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Author: Jackie Walker – Research Nurse, NZICHC
Title: Examining the benefits of professional clinical supervision
Publication: Kai Tiaki New Zealand, 2009 June; 15(5): 12-14
Abstract: Professional clinical supervision is an important strategy to support nurses, enhance patient care and promote ongoing professional development. This article discusses definitions of professional clinical supervision and the process involved for nurses. The benefits of professional clinical supervision for senior nurses (i.e. clinical nurse specialists, nurse educators) are analysed in relation to current literature and issues related to access to professional clinical supervision are identified.
Author contact: jackie.walker@nzichc.org.nz
Authors: Jackie Walker and Pauline Lane, Hospice Palliative Care Service, Nurse Maude
Title: Challenges and choices: an audit of the management of nausea, vomiting and bowel obstruction in metastatic ovarian cancer
Publication: Contemporary Nurse, 2007 Dec; 27(1): 39-46
Abstract: Women living with metastatic ovarian cancer experience many distressing symptoms, such as vomiting and bowel obstruction, which challenge the expertise of nurses working in Palliative Care to promote quality of life. These clinical challenges prompted us to audit our management of nausea/vomiting and bowel obstruction in a New Zealand Palliative Care service, with a focus on both pharmaceutical and non-pharmaceutical interventions (e.g. dietary advice, relaxation strategies). The audit involved a retrospective chart review of 17 patients and identified the current clinical management of these symptoms in comparison with best practice guidelines.
The results indicated many areas of symptom management were in line with current evidence-based practice, however the use of non-pharmaceutical interventions was limited. There were several implications for clinical practice, specifically supporting the use of electronic integrated patient management systems and a greater use of non-pharmaceutical (complementary) interventions.
The audit process provided useful data for the authors to analyse current practice and promote more effective management of these distressing symptoms.
Author contact: jackie.walker@nzichc.org.nz and paulinel@nursemaude.org.nz
Author: Judy Yarwood, 2000 Campbell Ballantyne Fellowship recipient
Title: Nurses Views of family nursing in community contexts
Publication: Nursing Praxis in New Zealand, 2008 July; 24(2): 41-51
Abstract: In their day to day practice nurses interact with ‘family’ as a whole in a variety of community locations. Public health, Practice, District , Well child health and Rural nurses participated in a qualitative study in which four focus groups were used to explore the ways in which each nurse integrated ‘family’ into their practice. Thematic analysis of the data revealed four related themes: the labyrinth of family nursing, relational webs, personal and professional knowing, and contextual determinants. It was found that ‘family’ was integrated into participants’ community practice in a “narrative, dialogical, relational and contextual” manner (Doane Hartrick, 2002, p.623). Each family /nurse interaction had its own story exemplifying the contextual complexity and uncertainty, while at the same time showing the deep satisfaction inherent in working with families. Paramount in this practice was dialogue and building relationships, not only with other families, but also with colleagues, health and other professionals. While it is apparent a family/family health nursing role has yet to be established, the possibilities of such a role have been recognised in this study. Yet considerable work still remains to be done before this nursing role is seen as an imperative in improving family health and nursing.
Author contact: yarwoodj@cpit.ac.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: Walking a Fine Line: Are we Over Formalising Volunteering
Publication: http://e-volunteerism.com/quarterly
Abstract: see website
Author contact: suek@nursemaude.org.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: The changing environment of volunteers in health care
Publication: http://e-volunteerism.com/quarterly/08jul/08jul-keyboard.php
Abstract: see website
Author contact: suek@nursemaude.org.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: Turn your organisation into a volunteer magnet (contribution on pages 123-125)
Publication: Turn your organisation into a volunteer magnet. Fryar, Jackson & Dyer (Eds) 2007
Author contact: suek@nursemaude.org.nz
Author: Sarah Johnson – RN, Hospice Palliative Care Service, Nurse Maude
Title: Hope in terminal illness: an evolutionary concept analysis
Publication: International Journal of Palliative Nursing, 2007 Sep; 13 (9): 451-9
Abstract: AIMS: to clarify the concept of hope as perceived by patients with a terminal illness, to develop hope as an evidence-based nursing concept, to contribute new knowledge and insights about hope to the relatively new field of palliative care; endeavouring to maximize the quality of life of terminally ill patients in the future.
