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Author |
Richardson, S. |
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Title |
Emergency departments and the inappropriate attender: Is it time for a reconceptualisation of the role of primary care in emergency facilities? |
Type |
Journal Article |
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Year |
1999 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
13-20 |
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Keywords |
Emergency nursing; Primary health care |
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Abstract |
This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK. |
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Call Number |
NRSNZNO @ research @ |
Serial |
641 |
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Permanent link to this record |
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Author |
Richardson, S. |
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Title |
Increasing patient numbers: The implications for New Zealand emergency departments |
Type |
Journal Article |
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Year |
1999 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
3 |
Pages |
158-163 |
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Keywords |
Emergency nursing; Organisational change |
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Abstract |
This article examines influences that impact on the work of the Emergency Departments (EDs). EDs are noticing increased attendance of patients with minor or non-urgent conditions. This increase in patient volume, together with on-going fiscal constraints and restructuring, has placed an added strain on the functioning of EDs. New Zealand nurses need to question the role currently given to EDs and identify the issues surrounding the increased use of these departments for primary health care. |
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Call Number |
NRSNZNO @ research @ 1108 |
Serial |
1093 |
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Author |
Vernon, R.A. |
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Title |
Clinical case study: Acute traumatic head injury |
Type |
Journal Article |
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Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
12 |
Pages |
3-9 |
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Keywords |
Trauma; Emergency nursing; Nursing specialties; Quality of health care |
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Abstract |
This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1281 |
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Permanent link to this record |
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Author |
Ward, J. |
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Title |
High acuity nursing |
Type |
Journal Article |
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Year |
2001 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
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Volume |
7 |
Issue |
12 |
Pages |
15-19 |
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Keywords |
Nurse-family relations; Emergency nursing; Technology |
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Abstract |
This article looks at the role of technology in nursing, and the interaction between it and human compassion and caring. The interface between critical care technologies and caring is explored, along with the social and political issues facing critical care areas. |
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Call Number |
NRSNZNO @ research @ 1298 |
Serial |
1283 |
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Permanent link to this record |
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Author |
Ardagh, M.; Wells, E.; Cooper, K.; Lyons, R.; Patterson, R.; O'Donovan, P. |
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Title |
Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial |
Type |
Journal Article |
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Year |
2002 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
115 |
Issue |
1157 |
Pages |
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Keywords |
Emergency nursing; Time factors; Clinical assessment; Clinical decision making |
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Abstract |
The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources. |
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Call Number |
NRSNZNO @ research @ |
Serial |
617 |
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Author |
O'Sullivan, C. |
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Title |
Cardiopulmonary resuscitation: Attitudes and knowledge of medical and nursing staff |
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Year |
2002 |
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 |
Attitude of health personnel; Emergency nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1262 |
Serial |
1247 |
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Permanent link to this record |
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Author |
Little, S. |
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Title |
An exploration of vicarious traumatisation in emergency nurses |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Occupational health and safety; Nursing research; Stress |
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Abstract |
This thesis explores the theoretical notions of suffering and caring within the nurse patient relationship in the context of emergency nursing. It includes a small pilot study that aimed to assess the feasibliity of a major research project, by describing the impact of vicarious traumatisation in emergency nurses, specifically in relation to their self capacities. This pilot study utilised a descriptive, correlational design. Data was collected by using the Inner Experience Questionnaire (IEQ) a twenty four-item questionnaire developed by Dr Pearlman (1995), and a profile sheet which identified demographic details. Twenty-seven emergency nurses participated in this pilot study. The IEQ was assessed for internal reliability by applying the Cronbachs alpha and utilising a focus group to gain insight into the usability and relevance of the questions. The internal reliability of the IEQ suggests that it may be an appropriate tool to measure disruption of self capacities in the population of emergency nurses. Although the results are limited, and conclusions cannot be drawn, findings suggest a correlation between the variables of age, experience, nursing qualifications and a history of personal trauma and the IEQ. There is evidence that emergency nurses are affected psychologically when caring for the victims of trauma in emergency departments and the IEQ has the potential as a tool to be integrated into future emergency nursing studies. A multidimensional methodological approach is recommended to capture the many contours of the complex phenomena of vicarious traumatisation and the emergency nurse. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1249 |
