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Issue 153 - 23 Sept 2010


1. Editorial: Nurses and publications – the impact of the impact factor.
By Jackson, Debra et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2537-2538
The author discusses the growth in the amount of written work on nursing written by nurses. She talks of the pressure for nurses to publish in high impact, quality medical/nursing journals. She considers the so-called impact factor (IF) of various journals, the ranking of journals, and the use of these factors to judge the academic quality of a journal.

2. Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence
By Bauer, Michael et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2539-2546
Aims and objectives.
This paper examined the available evidence concerning hospital discharge practices for frail older people and their family caregivers and what practices were most beneficial for this group.
Background. Hospital discharge practices are placing an increasing burden of care on the family caregiver. Discharge planning and execution is significant for older patients where inadequate practices can be linked to adverse outcomes and an increased risk of readmission.
Design. Literature review.
Methods. A review of English language literature published after 1995 on hospital discharge of frail older people and family carer’s experiences.
Results. Numerous factors impact on the hospital discharge planning of the frail older person and their family carer’s that when categorised focus on the role that discharge planning plays in bridging the gap between the care provided in hospital and the care needed in the community, its potential to reduce the length of hospital stay, the impact of the discharge process on family carer’s and the need for a coordinated health professional approach that includes dissemination of information, clear communication and active support.
Conclusion. The current evidence indicates that hospital discharge planning for frail older people can be improved if interventions address family inclusion and education, communication between health care workers and family, interdisciplinary communication and ongoing support after discharge. Interventions should commence well before discharge. Relevance to clinical practice. An awareness of how the execution of the hospital discharge plan is perceived by the principal family carer of a frail older person, will allow nurses and others involved with the discharge process to better reconcile the family caregivers’ needs and expectations with the discharge process offered by their facility. The research shows there is a direct correlation between the quality of discharge planning and readmission to hospital.

3. Patient and public involvement: models and muddles.
By Forbat, Liz et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2547-2554
Aims and objectives.
This paper explores the range of models of involvement which are drawn upon in an empirical study and which are invoked in the literature and policy. The results and discussion of the study help to excavate and explore the muddle of conceptualisations of involvement and how this leads to difficulties for practitioners, patients and managers in implementing the relevant policy.
Background. Patient and public involvement has developed an important profile internationally within health and social care policy. However, its importance as a rhetorical device has not been accompanied by adequate developments in how it is operationalised.
Design. Cross-sectional study, with an intervention conducted at three sites, and non-intervention measures taken at two control sites.
Methods. This paper draws on an empirical study of involvement. Focus groups were conducted with a lung cancer team and people affected by cancer at five health boards across Scotland. Chief executives of each of these five health boards also took part in individual interviews. Participants were asked to describe their ideas of what involvement is and their application of it. Results. A range of ways of conceptualising involvement were apparent. Few of these moved beyond the use of patient satisfaction questionnaires. At times, troubling understandings were articulated, for example, using public meetings to communicate decisions about service closures to the public.
Conclusion. The slow escalation of involvement is in part because of the myriad ways in which it is conceptualised and discussed. Thus, we conclude that one of the greatest barriers to truly integrating patient involvement into health services, policy and research is the conceptual muddle with which involvement is articulated, understood and actioned.
Relevance to clinical practice. Clinicians need to be supported to seek clarity in the use and operationalisation of involvement if the agenda is to be truly adopted and strengthened. [ABSTRACT FROM AUTHOR]

