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Author |
O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J. |
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Title |
Clinical indicators as measures of mental health nursing standards of practice in New Zealand |
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Journal Article |
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Year  |
2004 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
13 |
Issue |
2 |
Pages |
778-788 |
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Keywords |
Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth |
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Abstract |
This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1059 |
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Author |
Hardy, D.J.; O'Brien, A.P.; Gaskin, C.J.; O'Brien, A.J.; Morrison-Ngatai, E.; Skews, G.; Ryan, T.; McNulty, N. |
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Title |
Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand |
Type |
Journal Article |
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Year |
2004 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
46 |
Issue |
1 |
Pages |
95-109 |
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Keywords |
Clinical assessment; Biculturalism; Professional competence; Psychiatric Nursing; Maori |
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Abstract |
The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1060 |
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Author |
Phillips, B.N. |
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Title |
An interpretation of four men's experiences of suicidality |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Gender; Qualiltative research |
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Abstract |
This study draws upon Gadamer's philosophical hermeneutics to explore the understandings that four men have had of their past suicidal experiences. The interpretations developed in this study, as far as possible, make explicit use of the author's own particular horizon of meaning as researcher and mental health nurse. In addition, by consciously bringing an anti-essentialist perspective of masculinity to this process, he explores the way in which gender impacts on men's suicidality. The primary source of information for this study is in-depth, open-ended conversations with four men of European descent in their middle adult years who were asked to talk about their past experiences of suicidality. The interpretations developed here show that for these men, the hermeneutic fusion of history, language, and sociocultural context, provided limited possibilities with which they were able to construe themselves as 'fitting in' with normative standards. These constraints, that are otherwise taken-for-granted and invisible, became explicit through their experience of ongoing victimisation. Furthermore, early understandings of these experiences became a potent horizon of meaning from which they then came to understand later difficult experiences. Victimisation became constitutive of an understanding of self as fundamentally different and (hierarchically)'less-than' other men. Ultimately, suicidality emerged out of a background of ever-present psychological pain accompanying a construction of self as being unable to see themselves as ever 'fitting in'. These men did not regard themselves as having recovered from suicidality, but remain in a process of recovering. This process did not mean figuring out how to 'fit in', or become 'normal' men, but rather, to live meaningfully as men in spite of not 'fitting in' with the sociocultural ideal. Recovering was a continual and idiosyncratic process, rather than an outcome of a specific technique or knowledge. The position taken in this study is that mental health nursing seeks to engage with people and work with them in collaborative, respectful, human relationships. It is argued that mental health nurses work with an individual's situated understandings rather than delivering prescribed treatment determined by diagnosis. Hence, viewing suicidality as socioculturally situated and historically emergent suggests mental health nurses must closely attend to the way in which we bring ourselves into relationships with our clients so that we are then able to create opportunities for change. |
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Call Number |
NRSNZNO @ research @ 1214 |
Serial |
1199 |
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Author |
Jacobs, S. |
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Title |
Advanced nursing practice: Time and meaning |
Type |
Journal Article |
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Year |
2003 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
19 |
Issue |
3 |
Pages |
29-39 |
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Keywords |
Advanced nursing practice; Nurse practitioners; Professional development; History of nursing |
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Abstract |
The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the nurse practitioner role at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001. Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. The focus is on clinical practice, research, teaching, consulting, higher education, and advancement of the profession. Historical aspects of advancement in New Zealand nursing are examined, including registration, unsupervised practice, technical specialisation, and career development. |
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Call Number |
NRSNZNO @ research @ |
Serial |
552 |
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Author |
Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B. |
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Title |
Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori |
Type |
Journal Article |
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Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
116 |
Issue |
1176 |
Pages |
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Keywords |
Advanced nursing practice; Hospitals; Clinical assessment; Evaluation |
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Abstract |
Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive. |
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Call Number |
NRSNZNO @ research @ 625 |
Serial |
611 |
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Author |