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Permanent link to this record |
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Author |
MacGeorge, J.M.; Nelson, K. |
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Title |
The experience of the nurse at triage influences the timing of CPAP intervention |
Type |
Journal Article |
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Year |
2003 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
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Volume |
11 |
Issue |
4 |
Pages |
234-238 |
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Keywords |
Emergency nursing; Clinical decision making; Hospitals; Quality of health care |
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Abstract |
This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. |
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Call Number |
NRSNZNO @ research @ |
Serial |
847 |
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Permanent link to this record |
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Author |
Mortensen, A.; Young, N. |
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Title |
Caring for refugees in emergency departments in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
20 |
Issue |
2 |
Pages |
24-35 |
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Keywords |
Emergency nursing; Culture; Mental health; Health status |
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Abstract |
This paper outlines some of the special health needs of people from refugee backgrounds who present in the emergency department, and the role of emergency department nurses in improving care for refugee and migrant peoples. Refugees and asylum seekers represent a significant proportion of attendees in emergency departments in Auckland Hospitals. Culture and ethnicity are a major factor to be considered in addressing the health care needs of this population. Other factors such as the physical and psychological sequelae of the refugee experience, health care experience prior to arrival in New Zealand, poverty, language, and the trauma of resettlement also have a major impact on health care seeking behaviours. |
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Call Number |
NRSNZNO @ research @ 557 |
Serial |
543 |
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Permanent link to this record |
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Author |
Baur, P. |
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Title |
Patients who present to the emergency department but do not wait: An exploratory study |
Type |
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Year |
2004 |
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 |
Emergency nursing; Hospitals |
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Abstract |
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Call Number |
NRSNZNO @ research @ |
Serial |
849 |
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Permanent link to this record |
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Author |
Ritchie, M.S. |
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Title |
Process evaluation of an emergency department family violence intervention programme |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Evaluation |
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Abstract |
Family violence is common and there are significant long-term negative health effects from victimisation. Health professionals are now recognised as key providers of family violence intervention. The Hawke's Bay District Health Board HBDHB) launched a Family Violence Intervention Programme in the emergency department in 2002, in accordance with national directives. The Family Violence Intervention Programme includes routine questioning for partner abuse within social history assessments for all women 16 years and over who seek healthcare services. Nurses assumed responsibility for implementing this programme into emergency department practice. Establishing partner abuse screening in practice requires an organisational and attitudinal change. Achieving and sustaining this change can be difficult. Evaluation was considered an essential aspect of the systems approach adopted within the HBDHB Family Violence Intervention Programme to support change. The aim of this study was to identify the enablers and barriers to routine questioning in the emergency department one year after the programme was launched and the strategies to address these barriers. The staff who have responsibility for routinely questioning women were considered well placed to provide this information. The methodology selected was evaluation research using semi-structured interviews. The design included member checking and triangulation of the findings. Eleven emergency department staff members participated in five (two group and three single) interviews. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department setting. Barriers to questioning exist and enablers can eliminate or minimise these. Enablers such as policy and training support routine questioning. Barriers identified included the lack of privacy and time. Participants suggested strategies to overcome these. These barriers, enablers and solutions were either personal or organisational in origin and all had a common theme of safety. An outcome of the study was the development of a model of barriers and enablers to ensure safety when routinely questioning women for partner abuse. This evaluation has utility within the HBDHB as it informs programme progression. However, the evaluation has wider implications. The experiences of the emergency department staff led to the emergence of key themes that may inform the development of comparable programmes. Introducing routine questioning requires a practice change; a multifaceted approach focusing on safety can assist staff to achieve that change. |
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Call Number |
NRSNZNO @ research @ |
Serial |
851 |
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Permanent link to this record |
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Author |
Gabolinscy, B. |
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Title |
Triage codes: A predictor of nursing care time in the emergency department |
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Year |
2005 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing; Time factors |
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Abstract |
