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Issue 156 - 15 October 2010

Stand up for your workers rights
National Day of Action - 20 October 2010
To find out more speak to your delegate, organiser, local NZNO office or go to:



1. Nurses addressing the challenges of chronic illness: From primary to palliative care.
By Patricia M. Davidson et al. Collegian, Volume 17, Issue 2: p43-45. (July 2010)
The 20th century has heralded unprecedented technological advances in health care and also considerable social change (Koh et al., 2010). Introducing innovative practices in prevention and treatment has decreased mortality for many conditions, previously causing premature death. These welcome advances in health outcomes have paradoxically created a new set of problems and challenges — equally as complex and challenging as those of previous centuries (Daar et al., 2007, Wagner, 1998). Globally, as life span lengthens, health care systems are facing the challenges of providing services to increasing numbers of people with chronic illnesses. Many of these individuals are older and facing a range of social challenges. These people and their families are living with an uncertain future and experiencing increasing demands physically, emotionally and financially (Koh et al. 2010, Parekh and Barton, 2010). In this setting the support from health professionals, particularly nurses, is important to ensure optimal health outcomes.

2. Cancer as a chronic disease
By Jane Louise Phillips & David C. Currow. Collegian, Volume 17, Issue 2: p47-50 (July 2010)

Over the past two decades the number of people living with cancer has increased. Many cancer survivors end up with long term disabilities requiring ongoing care and support. For many people, cancer survival now means living with a chronic and complex condition.
The purpose of this paper is to provide an overview of the long term management issues for cancer survivors and strategies to enhance their care.
Cancer survivors require ongoing support in four key areas: prevention; surveillance; intervention for consequences of cancer and its treatment; and coordination between specialist and generalist providers.
Cancer survivors experience significant physical and psychological morbidity which makes minimising their burden of disability and distress an important priority. Survivors require ongoing care that is well co-ordinated, focuses on prevention, provides going surveillance whilst minimising and managing the long term effects of treatment and other co-morbidities.
3. The Healthy Ageing Model: Health behaviour change for older adults
By Kathleen M. Potempa et al. Collegian, Volume 17, Issue 2: p51-55 (July 2010)
Proposed is a model of primary care for older adults with chronic health conditions that focuses on active engagement in health care. The Healthy Ageing Model is anchored in established theory on motivation and health behaviour change. The model draws on empirical and applied clinical underpinnings in such diverse areas as health promotion and education, treatment of addictions or obesity, management of chronic diseases, goal-setting, and coaching techniques. The conceptual foundation for the Healthy Ageing Model is described first, followed by a brief description of the key characteristics of the model. In conclusion, suggestions are offered for the clinical application and for further developing the model.

4. Uptake of Medicare chronic disease items in Australia by general practice nurses and Aboriginal health workers
By Elizabeth J. Halcomb et al. Collegian, Volume 17, Issue 2: p57-61 (July 2010)

The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and support to people with a chronic disease for and on behalf of a general practitioner (GP). The uptake of Medicare Item 100997 from 2007 to 2009, to monitor chronic disease interventions provided by general practice nurses has increased dramatically. The rate of uptake of Item 100997 has not been consistent across States and Territories, even allowing for population distributions. Exploring reasons for these regional variations and linking uptake of Medicare Item numbers to patient outcomes is important in developing the nursing role in Australian general practice.

5. Can principles of the Chronic Care Model be used to improve care of the older person in the acute care sector?
By Louise D. Hickman et al. Collegian, Volume 17, Issue 2: p63-69. (July 2010)

There is increasing evidence that hospitals are failing to meet the needs of older people. As a consequence acute care needs to be adapted to meet the needs of older people. Although initially developed for chronic conditions the Chronic Care Model (CCM) provides useful strategies for improving continuity and quality of care.
This paper describes the elements of the CCM and discusses how a chronic care approach can improve models of care delivery for older persons in the acute care hospital settings.
The CCM provides a potentially useful approach to improve health care for older people in the acute care setting. Positive policy environments, interdisciplinary care collaboration, evidence-based practice, an emphasis on self-management strategies and empowered communities are essential elements for driving development of effective models of care.
Models of care require a multifaceted collaborative approach for sustainability. Implementing elements of the CCM in developing models of acute care may improve patient outcomes and decrease unnecessary admissions to hospital for older people.
Implications for practice
This paper provides suggestions for models of care to improve care of the older person in the acute care setting.
6. The role of parents in managing asthma in middle childhood: An important consideration in chronic care
By Nicola Brown et al. Collegian, Volume 17, Issue 2: p71-76 (July 2010).

