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Issue 192 - 18 August 2011

NZNO Members 
Vote for your representatives - NZNO Board of Directors

The Election process
Following the first round of nominations and the Board of Director's decision to duly appoint all, we were left with one position outstanding for both the Nursing and Midwifery Advisory Committee (NMAC) and College and Section Representative on the Board of Directors. 
Voting is now open and will remain open for seven weeks closing at 5.00pm on Friday 30th September 2011. Please remember that only one vote per member is valid.
There is the option of a paper ballot on request especially for those members without internet access.  To request a paper ballot please contact  

Articles: -
Hypothermia, Frostbite and Chilblains

1. Learn the chilling facts about hypothermia
By Snyder, Major Michelle L. Nursing, Feb 2005, Vol. 35 Issue 2: p32hn1-32hn4
This article focuses on unintentional hypothermia and discusses how interventions could mean the difference between life and death. It states that hypothermia is confirmed when the patient's core temperature is below 36 degree centigrade at two sites, such as the rectum and the esophagus. The severity of hypothermia and the available resources determine which re-warming strategy to use. According to the author, whatever option one uses, one should keep patient lying flat to avoid aggravating hypotension. One should also avoid rough movement and excessive activity, which could precipitate a lethal arrhythmia.

2. Time for a change to assess and evaluate body temperature in clinical practice
By Sund-Levander, Märtha; Grodzinsky, Ewa. International Journal of Nursing Practice, Aug 2009, Vol. 15 Issue 4: p241-249
The definition of normal body temperature as 37°C still is considered the norm worldwide, but in practice there is a widespread confusion of the evaluation of body temperature, especially in elderly individuals. In this paper, we discuss the relevance of normal body temperature as 37°C and consequences in clinical practice. Our conclusion is that body temperature should be evaluated in relation to the individual variability and that the best approach is to use the same site, and an unadjusted mode without adjustments to other sites. If the baseline value is not known, it is important to notice that frail elderly individuals are at risk of a low body temperature. In addition, what should be regarded as fever is closely related to what is considered as normal body temperature. That is, as normal body temperature shows individual variations, it is reasonable that the same should hold true for the febrile range. [ABSTRACT FROM AUTHOR].

3. Prevention of hypothermia
By McLafferty, Ella et al. Nursing Older People, May 2009, Vol. 21 Issue 4: p34-39
This article examines normal thermoregulation and the changes in temperature control associated with the ageing process. Factors that influence hypothermia in older people are identified and the article concludes with advice that nurses may give to older people to prevent hypothermia. [ABSTRACT FROM AUTHOR].

4. Treatment of Severe Hypothermia With Intravascular Temperature Modulation
By Lasater, Marie. Critical Care Nurse, Dec 2008, Vol. 28 Issue 6: p24-31
The article describes a method of rewarming a patient who suffered from hypothermia. It provides an overview of several warming methods such as passive rewarming, forced air warming, active core rewarming, airway rewarming and heated irrigation. It explains why the use of meperidine is contraindicated in all methods of rewarming. It explores the impact of intravascular rewarming

Critical Care Nurse, Dec 2008, Vol. 28 Issue 6: p25-26
The article describes the case of an 81-year-old man who suffered from hypothermia. It relates the physical symptoms of the patient consistent with hypothermia. The patient was treated with active rewarming. The ICY catheter was used to warm the patient gradually. It relates the outcome of the rewarming of the patient..

6. Winter safety tips for older adults.
Geriatrics, Feb 2007, Vol. 62 Issue 2: p15
The article offers winter safety tips for older people. It cites that shivering, cold skin that is pale or ashy, feeling tired and weak are the warning signs of hypothermia. It advises to keep all parts of the body covered from the cold weather to prevent frostbite. It recommends to put a smoke detector and battery-operated carbon monoxide detector in areas where fireplaces, wood stoves or kerosene heaters are located.

7. BY THE WAY, DOCTOR. What can I do about chilblains?
By Robb-Nicholson, Celeste. Harvard Women's Health Watch, Dec 2010, Vol. 18 Issue 4: p8
The article provides an answer to a question regarding the causes and treatment of chilblains.

