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Author |
McManus, L.M.; Cuthbertson, S.; Streat, S.J. |
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Title |
When the lights went out in Auckland |
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1998 |
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DCCM, Private Bag 92024 Auckland |
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As the clinical consequences of power failure in intensive care are seldom documented we reviewed the effects of a power failure on patient care, outcomes and the adequacy of our disaster plan. We reviewed clinical records of all ten patients in our department during a 20-minute total hospital power failure, determined the impact of the failure on the therapies being given, and the costs of failed equipment. We assessed the departments disaster plan and identified the causes of the power failure.Nine patients were intubated; six ventilated (one receiving nitric oxide) and three receiving continuous positive airway pressure. Two patients were ventilated by Servo 300,? which continued on batteries, the other four patients were ventilated manually. Six patients were receiving nine inotrope infusions through IMED Gemini,? (battery life 30 minutes). One patient was receiving high volume ultrafiltration using a Gambro? haemodialysis system, which failed. Blood flow to prevent clotting was maintained by turning the roller pump manually. All networked monitoring (SpaceLabs?) failed and three haemodynamically unstable patients were monitored by transport monitors (SpaceLabs Scout?). No patient suffered any ill effect. Failed electronic circuits cost $NZ11,724. The disaster plan was implemented and functioned well. The aged cables supplying Auckland Central failed during an El Nino summer. The hospital generators, supplying power to the city grid, failed to switch over to the hospital. During power failure infusion pumps should be only for inotropes. We now have external 12-volt battery backup. With good pre-planning, safe intensive care continued during a short power failure |
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NRSNZNO @ research @ 206 |
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206 |
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Author |
Pearce, L.; Kirkham, S.; Cuthbertson, S. |
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Title |
Quality of follow-up for self-poisoning patients after discharge from intensive care: 1996, one year later |
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1996 |
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DCCM, Auckland Hospital, P.O.Box 92024, Auckland |
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In 1995 we conducted a retrospective audit on a prospectively collated database to find out which intensive care patients missed out on psychiatric care after self poisoning. Our results showed that 57 patients in 1995 may not have received psychiatric follow-up assessment. Department of Critical Care Medicine (DCCM) follow-up was also less successful for this particular group. It was recommended that on admission to intensive care, all self poisoning patients would be referred to the Liaison Psychiatry Service (LPS).In 1996 we reviewed the databases of DCCM and LPS to determine if the quality of psychiatric follow-up had improved after the initial 1995 audit. In 1996 124 patients had 149 admissions (85F, age range 14.6-85.3, median 35, median GCS 9, 99 ventilated, 3 deaths). Thirteen patients had 25 admissions within 6 months of their index admission , 7/13 had a major psychiatric disorder. Mixed poisoning remained common. Forty-five admissions took cyclic antidepressants, 21 sedatives, 52 other medications, 25 ethanol (median 43 mmol/l ), 30 carbon monoxide and 5 took various non-prescription poisons.Thirteen went home, 32 to other hospitals, 4 to psychiatric hospitals and 97 were transferred to wards within Auckland Hospital. Psychiatric follow-up assessment was successful in 96/97 patients prior to discharge from Auckland Hospital. Those discharged to other hospitals or home were referred and followed up by LPS teams or other Mental Health Services.DCCM follow-up 4-6 weeks post discharge was more successful for 1996 with 120/146 contacted of which 33/120 were receiving ongoing psychiatric care. |
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Call Number |
NRSNZNO @ research @ 207 |
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207 |
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Author |
Idour, D.M.G. |
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Title |
Stepping beyond the known – the lived experience of returning registered nurse students: an interpretive descriptive study |
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1998 |
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Massey University Library, NZNO Library, UMI Disse |
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A Heideggerian Hermeneutical Analysis (HHA) approach was used for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) nursing studies?Research from the RRNS viewpoint is scarce, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. Participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favorable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace.Fourteen RRNS from an established university nursing programme participated in an expended non-structured interviews lasting 60 – 90 minutes. The interviews were held during 1993 in places selected by participants, some in the home but mostly in the work setting. With the consent of the participants interviews were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology, a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heiedeggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenemenology that, in general, an understanding of the meaning and significance of the lived experience can be required from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions.The study revealed several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing' is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and,, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge ad test the learning experiences we provide for RRNS.The fourteen participants traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the ' reflective openness' Senge(1990) advocates, as being a pre-requisite for 'learning organisations'. Contemporary oganisations require us to challenge our own thinking as well as being free to speak our minds ('participant openness'). Since, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements |
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NRSNZNO @ research @ 208 |
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208 |
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Author |
Corbett, A. |
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Title |
The use of breast milk and the re-establishment of the Human Breast Milk Bank in the Neonatal Unit in Waikato Hospital |
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1992 |
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Abbreviated Journal |
Neonatal Unit, Waikato Hospital |