Asthma is a significant illness for Australian children and their families. In childhood, parents have the primary responsibility for managing asthma on a day-to-day basis, and therefore understanding the management of asthma by parents is important to nursing practice. Middle childhood (5–12 years) is an important time in the lives of children and families with asthma, as children commence school and spend increasing amounts of time away from direct parental care. In order to manage asthma during middle childhood, parents need to understand asthma as an illness, understand the treatment of asthma, be able to monitor and respond to changes in condition, manage other carers, manage asthma in the context of family life and guide the development of self-management responsibility in their child with asthma. While the scope of parent management in terms of asthma knowledge and treatment has been well explored in the literature, less is known about the process by which parents support the development of self-management responsibility in children with asthma

7. The nurse educator role in Australian hospitals: Implications for health policy
By Jan M. Sayers & Michelle DiGiacomo. Collegian, Volume 17, Issue 2: p77-84 (July 2010).

To date, the nurse educator role in the Australian hospital setting has been poorly described. Current pressures for health care reform have prompted reviews of nursing roles. This paper discusses the literature pertaining to the nurse educator role within the context of the Australian health care environment and current health care policy. Building on this synthesis, barriers and facilitators impacting on the nurse educator role are identified and strategic directions for policy, role clarification and advanced practice role development are highlighted. Further research identifying the impact of the hospital-based nurse educator on patient outcomes and professional nursing practice are proposed.

8. Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia – Sydney experience
By John M. Ramjan et al. Collegian, Volume 17, Issue 2: p85-91 (July 2010).

The majority of society's deaths occur in a health care environment. Regardless of whether a death occurs in acute care, hospice, residential aged care or community settings, nurses are the health professionals that will spend the largest proportion of time with the patient who has a terminal condition and their families. As few nurses have specialist palliative care qualifications it is essential that nursing education prepares graduates to achieve the core capabilities required for the delivery of best evidenced based palliative care. This reality makes the integration of palliative care content into the undergraduate nursing curricula an important priority.
This paper aims to describe how palliative care content has been embedded throughout the three-year University of Notre Dame Australia, Sydney (UNDA) undergraduate nursing degree.
The School of Nursing at the University of Notre Dame Australia, Sydney campus is committed to ensuring that students graduate with the capabilities to deliver appropriate care to people with requiring end-of-life care. The establishment of this new School of Nursing coincided with the release of the ‘The Palliative Care Curricula for Undergraduates Program’ (PCC4U) learning resources. These resources have been integrated into relevant units across the three-year nursing curricula.
The nursing curriculum has been design to supports the integration of palliative care knowledge into clinical practice. The Palliative Care Curricula for Undergraduates Program learning resources offer engaging palliative care case studies and scenarios for academics to utilise. Adopting an iterative approach where palliative care content is spiralled across multiple units provides opportunities for undergraduate nursing students to sequentially build and consolidate their palliative care capabilities.
Developing a new curricular provided an ideal opportunity to integrate and embed palliative care content into the undergraduate nursing degree. The next stage of the curriculum development is to explore inter-professional palliative care education opportunities. Evaluating the palliative care capabilities of our nursing graduates is also an important consideration.
Implications for practice
This paper provides practical suggestions for integrating palliative care education into an undergraduate nursing curriculum.

9. Meeting the challenges of chronic illness: A nurse-led collaborative community care program in Thailand
By Siriorn Sindhu et al. Collegian, Volume 17, Issue 2: p93-99 (July 2010)