8. Itchy, red lumps prove to be a chilling torture
By: Helen Meikle. Sydney Morning Herald, 04/08/2006
Database: Australia/New Zealand Reference Centre.
I HATE winter. I hate the cold, the grey, the bare trees and the general dreariness of it all. I even hate the ads for cough mixture. But most of all, I hate chilblains

9. Out of the cold: management of hypothermia and frostbite
By Biem, Jay et al. CMAJ: Canadian Medical Association Journal, 2/4/2003, Vol. 168 Issue 3: p305-312
Discusses cold induced injury such as hypothermia and frostbite. Statement that humidity and skin moisture increase the rate of skin cooling; Discussion of protective clothing; Conditions that increase a persons susceptibility to cold; Discussion of cellular, tissue, and systemic effects; Description of rewarming techniques..

10. What's your assessment?
By Bielan B. Dermatology Nursing, 2006 Oct; 18 (5): 445-6
Source: CINAHL Database
Frostbite symptoms and diagnosis

Backpacker, Mar 2011, Vol. 39 Issue 2, p48
Source: MasterFile Premier database
A quiz concerning frostbite is presented

12. Winter worries: hypothermia & frostbite
By Sherek, Becky. Minnesota Fire Chief, Nov/Dec2009, Vol. 46 Issue 2: p34-35
Source: MasterFile Premier database
The article features cold injuries for firefighters namely, hypothermia and frostbite. Hypothermia is explained including the reasons why heat is lost from the body and the body's normal response to cold. The slow progression of symptoms is described in relation to the temperature when they manifest. Frostbite is defined along with the factors that contribute to it. Proper treatment of these injuries are discussed as well as the importance of managing cold stress by modifying the firefighters' work practices.

Journal - Table of Contents

13. From JONA (The Journal of Nursing Administration), June 2011, Volume 41, Number 6

13A. The Lasting Influence of an Editor
In My Opinion
13B. Should LPNs Be Educated in Hospitals?;Commentary From the Editor of JONA, Dr Karen Hill
Staff Issues
Physical Activity and Diet-Focused Worksite Health Promotion for Direct Care Workers
Leadership Development
13D. Transformational Leadership Skills of Successful Nurse Managers
13E. Developing and Testing a Clinical Information System Evaluation Tool: Prioritizing Modifications Through End-User Input
13F. Development of a Professional Nursing Framework: The Journey Toward Nursing Excellence
13G. Closing the RN Engagement Gap: Which Drivers of Engagement Matter?
13H. Same-Handed and Mirrored Unit Configurations: Is There a Difference in Patient and Nurse Outcomes?
13I. Promoting Clinical Inquiry and Evidence-Based Practice: The Sacred Cow Contest Strategy
13J. Implementing Relationship-Based Care

14. Nurses Utilisation of Evidence to Inform Practice Project - Ministry of Health funded
The Nurses Utilisation of Evidence to Inform Practice (NUEIP) project is being evaluated throughout August. NUEIP is a Ministry of Health funded project looking at ways to improve the accessibility of information to support nurses either in their workplace or at home. To help improve access to information, Nursing Evidence is a website that has been created which has a range of high quality web resources and a tutorial section to support staff to find reliable information. A teaching package has been distributed and the project team are aiming to allow access to a funded database such as Proquest or Ebsco through Nursing Evidence. Although the Ministry of Health funding for this project covered the South Island, all nurses from New Zealand are invited to take part in this survey to provide valuable information for the project team to take forward into the future. Please follow this link directly to the survey Any queries please contact

News - National

15. Women's lower pay still an issue
TVNZ -  18 August 2011
Lower pay for women is in the spotlight again after a petition was launched today. The Greens and Council of Trade Unions want to prove equal pay is still a major concern in modern workplaces, particularly after comments by former Employers and Manufacturers Association boss Alasdair Thompson. MP Catherine Delahunty said her Equal Pay member's bill had received strong support but they wanted to draw even more attention to the issue.

News - International

16. AMA should stick to healthcare: Lib MP 
Sydney Morning Herald - 18 August, 2011
A federal Liberal MP has taken a doctors' group to task saying it should stick to its core business of healthcare and not activist statements. There was no place for the Australian Medical Association (AMA) to comment on policies outside its area, Don Randall said. The MP was responding to criticism the association has made of mandatory detention for all asylum seekers arriving by boat

17. PM trumpets Labor health reforms to AMA
Sydney Morning Herald - August 17, 2011
Prime Minister Julia Gillard has trumpeted Labor achievements in health reform to a captive audience of the Australian Medical Association (AMA) and Opposition leader Tony Abbott. Addressing the AMA parliamentary dinner, Ms Gillard said Labor and the AMA had not always agreed on policy but were always at one on the need to provide Australians with quality health care. She said the health system needed to be strengthened and renewed as the nation faced the ageing of the baby boomers and a rising tide of chronic illness and disease.

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