METHOD: utilizing Rodgers' (2000a) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology, from the disciplines of nursing and medicine have been reviewed and analyzed. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness.
RESULTS: Ten essential attributes of the concept were identified: positive expectation; personal qualities; spirituality; goals; comfort; help/caring; interpersonal relationships; control; legacy; and life review. Patients' hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones.
CONCLUSION: By completing all the steps to Rodgers' (2000a) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved. This provides a solid conceptual foundation for further study.
Author contact: sarahj@nursemaude.org.nz
Author: M. Romanelli, V. Dini, L. Rogers and Cathy Hammond
Title: Clinical evaluation of a wound measurement and documentation tool
Publication: Wounds, 2008, 20(9): 258-264
Abstract: see author
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: The ARANZ Medical Silhouette: an innovative wound measurement and documentation system.
Publication: Acute Care Perspectives, 2008 Summer; 17(2): 12-5
Abstract: contact author http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2010058775&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Achieving accurate measurement and monitoring of wounds
Publication: NZ Practice Nurse, June 2008: 30-31
Abstract: contact author
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Building Bridges: Conference report of NZ Wound Care Society Conference, Te Papa, Wellington: 6-8 April 2006
Publication: Nursing Praxis in New Zealand, 2006, 22(2): 39-40
Abstract: This year's conference theme 'Building Bridges' stimulated discussion around the concept of bridging the gap between research, education and clinical practice in the primary and secondary care settings. Approximately 200 delegates attended from New Zealand and some areas of Australia. All papers were plenary.
http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2009497176&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Building Bridges: Conference report of NZ Wound Care Society Conference, Te Papa, Wellington: 6-8 April 2006
Publication: Nursing Praxis in New Zealand, 2006, 22(2): 39-40
Abstract: This year's conference theme 'Building Bridges' stimulated discussion around the concept of bridging the gap between research, education and clinical practice in the primary and secondary care settings. Approximately 200 delegates attended from New Zealand and some areas of Australia. All papers were plenary.
http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2009497176&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Silence kills: challenging unsafe practice
Publication: Kai Tiaki NZ, 2007, April 13(3): 16-19
Abstract: One in eight patients in New Zealand is estimated to suffer an adverse event during their time in hospital. Good communication and team work are the keys to overcoming these errors.
Author contact: sandie@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes
Publication: Paediatric Intensive Care Nursing Journal, 2003, 4(2): 2-12
Abstract: Currently I am practicing as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand. This is a mixed-age ICU, caring for patients throughout their life span. The most common reason for a patient's admission to the ICU is the need for mechanical ventilation. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering.
However, reflection within my own practice leads me to believe that the use of 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 (Marraro, 2003). 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 not always be optimal for the infant/child.
A new ventilator is becoming available to the unit, with a pressure controlled, flow breath-triggering mode available. I will critique 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. I believe this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
Author contact: sandie@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Child abuse: nurse identification of at-risk children
Publication: Nursing Praxis in New Zealand, 2003, 19(3): 22-28
Abstract: Advanced nursing practice is now formally endorsed in New Zealand. However, the framework of competencies that nurses applying for endorsement need to demonstrate is functionally oriented. There is no recognition of the relational competencies required to practice caring as a moral imperative. This gap denies the significance of nursing as a moral practice. In this paper it is argued that a more balanced framework would give equal attention to both functional and relational competencies. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies. Also evident in the practice exemplar is the view that practicing the relational competencies associated with the nursing as a caring practice discourse 'pushes the boundaries' of the dominant discourse of nursing as a functional service. This paper explores the history of these two discourses and the assumptions that underpin them. When missing from descriptions of advanced nursing practice, relational competencies are rendered invisible and peripheral, rather than central and therapeutic. In our highly technological health service the recognition of human to human connection is more important than ever.