4. Patient participation in emergency care – a phenomenographic analysis of caregivers’ conceptions
By Frank, Catharina et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2555-2562
Aims and objectives
. The aim of this study was to describe caregivers’ conceptions of patient participation in an emergency care unit.
Background. Patient participation is an important goal in health care. Patients who are given the opportunity to participate in care situations are able to influence care in a way that is more
beneficial to them. Patients’ participation in caring has been studied in different contexts, but little health care research has been conducted into patient participation in the emergency care unit. Patients treated in emergency care units sometimes express dissatisfaction with their care situation and it would therefore be important to find out how caregivers in emergency care experience patient participation.
Design. A phenomenographic research method based on life world theory was used in the study.
Method. Data were collected from 11 caregivers with experience of working in an emergency department. The caregivers were from different professions: three physicians, four nurses and four auxiliary nurses.
Results. The caregivers’ conceptions of patient participation can be divided into three different descriptive categories: caregivers offer the opportunity for participation, patients demand participation and mutual participation.
Conclusions. The study adds knowledge that caregivers’ different qualitative conceptions of patient participation are mainly conditional from caregivers.
Relevance to clinical practice. Mutual participation is perceived occasionally and often unexpectedly, when the right circumstances occur, despite international and national guidelines that lay down the need for patient participation. [ABSTRACT FROM AUTHOR]

5. Hospice family caregivers’ quality of life
By Tang, Woung-Ru. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2563-2572
Aims and objectives.
To study quality of life (QOL) and its important correlates among family caregivers of terminally ill patients receiving in-home hospice care.
Background. Caregiver QOL has been identified as a core outcome variable in studies of dying patients and their families, but few studies have assessed QOL among caregivers of patients with terminal illness, particularly those in hospice care.
Design. For this cross-sectional correlational study, 60 caregivers were recruited from two local in-home hospice programmes in the Midwestern United States.
Methods. Self-report data were provided by caregivers using the Caregiver Quality of Life Index – Cancer, Spiritual Well-Being Scale, American Pain Society Patient Outcomes Questionnaire, Eastern Cooperative Oncology Group Performance Status Rating and Medical Outcome Study Social Support Survey to measure their QOL, spirituality, health status and social support.
Results. Caregivers’ educational status, physical health status, spirituality and qualitative and quantitative social support, as a set, explained 42% of the variance in their QOL. Caregivers with higher education, better physical health status, greater spirituality and more qualitative and quantitative social support, had a significantly better QOL.
Conclusions. QOL for this sample of hospice caregivers was significantly predicted only by physical health status and spirituality, likely because of collinearity among the independent variables. Additional research is needed to explore the factors that sustain or promote caregivers’ QOL over time.
Relevance to clinical practice. In the delivery of hospice services, the family caregiver is both a vital member of the health care team and a recipient of care. Health care providers should therefore pay more attention to the health status and spirituality of major caregivers, thus helping them maintain and improve their QOL.

6. Patients and families experiences with video telehealth in rural/remote communities in Northern Canada
By Sevean, Pat et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2573-2579
To explore patients’ and families’ experiences with video telehealth consultations as a method of health care delivery in rural/ remote communities in Northern Canada.
Background. Accessing health services in isolated populations where human resources and infrastructure are constrained by vast geographical landmasses poses challenges and opportunities for nurses, health care providers, patients and families.
Design. A qualitative approach was adopted with a purposeful sample of 10 patients and four family members representative of nine communities.
Method. Selection criteria included patients receiving telehealth visits for a minimum of a year and willing to share their experiences. Data were collected during the winter of 2006 using semi-structured video taped interviews and analysed using a qualitative thematic content analysis.
Results. Patients and families experiences of their telehealth visits centered on three key themes: lessening the burden (costs of travel, accommodations, lost wages, lost time and physical limitations), maximising supports (access to family, friends, familiar home environment, nurses and other care providers), tailoring specific e-health systems to enhance patient and family needs.
Conclusion. The benefits of telehealth extend not only to patients and families but are linked to benefits for providers as well as the health care system.
Relevance to clinical practice. This study indicates that video telehealth is an effective mechanism for delivering nursing and other health services to rural/remote communities and can impact positively on the quality of health care. The integration of telehealth practice can enhance the coordination, organisation and implementation of health care services. [ABSTRACT FROM AUTHOR]

