|
|
MacGeorge, J. M., & Nelson, K. (2003). The experience of the nurse at triage influences the timing of CPAP intervention. Accident & Emergency Nursing, 11(4), 234–238.
Abstract: This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
|
|
|
|
Strickland, A. (2006). Nurse-initiated retinoblastoma service in New Zealand. Insight: The Journal of the American Society of Ophthalmic Registered Nurses, 31(1), 8–10.
Abstract: This article describes the implementation of a nurse-led, dedicated support network and service for children with a diagnosis of retinoblastoma and their families. Nurses with an interest in retinoblastoma at an Auckland Ophthalmology Department realised that the service provided was not meeting the needs of patients and families, particularly since the numbers had increased over the past two years. This article outlines the development of a cost-effective approach that improved the service.
|
|
|
|
Pirret, A. M. (2003). A preoperative scoring system to identify patients requiring postoperative high dependency care. Intensive & Critical Care Nursing, 19(5), 267–275.
Abstract: The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
|
|
|
|
DeSouza, R. (2005). Transforming possibilities of care: Goan migrant motherhood in New Zealand. Contemporary Nurse, 20(1), 87–101.
Abstract: This paper reports on a study of the maternity care experiences of women from Goa (India) in Auckland. Multiple research strategies were incorporated into the process to prevent reproduction of deficiency discourses. Interviews were carried out with Goan women who had experiences of migration and motherhood. The findings revealed that as a consequence of motherhood and migration, migrant mothers were able to reclaim and re-invent innovative solutions. Nurses and other health professionals can have a significant role in supporting women and their families undergoing the transition to parenthood in a new country and develop their knowledge and understanding of this dual transition.
|
|
|
|
Clendon, J. (2004). Demonstrating outcomes in a nurse-led clinic: How primary health care nurses make a difference to children and their families. Contemporary Nurse, 18(1-2), 164–176.
Abstract: The study outlined here explored outcomes from the provision of primary health care to children aged 5-13 years in a nurse-led clinic based in a primary school in Auckland. This multi-faceted study collected both qualitative and quantitative data, however it is the results of the quantitative arm of the study that are presented here. Data were collected from a variety of sources concerning conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage. Findings demonstrate that the provision of comprehensive primary health care by the nurse at the clinic impacts positively on hospital visitation by children from the area where the clinic is located.
|
|
|
|
Clendon, J., & White, G. E. (2001). The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis. Journal of Advanced Nursing, 34(2), 171–178.
Abstract: The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required.
|
|
|
|
Goodyear-Smith, F., & Janes, R. (2008). New Zealand rural primary health care workforce in 2005: More than just a doctor shortage. Australian Journal of Rural Health, 16(1), 40–46.
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.
|
|
|
|
Shaw, S. (2007). Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? Kai Tiaki: Nursing New Zealand, 13(1), 16–18.
Abstract: This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective.
|
|
|
|
Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
|
|
|
|
Mackay, B. (2007). Leadership strategies for role development in primary health care nursing. coda, An Institutional Repository for the New Zealand ITP Sector, 11, 31–39.
Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
|
|
|
|
Pearson, J. R., & Holloway, K. T. (2006). A postgraduate primary health care programme for experienced registered nurses and newly graduated nurses. Whitireia Nursing Journal, 13, 44–52.
Abstract: This paper outlines the historical development of the Postgraduate Certificate in Primary Health Care Specialty Nursing programme. The paper discusses the multiple contextual considerations for the programme in terms of New Zealand health policy direction, academic level, and appropriate level of competency development for nurses new to primary health care and newly graduated nurses.
|
|
|
|
Horsburgh, M., Merry, A., Seddon, M., Baker, H., Poole, P., Shaw, J., et al. (2006). Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative. Journal of Interprofessional Care, 20(5), 555–557.
Abstract: This article describes two interprofessional learning modules offered by the Faculty of Medical and Health Sciences at the University of Auckland to undergraduate medicine, nursing and pharmacy students. The modules, 'Maori Health“ and ”Patient Safety", have a focus on quality improvement in healthcare and are used to bring together students for a shared learning programme.The specific dimensions of healthcare quality covered in the programme are: patient safety, equity, access, effectiveness, efficacy and patient-centeredness.
|
|
|
|
Neville, S. J., & Henderson, H. M. (2006). Perceptions of lesbian, gay and bisexual people of primary healthcare services. Journal of Advanced Nursing, 55(4), 407–415.
Abstract: This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
|
|
|
|
O'Brien, A. P., Boddy, J. M., Hardy, D. J., & O'Brien, A. J. (2004). Clinical indicators as measures of mental health nursing standards of practice in New Zealand. International Journal of Mental Health Nursing, 13(2), 778–788.
Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
|
|
|
|
Gohns, A. (2002). Management of opioid substitution treatment in the primary health care setting: A national training course for service providers. Full text online from the Royal New Zealand College of General Practitioners' website, 29(3), 172–175.
Abstract: The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it.
|
|