Author contact: sandie@nursemaude.org.nz
Author: Mary Thomson, Jackie Walker
Title: Collaborative lymphoedema management: developing a clinical protocol
Publication: International Journal of Palliative Nursing. (2011) 17(5):231-237
Abstract: Lymphoedema is a very distressing chronic condition prevalent in some metastatic cancers. Conservative treatment of lymphoedema in palliative care involves complete/complex decongestive therapy (CDT) using manual lymphatic drainage (MLD), compression therapy (bandaging and/or garments), skincare, and remedial exercises, adapted to the needs of the patient. The aim of this service development project was to identify current practice in a hospice palliative care service, develop new assessment tools, and implement a collaborative clinical protocol to improve access to lymphoedema management for patients in the hospice. Two audits provided new evidence about patient profiles, patient assessment, and treatment outcomes for cancer- and non-cancer-related lymphoedema. This project had a quality-improvement effect on service delivery and developed an effective partnership approach to lymphoedema management between local district nursing services and the specialist lymphoedema physiotherapist.
Author contact: maryt@nursemaude.org.nz
Title: Collaborative lymphoedema management: developing a clinical protocol
Publication: International Journal of Palliative Nursing. (2011) 17(5):231-237
Abstract: Lymphoedema is a very distressing chronic condition prevalent in some metastatic cancers. Conservative treatment of lymphoedema in palliative care involves complete/complex decongestive therapy (CDT) using manual lymphatic drainage (MLD), compression therapy (bandaging and/or garments), skincare, and remedial exercises, adapted to the needs of the patient. The aim of this service development project was to identify current practice in a hospice palliative care service, develop new assessment tools, and implement a collaborative clinical protocol to improve access to lymphoedema management for patients in the hospice. Two audits provided new evidence about patient profiles, patient assessment, and treatment outcomes for cancer- and non-cancer-related lymphoedema. This project had a quality-improvement effect on service delivery and developed an effective partnership approach to lymphoedema management between local district nursing services and the specialist lymphoedema physiotherapist.
Author contact: maryt@nursemaude.org.nz
Author: Jackie Walker, Pauline Lane, and Clare McKenzie
Title: Evidence-based Practice Guidelines: A Survey of Subcutaneous Dexamethasone Administration
Publication: International Journal of Palliative Nursing. (2010) 16(10):494-498
Abstract: Searching for 'good evidence' to develop clinical practice guidelines can be challenging, as research may not be published or available. A simple question set the authors on a journey to find evidence related to the nursing administration of subcutaneous dexamethasone in the palliative setting. This article outlines the search for evidence and discusses the survey results to gather expert opinion about the nursing administration of dexamethasone. Survey results indicated that only 39% of community services gave dexamethasone via a bolus injection and 88$ gave it via a continuous infusion, mainly for site preservation. The diluents used were water for injection or normal saline. Many procedural aspects were supported by current guidelines, with several services using the New Zealand Waitemata District Health Board's (2008) clinica guidelines. Developing and implementing procedural recommendations for nurses to administer this subcutaneous medication will form the next stage of the project.
Author contact: jackie.walker@nzichc.org.nz
Title: Evidence-based Practice Guidelines: A Survey of Subcutaneous Dexamethasone Administration
Publication: International Journal of Palliative Nursing. (2010) 16(10):494-498
Abstract: Searching for 'good evidence' to develop clinical practice guidelines can be challenging, as research may not be published or available. A simple question set the authors on a journey to find evidence related to the nursing administration of subcutaneous dexamethasone in the palliative setting. This article outlines the search for evidence and discusses the survey results to gather expert opinion about the nursing administration of dexamethasone. Survey results indicated that only 39% of community services gave dexamethasone via a bolus injection and 88$ gave it via a continuous infusion, mainly for site preservation. The diluents used were water for injection or normal saline. Many procedural aspects were supported by current guidelines, with several services using the New Zealand Waitemata District Health Board's (2008) clinica guidelines. Developing and implementing procedural recommendations for nurses to administer this subcutaneous medication will form the next stage of the project.
