Abstract: This research paper reports on the findings of a literature review conducted to establish and analyse the international magnitude, context and effectiveness of nurse-led heart failure initiatives. The research revealed that the underlying philosophy in establishing nurse-led disease management programmes of care is that, by treating chronic heart failure as a continuum, it is possible to decrease exacerbations and improve patient outcomes. Regardless of the type of heart failure management programme, critical components of care include a collaborative supportive approach that educates and empowers the patient (including family/whanau) to recognise the early indicators of exacerbation, access expedient care, and to adhere to evidence based treatments. The author points to significant evidence to support the establishment of nurse-led heart failure programmes. The positive outcomes associated with this model of care delivery include decreased readmissions, reduction in mortality, and cost efficiencies. However, the organisational model of care, or programme components that are the most effective in optimising patient outcomes, need to be selected on the basis of local healthcare infrastructure, services and resources. The author suggests that New Zealand has a unique opportunity to encompass the recent emergence of the Nurse Practitioner role in facilitating, coordinating and monitoring of heart failure programmes across the continuum of care. The delivery of evidence-based, cost effective, heart failure programmes is a prerequisite to improving the delivery of optimal treatment and ensuring that heart failure patients have the opportunity to attain quality care outcomes.

Abstract: An essential part of nursing practice for the nurse on the surgical floor is to relieve the discomfort of post operative pain for patients in their care. Post operative pain management encompasses a series of processes from assessing pain, providing relief, assessment of measures used to relieve pain through to documentation in the patient record. Yet literature, both internationally and from Australia and New Zealand, suggests that post operative pain continues to be poorly managed despite having the means to provide more than adequate relief. Events leading up to the commencement of this study indicated that locally, post operative pain assessment, including documentation in the patient record may be substandard. The objective of this study was to develop and test an audit tool; undertake a retrospective audit of nursing records, including nursing notes and the nursing care plan, in respect of what postoperative pain assessments nurses document in the patient record; evaluate data and make recommendations for practice. Methodology: A five part, 23 question Likert scale audit tool, designed specifically for this study was used to collect data over a period of two months. In total 40 patient records that met the inclusion criteria were audited.The results indicate that local practice reflects poor documentation standards found in other studies. The most complete recordings were those entered on specifically designed charts such as the Patient Controlled Analgesia and Epidural charts (N 28) but this did not carry over into the patient record. Despite that fact that the patient's self reports of pain is said to be the single most reliable indicator of pain, there was only four occasions when the patient's verbal response to pain was recorded. None of those responses were according to any type of pain rating scale. Evidence of evaluation following measures used to relieve pain was more likely to be recorded if pain was poorly controlled or when side effects such as nausea were experienced by the patient. The author concludes that overall the audit has highlighted many gaps in what is or is not recorded in the patient record in respect of post operative pain assessment and has highlighted the need to develop standards of practice that will improve post operative pain management practices.

Abstract: The authors review the literature on the residual effects of Guillain-Barre Syndrome (GBS), which can include fatigue, foot drop or numbness, reduced mobility and nerve tingling. In GBS the peripheral nerves are attacked by the body's defence system, an auto-immune attack, and as a result, the myelin sheath and axons of nerves are impaired. The pathophysiology of the illness and long term effects are presented, and implications for nursing care and rehabilitation are discussed. Two case studies are included which illustrate coping with the long-term effects of GBS, the effect of GBS residuals on extreme fatigue and depression.

Abstract: This paper will focus on nursing leadership, in particular the place of whanau ora in nursing practice. It explores one Maori and one tauiwi leadership style in relation to nursing practice in a whanau ora context. A critical appraisal of the Maori leadership style is given alongside discussion of how it promotes positive shifts in the health status of Maori communities. Finally, the paper discusses how this Maori leadership style supports the learning and development of Maori student nurses preparing for registered practice.

Abstract: Determines what mental health (MH) nurses understand the concept of self-management to mean in relation to patients with a diagnosis of Borderline Personality Disorder (BPD). Interviews 10 MH nurses using a semi-structured format and analyses data using the general inductive approach, resulting in 26 sub-themes organised into three over-arching themes: self management is self-responsibility, self-management is self-awareness, self-management is maintaining safety.

Abstract: Evaluates the SIP/PIP process to illuminate the views of the nurse managers and preceptors on the effectiveness of the SIP/PIP programme in ensuring competent practice and provides recommendations for improvement and strengthening of the framework. Uses a qualitative approach with data collected through individual semi-structured interviews with preceptors and nurse managers. Due to lack of participation in the quantitative arm a mixed-method study was not completed using an anonymous survey. Undertakes thematic data analysis utilising NVIVO 10 software. Draws four major themes from the qualitative data: (1) Feedback- insight loop, (2) Process clarity, (3) Relationships, commitment & reflective response to participation in the SIP/PIP process, (4) Barriers and enablers to the SIP/PIP process.

Abstract: Investigates the neonatal intensive care unit (NICU) nurse-infant relationship, with a focus on vocal soothing. Undertakes two observational studies to record the use of voice by NICU nurses during painful and non-painful procedures. Develops a model of vocal soothing and tests it for its ability to provide comfort to pre-term infants undergoing painful procedures. Measures pain using the Premature Infant Pain Profile Revised.