7. Empowerment from the perspective of next of kin in intensive care
By Wåhlin, Ingrid et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2580-2587
Aims and objectives.
To describe next of kin empowerment in an intensive care situation.
Background. Next of kin is important in reducing intensive care patients’ fear and anxiety. However, admission to an intensive care unit is often recognised as an extremely stressful event, causing next of kin to experience shock, fear, anxiety and vulnerability. More knowledge is needed about how next of kin in intensive care can be empowered.
Design. The study was conducted using a phenomenological method.
Methods. Ten interviews were conducted with intensive care patients’ next of kin.
Findings. Perceptions of both a genuine will and a capacity to help and relieve were found to be essential for next of kin’s experiences of empowerment in an intensive care situation. All informants were empowered by a caring atmosphere where they received continuous, straightforward and honest information that left room for hope and in which closeness to the patient was facilitated and medical care was perceived as the best possible. Some of the informants were also strengthened by support from other family members and/or by being involved in caring for the patient.
Conclusions. Next of kin empowerment was found to be associated with being met with human warmth and sensitivity. This emphasises the importance of discussing attitudes and behaviours as well as surveillance and treatment when trying to improve the care of next of kin in intensive care unit and when working with staff development.
Relevance to clinical practice. Knowledge of how to empower next of kin in an intensive care situation allows caring staff to support these persons in a more sensitive and appropriate way. Findings underline the importance of creating caring relations with patients’ next of kin. [ABSTRACT FROM AUTHOR]

8. Caregiver self-efficacy for managing behavioural problems of older people with dementia in Taiwan correlates with care receivers’ behavioural problems.
By Huang, Huei-Ling et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2588-2595
Aims and objective.
To investigate the relationship between family caregivers’ self-efficacy for managing behavioural problems of older people with dementia and their behavioural problems in Taiwan.
Background. Older people with dementia commonly have at least one behavioural problem, which caregivers complain is difficult to handle. To provide interventions that can help caregivers more effectively manage the behaviouralproblems of care receivers with dementia, caregivers’ self-efficacy on managing behavioural problems must be  assessed. However, it is not clear yet how these behavioural problems of older people with dementia may influence caregivers’ self-efficacy for managing behavioural problems.
Design. A prospective, correlational study. Method. Eighty dyads of older people with dementia and their family caregivers were recruited from neurological clinics of a medical centre in Taiwan. Care receivers were assessed for behavioural problems using the Chinese version of Cohen-Mansfield Agitation Inventory, community form. Caregivers’ self-efficacy for managing care receivers’ agitation was measured by the research team-developed Agitation Management Self-Efficacy Scale.
Results. Caregiver self-efficacy for managing behavioural problems was significantly and positively associated with more caregiver education, greater duration of caregiving and with care receivers’ less physically non-aggressive behaviours. When caregiver characteristics were controlled for in hierarchical regression analysis, physically non-aggressive behaviours explained 6% of the variance in caregiver self-efficacy.
Conclusions. Results of this study contradict the general belief that physically aggressive behaviours of elders with dementia are more difficult for family caregivers to handle than other behavioural problems. Clinicians need to address physically non-aggressive problem behaviours.
Relevance to clinical practice. Nurses could assess older patients with dementia for physically non-aggressive behaviours and train less educated caregivers to improve their self-efficacy for managing problem behaviours, thus enhancing the quality of life for both caregivers and care receivers. [ABSTRACT FROM AUTHOR]

9. Use of the measurement of medication administration hassles with Mexican American family caregivers.
By Kao, Hsueh-Fen S & Lynn, Mary R. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2596-2603
Aims and objectives.
This study builds on earlier work on medication administration hassles, minor daily irritants experienced by family caregivers of older relatives, by investigating the feasibility of using the Family Caregiver Medication Administration Hassles Scale (FCMAHS) for use with Mexican American caregivers.
Background. Appropriate medication administration is a critical factor in the effective management of chronic illness. When medication regimens are managed on behalf of an older care recipient, especially those with numerous medications for a variety of conditions, the caregiving task is even more complex. Relying on family support is common for older Mexican Americans. Despite this, there is little known about how Mexican Americans
are handling their caregiving duties at home.
Design. A non-experimental methodological design was used to
assess the psychometric properties of the FCMAHS with Mexican Americans, chosen because they are a rapidly growing population in the US.
Methods. A purposive sample of 239 Mexican American adult caregivers, recruited in Dallas and San Diego, completed a brief biographical survey and the version of the FCMAHS created for Mexican Americans, i.e., the FCMAHS-MA.
Results. Principal axis factoring with orthogonal rotation was used to extract six factors which accounted for 53% of the variance in total scores – initial information seeking, safety issues, advanced information acquisition, scheduling, daily routine and prescription filling. Reliability estimates for the factors (alpha) ranged from 0·70–0·90. Test-retest reliability across a three-week interval was r = 0·64.
Conclusions. The FCMAHC-MA shows promise as a guide for future caregiving intervention studies on family medication management for older relatives; however, it would benefit from refinement in future studies.
Relevance to clinical practice. Understanding family caregivers’ hassles with medication administration is important because these hassles can accumulate and lead to caregiver strain. Culturally relevant intervention depends on accurate measurement of the hassles experienced by these caregivers. [ABSTRACT FROM AUTHOR]

