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Author |
Key, R.; Habashi, S.; Baber, C.; Cuthbertson, S.; Streat, S.J. |
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Title |
Long-term follow-up after Bjork flap tracheostomy |
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Year  |
1994 |
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Abbreviated Journal |
DCCM, Private Bag 92024, Auckland |
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Abstract |
Because of concern about long-term complications of bjork flap tracheostomy we followed-up 136 intensive care patients who had Bjork flap tracheotomy in 1992 a median of 117 (range 5-402) hours after intubation. Twenty died in hospital, none as a result of tracheostomy. Twenty- six patients were lost to follow-up and eleven declined. The remaining 79 had measures of health status, a quality of life questionnaire, respiratory function testing and physical examination of the neck and upper airway 9-27 months (median 14) later. Various health status measures deteriorated in 9 to 51 of 77 patients. Forty-two of 77 patients were taking prescription medication and 15/32 smokers had stopped smoking. FEV1, FVC and FEV1/FVC were significantly reduced from predicted normal (n=70, 2.8+ 1.1 vs 3.2 +0.9 p<.0001, 3.7 + 1.3 vs 4.0 + 1.0 p<.0001, 76 +11vs 79 +3 p= 0.035 respectively). Pulse oximetry was normal (>92%) in 73/74 patients tested. The median horizontal scar dimension was 45mm (range 20 to 75 mm). Nine had a median vertical scar dimension 15mm (range 8 to 25mm). Nineteen scars were hypertrophic, 56 were tethered. Two patients had already undergone tracheal scar revision at follow-up and further 13 accepted scar revision. Ten patients had abnormal voice examination, four abnormal cough, two stridor, three vocal cord lesions, three tracheal polyps and fourteen asymptomatic tracheal narrowing from 10-60% (median 25%) of the tracheal luminal diameter. Patients surviving critical illness with bjork flap tracheostomy have reduced quality of life and respiratory function and poor cosmetic result but a low incidence of important airway problems |
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Call Number |
NRSNZNO @ research @ 201 |
Serial |
201 |
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Author |
Key, R.; Cuthbertson, S.; Streat, S.J. |
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Title |
Feasibility of a nurse-based critical care follow-up clinic |
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Year |
1994 |
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Abbreviated Journal |
DCCM, Auckland Hospital Private Bag 92024 Aucklan |
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We are about to implement a nurse-based critical care follow-up service and used a follow-up study of tracheostomy to determine the feasibility of such a service. Nine to 27 months median 14 after intensive care admission we attempted to follow-up 116 of our most severely ill survivors. Twenty six could not be found, 11 declined follow-up. A questionnaire, interview and limited examination were used to determine health status. Ten patients unable to come to a clinic were seen at home. Interview time varied between patients but 79 patients took 100 nurse-hours. Ninety percent of patients co-operated with respiratory function testing. Pulse oximetry identified one with severe chronic respiratory failure. In this highly selected group of patients with on going problems (perceived poor health, dependency, disability, changes in appearance, deterioration in personal relationships, poor sleep, pain, altered diet, unaddressed chronic health problems, poor access to health services, and continuing prescription medication) were common, and addressed to some extent by appropriate referral. Approximately 20% of patients reported improvement in their health and personal relationships after critical illness and half of the smokers had given up. Factors contributing to follow-up difficulty included distance, delay in initial contact, change of address (255 of this group), disability and poverty. A nurse-run critical care follow-up clinic is feasible, time consuming but productive. A register of current addresses and phone numbers is recommended. The optimal time for follow-up will vary with patients conditions but early follow-up with protocol- based lines of referral is recommended to reduce persistent health problems |
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Call Number |
NRSNZNO @ research @ 205 |
Serial |
205 |
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Author |
Morrison, M. |
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Title |
Body-guarded: the social aesthetics of critical care |
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Year |
1994 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 297 |
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297 |
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Author |
MacManus, M. |
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Title |
Reflective practice: teaching the practice of nursing |
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Year |
1994 |
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University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 299 |
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299 |
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Author |
Kerslake, M.T. |
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Title |
The nurse practitioner in the South Pacific region: concerns about this innovation |
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1994 |
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Abbreviated Journal |
University of Auckland Library |
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NRSNZNO @ research @ 302 |
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302 |
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Author |
Palmer, S.G. |
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Title |
Positively positive: an experimental evaluation of the Wellness Programme, Burnett Centre |
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1993 |
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Abbreviated Journal |
University of Auckland |
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Call Number |
NRSNZNO @ research @ 294 |
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294 |
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Author |
Messervy, L. |
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Title |
The rise of the independent nurse practitioner: a comparative study of independent nurse practitioners and nurses in traditional work places |
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Year |
