Abstract: Utilises a critical realist case study framework to explore how rehabilitation nurses documented their contribution for clients with traumatic brain injury (TBI), and the influences on that documentation. Administers a questionnaire, undertakes an audit and interviews the nurses about their contribution. Makes six recommendations in relation to organisational level decision-making and the practice of individual nurses.

Abstract: Draws on the author's doctoral thesis to examine the prejudices, paradoxes and possibilities inherent in nursing a person from a culture other than one's own.

Abstract: This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription.

Abstract: This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.

Abstract: Objective; The objective of this study is to determine if attending a nursing education session on menopause has an impact on women's management of their menopausal symptoms and consequently their quality of life for women aged 40 to 60 years. The hypothesis is that women attending education sessions will start or increase health promotion activities which will reduce menopausal symptoms and thus improve their quality of life.Design and method; Two questionaires were given to the women on the day of the education sessions and another questionnaire was sent to the participant three months later. The sample of 30 completed questionnaires includes feedback from Pacific Island women. A combination of quantitative and qualitative methods were used. The measure of quality of life has been based on the level of impact of menopausal on each women's life before the education session and three months later.Results; Initial analysis indicates that diet, exercise and time out were most commonly reported health activities utilized for relief of symptoms with HRT and herbal remedies used less often. Three months after the education session there was a significant reduction in the impact of symptoms in most categories with 140 incidences of total disappearance of symptoms, 24 incidences of reduction of symptoms, 17 incidences of symptoms increasing while 36 symptoms remained unchanged. Only one woman reported that she continued to have no control over her symptoms while the rest of the sample indicated that they had some or total control. The most common changes in health promotion activities were reduction in caffeine, exercise, relaxation and lubrication with sex. Herbal, homeopathy, dietary and hormone treatment rated low in health activities after the three months.Conclusion; Initial analysis indicates that menopausal symptoms has significantly improved for the majority of women who attended the nursing education session

Abstract: A dissertation submitted in partial fulfilment for the degree of Master of Health Sciences.
Primary nursing as a framework within which nurses deliver patient care has been a nursing care delivery system of choice in New Zealand for the last two decades. A number of studies have been carried out, with a review of the literature suggesting inconclusive support for this delivery system over other functional nursing care models. However, there is support for the philosophy underpinning this model, with documented evidence that this framework can help nurses achieve a degree of professional development and autonomous practice that other models cannot. Using documented information created during the move from one model of nursing care to another this work evaluates what were the drivers for the change, how it was managed and what the outcomes were.
Findings indicated that this change project was a success. Analysis of the data collected pre and post implementation indicated some positive shifts, but more importantly it was the information gathered from both patients and nurses that gave creditability to the new model of nursing care.

Abstract: This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being.

Abstract: This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism.