|Funding Body:||Nurse Maude Association|
|Project Description/Update:||This project evaluated the Nurse Maude Complex Restorative Care Service (TotalCare) which commenced in May 2011 with the main aim of providing a responsive community based health service to patients who would otherwise have required hospitalisation and/or admission to a rest home. The Canterbury District Health Board (CDHB) funded this service which is based on the Integrated Community Services model, with care coordinated by a registered nurse who assesses and case manages the patient’s service care needs, then oversees support workers who provide the majority of personal cares for the patient. Patients also have access to:
|Project Outcomes:||Overall the evaluation indicated that the patient profile matched those for whom the service was planned, i.e. those who require a high level of care and monitoring to remain in their own homes. The evaluation report was provided to Nurse Maude in November 2012.|
|Funding Body:||Nurse Maude Campbell Ballantyne Fellowship|
|Project Description/Update:||In mid 2007 Canterbury District Health Board funded the establishment of an Acute Demand Service to support general practice to safely manage people in the community during an acute episode, reduce inappropriate ED attendance, reduce hospital admissions, and support the transfer of patient care from the Emergency Department.
The service was provided by Nurse Maude in partnership with Pegasus Health and St John's Ambulance service. The acute community nursing team provided an intravenous antibiotic programme for patients with acute cellulitis who would normally require treatment in hospital.
Cellulitis is ranked third in the leading causes of avoidable hospitalisation in New Zealand (SISSAL 2008). Over a 12 month period from 16 April 2009, of the 2565 admissions to the acute community nursing service, 947 (36.9%) admissions required IV antibiotic treatment for acute cellulitis. This project involved analysis of this client group and production of a report that profiled these patients including their outcomes.
|Project Outcomes:||The final report was presented to Nurse Maude in 2010.|
|Funding Body:||Canterbury District Health Board|
|Project Description/Update:||The Institute provided the project management functions for this clinical research carried out by Professor Ted Arnold and Research Nurse Dot Milne. It was designed to estimate the efficacy of a 12-week course of conservative therapy for incontinence tailored to the needs of each participating female rest home resident and devised by a qualified continence advisor. A second aim was to relate any benefit to its cost.|
|Project Outcomes:||In total, residents from 26 resthomes around Canterbury recruited for this project. The outcomes of this project will be published in the New Zealand Medical Journal.|
|Funding Body:||Waikato District Health Board|
|Project Description/Update:||The main aim of this project was to undertake a feasibility study to ascertain the clinical safety and acceptability of continuing to deliver primary maternity services from the Matariki facility in Te Awamutu and the Rhoda Read facility in Morrinsville, compared to consolidating those services in Hamilton. The process was designed to identify:
|Project Outcomes:||The final report and recommendations were presented to the Waikato DHB in December 2013 and formed the basis of community consultation early in 2014.|
|Funding Body:||Canterbury Medical Research Foundation|
|Project Description/Update:||Pancreatic enzyme supplementation is part of standard treatment for patients with pancreatic cancer in the United States (NCCN Guidelines, 2011) and in the United Kingdom (Pancreatic Section of the British Society of Gastroenterology, 2005). At the present time it is not routinely prescribed for patients with pancreatic cancer in New Zealand. Nurse Maude Hospice palliative care service proposes to survey its’ current management of patients with pancreatic cancer in an evaluation study with two phases.
The first phase of this study involved a retrospective audit of patient’s case records to establish symptomology and current practice in the management of symptoms over the last 12 months.
The second phase involved a prospective study of patients who are routinely prescribed pancreatic enzyme replacement therapy (PERT), given education about the symptoms of pancreatic insufficiency, and followed up to monitor symptom management. In phase 2, the same audit tool was applied both before and after enzyme replacement to see if symptoms had been influenced and quality of life was measured measured. The study results were positive,
|Project Outcomes:||The second phase study results were positive and an article was published in the BMJ Supportive and Palliative Care Journal. Landers, C., Muircroft, W., Brown, H. Pancreatic enzyme replacement therapy (PERT) for malabsorption in patients with metastatic pancreatic cancer. BMJ Support Palliat Care doi:10.1136/bmjspcare-2014-000694|
|Further Information:||Contact: firstname.lastname@example.org|
|Funding Body:||NZ Wound Care Society|
|Project Description/Update:||The New Zealand Institute of Community Health Care completed an audit of data collected by the Nurse Maude Specialist Wound Management Service over a period of 23 months between April 2009 and February 2011. During this time, 562 patients had data on their wound care assessment entered into SilhouetteMobile which had been developed by a local vendor, Applied Research Associates of New Zealand (ARANZ Medical). Data from this tool was extracted from a central database and analysed by a Statistician using Microsoft Access and Excel.
