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Author |
Johnson, H. |
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Title |
Clinical trials in the intensive care setting: A nursing perspective |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Evaluation; Intensive care nursing |
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Abstract |
As carers of patients who are clinical research participants, nurses' contribution to the success of clinical trials is acknowledged in the literature. Ethical dilemmas and challenges that clinical trials may present for nurses are also recognised. Although there is some discussion regarding these issues, few studies explore and identify the perceptions of intensive care nurses regarding clinical trials and how they may impact on nursing practice. This thesis explores and describes the viewpoints and experiences of sixty intensive care nurses from a tertiary level referral centre in New Zealand engaged in clinical research activities. The descriptive study utilised a self-administered questionnaire to gather information regarding nurses' roles in clinical trials, associated issues encountered and contributory factors, and the impact of issues on nursing practice, stress and satisfaction levels. Suggestions for potential strategies to minimise the impact of issues on nurses' practice were also sought. Descriptive statistical and content data analyses identified three key areas in which nurses' encounter issues associated with clinical trials and their practice: nurses' workload; ethical concerns; educational preparation and support. The findings indicate that, when issues exist in these areas, routine patient care can be delayed, the enactment of nurses' patient advocacy role can be affected, and nurses' stress and satisfaction levels can be negatively impacted upon. The perceptions of a group of intensive care nurses who are enveloped in the daily balance of patient care, the need for clinical research, and their professional obligations are discussed in this thesis. While the study's findings are reflective of one group of nurses in a distinct practice setting, their experiences can prompt other nurses, research teams and clinical leaders to reflect upon their own clinical research environment. |
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Call Number |
NRSNZNO @ research @ |
Serial |
923 |
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Author |
Hardcastle, J. |
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Title |
What is the potential of distance education for learning and practice development in critical care nursing in the South Island of New Zealand? |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Nursing; Education |
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Abstract |
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Call Number |
NRSNZNO @ research @ |
Serial |
1116 |
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Author |
Ryder-Lewis, M. |
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Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Interprofessional relations |
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Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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Author |
Turner, C.L.E. |
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Title |
A process evaluation of a shared leadership model in an intensive care unit |
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Year |
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Publication |
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Abbreviated Journal |
Massey University, Palmerston North, Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Leadership; Intensive care nursing; Nursing models |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1277 |
Serial |
1262 |
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Author |
Rummel, L. |
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Title |
Safeguarding the practices of nursing: The lived experience of being-as preceptor to undergraduate student nurses in acute care settings |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Massey University, Albany, Library |
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Issue |
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Pages |
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Keywords |
Preceptorship; Nursing; Education; Identity; Intensive care nursing |
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Abstract |
This thesis used a Heideggerian Hermeneutic approach to explore the experiences of registered nurses who act as preceptors to undergraduate student nurses. The researcher interviewed fifteen volunteer registered nurses twice as preceptors to investigate their experience. The data generated was audio-taped and analysed. Four dominant themes emerged. The first, 'Becoming attuned – the call', related to registered nurses responding to the call to be preceptors to students in their clinical placement. The second, “The emerging identity of being-as preceptor: keeping the student in mind”, related to preceptors cultivating their own identity as preceptors as they worked with students in the world of nursing practice. The third, 'Assessing where the student is at: the preceptor and preceptee working and growing together', related to a constant evaluation by preceptors of students' knowledge, readiness to learn, and the provision of learning opportunities. The fourth, 'Preceptors as builders of nursing practice through teaching reality nursing', facilitated the preceptee's experience of the real world of nursing practice. An overall constitutive theme: 'Preceptors as the safeguarders of the practices of nursing', emerged as the essence of the experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1263 |
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Author |
McNamara, N. |
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Title |
The meaning of the experience for ICU nurses when a family member is critically ill: A hermeneutic phenomenologcial study |
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Year |
2007 |
Publication |
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Abbreviated Journal |
NZNO Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Nurse-family relations |
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Abstract |
This study provides insight into the experience of being an ICU nurse and relative of a critically ill patient. Analysis of data from interviews of four ICU nurses who had experienced having a family member admitted to ICU brought up several themes. These included: a nurses' nightmare, knowing and not knowing, feeling torn, and gaining deeper insight and new meaning. Recommendations for organisational support for ICU nurse/relatives, and education for staff are made, based on the findings. |
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Call Number |
NRSNZNO @ research @ 1312 |
Serial |
1296 |
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Author |
Haji Vahabzadeh, Ali |
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Title |
Optimal Allocation of Intensive Care Unit nurses to Patient-At-Risk-Team |
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Book Whole |
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Year |
2018 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
224 p. |
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Keywords |
Intensive Care Units; Intensive care nursing; Patients; Mortality; Health economics |
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Abstract |
Explains the need for nurse-led Patient-at-Risk-Teams(PART) to prevent unnecessary ICU admissions. Investigates which nurse allocation policy between PART and ICU would result in the best outcomes for patients and hospitals. Provides econometric models to estimate the impact of critical care nurses on hospital length of stay. Proposes queueing and simulation models to obtain the optimal nurse allocation policy for minimising the ICU mortality rate. Validates proposed models at Middlemore Hospital from 2015 to 2016. Estimates the financial and mortality impact of allocating another nurse to PART per shift. |
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Call Number |
NZNO @ research @ |
Serial |
1647 |
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Author |
Evans, S. |
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Title |
Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes |
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Journal Article |
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Year |
2003 |
Publication |
Pediatric Intensive Care Nursing |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
7 |
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Keywords |
Nursing specialties; Intensive care nursing; Equipment and Supplies |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