10. Caring in residential aged-care. Qualitative findings from an e-cohort sub-study
By Tuckett, Anthony et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2604-2612
The aim of this e-cohort sub-study was to explore and describe nurses’ understandings of ‘caring’ in residential aged-care.
Background. The quality of the work environment is an important issue for recruitment, retention and workforce planning. Knowledge about the people in and the place that is the residential aged-care facility may assist with the problems surrounding the recruitment and retention of nurses in the workforce.
Design. Qualitative electronic cohort sub-study. Methods. This paper presents the qualitative research findings from an electronic
cohort sub-study of 58 registered and enrolled nurses working in the residential aged-care sector in 2007. Data were collected through an open ended question and a qualitative content analysis was used to generate the core categories.
Results. The concept of caring was grounded in and constrained by, the everyday reality of the nurses in the study. Organisational imperatives for the completion of documentation necessary for accreditation and funding combined with under-staffing restricted the time available for caring practices. Some nurses represented
residential care faculties as devoid of care, others as a place where the resident was central to their work and care. The staff perceived of themselves as an ageing workforce in need of rejuvenation and resourcing.
Conclusion. The concept of caring is manifest in nurses’ language as they describe their workplace, the residents, themselves and the structures that impact on what they do. Good caring manifests itself when the residents are central to the business of the aged care facility. However, nurses in this study describe a range of restrictive factors impeding caring practices and diminishing workforce morale and motivation to create environments that
can truly be called a ‘home-away-from-home’ and one that all people would find acceptable.
Relevance to clinical practice. These findings have implications for aged-care sector recruitment, retention and workforce planning
within residential aged-care facilities. [ABSTRACT FROM AUTHOR]

11. Nurses’ experiences of guideline implementation: a focus group study.
By Alanen, Seija et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18: p2613-2621
The aim of the study was to address the following questions: What kind of experiences do primary care nurses have of guideline implementation? What do nurses think are the most important factors affecting the adoption of guidelines?
Background. The implementation of clinical guidelines seems to be dependent on multiple context-specific factors. This study sets out to explore the experiences of primary care nurses concerning
guideline implementation.
Design. Qualitative interview.
Methods. Data were generated by four focus group interviews involving nurses working in out-patient services in primary health centres in Finland. Purposive sampling was used to select health centres. Inductive content analysis was used to identify themes emerging from the data.
Results. Four main groups of factors were identified from the analysis of data: (i) factors related to the organisation, (ii) factors related to nurses, (iii) factors related to the anticipated consequences and (iv) factors related to the patient group. Nurses’ awareness and acceptance of guidelines and the anticipated positive consequences facilitate the implementation of guidelines. Organisational support, especially the adapting of guidelines to local circumstances, seems to be crucial for successful implementation.
Conclusions. Clinical guidelines can be promising tools in enhancing evidence-based nursing practice, as nurses see them as practical work tools in patient care and so are willing to adopt them. However, support from management and physicians is needed to ensure the successful implementation of guidelines into nursing practices.
Relevance to clinical practice. Based on the findings of this study and previous knowledge of guideline implementation some practical recommendations are suggested. Select the most relevant guidelines to clinical practice, organise the adaptation of guidelines to local circumstances, inform all practitioners involved in treatment and give clear instructions for the adoption of the guidelines. [ABSTRACT FROM AUTHOR]

