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Author Tweed, C.; Tweed, M. openurl 
  Title Intensive care nurses' knowledge of pressure ulcers: Development of an assessment tool and effect of an educational program Type Journal Article
  Year 2008 Publication American Journal of Critical Care Abbreviated Journal  
  Volume (up) 17 Issue 4 Pages 338-347  
  Keywords Intensive care nursing; Training; Evaluation  
  Abstract The aim of this study was to assess intensive care nurses' knowledge of pressure ulcers and the impact of an educational programme on knowledge levels. A knowledge assessment test was developed. A cohort of registered nurses in a tertiary referral hospital in New Zealand had knowledge assessed three times: before an educational programme, within two weeks after the programme, and 20 weeks later. Completion of the educational programme resulted in improved levels of knowledge. Mean scores on the assessment test were 84% at baseline and 89% following the educational programme. The mean baseline score did not differ significantly from the mean 20-week follow-up score of 85%. No association was detected between demographic data and test scores. Content validity and standard setting were verified by using a variety of methods. Levels of knowledge to prevent and manage pressure ulcers were good initially and improved with an educational programme, but soon returned to baseline.  
  Call Number NRSNZNO @ research @ Serial 958  
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Author Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. openurl 
  Title Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units Type Journal Article
  Year 2008 Publication Journal of Clinical Nursing Abbreviated Journal  
  Volume (up) 17 Issue 8 Pages 1035-1043  
  Keywords Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison  
  Abstract The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU.  
  Call Number NRSNZNO @ research @ Serial 962  
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Author Pirret, A.M. openurl 
  Title The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making Type Journal Article
  Year 2007 Publication Intensive & Critical Care Nursing Abbreviated Journal  
  Volume (up) 23 Issue 3 Pages 145-155  
  Keywords Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education  
  Abstract The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.  
  Call Number NRSNZNO @ research @ Serial 933  
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