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Issue 32 - 24 Sept 2013

The latest NZ nursing research

Do you want to keep up to date with the latest NZ nursing research, that’s relevant to your teaching, your practice or your study? Look no further than NZNO’s own research journal
Kai Tiaki Nursing Research - fourth issue -  August  2013
Topical and the biggest yet - five strong  peer-reviewed articles.
Two research studies glean new information about the aftermath of the Christchurch earthquake. One looks at the effect of the disaster on Nurse Maude’s vulnerable community clients. The second takes the educator’s viewpoint – what impact did the quake have on staff and students of a bachelor of nursing course? Another article looks at the value of critical care outreach nurses and the early warning score tool, while a meta-study tries to find whether support for palliative care nurses leads to better quality of care. Finally, why do Maori nurses smoke and what would make them stop? The first part of a two-part study examines the conflicted roles of smoker and health-care role model.
Subscribe:0800 28 38 48 or Email: subscriptions@nzno.org.nz.
Submission of content enquiries (eg research manuscripts, letters to the editor): kaitiakiresearch@nzno.org.nz.
More information: http://www.nzno.org.nz/services/kai_tiaki/ktnr_nursing_research_journal


Articles - Change Management

1. Shaping a Unit's Culture Through Effective Nurse-Led Quality Improvement
By Shafer, Lucretia; Gillaspie Aziz, Marisa. MEDSURG Nursing. Jul/Aug 2013, Vol. 22 Issue 4, p229-236
Abstract:
The article focuses on effective nurse-led quality improvement at Saint Francis Hospital 28-bed medical telemetry unit in Federal Way, West Virginia through participation in the Transforming Care at the Bedside (TCAB) initiative. It states that the unit at the hospital showed improved metrics and positive cultural changes using the initiative. It mentions that the process of improvement needs a set of skill that must be practiced to become successful..

2. Planning successful change incorporating processes and people
By Hewitt-Taylor, Jaqui. Nursing Standard. 5/22/2013, Vol. 27 Issue 38, p35-40
Abstract
: Implementing change is a core element of developing healthcare practice. While planning the practical aspects of change is vital, so too is considering how people will perceive and be affected by an innovation, including what individuals and teams will gain or lose, who the opinion leaders will be and the influence of workplace culture. The aim of this article is to highlight some of the considerations that may be useful in planning successful change.[ABSTRACT FROM AUTHOR] .

3. Selecting the best theory to implement planned change
By Mitchell, Gary. Nursing Management - UK. Apr2013, Vol. 20 Issue 1, p32-37
Abstract
: Planned change in nursing practice is necessary for a wide range of reasons, but it can be challenging to implement. Understanding and using a change theory framework can help managers or other change agents to increase the likelihood of success. This article considers three change theories and discusses how one in particular can be used in practice.[ABSTRACT FROM AUTHOR] .

4.First-line nurse leaders' health-care change management initiatives
By MACPHEE, MAURA; SURYAPRAKASH, NITYA. Journal of Nursing Management. Mar 2012, Vol. 20 Issue 2, p249-259
Abstract:
  Aim - To examine nurse leaders' change management projects within British Columbia, Canada. Background British Columbia Nursing Leadership Institute 2007-10 attendees worked on year-long change management initiatives/projects of importance to their respective health-care institutions. Most leaders were in first-line positions with <3 years' experience.

5. Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process
By Salmela, Susanne; Eriksson, Katie; Fagerström, Lisbeth. Journal of Advanced Nursing. Feb 2012, Vol. 68 Issue 2, p423-433
Abstract
; Aim. This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process. 
Results. The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture

6. Change-related expectations and commitment to change of nurses: the role of leadership and communication
By PORTOGHESE, IGOR; GALLETTA, MAURA; BATTISTELLI, ADALGISA; SAIANI, LUISA; PENNA, MARIA PIETRONILLA; ALLEGRINI, ELISABETTA. Journal of Nursing Management. Jul 2012, Vol. 20 Issue 5, p582-591. 10p
Abstract:
The purpose of this study was to test a theoretical model linking the impact of expectations on commitment to change and to explore whether change-related communication is a mediating variable between leader-member exchange and expectations. Background Expectations for change outcomes are an important condition to increase nurses' commitment to change. To understand the role of leadership and communication in expectations development is crucial to promote commitment to change

