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Author O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J.
Title Clinical indicators as measures of mental health nursing standards of practice in New Zealand Type (up) Journal Article
Year 2004 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 13 Issue 2 Pages 778-788
Keywords Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth
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.
Call Number NRSNZNO @ research @ Serial 1059
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Author Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N.
Title Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand Type (up) Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 46 Issue 1 Pages 95-109
Keywords Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori
Abstract The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
Call Number NRSNZNO @ research @ Serial 1060
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Author Carter, H.; MacLeod, R.; Brander, P.; McPherson, K.
Title Living with a terminal illness: Patients' priorities Type (up) Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 45 Issue 6 Pages 611-620
Keywords Terminal care; Quality of life; Nursing models; Cancer
Abstract The aim of this paper is to report on an exploratory, qualitative study exploring what people living with terminal illness considered were the areas of priority in their lives. Ten people living with terminal cancer were interviewed. Analysis of the interviews incorporated principles of narrative analysis and grounded theory. Over 30 categories were identified and collated into five inter-related themes (personal/intrinsic factors, external/extrinsic factors, future issues, perceptions of normality and taking charge) encompassing the issues of importance to all participants. Each theme focused on 'life and living' in relation to life as it was or would be without illness. Practical issues of daily living and the opportunity to address philosophical issues around the meaning of life emerged as important areas. The central theme, 'taking charge', concerned with people's levels of life engagement, was integrally connected to all other themes. The findings suggest that the way in which health professionals manage patients' involvement in matters such as symptom relief can impact on existential areas of concern. The findings challenge some aspects of traditional 'expert-defined' outcome measures. As this was an exploratory study, further work is needed to test and develop the model presented.
Call Number NRSNZNO @ research @ Serial 1061
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Author Richardson, S.
Title Aoteaoroa/New Zealand nursing: From eugenics to cultural safety Type (up) Journal Article
Year 2004 Publication Nursing Inquiry Abbreviated Journal
Volume 11 Issue 1 Pages 35-42
Keywords Cultural safety; History of nursing; Nursing philosophy
Abstract The concept of cultural safety offers a unique approach to nursing practice, based on recognition of the power differentials inherent in any interaction. Clarification of the concept is offered, together with a review of the historical shift in nursing attitudes that has led to the emergence of “cultural safety” as a viable and valued component of nursing practice. The argument is made that cultural safety has allowed for a more reflective, critical understanding of the actions of nursing to develop. This includes recognition that nurses' attitudes and values have inevitably been influenced by social and political forces, and as such are in part reflective of those within the wider community. Comparison between the support given by nurses in the early 1900s to the theory of eugenics and the current acceptance of cultural safety is used to highlight this point. An examination of the literature identifies that ideological and conceptual changes have occurred in the approach of Aoteaoroa/New Zealand nurses to issues with cultural implications for practice. A review of background factors relating to Maori health status and the Treaty of Waitangi is presented as a necessary context to the overall discussion. The discussion concludes with an acknowledgement that while the rhetoric of cultural safety is now part of nursing culture in New Zealand, there is no firm evidence to evaluate its impact in practice. Issues identified as impacting on the ability to assess/research a concept, such as cultural safety, are discussed. For cultural safety to become recognised as a credible (and indispensable) tool, it is necessary to further examine the “end-point” or “outcomes” of the process.
Call Number NRSNZNO @ research @ Serial 1062
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Author Hughes, C.
Title Perioperative nurses in NZ & evidence-based practice Type (up) Journal Article
Year 2004 Publication Dissector Abbreviated Journal
Volume 31 Issue 4 Pages 8, 10-1
Keywords Evidence-based medicine; Nursing specialties; Access
Abstract This project is a study of the barriers perceived by perioperative nurses to accessing and using research-based information. A survey questionnaire was distributed to 184 perioperative nurses working in five public and two private hospitals in the Auckland area. The number of completed questionnaires was 106 (57.6%). The results showed that the lack of time during work hours was ranked as the highest barrier. The results also showed that many nurses feel they do not have the skills to find and appraise research articles.
Call Number NRSNZNO @ research @ Serial 1063
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Author Gaskin, C.J.; O'Brien, A.P.; Hardy, D.J.
Title The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand Type (up) Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 4 Pages 259-270
Keywords Professional competence; Psychiatric Nursing; Clinical decision making; Nursing research
Abstract This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
Call Number NRSNZNO @ research @ Serial 1064
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Author Wilson, D.
Title The nurse's role in improving indigenous health Type (up) Journal Article
Year 2003 Publication Contemporary Nurse Abbreviated Journal
Volume 15 Issue 3 Pages 232-240
Keywords Transcultural nursing; Maori; Health status
Abstract The health status of indigenous peoples is a global concern with mortality and hospitalisation data indicating that the health of indigenous groups falls below that of other ethnic groups within their countries. The preliminary findings of grounded theory research project undertaken with a group of 23 New Zealand Maori women about their health priorities and 'mainstream' health service needs provide the foundation for an exploration of issues impacting on the health status of indigenous people. The role that nursing and nurses have in improving access and use of health services by indigenous people is discussed. Strategies are suggested that nurses can utilise within their practice when working with local indigenous groups.
Call Number NRSNZNO @ research @ Serial 1065
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Author Bishop, D.; Ford-Bruins, I.
