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Paterson, J. E. (2006). Nurses' clinical decision-making: The journey to advancing practice. Ph.D. thesis, , .
Abstract: This dissertation reports on a scholarly journey to better understand the processes of clinical decision-making by nurses. It begins by identifying the various terms used to describe a clinical decision, its components and the contexts within which clinical decisions are made. Two philosophies of decision-making are summarised. Some insight into the history of the phenomenological and the rationalist theories of decision-making is offered. The author notes that it became evident that both of these theories are applicable to all nurses and their clinical decision making competencies. Four studies that were undertaken to analyse the decision-making methods of nurse practitioners are critiqued. Of the studies two are British, one is American and one is Australian. The author has summarised the combined findings that identified that the nurses were using a blend of decision-making processes that involved rational decision making as well as the use of intuition. The studies identified that sound clinical decision-making is determined by appropriate educational and clinical preparation and supported by a formal mentoring process and the use of critical reflective practice. In conclusion, the author reflects on her knowledge of decision making prior to embarking on the dissertation and states her intent to facilitate and support advanced decision-making by her colleagues. She goes on to say that uppermost is the need for an institutional and managerial environment that encourages advanced and independent decision-making by nurses.
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Elliott, M. M. (2006). Model of care development: Moving between liaison and complex care coordination in the community health setting.
Abstract: Healthcare systems in New Zealand and the western world are grappling with changes with an aging population; increased use of technology resulting in shorter inpatient stays, increasing chronic illness rates and people with complex health needs. Supporting people through the health system and meeting their needs is an aim of all services. Trying to support seamless transition and manage complex care requirements has become important for community health services. In the district health board, where the author works, the role of Liaison Nurse/Complex Coordinator was established to support this. This role has become important in reviewing what the best model of care for Community Health Services is and how to describe the current practices in this context in an appropriate way. The first section of the report reviews the literature and current practice in relation to liaison nursing. This section explores how to make the role clear and identify its clinical and organisational effectiveness, drawing out the key elements and aspects for this role that will contribute to a model of care. The second section progresses onto the clinical work related to managing patients with chronic illness and complex needs. Utilising literature to inform current practice when supporting patients through health transitions to achieve seamless care and identifying key aspects required to manage this and adding these aspects to the model of care. Following this, a review of current care models available and in use in the health care systems is undertaken. There are some elements and aspects similar in these models and those explicated in the previous sections. Finally a model of care is developed bringing all the key aspects and elements together. This model describes the practice of Liaison/Complex Coordination role in community health service in New Zealand and identifies the need for care, provision of care, outcomes of care provided and impact for the service and organisation. The author suggests that this model is relevant for any liaison or complex coordination role and could be a basis for other models of care to expand upon the specific needs for their services.
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Martin, H. E. (2006). Marking space: A literary psychogeography of the practice of a nurse artist. Ph.D. thesis, , .
Abstract: The author suggests that the thesis as a production of disciplined work presented in a creative style is congruent with performance and presentation best practice in community arts. As a practising nurse artist the author describes creating spaces of alternate ordering within the mental health field environment. “I also inhabit the marginal space of the artist working in hospital environments. This Other Place neither condones nor denies the existence of the mental health field environment as it is revealed. Yet, it seeks to find an alternative to the power and subjectivity of the [social] control of people with an experience of mental illness that inhabit this place both voluntarily and involuntarily. I have used a variety of texts to explore the experience and concept of Otherness. The poems are intended to take you, as a reader where you could not perhaps emotionally and physically go, or might have never envisaged going. They also allow me as the author to more fully describe the Otherness of place that is neither the consumer story nor the nurse's notation, but somewhere alternately ordered to these two spaces. Drawing on the heuristic research approaches of Moustakas and literary psychogeography , particularly the work of Guy Debord, this thesis creates the space to explore the possibilities of resistance and change and the emergence of the identity of the nurse artist within the mental health field environment”.
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Mulcahy, D. M. (2006). Journeys cross divides: Nurses and midwives' experiences of choosing a path following separation of the professions. Ph.D. thesis, , .