Author contact: jackie.walker@nzichc.org.nz
Author: Hammond CE, Than M, and Walker JW
Title: From the Laboratory to the Leg: Patients' and Nurses' Perceptions of Product Application using Three Different Dressing Formats
Publication: Wound Practice and Research, (2010) 18(4):189-195
Abstract: Leg ulcers (for example, venous, arterial or mixed aetiology ulcers) produce a significant burden for the patient, their family and health service because of slow healing and chronic recurrence requiring intensive wound products and nursing time. The mainstay of treatment for venous ulcers is compression therapy to address the underlying cause of chronic venous hypertension. Many wound products have been trialled to improve the efficacy of leg ulcer healing. A key part of product development is evaluation of product acceptability for patients and nurses. This study examined the user acceptability of three new types of keratin wound dressings, during development. A convenience sample of 23 patients, with leg ulcers of differing aetiology, were recruited from a nurse-led, community-based Wound Management Clinic in New Zealand using inclusion/exclusion criteria. Patients and nurses were asked to complete a structured questionnaire at each dressing change and provide comments on each product. The results showed that both patients and nurses preferred all the dressings over previous products. For the gel and foam, the preference was virtually unanimous for both nurses and patients. For the matrix, the preference was still strong (82% for patients and 64% for nurses) and for those nurses who did not prefer the matrix, the main reasons were that it was more difficult and time consuming to apply. Comments on usability have enabled the company to improve the matrix's structure to address these issues. The study has highlighted the importance of patients and nurses being involved in product testing to ensure the product meets criteria of comfort, duration, timeliness, ease of use and overall preferability.
Author contact: jackie.walker@nzichc.org.nz
Title: From the Laboratory to the Leg: Patients' and Nurses' Perceptions of Product Application using Three Different Dressing Formats
Publication: Wound Practice and Research, (2010) 18(4):189-195
Abstract: Leg ulcers (for example, venous, arterial or mixed aetiology ulcers) produce a significant burden for the patient, their family and health service because of slow healing and chronic recurrence requiring intensive wound products and nursing time. The mainstay of treatment for venous ulcers is compression therapy to address the underlying cause of chronic venous hypertension. Many wound products have been trialled to improve the efficacy of leg ulcer healing. A key part of product development is evaluation of product acceptability for patients and nurses. This study examined the user acceptability of three new types of keratin wound dressings, during development. A convenience sample of 23 patients, with leg ulcers of differing aetiology, were recruited from a nurse-led, community-based Wound Management Clinic in New Zealand using inclusion/exclusion criteria. Patients and nurses were asked to complete a structured questionnaire at each dressing change and provide comments on each product. The results showed that both patients and nurses preferred all the dressings over previous products. For the gel and foam, the preference was virtually unanimous for both nurses and patients. For the matrix, the preference was still strong (82% for patients and 64% for nurses) and for those nurses who did not prefer the matrix, the main reasons were that it was more difficult and time consuming to apply. Comments on usability have enabled the company to improve the matrix's structure to address these issues. The study has highlighted the importance of patients and nurses being involved in product testing to ensure the product meets criteria of comfort, duration, timeliness, ease of use and overall preferability.
Author contact: jackie.walker@nzichc.org.nz
Author: Jackie Walker – Research Nurse, NZICHC
Title: Examining the benefits of professional clinical supervision
Publication: Kai Tiaki New Zealand, 2009 June; 15(5): 12-14
Abstract: Professional clinical supervision is an important strategy to support nurses, enhance patient care and promote ongoing professional development. This article discusses definitions of professional clinical supervision and the process involved for nurses. The benefits of professional clinical supervision for senior nurses (i.e. clinical nurse specialists, nurse educators) are analysed in relation to current literature and issues related to access to professional clinical supervision are identified.