This thesis explores triage code as a predictor of direct nursing care time, thus its potential usefulness in a model for calculating and allocating nurse requirements in emergency departments. A framework for nursing work is proposed. This framework is based on the works of O'Brien-Pallas, Irvine, Peereboom, and Murray (1997) and Houser (2003). It suggests that the structures of environmental complexity, nursing characteristics, patient nursing complexity, and patient medical condition and severity, impact on the processes of direct and indirect nursing care to affect patient outcomes. A prospective, non-experimental study was undertaken to examine the relationship between direct nursing care time and triage code. Six potential confounding variables were selected for this study: length of stay, age, ethnicity, sex, complaint type, and discharge category. Data were collected for 261 visits over a three day period in one New Zealand emergency department. Patient visits averaged 200 minutes. The mean direct nursing care time per visit was 49 minutes. On average, patients with more urgent triage codes, longer length of stay, or who were not discharged, received more direct nursing care. The model developed predicted 49% of variation in direct nursing care time (p < .05) related to triage code (16%), length of stay (31%) and disposition category (2%). The author suggests that further exploration of the proposed framework has potential to develop a model allowing managers to identify nurse staffing required for optimal nursing care in emergency departments. |
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Call Number |
NRSNZNO @ research @ 481 |
Serial |
468 |
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Permanent link to this record |
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Author |
McKerras, R. |
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Title |
Waiting in the emergency department – it doesn't have to take all day |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Emergency nursing |
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Abstract |
This thesis explores the nature of the emergency department environment as it continues to challenge emergency nurses to meet the health needs of an increasingly complex emergency department population. The emergency nurse is also facing conflict and challenge with regard to workplace safety and patient rights. The author suggests that, until recently, very little debate or consideration has been given to the moral dilemmas raised in the ability of emergency department staff to deliver timely and appropriate care in an overcrowded environment. She goes on to say that, in New Zealand, there is no national consistency with regard to the waiting crisis, no national guidelines and no national consensus putting the emergency nurse at risk. This thesis argues the need to acknowledge waiting times as a significant safety issue at a national level as increasing waiting times continue to impact on patient outcomes and nursing practice. It challenges current practice, in particular the role of the emergency nurse and the potential to legitimise expansion of the role to improve the patient experience of waiting in the emergency department. |
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Call Number |
NRSNZNO @ research @ |
Serial |
512 |
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Permanent link to this record |
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Author |
Richardson, S. |
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Title |
Incorporation of research into clinical practice: The development of a clinical nurse researcher position |
Type |
Journal Article |
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Year |
2005 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
21 |
Issue |
1 |
Pages |
33-42 |
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Keywords |
Emergency nursing; Nursing research; Hospitals |
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Abstract |
The author backgrounds the development of the role of an innovative Nurse Researcher (Emergency Medicine) role at Christchurch Hospital. She describes the emergency department and the factors leading to the creation of the role. Specific nursing research projects are reviewed, and the nature of nursing in relation to research is discussed. The author argues that the nurse researcher is integral to the expansion of evidence-based nursing, and that the role of Clinical Nurse Researcher in the emergency department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance. |
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Call Number |
NRSNZNO @ research @ |
Serial |
536 |
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Permanent link to this record |
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Author |
Thompson, C.M.M. |
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Title |
Caring for people with mental health problems who present at the emergency department: A nurse educator's journey |
Type |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Emergency nursing; Education |
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Abstract |
The New Zealand emergency department (ED) nurse is faced daily with the challenge of caring for patients of all ages with a wide variety of presenting complaints. Courses are available for ED specialty work such as trauma and paediatric assessment. However, this thesis argues, it is difficult to access updated and ongoing education in relation to caring for people with mental health problems who present to the emergency department. In addition to this education deficit, are the challenges of providing care in an overcrowded ED environment. The author goes on to say that such factors contribute to a perceived lack of confidence and sometimes ambivalence or frustration on the part of nursing staff in caring for this group. This may result in an inconsistent standard of care for the person with a mental health problem unless such issues are addressed. The aim of this research paper was to explore the education needs of ED nurses when caring for people with mental health problems. A literature review was undertaken to investigate the broad education strategies available to overcome these challenges. Diverse approaches were identified such as workshops, clinical guidelines, and mental health consultation-liaison roles. Research was also identified that examined ED nursing attitudes and their learning needs in relation to mental health. This paper concludes with a discussion of recommendations for the New Zealand setting with the intention of developing a more confident and competent nursing workforce, who are better prepared to care for the person with a mental health problem. |
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Call Number |
NRSNZNO @ research @ |
Serial |
575 |
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Permanent link to this record |