |
|
Abbreviated Journal |
ResearchArchive@Victoria |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Interprofessional relations |
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. |
Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
Permanent link to this record |
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Author |
Booher, J. |
Title |
Professional practice models: Shared governance and magnet hospitals |
Type |
Journal Article |
Year |
2003 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
|
Volume |
|
Issue |
June |
Pages |
|
Keywords |
Nursing models; Intensive care nursing; Clinical governance |
Abstract |
This article explores the application of professional practice models in nursing. Particular reference is made to the magnet hospital model and the concept of shared governance. Key principles from these models are explored in relation to the implementation of a professional practice model in an intensive care environment. Historical, cultural and professional factors that may be seen as barriers to the implementation of this professional practice model are also explored. In conclusion, the article identifies recommendations that may contribute to a successful implementation and duration of a model in practice. |
Call Number |
NRSNZNO @ research @ |
Serial |
861 |
Permanent link to this record |
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Author |
Morrison, M. |
Title |
Posthuman pathology: A postmodern art project located in critical care |
Type |
|
Year |
2003 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
Volume |
|
Issue |
|
Pages |
|
Keywords |
Intensive care nursing; Nursing philosophy; Culture; Technology |
Abstract |
The author's art project “Posthuman Pathology” is a postmodern examination of the resolutely modernist culture of critical care medicine. She uses conceptual art practices in conjunction with the techniques of anti-aesthetics in order to dismantle, open out and critique ideas which are foundational to the culture of critical care. |
Call Number |
NRSNZNO @ research @ 580 |
Serial |
566 |
Permanent link to this record |
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|
|
Author |
Haji Vahabzadeh, Ali |
Title |
Optimal Allocation of Intensive Care Unit nurses to Patient-At-Risk-Team |
Type |
Book Whole |
Year |
2018 |
Publication |
|
Abbreviated Journal |
|
Volume |
|
Issue |
|
Pages |
224 p. |
Keywords |
Intensive Care Units; Intensive care nursing; Patients; Mortality; Health economics |
Abstract |
Explains the need for nurse-led Patient-at-Risk-Teams(PART) to prevent unnecessary ICU admissions. Investigates which nurse allocation policy between PART and ICU would result in the best outcomes for patients and hospitals. Provides econometric models to estimate the impact of critical care nurses on hospital length of stay. Proposes queueing and simulation models to obtain the optimal nurse allocation policy for minimising the ICU mortality rate. Validates proposed models at Middlemore Hospital from 2015 to 2016. Estimates the financial and mortality impact of allocating another nurse to PART per shift. |
Call Number |
NZNO @ research @ |
Serial |
1647 |
Permanent link to this record |
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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 |
|
Pages |
|
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 |
Permanent link to this record |