Title Nurses' perceptions of mental health assessment in an acute inpatient setting in New Zealand: A qualitative study Type (up) Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 3 Pages 203-212
Keywords Psychiatric Nursing; Clinical assessment; Attitude of health personnel; Nursing models
Abstract This qualitative study explores the perceptions of mental health nurses regarding assessment in an acute adult inpatient setting in Central Auckland. Fourteen mental health nurses took part in semi-structured interviews answering five open-ended questions. The analysis of data involved a general inductive approach, with key themes drawn out and grouped into four categories (roles, attitudes, skills and knowledge) in order to explore the meaning of information gathered. The outcome of the study acknowledged the importance of contextual factors such as the physical environment and bureaucratic systems, as well as values and beliefs present within the unit. The participants expressed concern that their input to assessment processes was limited, despite belief that 24-hour care and the nature of mental health nursing generally suggested that a crucial role should exist for nurses. In order for nurses to be established as central in the assessment process on the unit the study concludes that a nursing theoretical framework appropriate for this acute inpatient setting needs to be developed.
Call Number NRSNZNO @ research @ 1082 Serial 1067
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Author Coleman, R.; Sim, G.
Title The sacredness of the head: Cultural implications for neuroscience nurses Type (up) Journal Article
Year 2003 Publication Australasian Journal of Neuroscience Abbreviated Journal
Volume 16 Issue 2 Pages 20-22
Keywords Paediatric nursing; Transcultural nursing; Culture
Abstract The aim of this paper is to increase neuroscience nurses' awareness of how the head is perceived as sacred by some cultures. This article will outline a definition of culture, discussion around the sanctity of the head for some cultures, the cultural significance of common neuroscience interventions, the use of traditional healing methods, and prayer. Examples will be provided of how nursing interactions and interventions affect some cultures, looking primarily at a Maori and Pacific Island perspective. The focus of this paper is within a New Zealand paediatric setting.
Call Number NRSNZNO @ research @ 1083 Serial 1068
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Author Crowe, M.; Carlyle, D.
Title Deconstructing risk assessment and management in mental health nursing Type (up) Journal Article
Year 2003 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 43 Issue 1 Pages 19-27
Keywords Psychiatric Nursing; Risk management; Policy; Culture
Abstract The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities.
Call Number NRSNZNO @ research @ Serial 1069
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Author Palmer, S.G.
Title Application of the cognitive therapy model to initial crisis assessment Type (up) Journal Article
Year 2003 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 12 Issue 1 Pages 30-38
Keywords Mental health; Clinical assessment; Psychiatric Nursing
Abstract This article provides a background to the development of cognitive therapy and cognitive therapeutic skills with a specific focus on the treatment of a depressive episode. It discusses the utility of cognitive therapeutic strategies to the model of crisis theory and initial crisis assessment currently used by the Community Assessment & Treatment Team of Waitemata District Health Board. A brief background to cognitive therapy is provided, followed by a comprehensive example of the use of the Socratic questioning method in guiding collaborative assessment and treatment of suicidality by nurses during the initial crisis assessment.
Call Number NRSNZNO @ research @ 1085 Serial 1070
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Author White, G.E.; Mortensen, A.
Title Counteracting stigma in sexual health care settings Type (up) Journal Article
Year 2003 Publication Insight: The Journal of the American Society of Ophthalmic Registered Nurses Abbreviated Journal
Volume 6 Issue 1 Pages
Keywords Sexual and reproductive health; Nursing specialties; Attitude to health
Abstract Sexual health clinics and the people who visit them commonly face stigma. Sexually transmitted infections have historically been used to divide people into “clean” and “dirty”. A grounded theory study of the work of sixteen nurses in six sexual health services in New Zealand was undertaken to explore the management of sexual health care. The study uncovered the psychological impact of negative social attitudes towards the people who visit sexual health services and to the staff who work there. Sexual health nurses manage the results of stigma daily and reveal in their interactions with clients a process of destigmatisation.
Call Number NRSNZNO @ research @ Serial 1071
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Author Pearson, J.R.
Title A discussion of the principles of health promotion and their application to nursing Type (up) Journal Article
Year 2003 Publication Whitireia Nursing Journal Abbreviated Journal
Volume 10 Issue Pages 23-34
Keywords Health promotion; Nursing
Abstract
Call Number NRSNZNO @ research @ 1088 Serial 1073
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Author Muir-Cochrane, E.; Holmes, C.; Walton, J.A.
Title Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand Type (up) Journal Article
Year 2002 Publication Contemporary Nurse Abbreviated Journal
Volume 13 Issue 2/3 Pages 136-145
Keywords Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison
Abstract This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area.
Call Number NRSNZNO @ research @ Serial 1074
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Author Nicol, M.J.
Title The teaching of genetics in New Zealand undergraduate nursing programmes Type (up) Journal Article
Year 2002 Publication Nurse Education Today Abbreviated Journal
Volume 22 Issue 5 Pages 401-408
Keywords Curriculum; Nursing; Education
Abstract This paper reports the results of a survey to determine how much genetics is taught in the bioscience component of the three-year Bachelor of Nursing degree offered by 16 tertiary education institutes in New Zealand. A questionnaire was mailed to the bioscience lecturers seeking information on the bioscience and genetics content of current programmes. They were also asked to indicate their perception of the impact and relevance of new genetic knowledge on health care and nursing education. Results indicated that on average 250-350 hours are devoted to the teaching of biosciences. Less than 10 hours are devoted to genetics at 66% of institutes, one institute did not teach any aspect of genetics. None of the institutes taught more than 20 hours of genetics in the programme, although 47% of lecturers said they would like to teach more genetics if there were more time available in the curriculum. Lecturers teaching bioscience to Bachelor of Nursing students are aware of the importance of genetics in health care and to nursing in particular, and the majority are of the opinion that more genetics should be included in undergraduate programmes, however 'curriculum crowding' is a problem.
Call Number NRSNZNO @ research @ Serial 1076
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