Abstract: This report presents an evaluation of the implementation of a best practice information sheet related to tracheal suctioning of adults with an artificial airway. The Centre for Evidence-Based Nursing Aotearoa, based in Auckland, conducted a systematic review of the evidence and produced the best practice information sheet. A survey of 105 nurses was conducted at three sites, in New Zealand and Australia. Using a before/after design, data were collected at the time of release of the information sheet and then approximately 12 months later. The study suggests a trend towards a modest uptake of best practice recommendations into nursing practice demonstrated by some behavioural changes within a 12-month period in the context of an implementation plan and the best practice information sheet.

Abstract: The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change.

Abstract: Huarahi whakatu describes a pathway for recognising the expertise of nurses working in kaupapa Maori mental health services and recommends a professional development programme that can lead to advancement along the pathway. An emphasis on dual competencies – cultural and clinical – underlies the rationale for regarding kaupapa Maori mental health nursing as a sub-specialty. Eight levels of cultural competencies and twelve levels of clinical competencies are used to differentiate career stages and it is recommended that movement from one level to another should be matched by increased remuneration. The report also contains a recommended professional development programme to support the operationalisation of the career pathway.

Abstract: This study aims to identify work related factors contributing to New Zealand nurses' intent to leave the job. Two hundred and seventy five surveys (response rate = 68.8%) from a random sample of 400 nurses employed in one district health board were used to explore intent to leave the job. Three research questions directed the description of levels of job satisfaction, job stress, and burnout found in nurse participants, correlations between the three variables, and the identification of variables predicting intent to leave the job through regression analyses. The survey found levels of job satisfaction were high, job stress was low, and burnout was average. Specifically, lack of opportunity to participate in organisational decision making, control over work conditions, control over what goes on in the work setting (key Magnet Hospital characteristics) were not evident, and with pay rates, were the main sources of job dissatisfaction. Workload was the most frequently experienced source of stress by nurse participants. Twenty-five per cent of nurse participants reported high levels of intent to leave the job. Correlations suggested that reductions in job satisfaction influenced increases in job stress and burnout. Job stress was associated with increases in emotional exhaustion. Emotional exhaustion was influenced by eight job satisfaction, job stress, and burnout subscales. Five subscales (professional opportunities, praise and recognition, interaction opportunities, extrinsic rewards, lack of support) explained 26.2% of the variance in nurse participant's intent to leave. The author concludes that issues of power and control were associated with job dissatisfaction, job stress and burnout in nursing practice. However, predictors of intent to leave the job suggest a growing realisation by nurse participants that postgraduate education and nursing research may provide the tools to create positive change in the health care environment and make nursing visible, valued and appropriately rewarded.

Abstract: Contents: Chapter 1 Kupu whakataki – introduction; Chapter 2 Raranga mohiotanga – literature review; Chapter 3 To te wahine mana tuku iho – theoretical framework; Chapter 4 Tahuri ki te rangahau – research methodology; Chapter 5 Whakaaturanga whakaoho – beginnings; Chapter 6 Kia pakari – positioning and contesting; Chapter 7 E ara ki runga wahine toa – standing and enduring; Chapter 8 Kua takoto te whariki.

Abstract: School staff are a conduit by which children and families can access the public health nursing service and the public health nurses can access children and their families. The author notes that, to benefit children, public health nurses need more than knowledge of health issues; they need to understand how to work well with staff from the education sector. A good professional relationship between public health nurses and school staff will therefore ultimately result in a benefit to children's health. This thesis reviews the literature using an interpretive lens to examine the position of public health nurses and schools. It argues that public health nurses need to access expertise from other sources besides nursing in order to develop and sustain the skills of relating professionally to staff from the education sector. It proposes collaboration as a model of public health nursing practice with school staff but recognises that further research on inter-sectorial collaboration is necessary.