McKenna, B.; Poole, S.; Smith, N.A.; Coverdale, J.; Gale, C. |
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Title |
A survey of threats and violent behaviour by patients against registered nurses in their first year of practice |
Type |
Miscellaneous |
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Year |
2003 |
Publication |
International Journal of Mental Health Nursing |
Abbreviated Journal |
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Volume |
12 |
Issue |
1 |
Pages |
56-63 |
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Keywords |
New graduate nurses; Workplace violence; Occupational health and safety; Training; Mental health; Psychiatric nursing |
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Abstract |
For this study, an anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats, verbal sexual harassment, and physical intimidation. There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents. After registration, 45 (37%) indicated they had received such training. The findings of this study indicate priorities for effective prevention programmes. |
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Call Number |
NRSNZNO @ research @ |
Serial |
649 |
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Author |
Farrow, T. |
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Title |
'No suicide contracts' in community crisis situations: A conceptual analysis |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Psychiatric & Mental Health Nursing |
Abbreviated Journal |
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Volume |
10 |
Issue |
2 |
Pages |
199-202 |
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Keywords |
Mental health; Community health nursing; Psychology; Suicide |
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Abstract |
'No suicide contracts' take the form of a 'guarantee of safety', along with a 'promise' to call specified persons if the suicidal ideation becomes unmanageable for the person concerned. They are commonly used in community crisis situations with suicidal people in New Zealand. This article describes and analyses the use of 'no suicide contracts' in these settings. It is argued that the theoretical base (transactional analysis) of the 'no suicide contract' is likely to be deleterious in the community crisis situation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
779 |
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Author |
Moko Business Associates, |
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Title |
Career pathways and core competencies in Maori mental health nursing |
Type |
Report |
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Year |
2003 |
Publication |
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Abbreviated Journal |
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Volume |
Trm/03/04 |
Issue |
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Pages |
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Keywords |
Maori; Mental health; Nursing; Careers in nursing; psychiatric nursing |
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Abstract |
This report reviews relevant literature pertaining to clinical career pathways and associated core competencies for nursing in New Zealand. The review identifies and analyses existing clinical career pathways for nurses and mental health workers in New Zealand, paying particular attention to the content, structure, strengths, criticisms and applicability to the development of a clinical career pathway for Maori registered nurses to work in Maori mental health (NGO organisations). This report is part of Te Rau Matatini's current work on the development of a career pathway for Maori registered nurses with mental health work experience to work in NGO, community settings. It is a preliminary report, based on existing literature. A subsequent report was planned detailing the career pathway developed by Te Rau Matatini, with strong guidance and input from Maori mental health nurses and the wider Maori mental health sector. |
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Call Number |
NRSNZNO @ research @ |
Serial |
823 |
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Author |
Bresaz, D.M. |
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Title |
Environmental influences on inpatient assaultive behaviour |
Type |
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Year |
2003 |
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 |
Workplace violence; Mental health; Psychiatric Nursing; Methodology; Administration |
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Abstract |
This retrospective quasi-experimental study reviewed assaults in two adult mental health inpatient rehabilitation units. The majority of clients in this area experience enduring mental health illnesses and have complex physical health issues. The service comprises of an intensive rehabilitation unit and a secure extended rehabilitation unit. Between May and August 2001 the service moved to purpose built facilities. The opportunity was taken to review clients' assaultive behaviour in the new environment and to compare the incidents with those in the old environment to see if there had been any significant changes. Data on assault incidents including time of assault, place of assault, who was involved and what preventative actions were suggested were collected from the Incident and Accident Hazard Reports (IAHR) dating from 1 April 2000 until 31 May 2002. Staff were expected to complete IAHR reports on all assault incidents. The research examined whether the change in environmental conditions impacted on clients' wellbeing in relation to assaultive behaviour. Trends within the IAHR reports were also examined in order to compare these to similar studies completed in other parts of the world. There were 141 IAHR reports of assault incidents. Fifty of these occurred in the pre move period, 38 in the transition phase and 53 in the post move. There was no significant difference in the rate of assaults in the pre-move to post move period. Completion of the IAHR forms was seen to be very problematic, especially in relation to legal status of perpetrators and documentation of prevention strategies. An urgent audit of existing practice is now required to establish if problems found with the quality and completion of the IAHR forms continues to be evident in the rehabilitation service and if present staff education is needed to improve the standard of documentation. Research is also needed to establish the extent to which staff implement strategies to prevent assaults, and to reduce recidivism. |
