Abstract: Accountability has been described by nurses as an elusive concept or myth. The author suggests that this elusive concept or myth can partly be attributed to accountability becoming visible usually following a critical incident. The overall goal of this project is to provide nurses working within mental health with the incentive to raise their awareness and explore what their roles and responsibilities are within the accountability process in a more positive scenario. This research paper reports on an exploration of the key components of accountability within the New Zealand mental health environment. It describes significant influences that affect accountability. This is achieved by the means of a literature review, sharing of the author's experience of being involved in a national inquiry, and the adaptation of a who what and how framework, in conjunction with a diagram displaying accountability levels and lines for mental health nurses. The author points out that the domains of accountability for nurses will continue to evolve and expand but what remains important is that consumers have access to good quality mental health care.

Abstract: New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.

Abstract: The primary aim of this research paper is to draw on the literature to offer some insight into end of life care in the acute hospital setting. The secondary purpose is to provide an understanding of the integrated clinical pathway (ICP) for the care of the dying, consider its influence related to some of the challenges shaping end of life care and the positive effect it can generate on the quality of care experienced. There are significant challenges that impact on both the delivery and receipt of care for dying patients and their families. Six key influential barriers are considered within the context of the acute setting. Communication and the acute environment are two areas that significantly impact on the quality of care delivered, and are explored in more depth. Narratives from nursing and medical staff convey the realities encountered and difficulties experienced when they are unable to provide the care to which they aspire. Stories are shared by patients and families, which reflect on their experience of end of life care in the acute setting, and offer heath professionals some insight into the lives of the people nurses care for. The literature in relation to the development and implementation of the Liverpool Care of the Dying Pathway, and an overview of the Pathway document is presented. The strengths and limitations of its use are considered, alongside its influence beyond the documentation of clinical care. It is not possible to transfer the hospice service into the hospital setting, however the author suggests that through the implementation of the clinical pathway there is an opportunity to transfer best practice guidelines and positively influence the palliative culture in the acute setting.

Abstract: The Well Child/Tamariki Ora Health Book (the Plunket book) is a small booklet given to New Zealand mothers on the birth of a child. Although use of the book has decreased since it?s inception in 1920, it is frequently kept within the family and handed on from mother to child. Utilising an oral history approach, this study has traced the development of the Plunket book over time and explored the experiences of a group of 34 women and one man who have reflected on their ownership of, or involvement with, Plunket books. The study found that the book remains an effective clinical tool for mothers and nurses. Nurses use the book as a tool to help develop a relationship with a mother and her family, and to identify and build on strengths. Mothers have used the book as a tool to link past with present, to maintain kinship ties across generations, to deal with change intergenerationally, and in a manner that contributes to their self-identity as woman and mother. The study recommends that nurses and other health professionals continue to use the Plunket book as a clinical tool mindful of the fact that the book remains in use beyond the health professional?s immediate involvement with the mother and child, playing an important role in the context of the New Zealand family across generations.

Abstract: A dissertation in partial fulfilment of Master Health Sciences (Clinical)through University of Otago
The nurse practitioner is one of the newest nursing health care professionals to be introduced to the New Zealand health system for many years. Eighty-six nurse practitioners are credentialed in New Zealand, with three working in urban Emergency Department settings. Nurse Practitioners are common internationally especially in the United States, Canada, United Kingdom and Australia. The purpose of this integrated literature review is to explore current research and literature in regards to the Emergency Department Nurse Practitioner, and their role within emergency settings. This review presents the growth and development of the nurse practitioner as an advanced practice nursing position. Four key themes emerge from the literature review; education of the Emergency Nurse Practitioner , how and who defined the Emergency Nurse Practitioner role, practice setting of the Emergency Nurse Practitioner, and what the barriers are to independent practice. The economic, legal and governance aspects of the Nurse Practitioner role are also portrayed. This integrated review documents the potential for further development and expansion of the Emergency Nurse Practitioner scope of practice to provide a broad range of patient care services within Emergency Departments, and emergency care settings. Future research is essential for the promotion of autonomous practice of the Emergency Nurse Practitioner within the international and New Zealand health care system.

Abstract: A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Nursing.

Abstract: This dissertation by Deborah Alleyne explores the current context of nursing in New Zealand prisons through rediscovering the history of its introduction and development, and review of relevant literature. Prison nursing is recognised as a unique branch of the wider nursing profession by virtue of the environment in which nurses work and the population for whom they provide care. Four key themes are identified from the literature review: custody versus caring; nurses' relationship with custody staff; nurses' relationship with prisoners; isolation.