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Farrow, T. (2003). 'No suicide contracts' in community crisis situations: A conceptual analysis. Journal of Psychiatric & Mental Health Nursing, 10(2), 199–202.
Abstract: 'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation.
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Lesa, R., & Dixon, D. A. (2007). Physical assessment: Implications for nurse educators and nursing practice. International Nursing Review, 54(2), 166–172.
Abstract: In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing.
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Spence, D., & Wood, E. E. (2007). Registered nurse participation in performance appraisal interviews. Journal of Professional Nursing, 23(1), 55–59.
Abstract: This article presents the findings of an interpretive study that explored and documented the meaning and impact of nurse participation in performance appraisal interviews. Data gleaned from nine New Zealand registered nurses employed by a single district health board provide evidence that nurses are often disappointed by the process of performance appraisal. Although they believe in the potential value of performance appraisal interviews, they seldom experience the feedback, direction, and encouragement necessary for an effective appraisal process. It is suggested that changes to the current professional development program and its accompanying performance appraisal will require skilled commitment on the part of nurses, managers, and the employing organisation to improve and develop the assessment and promotion of nursing practice.
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Holloway, K. T. (2000). The future for nursing education: UKCC review has relevance for New Zealand. Nursing Praxis in New Zealand, 16(2), 17–24.
Abstract: The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation.
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Nichols, J. (2004). An exploration of clinical supervision within mental health nursing. Vision: A Journal of Nursing, (November).
Abstract: The purpose of this paper is to shed some light on the concept of clinical supervision specifically in relation to mental health nursing. The author talks briefly about the naming and history of clinical supervision and aims to provide some clarity around defining the concept. There is discussion around the role, value and objectives of clinical supervision before critical examination of two models of clinical supervision within two different contexts. Finally the strengths and weaknesses of each model are discussed, and the differences illustrate some of the contextual factors of clinical supervision.
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Neville, S. J., Gillon, D., & Milligan, K. (2006). New Zealand registered nurses' use of physical assessment skills: A pilot study. Vision: A Journal of Nursing, (14(1)).
Abstract: The objective of this project was to ascertain registered nurses' use of selected physical assessment skills before and after participation in a health assessment course. A pre- (also referred to as part I) and post- (part II) test design was used to investigate the research aim. Participants were obtained via a convenience sample. A questionnaire was completed at the beginning of the educational programme and then four to six weeks after completion of the assessment course. A two tailed t-test was used to identify any significant differences in the characteristics of participants from part I (N = 206) to part II (N = 145), with no differences identified. However, there was an overall mean percentage difference of 17.1% in the use of physical assessment skills after having completed the educational programme. In conclusion, the researchers found that four to six weeks after completion of a health assessment course, nurses were using the skills learned to improve their nursing practice more frequently than before the programme.
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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.
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Ho, T., & Mok, J. (2003). Condensate clearance from CPAP circuit: An examination of two methods of draining condensate from the inspiratory tubing. Journal of Neonatal Nursing, 9(4), 117–120.
Abstract: Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate.
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Evans, S. (2003). Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes. Pediatric Intensive Care Nursing, 4(2), 7.
Abstract: The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
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Hughes, F. (2006). Reconnecting with policy: Requirements for survival as a mental health nurse. Journal of Psychosocial Nursing & Mental Health Services, 44(8), 30–39.
Abstract: This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships. It is suggested this will benefit consumers, provide influence in health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, the author draws on her own experiences and applies these to a discussion of how mental health nurses can influence and strengthen their relationships with nursing policy.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.
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Stone, P. W., Tourangeau, A. E., Duffield, C. M., Hughes, F., Jones, C. A., O'Brien-Pallas, L., et al. (2003). Evidence of nurse working conditions: A global perspective. Policy, Politics, & Nursing Practice, 4(2), 120–130.
Abstract: The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organisational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organisational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarised.
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Egan, M. (1999). The nursing and midwifery practice structure at Healthcare Hawkes Bay: An evaluation and improvement process. Vision: A Journal of Nursing, 5(8), 27–29.
Abstract: This article describes the Nursing and Midwifery Practice Structure, which has been in place at Healthcare Hawkes Bay since 1996. It was developed to provide nurses and midwives in clinical positions with a professional development structure, and uses a framework to recognise and reward competence. It encourages clinical progression and was developed to link nursing competence with remuneration. The Practice Structure, based on the work of Patricia Benner (Benner, 1984), is made up of 4 levels: Beginner/Advance Beginner Practitioner, Competent Practitioner, Proficient Practitioner, Expert Practitioner. The Structure was reviewed in 1998, and a Steering Group was formed to collect feedback from nurses and midwives, identify areas of concern, and make recommendations for improvements. At the time of writing, these recommendations are being implemented and systems are being developed to ensure the Nursing and Midwifery Practice Structure continues to develop.
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Murphy, R. (2005). A day in the life of an acute hospital psychiatric nurse. Kai Tiaki: Nursing New Zealand, 11(9), 24–25.
Abstract: A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies.
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McKenna, B., Thom, K., & O'Brien, A. J. (2008). Return to nursing programmes: Justifications for a mental health specific course. Intensive & Critical Care Nursing, 5(1), 1–16.
Abstract: This paper presents the findings from research that investigated the feasibility of developing a specialty return to mental health nursing programme in New Zealand. This was achieved through a scoping of existing return to nursing programmes; a survey of non-active nurses; and stakeholder consultation via interviews or focus groups. Existing generic programmes fail to attract non-active nurses wishing to focus on mental health nursing. The non-active nurses survey found 142 nurses who presently would or might possibly return to mental health nursing and participate in a programme. Most stakeholders supported the idea of implementing such a programme. The findings from this research indicate both feasibility and enthusiasm for the introduction of return to mental health nursing programmes. It is recommended that all aspects of this course mirror the service user focused 'recovery paradigm' that is a central tenet in contemporary mental health service delivery.
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