926 |
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Author |
Dredge, A. |
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Title |
An insider's view of professional nursing and care management of the critically ill patient |
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Journal Article |
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Year |
1999 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
5 |
Issue |
8 |
Pages |
13-16 |
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Keywords |
Intensive care nursing; Interprofessional relations; Registered nurses |
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Abstract |
This article explores the role of the registered nurse (RN) in the critical care environment. It presents the Intensive Care Unit (ICU) as a unique environment, with a specific relationship to technology, and a history that mirrors scientific development. It explores the tensions for a caring profession with a distinct culture practising in a highly medicalised, acute environment, and affirms the value of quality human care. |
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Call Number |
NRSNZNO @ research @ 1302 |
Serial |
1287 |
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Author |
Ho, T. |
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Title |
Ethical dilemmas in neonatal care |
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Journal Article |
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Year |
2000 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
6 |
Issue |
7 |
Pages |
17-19 |
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Keywords |
Intensive care nursing; Paediatric nursing; Ethics; Clinical decision making |
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Abstract |
The author explores possible approaches to the ethical dilemma confronting nurses of critically ill premature infants with an uncertain or futile outcome despite aggressive neonatal intensive care. A case history illustrates the issues. The morality of nursing decisions based on deontological and utilitarian principles is examined, as are the concepts of beneficence and non-maleficence. A fusion of virtue ethics and the ethic of care is suggested as appropriate for ethical decision-making in the neonatal intensive care environment. |
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Call Number |
NRSNZNO @ research @ 1035 |
Serial |
1019 |
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Author |
Wright, R. |
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Title |
Linking theory with practice |
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Journal Article |
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Year |
2001 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
7 |
Issue |
2 |
Pages |
14-15 |
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Keywords |
Intensive care nursing; Nurse-family relations; Nursing models |
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Abstract |
This article describes the care of a brain-dead intensive care unit patient. The human caring theory of Jean Watson is used to interpret the interactions between family, patient and nurse in this case study. Watson's concepts of care are examined as they relate to each stage of caring for the patient and his family. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1012 |
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Author |
Powell, J. |
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Title |
Caring for patients after an ICU admission |
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Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
7 |
Pages |
24-25 |
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Keywords |
Intensive care nursing; Nurse-patient relations; Trauma; Communication |
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Abstract |
The author presents research on nursing strategies that reduce the psychological effects of critical illness and prevent the intensive care unit (ICU) atmosphere from adversely affecting the nurse-patient relationship. Post-traumatic stress disorder and other phobic anxiety syndromes are noted as a risk among former ICU patients. Four interventions to put in place for discharge are presented: patient-centred nursing, communication, multidisciplinary care, and patient/family education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
954 |
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Author |
Hansen, G. |
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Title |
The role of massage in the care of the critically ill |
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Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
7 |
Pages |
14-16 |
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Keywords |
Nursing; Alternative therapies; Intensive care nursing |
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Abstract |
This article looks at the research on the benefits of massage for alleviating the anxiety of patients in critical care. The author draws on her own experiences with cardiac patients and affirms the lasting psychological benefit of massage. She provides advice on which parts of the body to massage on patients in critical care, which to avoid and how to know when it is contraindicated. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1010 |
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Author |
Lui, D.M.K. |
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Title |
Nursing and midwifery attitudes towards withdrawal of care in a neonatal intensive care unit: Part 2. Survey results |
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Journal Article |
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Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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Volume |
9 |
Issue |
3 |
Pages |
91-96 |
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Keywords |
Intensive care nursing; Paediatric nursing; Ethics; Attitude of health personnel |
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Abstract |
Discontinuation of life support measures for an extremely low birthweight or very premature baby is controversial and difficult for both the parents and the healthcare professional involved in caring for the infant. This study seeks to investigate the attitude of nurses and midwives to the withdrawal of care from sick neonates. Part 1 reviewed the literature on this subject. Part 2 reports the results of a survey carried out in a New Zealand NICU. |
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Call Number |
NRSNZNO @ research @ 966 |
Serial |
950 |
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Author |
Evans-Murray, A. |
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Title |
Meeting the needs of grieving relatives |
Type |
Journal Article |
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Year |
2004 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
10 |
Issue |
9 |
Pages |
18-20 |
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Keywords |
Intensive care nursing; Grief; Communication |
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Abstract |
This article examines the role of nurses working in intensive care units who may need to work with families as they face the death of a loved one. How the nurse communicates with relatives during these crucial hours prior to the death can have profound implications on their grief recovery. Universal needs for families in this situation have been identified in the literature, and include: hope; knowing that staff care about their loved one; and having honest information about their loved one's condition. A case study is used to illustrate key skills and techniques nurses can employ to help meet these universal needs. In the first stage of grief the bereaved is in shock and may feel a sense of numbness and denial. The bereaved may feel confused and will have difficulty concentrating and remembering instructions, and they may express strong emotions. Studies on families' needs show that honest answers to questions and information about their loved one are extremely important. It is often very difficult for the nurse to give honest information when the prognosis is poor. Good communication skills and techniques are discussed, in which hope is not offered at the expense of truthfulness, and the nurse facilitates the process of saying goodbye and expressing emotions. Practical techniques, such as including the family in basic care such as foot massaging and simple hygiene routines, may also be used to move the family from being bystanders to the impending death, to comforters. |
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Call Number |
NRSNZNO @ research @ 1004 |
Serial |
988 |
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