Author contact: jackie.walker@nzichc.org.nz
Authors: Jackie Walker and Pauline Lane, Hospice Palliative Care Service, Nurse Maude
Title: Challenges and choices: an audit of the management of nausea, vomiting and bowel obstruction in metastatic ovarian cancer
Publication: Contemporary Nurse, 2007 Dec; 27(1): 39-46
Abstract: Women living with metastatic ovarian cancer experience many distressing symptoms, such as vomiting and bowel obstruction, which challenge the expertise of nurses working in Palliative Care to promote quality of life. These clinical challenges prompted us to audit our management of nausea/vomiting and bowel obstruction in a New Zealand Palliative Care service, with a focus on both pharmaceutical and non-pharmaceutical interventions (e.g. dietary advice, relaxation strategies). The audit involved a retrospective chart review of 17 patients and identified the current clinical management of these symptoms in comparison with best practice guidelines.
The results indicated many areas of symptom management were in line with current evidence-based practice, however the use of non-pharmaceutical interventions was limited. There were several implications for clinical practice, specifically supporting the use of electronic integrated patient management systems and a greater use of non-pharmaceutical (complementary) interventions.
The audit process provided useful data for the authors to analyse current practice and promote more effective management of these distressing symptoms.
Author contact: jackie.walker@nzichc.org.nz and paulinel@nursemaude.org.nz
Author: Judy Yarwood, 2000 Campbell Ballantyne Fellowship recipient
Title: Nurses Views of family nursing in community contexts
Publication: Nursing Praxis in New Zealand, 2008 July; 24(2): 41-51
Abstract: In their day to day practice nurses interact with ‘family’ as a whole in a variety of community locations. Public health, Practice, District , Well child health and Rural nurses participated in a qualitative study in which four focus groups were used to explore the ways in which each nurse integrated ‘family’ into their practice. Thematic analysis of the data revealed four related themes: the labyrinth of family nursing, relational webs, personal and professional knowing, and contextual determinants. It was found that ‘family’ was integrated into participants’ community practice in a “narrative, dialogical, relational and contextual” manner (Doane Hartrick, 2002, p.623). Each family /nurse interaction had its own story exemplifying the contextual complexity and uncertainty, while at the same time showing the deep satisfaction inherent in working with families. Paramount in this practice was dialogue and building relationships, not only with other families, but also with colleagues, health and other professionals. While it is apparent a family/family health nursing role has yet to be established, the possibilities of such a role have been recognised in this study. Yet considerable work still remains to be done before this nursing role is seen as an imperative in improving family health and nursing.
Author contact: yarwoodj@cpit.ac.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: Walking a Fine Line: Are we Over Formalising Volunteering
Publication: http://e-volunteerism.com/quarterly
Abstract: see website
Author contact: suek@nursemaude.org.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: The changing environment of volunteers in health care
Publication: http://e-volunteerism.com/quarterly/08jul/08jul-keyboard.php
Abstract: see website
Author contact: suek@nursemaude.org.nz
Author: Sue Kobar – Manager of Volunteers, Hospice Palliative Care Service, Nurse Maude
Title: Turn your organisation into a volunteer magnet (contribution on pages 123-125)
Publication: Turn your organisation into a volunteer magnet. Fryar, Jackson & Dyer (Eds) 2007
Author contact: suek@nursemaude.org.nz
Author: Sarah Johnson – RN, Hospice Palliative Care Service, Nurse Maude
Title: Hope in terminal illness: an evolutionary concept analysis
Publication: International Journal of Palliative Nursing, 2007 Sep; 13 (9): 451-9
Abstract: AIMS: to clarify the concept of hope as perceived by patients with a terminal illness, to develop hope as an evidence-based nursing concept, to contribute new knowledge and insights about hope to the relatively new field of palliative care; endeavouring to maximize the quality of life of terminally ill patients in the future.
METHOD: utilizing Rodgers' (2000a) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology, from the disciplines of nursing and medicine have been reviewed and analyzed. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness.
RESULTS: Ten essential attributes of the concept were identified: positive expectation; personal qualities; spirituality; goals; comfort; help/caring; interpersonal relationships; control; legacy; and life review. Patients' hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones.
CONCLUSION: By completing all the steps to Rodgers' (2000a) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved. This provides a solid conceptual foundation for further study.