12. Identifying the core components of cultural competence: findings from a Delphi study
By Jirwe, Maria et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2622-2634
To identify the core components of cultural competence from a Swedish perspective.
Background. The cultural diversity of Swedish society raises challenges for nursing practice. Nurses need to be culturally competent, i.e. demonstrate the effective application of knowledge, skills and attitudes to practice safely and effectively in a multicultural society. Existing frameworks of cultural competence reflect the socio-cultural, historical and political context they were developed in. To date, there has been no research examining cultural competence within a Swedish context.
Design. A Delphi survey.
Methods. A purposeful sample of 24 experts (eight nurses, eight researchers and eight lecturers) knowledgeable in multicultural issues was recruited. Interviews were undertaken to identify the knowledge, skills and attitudes that formed the components of cultural competence. Content analysis yielded statements which were developed into a questionnaire. Respondents scored questionnaire items in terms of perceived importance. Statements which reached consensus were removed from questionnaires used in subsequent rounds. Three rounds of questionnaires
were distributed during 2006.
Results. A total of 118 out of 137 components reached a consensus level of 75%. The components were categorised into five areas, cultural sensitivity, cultural understanding, cultural encounters, understanding of health, ill-health and healthcare and social and cultural contexts with 17 associated subcategories.
Conclusions. There are some similarities between the issues raised in the current study and existing frameworks of cultural competence from the USA and the UK. However, Swedish experts placed less emphasis on ethnohistory and on developing skills to challenge discrimination and racism.
Relevance to clinical practice. This study identified the core components of cultural competence important to nurses practising within a multicultural society such as Sweden. Acquisition of the knowledge, skills and attitudes identified should enable nurses to meet the needs of patients from different cultural backgrounds. The componentsof cultural competence can form the basis of nursing curricula. [ABSTRACT FROM AUTHOR]

13. The role of specialist and general nurses working with people with multiple sclerosis
By While, Alison et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2635-2648
To describe the perceived role of nurses and other carers of people with multiple sclerosis from the perspective of different stakeholders (people with multiple sclerosis, non-specialist nurses, specialist nurses and other health care professionals).
Background. Multiple sclerosis is one of the commonest causes of disability in young adults. People with multiple sclerosis require supportive care during the disease trajectory. The role of different health and social care providers has not been reported previously.
Design. Survey.
Method. Questionnaire data collected in 2002 during the first phase of scale development (health professionals n = 459; people with multiple sclerosis n = 65; total response rate 59·4%). The data were reanalysed to compare responses across sample groups.
Results. There was consensus that neurologists and specialist nurses were the most appropriate professionals in the provision of
specialist care with specialist nurses also being identified as key providers of emotional support. However, there were also significant differences in nominations reflecting the different perspectives of the stakeholder groups and a self-report bias. Each stakeholder group frequently emphasised their own perceived contribution to care. The different perspective of people with multiple sclerosis was also noteworthy with their greater emphasis on social care and lay support.
Conclusions. The findings indicate a dissonance in the views of
different stakeholders within the care system. The division of labour associated with nursing care requires further exploration. The contrasting paradigms of health care professionals and people with multiple sclerosis regarding models of disability were highlighted.
Relevance to clinical practice. Multiple sclerosis, like other
chronic illnesses, requires substantial nursing care. There is a growing number of specialist nurses in the workforce, however, little is known how their role interfaces with other nurses. [ABSTRACT FROM AUTHOR]