Articles - Turner Syndrome

7. Ischemic stroke in a young adult with Turner syndrome
By Irioka, Takashi; Mizusawa, Hidehiro. Neurological Sciences. Apr 2011, Vol. 32 Issue 2, p317-319.
Abstract:
37-year-old woman suffered from sudden hemiparesis due to an ischemic stroke. Physical examination revealed dysmorphic features, cognitive impairment, and emotional lability. Radiological studies showed multiple intracranial arterial stenoses, and laboratory examination revealed diabetes mellitus, dyslipidemia, and endocrinological abnormalities consistent with secondary amenorrhea. Karyotyping disclosed partial monosomy of the short arm of the X chromosome. We diagnosed the patient with Turner syndrome and concluded that premature atherosclerosis was a cause of stroke. We emphasize a possible relationship between strokes and Turner syndrome. Physicians need to manage adult Turner patients carefully, especially with regard to metabolic dysfunctions, to prevent strokes.[ABSTRACT FROM AUTHOR] .

8. Abnormalities of the major intrathoracic arteries in Turner syndrome as revealed by magnetic resonance imaging
By Mortensen, Kristian Havmand; Hjerrild, Britta Eilersen; Andersen, Niels Holmark; Sørensen, Keld Ejvind; Hørlyck, Arne; Pedersen, Erik Morre; Lundorf, Erik; Christiansen, Jens Sandahl; Gravholt, Claus Højbjerg. Cardiology in the Young. Apr2010, Vol. 20 Issue 2, p191-200. 10p.
Abstract
:  Ectatic aortopathy and arterial abnormalities cause excess morbidity and mortality in Turner syndrome, where a state of vasculopathy seemingly extends into the major head and neck branch arteries.
Objective: We investigated the prevalence of abnormalities of the major intrathoracic arteries, their interaction with arterial dimensions, and their association with karyotype. Design: Magnetic resonance imaging scans determined the arterial abnormalities as well as head and neck branch artery and aortic dimensions in 99 adult women with Turner syndrome compared with 33 healthy female controls.

9.  Left Ventricular Thickness Is Increased in Nonhypertensive Turner's Syndrome
By Sozen, Ahmet Bilge; Cefle, Kıvanc; Kudat, Hasan; Ozturk, Sukru; Oflaz, Huseyin; Akkaya, Vakur; Palanduz, Sukru; Demirel, Seref; Ozcan, Mustafa; Goren, Taner; Guven, Ozen. Echocardiography. Sep 2009, Vol. 26 Issue 8, p943-949
Abstract:
Turner's syndrome (TS), the most frequent congenital anomaly in newborn girls, is associated with various cardiovascular abnormalities, predominantly bicuspid aortic valves and aortic coarctation. The causes of the left ventricular hypertrophy (LVH) and ECG findings associated with TS are unknown. We used echocardiography to assess cardiac structure and function in normotensive patients with TS. 
Results: With 24-hour-ambulatory ECG recording, the mean heart rate (HR) of TS women was higher than non-TS women. With echocardiographic examination, the interventricular septum diastolic thickness, left ventricle posterior wall diastolic thickness (LVPW), the LV mass index (LVMI), and left atrial diameter index (LADi) were significantly higher in TS women compared with controls. Mitral flow A velocity was significantly higher and the ratio of early to late diastolic filling was significantly lower in TS patients.
Conclusion: HR, LV wall thicknesses, LVMI and the LADi are significantly increased in normohypertensive TS women. There is also subclinical diastolic dysfunction in these patients.[ABSTRACT FROM AUTHOR] .

Articles - Primary Health Care

10. The Origins of Public Health Nursing: The Henry Street Visiting Nurse Service
By Fee, Elizabeth; Bu, Liping. American Journal of Public Health. Jul 2010, Vol. 100 Issue 7, p1206-1207
Abstract:
The article discusses the history of public health nursing, noting its pioneer Lillian Wald and her role in defining the practice to include care for social and economic problems as well as sickness. The article describes efforts taken by Wald and her nursing partner Mary Brewster to help tenement dwellers in New York City and the history of the pair's Henry Street Nurses' Settlement. The associated Henry Street Visiting Nurse Service grew to provide services to the poor and immigrants across the city. A photograph of Henry Street visiting nurse Miss Pearson with a Chinese mother and her children is described..