The audit was designed to achieve four main functions:
|Project Outcomes:||A report was developed profiling this client group for Nurse Maude. Also recommendations were made over the type of information that needed to be captured to more fully inform service development and client outcomes.|
|Funding Body:||Nurse Maude Campbell Ballantyne Fellowship|
|Project Description/Update:||Patients with advanced chronic obstructive pulmonary disease (COPD) experience physical and psychosocial stresses such as breathlessness, depression, anxiety, often leading to a poor quality of life. Studies have identified unmet physical and psycho-social needs and difficulty accessing aids and financial benefits for these patients (Fitzsimmons et al, 2007; Gruffydd-Jones et al, 2007). We have limited evidence about the healthcare needs of people with advanced lung disease in Canterbury. This collaborative research will involve the Nurse Maude Hospice palliative care service, CDHB Respiratory Service and the NZ Institute of Community Health Care (NZICHC).
This study was designed to identify the health care needs of people with severe COPD by:
|Project Outcomes:||Recruitment and analysis of information was completed in mid 2013. One article has been published to date and is available here.|
|Funding Body:||Ministry of Health|
|Project Description/Update:||This project was developed to provide evidence and recommendations to inform the future development of DNS across NZ in order to maximise the use of the workforce and to optimise patient outcomes. This project will also provided a benchmark against which the impact and outcome of different community based DNS models can be measured in terms of both patient outcomes and workforce utilisation in order to guide further development of services.
Essentially the research team including District Nurses from Capital and Coast and from MidCentral District health Boards systematically carried out a national stocktake of all District Nursing services in the country with a brief description of the populations they served.
|Project Outcomes:||Two publications emerged out of this 15 month project; one that profiled the district nursing workforces and services by DHB for the entire country and the other identifying innovations in practice and service delivery that were found during the stocktake.|
|Further Information:||The reports are available through the link below.
|Funding Body:||Nurse Maude Campbell Ballantyne Fellowship & Canterbury District Health Board|
|Project Description/Update:||Nurse Maude and the Canterbury Clinical Network, with support from Canterbury District Health Board, established a pilot Older Adult Nurse Practitioner (NP) service to support a group of seven General Practice teams in a part of Christchurch, to work with community care services and local pharmacists. This role took a restorative focus for clients aged 75 years and over (excluding those with palliative needs). It provided case management and support for those with complex sub acute care needs to assist them to stay at home longer and reduce inappropriate hospital admissions. The service was co-located with Nurse Maude District Nursing and Home Support services but worked collaboratively with all providers of district nursing and homecare services. The service was planned for commencement in November 2010, however unavoidable delays meant that the NP commenced recruiting her caseload in February 2011.
An evaluation process, using a prospective clinical audit and survey method, was developed to identify which patients were referred to the NP service, their health status, how this role developed and service delivery outcomes. A patient satisfaction survey and a survey of the perceptions of general practice teams about the NP service were conducted. The direct, indirect, and service related activities undertaken by the NP were identified, along with issues in service delivery and identified gaps in community support services.
|Project Outcomes:||An evaluation report was developed and presented to the Canterbury District Health Board to inform decision making over the role.|
|Funding Body:||Nurse Maude|
|Project Description/Update:||Nurse Maude provides a district nursing, nurse specialist, hospice and hospital service to about 13,000 clients annually. These activities generate a significant amount of information that can be de-identified and used for a quality assurance processes including:
|Project Outcomes:||Reports have been made available to Nurse Maude for the 2012/13, 2013/14 and 2014/15 years and is summarised in Nurse Maude's annual reports.|
|Funding Body:||Nurse Maude|
|Project Description/Update:||Nurse Maude keeps records on the use of wound care products by its 250 District Nurses. This information was de-identified and analysed to profile:
|Project Outcomes:||The report on this project was shared with the District Nurses and used by them to reflect on their current practices and a re-run of the data will be used to map the impact of changes over the following 12 months.|