14. A review of the role of emergency nurses in management of chemotherapy-related complications
By Considine, Julie et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2649-2655
Aims and objectives.
To examine the role of emergency nurses in caring for patients who receive chemotherapy in ambulatory oncology settings. Reasons for emergency department presentations are examined, specific sources of clinical risk for patients receiving chemotherapy who require emergency care are discussed and cost implications of emergency department presentations related to chemotherapy are analysed.
Background. Given the increased administration of chemotherapy in ambulatory settings, emergency nurses play an important role in the management of patients undergoing adjuvant chemotherapy. Emergency departments are the major entry point for acute inpatient hospital care of complications arising from chemotherapy.
Design. Systematic review.
Results. Chemotherapy-related emergency department presentations have considerable clinical and cost implications for patients and the healthcare system. Strategies to improve emergency department management of chemotherapy complications and reduction in preventable emergency department presentations has significant implications for improving cancer patients’ quality of life and reducing the cost of cancer care.
Conclusions. Nurses are well placed to play a pivotal role in chemotherapy management and lead interventions such as a specialist oncology nursing roles that provide information and support to guide patients through their chemotherapy cycles. These interventions may prevent emergency department presentations for patients receiving chemotherapy in ambulatory
Relevance to clinical practice. Patients receiving chemotherapy require access to specialised care to manage distressing symptoms, as they are at significant clinical risk because of immunosuppression and may not exhibit the usual signs of critical illness. A team approach both within and across nursing specialities may improve care for patients receiving chemotherapy and increase effective use of healthcare resources.

15. The structure of contraceptive education and instruction within nurse led family planning clinics: a grounded theory study.
By Hayter, Mark. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2656-2667
This study aimed to explore and analyse how nurses instruct women in contraceptive use during consultations in family planning clinics to produce a grounded theory of contraceptive education.
Background. Nurses play a key role in instructing women how to use contraception in family planning clinic consultations. These one-to-one situations are encounters where women are taught how to use contraceptive methods effectively. However, very little is known about the nature of these consultations.
Design. A qualitative study using a grounded theory approach was used.
Results. Three linked ‘core categories’ emerged from the data analysis. Firstly, women are educated about their body and how it responds to contraception: ‘reproductive education’. This core category is closely linked to ‘surveillance’ where women are
taught to monitor their reproductive health and to ‘contraceptive regimen’ where women are instructed in techniques to successfully use a contraceptive method. Together these three core categories present a grounded theory of ‘contraceptive education’.
Conclusions. Nursing practice in this important area of women’s health care is complex and requires skilled practitioners. This study presents unique empirical data into how nurses conduct
one-to-one consultations with women – providing a novel insight into how contraception is explained in clinical situations. Key issues for practice from the data were the lack of a balance when discussing side effects, the rigidity of some instructions and the lack of recognition of risk from sexually transmitted infection.
Relevance to clinical practice. Nurses working in sexual health need to ensure that women understand the often complex instructions they provide and that rigid instruction be occasionally amended to enable some flexibility.  The manner in which side-effects are discussed should also be balanced. Nurses need to address the risk of sexually transmitted infections more substantially in contraceptive discussions. [ABSTRACT FROM AUTHOR]

16. Nurse prescribing by children’s nurses: views of doctors and clinical leads in one specialist children’s hospital.
By Courtenay, Molly et al. Journal of Clinical Nursing, Sep 2009, Vol. 18 Issue 18:p2668-2675
To explore the views of doctors and clinical leads (CLs), who care for children and young people, on nurse prescribing in one specialist children’s hospital.
Background. Nearly 14,000 nurses in the UK have virtually the same prescribing rights as doctors. Benefits of nurses adopting this role have been reported, but doctors do have some concerns. Increasing numbers of specialist nurses involved in the care of children in the hospital setting are undertaking prescribing training. No research has explored the views of health care professionals on nurse prescribing in this setting.
Design. A subset of qualitative data taken from a larger study that adopted an intrinsic case study design.
Method. Interviews were conducted between October 2006–July 2007 with 11 doctors and three clinical leads in one specialist children’s hospital. A thematic analysis was conducted on the interview data.
Results. Nurse prescribing improved access to medicines and continuity of care. Concerns included the need for doctors to have confidence in the ability of the nurse who wanted to become a prescriber, the selection of nurses for prescribing training, the effects of nurse prescribing on the individual roles and responsibilities of doctors and nurses’ clinical skills.
Conclusion. Doctors and clinical leads working in a specialist children’s hospital in the UK recognise that nurse prescribing makes a positive contribution to the delivery of services. However, it is important that nurses have the appropriate clinical skills and doctors understand nurse prescribing. This will only take place if there is good communication across professional boundaries. Relevance to clinical practice. Selection processes for the prescribing programmes must ensure that students have the
necessary course prerequisites. Communication across professional boundaries is crucial to the successful implementation of nurse prescribing in the care of children and young people in the hospital setting.