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The suitability of human breast milk for the nurturing and development of the human species is proven over hundreds of thousands of years. Human milk is without peer in containing all the nutrients required for the growth and development of the human infant.Over and above the nutrient factors, human milk has significant immunological, anti-infective, and anti-allergy properties that should be foremost in deliberations of neonatal nurses and doctors, before one considers calorie counts and weight gain. Lucas and Cole ( 1990) have shown the terrible consequences of using formula in preterm babies over those fed only human milk, The NZ Cot Death Studies' first year results have shown the significance of breast feeding in reducing the incidence of cot death., giving an oblique reference to the effects of neonatal staff attitude on mothers milk of at risk babies.A ready supply of human breast milk used to be available to neonatal staff from the milk bank. All but a very few of these banks were closed down all over the world due to AIDS phobia rather than by any scientific fact. Sufficient time has gone by for science and nationality to govern the use of human breast milk, and a case is made for the reopening of the Milk Banks |
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NRSNZNO @ research @ 209 |
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209 |
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Author |
Berry, R. |
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Title |
Psychiatric comorbidity and childhood adversity in women seeking treatment for alcohol and/or drug dependence |
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1999 |
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Abbreviated Journal |
University of Otago Library, Dunedin |
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Eighty alcohol and/or drug dependent women who were consecutive admissions to an outpatient alcohol and drug service were interviewed with the aim of gathering information regarding childhood adversity, psychiatric comorbidity and alcohol and drug history, including extent of treatment and alcohol and drug related criminality. A secondary aim of the study was to investigate associations between both the multiplicity of alcohol and drug dependence diagnosis and the presence of psychiatric comorbidity in relation to exposure to childhood adversity, including sexual, physical and emotional abuse.The data demonstrate that the study sample was a relatively severe group of alcohol and drug dependent women. A sizeable percentage came from backgrounds characterised by parental separation, conflict and alcohol and drug problems. Many were regularly exposed to physical abuse perpetrated by both parents or main parental figures and over two-thirds were exposed to some form of sexual abuse within their first 15 years. Sixty percent had been dependent on more than one psychoactive substance, with half having undergone previous alcohol and drug treatment. The women also presented with substantial histories of criminal convictions, with a quarter having served a prison sentence. The results indicate the presence of extensive psychiatric comorbidity in the sample. Two-thirds of the women met current DSM-IV criteria forat least one of the following Axis I disorders: major depressive syndrome, social phobia or bulimia nervosa, while nearly half had antisocial personality disorder. More importantly, significant associations were found regarding the presence of psychiatric comorbidity in relation to four measures of severe childhood adversity, i.e. childhood sexual, physical and emotional abuse and parental problems. Multiplicity of alcohol and drug dependence diagnosis was associated with severe emotional abuse, severe parental problems andpsychiatric comorbidity. Emotional abuse during childhood was the most pervasive indicator of comorbidity and multiplicity of alcohol and/or drug dependence. The main implication for clinical practice arising from the results of this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug service may need to routinely screen and plan treatment for unresolved childhood trauma, psychiatric disorder and other problems related to alcohol and drug use in all clients presenting for alcohol and drug treatment |
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NRSNZNO @ research @ 210 |
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210 |
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Author |
McKinlay, E.M. |
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Title |
Within the circle of care: the patient's lived experience of receiving palliative care |
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1998 |
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Abbreviated Journal |
Mary Potter Hospice Library, Wellington |
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The objective of this research was to determine aspects of hospice based palliative care which patients described as being important and valued. This research is to be the basis of future work on the development of consumer generated quality indicators. Palliative care managers could use these to evaluate hospice based care, and provide output measures for health providers. The methodology used by the researcher was qualitative descriptive informed by phenomenology. Six recently discharged hospice patients who had at least two episodes of palliative care were interviewed about their experience of care. The resulting data, after reflection, formed a representation; the circle of care. This included aspects of valued care generated by actions of the interdisciplinary staff, and other aspects of care generated within the palliative care environment which the patient perceived as being meaningful and important. In conclusion, the reality of people receiving palliative care is characterised by a number of supportive traditional and non-traditional aspects of caring. Although some characteristics have been described within general health and the palliative care literature, some appear to have been generated by these particular participants as part their reality. The researcher believes that the resulting representation of care requires further research in other palliative care settings. The process of interviewing terminally ill people although not without concern to the interviewer, and inherently difficult for the patients, appeared to allow the patient to tell the story of both their illness and care |
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NRSNZNO @ research @ 211 |
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211 |
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Author |
White, E. L. |
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Title |
A co-operative approach to nursing manpower planning |
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1980 |
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The paper reviews, as a case history, the progress (to 1980) of the development of a Nursing Manpower Plan for Wellington Hospital Board.The main features of protocol are delineated.The prime requirement for the development of a manpower plan are perceived of as having available, reliable, quantifiable and comparable data.Discussion indicates the methods of collection, analysis and use (actual and potential) of quantifiable data.The use of quantifiable data indicated the potential, for the use of “nursing hours per patient per day” |
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NRSNZNO @ research @ 212 |
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212 |
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Author |
Stokes, C. |