11. Maternal Child Home Visiting Program Improves Nursing Practice for Screening of Woman Abuse
By Vanderburg, Sharon; Wright, Leslie; Boston, Susan; Zimmerman, Greg. Public Health Nursing. Jul/Aug 2010, Vol. 27 Issue 4, p347-352
Abstract:
This study investigated changes in public health nurse practices and the incidence of abuse inquiry and disclosure. Design and Sample: A retrospective record review of cross-sectional data was collected before and after implementation of the Routine Universal Comprehensive Screening (RUCS) protocol within a maternal child home visiting program. Records of postpartum women receiving a universal home visit within 48 hr of discharge from the hospital were reviewed (pre-RUCS, n=459; post-RUCS, n=485). Also reviewed were the records of women receiving a family assessment for at risk home visiting (pre-RUCS, n=79; post-RUCS, n=66)

12. Immunizing Children Who Fear and Resist Needles: Is It a Problem for Nurses?
By Ives, Mary; Melrose, Sherri. Nursing Forum. Jan-Mar 2010, Vol. 45 Issue 1, p29-39. 11p
Abstract
:  Despite increasing evidence that immunization procedures can be stressful for children, little is known about what the experience of immunizing frightened and needle-resistant children can be like for nurses.  
Results. The following four overarching themes were identified and are used to explain and describe significant features of the immunization experience that were stressful and problematic for nurses: (a) nurses experience stress when immunizing children who fear and resist needle injection; (b) the strength of child resistance and some adult behavior creates an ethical dilemma for nurses; (c) some adult responses make immunizing difficult and unsafe; and (d) resources to help nurses cope with these situations are inconsistent.[ABSTRACT FROM AUTHOR] .

13. Child health promotion in the United Kingdom: does health visitors’ practice follow policy?
By Condon, Louise. Journal of Advanced Nursing. Jun 2008, Vol. 62 Issue 5, p551-561
Abstract:
This paper is a report of a study to assess to what extent national child health promotion policy is reflected in health visitors’ practice across the United Kingdom. Background. Community or public health nurses are often key providers of child health promotion programmes for well children. Over the last decade, national United Kingdom policy concerning universal preventive health services for preschool children has changed rapidly. Health promotion contacts are increasingly targeted to those with the highest health needs. Method. A survey was conducted in 2005 of health visitors’ Child Health Promotion Programme practice.

14. Early childhood home visiting programme: factors contributing to success
By Heaman, Maureen; Chalmers, Karen; Woodgate, Roberta; Brown, Judy. Journal of Advanced Nursing. Aug 2006, Vol. 55 Issue 3, p291-300.
Abstract
: This paper reports a study of the factors that public health nurses, home visitors and parents consider important for the success of an early childhood home visiting programme. Background. The primary aim of early child home visiting programmes is to promote healthy and safe growth and development of infants and children in at-risk families. Few studies have focused on actual programme components which foster this outcome.
Methods. The research was a descriptive, qualitative evaluation. Success of the programme was defined as positive changes in families which were seen as directly related to participation.

Journal - Table of Contents

15. From Journal of Infection Prevention, September 2013; 14 (5)
Conference Editorial
15A.
Inspiring, challenging, supporting – our conference; your competence
Report
15B.
Cooking up a storm: developing an infection prevention training recipe book
Peer reviewed articles
15C.
Chlorhexidine for the prevention of ventilator associated pneumonia in critically ill adults
15D. Impact of a multi-hospital intervention utilising screening, hand hygiene education and pulsed xenon ultraviolet (PX-UV) on the rate of hospital associated meticillin resistant Staphylococcus aureus infection
15E. Continuous decontamination of an intensive care isolation room during patient occupancy using 405 nm light technology
Opinion/Comment
15F.
Outbreak Column 10: What causes outbreaks – questions of attribution