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Call Number |
NRSNZNO @ research @ |
Serial |
858 |
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Author |
Jenkinson, F.H. |
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Title |
An evaluation of nursing documentation as it relates to pro re nata (prn) medication administration |
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Year |
2003 |
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 |
Drug administration; Psychiatric Nursing; Administration; Mental health |
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Abstract |
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Call Number |
NRSNZNO @ research @ 875 |
Serial |
859 |
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Author |
Laracy, K. |
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Title |
Exploration of the self: The journey of one pakeha cultural safety nurse educator |
Type |
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Year |
2003 |
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 |
Cultural safety; Teaching methods; Nursing; Education; Professional development; Transcultural nursing; Maori; Identity |
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Abstract |
Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand. |
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Call Number |
NRSNZNO @ research @ |
Serial |
864 |
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Author |
Pirret, A.M. |
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Title |
A preoperative scoring system to identify patients requiring postoperative high dependency care |
Type |
Journal Article |
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Year |
2003 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
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Volume |
19 |
Issue |
5 |
Pages |
267-275 |
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Keywords |
Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment |
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Abstract |
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions. |
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Call Number |
NRSNZNO @ research @ 904 |
Serial |
888 |
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Author |
Ho, T.; Mok, J. |
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Title |
Condensate clearance from CPAP circuit: An examination of two methods of draining condensate from the inspiratory tubing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Neonatal Nursing |
Abbreviated Journal |
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Volume |
9 |
Issue |
4 |
Pages |
117-120 |
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Keywords |
Neonatal nursing; Infection control; Equipment and Supplies |
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Abstract |
Clinical studies on adult ventilated patients demonstrate that bacterial contamination of the condensate occurs in ventilator circuits. The purpose of this research is to find out if this is also true of the condensate in the Continuous Positive Airway Pressure (CPAP) circuit. It aims to determine whether there is bacterial contamination in the humidifier reservoir of the CPAP system when the condensate is drained back into the humidifier reservoir without disconnecting the circuit, or when the inspiratory tubing is disconnected to drain out the condensate. |
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Call Number |
NRSNZNO @ research @ |
Serial |
889 |
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Author |
Evans, S. |
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Title |
Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes |
Type |
Journal Article |
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Year |
2003 |
Publication |
Pediatric Intensive Care Nursing |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
7 |
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Keywords |
Nursing specialties; Intensive care nursing; Equipment and Supplies |
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Abstract |
The author draws on her experience as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand to examine the proposed changes to ventilation practice. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering. The author suggests this mode can compromise effective ventilation of paediatric patients, due to air leaks around the uncuffed endotracheal tubes of infants and small children. This air leak makes a guaranteed tidal volume almost impossible and can cause ventilator breath stacking and volutrauma. This can impact on the patient's comfort, sedation requirements and airway security, and affects how these patients are nursed. Thus the ventilation of these paediatric patients by the current volume-limiting mode may be not always be optimal for the infant/child. A new ventilator will be available to the unit, with a pressure-controlled, flow breath-triggering mode available. The author critiques the possibility of using this mode of ventilation, suggesting how this will impact on nursing practice in ICU, and of the education and knowledge that will be required. She suggests this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
926 |
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Author |
Stone, P.W.; Tourangeau, A.E.; Duffield, C.M.; Hughes, F.; Jones, C.A.; O'Brien-Pallas, L.; Shamian, J. |
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Title |
Evidence of nurse working conditions: A global perspective |
Type |
Journal Article |
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Year |
2003 |
Publication |
Policy, Politics, & Nursing Practice |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
120-130 |
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Keywords |
Nursing; Recruitment and retention; Policy; Cross-cultural comparison; Nursing research |
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Abstract |
The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organisational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organisational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarised. |
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Call Number |
NRSNZNO @ research @ |
Serial |
951 |
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