Author contact: sarahj@nursemaude.org.nz
Author: M. Romanelli, V. Dini, L. Rogers and Cathy Hammond
Title: Clinical evaluation of a wound measurement and documentation tool
Publication: Wounds, 2008, 20(9): 258-264
Abstract: see author
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: The ARANZ Medical Silhouette: an innovative wound measurement and documentation system.
Publication: Acute Care Perspectives, 2008 Summer; 17(2): 12-5
Abstract: contact author http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2010058775&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Achieving accurate measurement and monitoring of wounds
Publication: NZ Practice Nurse, June 2008: 30-31
Abstract: contact author
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Building Bridges: Conference report of NZ Wound Care Society Conference, Te Papa, Wellington: 6-8 April 2006
Publication: Nursing Praxis in New Zealand, 2006, 22(2): 39-40
Abstract: This year's conference theme 'Building Bridges' stimulated discussion around the concept of bridging the gap between research, education and clinical practice in the primary and secondary care settings. Approximately 200 delegates attended from New Zealand and some areas of Australia. All papers were plenary.
http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2009497176&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Cathy Hammond – Clinical Nurse Specialist/Nurse Educator, Wound Care, Nurse Maude
Title: Building Bridges: Conference report of NZ Wound Care Society Conference, Te Papa, Wellington: 6-8 April 2006
Publication: Nursing Praxis in New Zealand, 2006, 22(2): 39-40
Abstract: This year's conference theme 'Building Bridges' stimulated discussion around the concept of bridging the gap between research, education and clinical practice in the primary and secondary care settings. Approximately 200 delegates attended from New Zealand and some areas of Australia. All papers were plenary.
http://search.ebscohost.com/login.aspx?direct=true&db=c8h&AN=2009497176&site=ehost-live
Author contact: catherineh@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Silence kills: challenging unsafe practice
Publication: Kai Tiaki NZ, 2007, April 13(3): 16-19
Abstract: One in eight patients in New Zealand is estimated to suffer an adverse event during their time in hospital. Good communication and team work are the keys to overcoming these errors.
Author contact: sandie@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Improving nursing care of infants and children ventilated with uncuffed endotracheal tubes
Publication: Paediatric Intensive Care Nursing Journal, 2003, 4(2): 2-12
Abstract: Currently I am practicing as the 'Paediatric Link Nurse' in an Intensive Care Unit (ICU) within a metropolitan area in New Zealand. This is a mixed-age ICU, caring for patients throughout their life span. The most common reason for a patient's admission to the ICU is the need for mechanical ventilation. Currently, due to ventilator availability and medical and nursing practice, the usual mode of mechanical ventilation is volume-limited with pressure breath triggering.
However, reflection within my own practice leads me to believe that the use of 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 (Marraro, 2003). 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 not always be optimal for the infant/child.
A new ventilator is becoming available to the unit, with a pressure controlled, flow breath-triggering mode available. I will critique 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. I believe this change to ventilation practice may improve comfort and safety for the intubated child/infant, through the delivery of an optimal mode of ventilation.
Author contact: sandie@nursemaude.org.nz
Author: Sandi Evans – RN, Acute Demand Team, Nurse Maude
Title: Child abuse: nurse identification of at-risk children
Publication: Nursing Praxis in New Zealand, 2003, 19(3): 22-28
Abstract: Advanced nursing practice is now formally endorsed in New Zealand. However, the framework of competencies that nurses applying for endorsement need to demonstrate is functionally oriented. There is no recognition of the relational competencies required to practice caring as a moral imperative. This gap denies the significance of nursing as a moral practice. In this paper it is argued that a more balanced framework would give equal attention to both functional and relational competencies. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies. Also evident in the practice exemplar is the view that practicing the relational competencies associated with the nursing as a caring practice discourse 'pushes the boundaries' of the dominant discourse of nursing as a functional service. This paper explores the history of these two discourses and the assumptions that underpin them. When missing from descriptions of advanced nursing practice, relational competencies are rendered invisible and peripheral, rather than central and therapeutic. In our highly technological health service the recognition of human to human connection is more important than ever.
Author contact: sandie@nursemaude.org.nz