Journals Table of Contents

17. From The Tube, Volume 25, Issue 2, August 2010
17A. Changes in the editorial team
Intro from Sherry Sharp, the new editor
17C. Task force update [Bowel cancer screening]
17D. The beginnings [How the gastro nurses began]
17E. International Nurse's day winner
17F. Olympus corner
17G. Conference 2009: How do we ensure patients are fully informed?
17H. Whakatane Conference Reports: New Zealand Viral Hepatitis Conference [Reports 1 and 2]
Waitemata Endoscopy; Hawkes Bay Endoscopy Unit
17J. Report from Gastro conference 2009 [GNS Nursing Survey Update]
17K. Biofilm in Duodenoscope, Hospital infection by pan-resistant aeruginosa pseudomonas related to endoscopic retrograde cholangiopancreatograpghy (ERCP)
17L. Report from Gendy Bradford on the Annual Scientific meeting - November 2009
17M. Westmead Endoscopy Symposium
17N. Directory of New Zealand Endoscopy Units 2010

18. From Employment Today, September/October 2010, Issue 150
18A. Working on resilience
18B. Kiwi men the biggest losers [New Zealand men are lagging behind their Australian counterparts in the wage stakes]; Work killing employee passion
18C. Talkative colleagues the worst distraction; Does my bum look big in this?
18D. Work notes; New path to teaching for industry workers; ipods help kiwi tune into work
18E. Video proves to be child's play; Record increase in youth unemployment
18F. Mobile office makes moving easy; Work in 2020
18G. Mowing down your goals
Duncan Brown [Head of people and performance, Deloitte, Auckland]
18I. On the road to a great future
Auckland-based Urgent Couriers is keeping its foot on the gas, while making sure its business is both economically and environmentally sustainable. HR manager Sue Bonnici-Carter tells Lyndsey Swan about a rapidly changing industry.
18J. Short stories … but true
Stories are central to influencing and inspiring change, says Paul Stewart. They stimulate the imagination and are a source of real organisational knowledge. He explains how to use your success stories to inspire employees and depict the value your organisation aims to create for others.
18K. Ticking the boxes
Professional development courses have been trimmed down, toned up and they’re performing better than ever, reports Jackie Brown-Haysom.  She finds businesses are taking a more considered approach to their executive learning programmes and ensuring the right people get the right training.
18L. Kiwi companies show leadership in literacy
Staff from two of New Zealand’s largest infrastructure companies are getting hooked on learning. Jacqui Gibson checks out the workplace literacy programmes at Fulton Hogan and Downer and finds they have lifted people’s confidence and benefited company culture.
18M. The power of conflict coaching
People problems are time-consuming, energy-sapping and often hard to resolve. What’s more, they can have a profound effect on an organisation’s bottom line. But with the right approach, conflict can also provide an opportunity to build understanding, bring about change, and promote innovation, says Gabrielle O’Brien.
18N. The strategic employee survey
If you or your management team see employee surveys as an unnecessary add-on, then it may be time to reconsider the role that measuring employee attitude and opinion can play in driving your organisation’s success—and how you go about it, says Dr Neal Knight-Turvey.
18O. Learning on the job
Professor Paul Kirkbride, a keynote speaker at the recent HRINZ 2010 Conference, looks at emerging trends in organisational learning and executive education, and at the challenges for the next decade and beyond.
18P. Secret ballots for strike action
A private member’s bill currently before Parliament will make secret ballots for strike action compulsory. Susan Hornsby-Geluk and Chloe Luscombe outline the proposed changes and discuss the implications.
18Q. Getting down to business
The transformation of HR professionals from their traditional roles to strategic business partners has been slow, says Clare Parkes. She examines the issue of HR business partnering and explains how to put HR at the centre of business strategy.
18R. Sustainable business: Corporate responsibility signals a smart approach
Forging a business path by specialising in corporate social responsibility has been a successful formula for Nikki Wright, who explains her central philosophy.
18S. Remuneration remedies: Under pressure
As the economy recovers, there is growing pressure from the workforce for solid pay increases. Susan Doughty provides a low-down on wages and salaries in the year ahead and how to deal with employee and union expectations.
18T. HRINZ news: Honestly, what do you think?
Surveys are an important part of organisational functioning and HR activity—but how useful are they, and what should HR professionals consider when implementing them, asks Bev Marshall. She outlines ways to ensure you get real value from your surveys.
18U. Recruitment: New recruitment DNA
The recruitment industry is undergoing massive change and must become more fully engaged with candidates, says Jane Kennelly. She looks at the skills those in the recruitment function of tomorrow will require in order to stay ahead of the game and add value.
18V. Public sector: He’s back
Reinstatement is the primary remedy under the Employment Relations Act. However, as Paul Robertson explains, if there is a potential for reinstatement to open old wounds and create disruption and conflict, then the practical solution is for the person to move on.