Conferences

16. Aged Care Service Delivery
With inspirational insights from leading industry experts, this event includes presentations from New Zealand Aged Care Association, Age Concern, Elizabeth Knox Home and Hospital, The Selwyn Foundation, New Zealand Nurses Organisation, and Waitemata DHB.
Date: 12 - 13 Nov, 2013
Venue: Crowne Plaza, Auckland
More information: http://www.conferenz.co.nz/conferences/aged-care-service-delivery

17. Contract Law for Non Lawyers 
An intensely practical guide through the essentials of contract law, exploring such details as when a contract will be required, when you have a contract (and don’t necessarily know it), what types of contract exist and the effect of statutes on your contractual arrangements
Date: 17 - 18 Feb, 2014
Venue: Auckland
Date: 24 - 25 Mar, 2014
Venue: Wellington
More information:  http://www.conferenz.co.nz/training/contract-law-for-non-lawyers
 

News - National

18. Changes freeze out older jobless
NZ Herald - Monday Sep 23, 2013
Older long-term unemployed people look set to lose out in a radical reshuffle of foundation education which will give higher priority to young people and others who can move into work quickly. The Foundation-Focused Training Opportunities (FFTO) scheme - the last remnant of the long-running Training Opportunities Programmes (TOPs) for the unemployed - is being axed from the end of this year because people referred to it were found to be actually less likely to move off benefits than a matched group who were not referred to it
http://www.nzherald.co.nz/nz/news/article.cfm?
c_id=1&objectid=11128700

19. Police push lower drink-driving limit
The Press - 18/09/2013
Lowering the drink-driving limits would make more people refuse to drive and stop people who were so intoxicated they were incapable of making a responsible decision from driving, police say. Lowering the alcohol limit would undoubtedly save lives, road policing Assistant Commissioner Dave Cliff said today He was speaking at Parliament's law and order select committee on an auditor-general's report on the enforcement of drink-driving laws
http://www.stuff.co.nz/the-press/news/transport/9180699/Police-
push-lower-drink-driving-limit

20. Sugary drinks should be regulated like tobacco - academic
Otago Daily Times - Wed, 18 Sep 2013
Sugar-sweetened beverages should be regulated like tobacco as a first step to combating New Zealand's obesity epidemic, the Public Health Association Conference was told today in New Plymouth. Gerhard Sundborn, from Auckland University, has proposed an 'end-game' strategy for sugar-sweetened beverages (SSBs) in New Zealand
http://www.odt.co.nz/news/national/273740/sugary-drinks-should-
be-regulated-tobacco-academic

News - International

21. GMC probe into Mid-Staffs slammed as "whitewash" as cases abandoned
The Telegraph - 23 Sept 2013
The General Medical Council (GMC) said it was closing the cases against four doctors who held senior management positions at Mid Staffordshire Hospitals trust as care deteriorated. The decision means that of 44 cases taken to the GMC involving doctors working at the trust during the scandal, just one has been struck off the medical register – for a case of fraud. The GMC said yesterday that it dropped the cases against four doctors who worked in senior management positions at the trust, after lawyers advised that there was “no realistic prospect” of securing a finding against them.
http://www.telegraph.co.uk/health/healthnews/10329203/GMC-
probe-into-Mid-Staffs-slammed-as-whitewash-as-cases-
abandoned.html

22. Retiring later does not reduce survival chances - study
The Telegraph - 23 Sept 2013
Researchers in Australia and Norway studied population data and concluded that there is no link between the age at which someone retires and that at which they die. There are contradictory theories about the effect of changing the retirement age on life expectancy
http://www.telegraph.co.uk/health/elderhealth/10328724/Retiring-
later-does-not-reduce-survival-chances-study.html

23. Cholesterol drugs heavy going for PBS and health
The Age - 22 Sept 2013
Obesity and cardiovascular disease is costing taxpayers nearly $1 billion in medication alone, according to the latest data from the taxpayer-funded Pharmaceutical Benefits Scheme. The two most prescribed drugs Atorvastatin and Rosuvastatin are members of the drug class known as statins - used for lowering blood cholesterol - and are the number one burden on the subsidised pharmaceutical scheme
http://www.theage.com.au/national/cholesterol-drugs-heavy-going
-for-pbs-and-health-20130921-2u6v9.html

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