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Title |
Nursing students experience of journalling |
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Miscellaneous |
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The aim of this study was to identify some nursing students' perceptions of how the process of journalling helps them to learn about nursing. The study sample were three students enrolled full time in a Bachelor of Nursing programme and at the end of their first year. Each student volunteer participated in a semi-structured audio-taped interview, guided by the opening question “What is journalling like for you?” The tapes were transcribed, coded and analysed for general themes. Each participant received a copy of her transcript and was invited to alter, add or delete any information. The findings highlighted the difficulties of beginning to journal, learning how to journal, personal growth through journalling, the journal as a critical document of oneself, a love-hate relationship with journalling, and what journalling is like now |
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NRSNZNO @ research @ 214 |
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214 |
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Author |
Neville, S.J. |
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Title |
Well-being in the older male: an investigation of mental, social and physical well-being indicators in Wanganui men |
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1998 |
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Massey University Library & Christchurch Polytechn |
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New Zealand's older population is gradually increasing. This will men the number of people with problems related to psychological and general well-being will also rise. When compared to women, men do not live as long, are more likely to die from intentional injury and use primary health services less. There is a paucity of research on older men, particularly within a New Zealand context. Because nurses work closely with people in primary, secondary and tertiary care settings they are well placed to undertake research and utilise research findings from studies relating to the older adult to promote health and well -being. The intention of the present study was to gain a greater understanding of those factors which impact on the well-being in older men. Based on Wan, Odell and Lewis's (1992) model of general well-being, mental, social and physical well-being indicators were investigated to examine their relationships to overall psychological well-being and physical health.The data for the present study was collected from a non-probability sample of 217 males (over 65 years) residing in the Wanganui area. Multiple regression analysis reveled that of the mental, social and physical indicators only satisfaction with social supports and number of visits to the doctor in the previous 12 months were significantly related to psychological well-being, and number of medications and illness/disabilities were significantly related to physical health as measured by self ratings of health.Findings are discussed in relation to the literature. It ids clear that nurses, and other health professionals, need to be aware of the relationship between objective health status and subjective well-being, and the distinction between the quality and quantity of support in order to provide effective care to older men. Finally the general limitations and future research implications are discussed |
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NRSNZNO @ research @ 215 |
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215 |
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Author |
Bird, A. |
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Title |
Social withdrawal among early patients in a long-stay psychiatric ward |
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Year |
1979 |
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Massey University Library |
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NRSNZNO @ research @ 216 |
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216 |
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Author |
Eopapong-Thongkajai, E. |
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Title |
Effects of structured pre-operative teaching upon post-operative physical recovery and psychological welfare |
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1980 |
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Massey University Library |
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NRSNZNO @ research @ 217 |
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217 |
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Author |
White, E. L.; Whiteman, E.J. |
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Title |
One approach to nursing manpower planning: a regional perspective |
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Miscellaneous |
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A dual presentation. This abstract gives only the research section of the presentation.A description of the data base components for Wellington Hospital Board Nursing Manpower Planning, which includes;Patients-: population based, bed based, best estimate, average daily bed occupancy andcategories.Nurses-: categories, whole time equivalents, attrition, nursing hours available, nursing hours lost.Finance.Assumptions for patient and nursing staff projections to 1986 are given.Financial constraints and the “buying” of nurses.A proportion of nursing positions are fixed by establishments and policy. The degree of flexibility remaining to “buy” differing categories of nursing staff |
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NRSNZNO @ research @ 218 |
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218 |
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Author |
Adamson, M.J. |
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Action research: the journey from enrolled nurse to registration and beyond. Discovering a process to promote self-efficacy and professional development |
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1997 |
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Victoria University of Wellington |
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NRSNZNO @ research @ 219 |
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219 |
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Author |
Tangamonsiri, D. |
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Title |
Teaching coping behaviour to psychiatric patients |
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1978 |
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Massey University Library |
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NRSNZNO @ research @ 220 |
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220 |
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Author |
Alessi, L. |
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Title |
The role of quality assurance strategies in the evaluation of New Zealand nursing services |
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1990 |
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Victoria University of Wellington Library |
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NRSNZNO @ research @ 221 |
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221 |
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