Conferences, Seminars, Courses

19. New Zealand Society of Gastroenterology and NZNO Gastroenterology Nursing Section Conference
Date: 17-19 November 2010
Venue: Auckland
More information:

20. Rural Health Forum 2010
Finding practical solutions to the challenges of delivering consistent and comprehensive healthcare to rural communities
Date: 30 November - 1 December 2010
Venue: InterContinental, wellington
More information:

Earthquake Advice

Last updated - 22 September 2010

News - National

22. Minister mulls rest home plan
Nelson Mail - 22nd Sep 2010
A "positive proposal" on the Joan Whiting Rest Home in Collingwood is still being considered by Health Minister Tony Ryall, West Coast-Tasman MP Chris Auchinvole said today.

23. Call to fund surgery for obese
The Press - 23 Sept 2010
Discrimination means obese people are being denied treatment for their lethal condition, a surgical specialist says. Richard Flint, of Southern Obesity Surgery, spoke at the Royal New Zealand College of GPs conference in Christchurch this month about the benefits of bariatric surgery for the morbidly obese.

News - International

24. Bad system putting health in jeopardy [By Carol Bennett]
Sydney Morning Herald - September 23, 2010
Our health authorities are failing to uphold public safety over vaccines, and in the case of the flu vaccines, this includes the safety of children. They are put at risk by a complex, confusing and flawed system of reporting problems. Successive governments have failed to address them and overhaul how medicines and other therapeutic goods are regulated.

25. AMAQ calls for health plan axe Petrina Berry
Sydney Morning Herald - September 23, 2010
The Australian Medical Association (AMA) says plans to introduce physician assistants into Queensland's public health system should be scrapped. The Queensland government conducted a 12-month trial where five physician assistants (PAs) from the United States of America worked in Brisbane, Mount Isa, Cooktown and Normanton. Physician assistants, used widely in the USA, are qualified to provide health care services, including diagnosing patients, under the direction and supervision of a doctor.

26. Alberta team combats osteoarthritis by using stem cells to generate new cartilage
Calgary Herald - 21 Sept 2010
CALGARY – A team of Calgary researchers are getting closer to repairing and even preventing osteoarthritis, a progressive disease that affects millions across Canada and up until this point, has been incurable. “Osteoarthritis is a terrible, progressive disease of joints in which people struggle with increasing pain,
swelling and disability until they cannot work, play or function in their lives,” says Dr. Cy Frank, professor of orthopedic surgery at the University of Calgary Faculty of Medicine

27. Use it or lose it: important way to stave off Alzheimer’s
Alzheimer's disease is the main form of dementia. With ageing populations worldwide, research is finding ways to prevent or postpone physical and mental degeneration with age, and to care for those who live with it.
Everybody Website - NZ


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