Abstract: In 2003 the Health Practitioners Competence Assurance Act was introduced and established separate regulatory authorities for nursing and midwifery. This study is designed to explore the experiences of dually registered practitioners affected by this divide, as now there are two separate and possible paths, and two corresponding sets of competencies to fulfil. The design for this qualitative descriptive study utilised the written and oral narratives of three practitioners affected by this professional regulation and demonstrated its impact on their career development. Individual storytelling, as narrative, provided a theoretical lens aiding insight into their experience and pattern of decision making. In addition, symbolic consideration of the study data was provided by collective storytelling via the perennial myth of the hero journey. Shifting professional ground following the Health Practitioners Competence Act 2003 generated a focus for the inquiry into practitioners' modes of adjustment. For the practitioners in the study, transition between the occupational roles of nursing and midwifery comprised the possible career trajectories. A status passage, as the process of change from one social status to another, is described and includes the transitional experience of anticipation, expectation, contrast, and change. The author suggests that the findings from this research provide illumination of the nuances of professional decision making as a lived experience, and highlight how these practitioners dealt with shifting meaning, values, awareness, choices, and relationships. Aspects of group agency and identity, change management, and professional role transition were revealed. Life pattern, revealed through narrative, was an important research construct for exposing the ways in which the participants negotiated change, and displayed the function of their thinking and reasoning through dilemmas. Perception of individual and group identity revealed attitudes of esteem to the dominant discourse, and exposed dynamic tension between work patterns and life stage. Renegotiating arrangements of personal and professional commitment resulted from this dynamic interplay, and the relationship to stress and burnout was explored.
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Goulding, M. T. (2006). The influence of work-related stress on nurses' smoking: A comparison of perceived stress levels in smokers and non-smokers in a sample of mental health nurses. Ph.D. thesis, , .
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Pepers, M. G. (2006). A grey zone: The experience of violence in remote nursing practice. Ph.D. thesis, , .
Abstract: This dissertation explores the issues affecting the exposure of isolated rural nurses working in New Zealand to violence from members of the local community, including the visiting public. Discussion on the collaborative role with the New Zealand Police is thematic in the issues presented. Challenges presented include the unique community dynamics of the Stewart Island nursing practice on the Island, with scope of practice, isolation and practice issues included. Role definition, present-day health-care delivery, the potential for violence including causation and reporting are presented. Incident management and risk strategies, including de-escalation are rationalised and described. Evidence for the nurse-police inter-service relationship along with issues including confidentiality and legislation are reviewed. Recommendations and conclusion are provided. The thread and theme of the dissertation is to encourage discussion within nursing circles on the provision of satisfactory safety standards for nurses working in remote isolated parts of New Zealand.
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Hamer, H. P., & McCallin, A. (2006). Cardiac pain or panic disorder? Managing uncertainty in the emergency department. Nursing & Health Sciences, 8(4), 224–230.
Abstract: This paper presents research findings from a New Zealand study that explored emergency nurses' differentiation of non-cardiac chest pain from panic disorder and raised significant issues in the nursing assessment and management of such clients. The data were gathered from focus group interviews and were analysed thematically. Three themes, prioritising time, managing uncertainty and ambiguity, and the life-threatening lens, were identified. The findings confirm that a panic disorder is not always diagnosed when biomedical assessment is used in isolation from a psychosocial assessment. Emergency nurses are pivotal in reversing the cycle of repeat presenters with non-cardiac chest pain. Recommendations for assessing and managing this complex condition are presented.
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Framp, A. (2006). Diffuse gastric cancer. Gastroenterology Nursing, 29(3), 232–238.
Abstract: This article provides an overview of gastric cancer using a unique case study involving a Maori family genetically predisposed to diffuse gastric cancer. The pathophysiology of diffuse gastric cancer, including prognosis, diagnosis, and treatment, along with important patient considerations is highlighted.
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van Rooyen, P., Dixon, D. A., Dixon, G., & Wells, C. C. (2006). Entry criteria as predictor of performance in an undergraduate nursing degree programme. Nurse Education Today, 27(7), 593–600.