1993 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 298 |
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298 |
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Author |
McKegg, A.H. |
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Title |
Ministering angels: the government backblock nursing service and the Maori health nurses, 1909 -1939 |
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Year |
1991 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 278 |
Serial |
278 |
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Author |
Hay, J. |
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Title |
A needs assessment of and for people with head injuries in the greater Auckland area |
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Year |
1991 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 308 |
Serial |
308 |
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Author |
Brown, M.B. |
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Title |
The Auckland School of Nursing, 1883 – 1990: the rise and fall |
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Year |
1991 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 312 |
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312 |
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Author |
Perry, J.(see also C.) |
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Title |
Currents – towards professionalism |
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Year |
1990 |
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Abbreviated Journal |
Auckland Institute of Technology Library, NZNO Li |
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Attitudes towards the concept of professionalism have not been explored to any great extent in this country, especially the attitudes of the Clinical Nurse practitioner. The importance of knowing what Nurses attitudes are to this concept is central to the recognition of the current developmental stage and growth of the profession. A twenty statement Like-style attitudinal questionnaire was given to Registered Nurses to measure current attitudes to professionalism. No statistical significance was found between the degree of positively to professionalism and years of service, educational qualifications eg, practise area, or involvement with a professional organisation. There appeared to be a positive relationship between questionnaire score and length of time in the current practise area ( the longer the service the higher the score). Further statistical significance was found in questions highlighting what Nurses think of Nursing as a profession. This study should form the basis of further research and provide some thought for Nurse leaders, educators and policy makers |
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Call Number |
NRSNZNO @ research @ 42 |
Serial |
42 |
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Author |
White, G.E. |
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Title |
Toward autonomy: an examination of midwifery education in New Zealand 1990 |
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Year |
1990 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 335 |
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335 |
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Author |
Alexander, S.M. |
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Title |
Evaluation as an aged-care management tool: a case study |
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Year |
1989 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 317 |
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317 |
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Author |
Horsburgh, M. |
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Title |
Graduate nurses' adjustment to initial employment |
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Year |
1987 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
University of Auckland, Auckland Institute of Te |
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Volume |
14 |
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Pages |
610-617 |
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Abstract |
An ethnographic study which attempts to understand what initial employment means to graduates from a comprehensive nursing course. The researcher participated in the first 3-4 months of the nurses' employment in general hospital settings. Five major themes emerge from the study indicating that the rhetoric practice of the school of nursing is different from the rhetoric and practice within general hospital settings. The reality of initial employment for the new graduated conflicts with the values and ideals of nursing promulgated by the comprehensive nursing course. The educational program stressed patient centred nursing, where nurses accepted responsibility for the continuing care of individuals. In contrast the hospital settings stress nursing as management of tasks across different patients. This conflict was a major source of frustration for the 'beginning' nurses. Ultimately they accept the reality of nursing as the management of tasks, but not without some personal cost. Orientation programs and the early employment period focus on 'fitting in to the system'. A significant determinant of the practice of new graduates are context effects such the time of their shift and the availability of experienced nurses. A number of management practices foster and maintain a beginning level of practice and new graduates have no opportunity to practice as autonomous nurses within a multi disciplinary health care team. Beginning practice is identified in new graduates through their difficulties in coping with unplanned or unexpected events. The initial employment period is dominated by shift work, resulting tiredness and adjustment to social activities.It is argued that management practices which support the ideals of comprehensive nursing courses and totally qualified nursing workforce have yet to occur. There are implications in this study for nursing education and nursing practice |
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Call Number |
NRSNZNO @ research @ 59 |
Serial |
59 |
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Author |
Wallace, S. |
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Title |
The professionalisation of nursing 1900-1930 |
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Year |
1987 |
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Abbreviated Journal |
University of Auckland Library |
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Call Number |
NRSNZNO @ research @ 291 |
Serial |
291 |
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