Abstract: This research explored the relationship between entry criteria and academic performance in the first and second year bioscience papers at Otago Polytechnic School of Nursing. The School's inclusion of a bioscience requirement varies from the Nursing Council criteria for acceptance into undergraduate nursing programmes. Six hundred and nineteen academic records of 1994-2002 graduates were sampled. Chi-square and correlational analyses found a relationship between entry qualifications and students' academic performance in the two papers. The entry criteria had a stronger relationship with the students' performance in the first year bioscience paper than the second year paper. Performance in the first year was predicative of second year performance. Age was also found to be a useful predictor of grades. These findings support the School's Bioscience entry criteria and provide important information for admission committees.
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Lim, A. G., & Honey, M. (2006). Integrated undergraduate nursing curriculum for pharmacology. Nurse Education in Practice, 6(3), 163–168.
Abstract: This article presents an integrated approach to pharmacology education for nurses aligned with constructivist learning theory, as taught at the School of Nursing, University of Auckland. The weaving of pharmacology through the three-year undergraduate curriculum is described, showing the development of a pharmacology curricula thread. The significance of supporting curricula content in areas such as communication skills, law and ethics, as well as sound biological science and physiology knowledge are highlighted.
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Honey, M., North, N., & Gunn, C. (2006). Improving library services for graduate nurse students in New Zealand. Health Information & Libraries Journal, 23(2), 102–109.
Abstract: This paper describes a collaboration between library staff and nurse educators, where information literacy skills are strengthened and embedded in the curriculum. A case-study approach was used with both quantitative and qualitative data. An anonymous questionnaire was distributed to all nurses enrolled in graduate courses in the second semester of 2002. Interviews were then undertaken with library staff. It was found that the university library services were not used by 43% of graduate nursing students . The library staff responded by developing a number of initiatives which aimed to improve awareness of services, access and provide education in a bid to improve literacy skills.
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Gage, J., Everrett, K. D., & Bullock, L. (2006). Integrative review of parenting in nursing research. Journal of Nursing Scholarship, 38(1), 56–62.
Abstract: The authors synthesise and critically analyse parenting research in nursing. They focused on studies published between 1993 and 2004 by nurse researchers in peer-reviewed journals. Data were organised and analysed with a sample of 17 nursing research studies from core nursing journals. The majority of parenting research has been focused on mothers, primarily about parenting children with physical or developmental disabilities. Research about fathers as parents is sparse. Parenting across cultures, parenting in the context of family, and theoretical frameworks for parenting research are not well developed. The authors conclude that the scope of nursing research on parenting is limited.
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McBride-Henry, K., & Foureur, M. (2006). Medication administration errors: Understanding the issues. Australian Journal of Advanced Nursing, 23(3), 33–41.
Abstract: This literature review focused on research that primarily addresses the issues related to medications that arise in tertiary care facilities. It finds that investigations into medication errors have primarily focused on the role of nurses, and tended to identify the nurse as deliverer of unsafe practice. Over the past few years a shift in how medication errors are understood has led to the identification of systems-related issues that contribute to medication errors. The author suggests that nurses should contribute to initiatives such as the 'Quality and Safe Use of Medicines' and develop nursing led research, to address some of the safety related issues with a view to enhancing patient safety.
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O'Brien, A. J., Hughes, F., & Kidd, J. D. (2006). Mental health nursing in New Zealand primary health care. Contemporary Nurse, 21(1), 142–152.
Abstract: This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.
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Giddings, D. L. S. (2006). Mixed-methods research: Positivism dressed in drag. Journal of Research in Nursing, 11(3), 195–203.
Abstract: The author critiques the claim that mixed method research is a third methodology, and the implied belief that the mixing of qualitative and quantitative methods will produce the 'best of both worlds'. The author suggests that this assumption, combined with inherent promises of inclusiveness, takes on a reality and certainty in research findings that serves well the powerful nexus of economic restraint and evidence-based practice. The author argues that the use of the terms 'qualitative' and 'quantitative' as normative descriptors reinforces their binary positioning, effectively marginalising the methodological diversity within them. Ideologically, mixed methods covers for the continuing hegemony of positivism, albeit in its more moderate, postpositivist form. If naively interpreted, mixed methods could become the preferred approach in the teaching and doing of research. The author concludes that rather than the promotion of more co-operative and complex designs for increasingly complex social and health issues, economic and administrative pressures may lead to demands for the 'quick fix' that mixed methods appears to offer.
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