Chronic illness is of concern to health care systems globally. Although a significant evidence base supports the concept of nurse-led interventions, less data is available to address unique features of health care systems in the developing world.
The purpose of this study aimed to undertake preliminary testing of an intervention of nurse-led community care program, the Network Collaborative Action Plan (N-CAP), to assess the impact on disease severity and patient satisfaction.
A quasi-experimental study, using historical controls, evaluated a collaborative nurse-led intervention to promote coordination and continuity of care for patients with chronic illness.
Participants, diagnosed with chronic obstructive lung disease (COPD), coronary heart disease (CHD) and chronic heart failure (CHF) were recruited. Prospective consecutive patient meeting the study criteria (n=47) were assigned into the control group and following development and implementation of the intervention eligible consenting patients were enrolled in the experimental group (n=44). Participants in the experimental group had significantly lower scores on severity of disease measurements during the third week (F=4.61, p=0.035) and the eighth week hospital (F=4.30, p=.041) following hospital discharge than those in the control group. Participants in the experimental group expressed significantly higher scores on satisfaction with community care than those in the control group.
A nurse-led, collaboratively developed program has potential to improve satisfaction and decrease symptom development in people with chronic illnesses in Thailand.

Journals Table of Contents

10. From nursing.aust, Winter 2010, Vol 11 No 2

10A. Let's talk [Comments on the Nursing and Midwifery Board of Australia and the College of Nursing CPD suite]
10B. Bev doesn't do sick [Bev's experiences with doctors and nurses as she had treatment for breast cancer]
10C. IVF turns 30
10D. Magda's story [The euthanasia debate and her husband's decision]
10E. Reflections on fellowship [Three College of Nursing Fellows reflect on what fellowship means to them]
10F. The future of aged care
10G. Want to get ahead? Get a College of Nursing Graduate Certificate
10H. The College of Nursing Continuing Education July 2010 - December 2010
10I. GLBT ageing: Life interrupted
10J. Gwen Burbridge and nursing reform
10K. Nurses and medical care
10L. Vale [Miss marie Lowndes OAM 13 October 1928 - 6 June 2010

11. From The Dissector, September 2010 Vol 38, No.2

11A. Taking care of patients [Kathryn Fraser looks at immunisation of nurses]
11B. Thoughts from abroad [Perioperative Nurses College Chairperson Leigh Anderson at the ACORN Conference]
11C. $2000 in 3M grants; Elderly gain from earlier hip fracture surgery; Concern about breast thermography
11D. Portrait of a nurse by Catherine Sinclair
Day surgery nursing in the 21st century: A change in perspective
11F. Radiation safety: A staff perspective
11G. Enabling safer patient care: Automatic identification standards for pharmaceuticals and medical devices
11H. Standing orders: Clarification of the role and responsibilities of the Registered Nurse practising in
cosmetic enhancement
11I. Staff changes [Changes of personnel, products & company movements within the medical supply industry
Male health sites

12. Latest news from the Ministry of Health

7 Oct : Pandemic Influenza H1N1 2009 (swine flu) - Update 211

1 Oct : Office of the Director of Mental Health- Annual Report 2009

1 Oct : Implementing the Clinical Guidelines for Weight Management in New Zealand: 2010/11

28 Sep: New health connectivity standards for telecommunication networks

News - National

13. Opportunity missed in aged care report
Friday, 15 October 2010, 4:55 pm
Press Release: Elder Family Matters

14. Largest stopwork meeting in decade
The Timaru Herald
The largest union stopwork meeting for more than a decade is expected in Timaru on Wednesday, as union members gather to protest about proposed changes to the Holidays and Employment Relations acts. The 1.30pm meeting on the piazza is expected to be attended by several hundred members of unions including the Engineers, Printing and Manufacturing Union, Maritime Union, PSA, nurses organisation, freezing and service workers, and local
government workers. The Timaru meeting is one of 25 planned throughout the country.

News - International

15. Global Handwashing Day - 15 October 2010
Handwashing with soap is the most effective and inexpensive way to prevent diarrheal and acute respiratory infections, which take the lives of millions of children in developing countries every year. Together, they are responsible for the majority of all child deaths. Yet, despite its lifesaving potential, handwashing with soap is seldom practiced and difficult to promote. The challenge is to transform handwashing with soap from an abstract good idea into an automatic behavior performed in homes, schools, and communities worldwide. Turning handwashing with soap before eating and after using the toilet into an ingrained habit could save more lives than any single vaccine or medical intervention, cutting deaths from diarrhea by almost half and deaths from  acute respiratory infections by one-quarter. A vast change in handwashing behavior is critical to meeting the Millennium Development Goal of reducing deaths among children under the age of five by two-thirds by 2015.

16. New Zealand Public Health and Disability Amendment
Wednesday, 13 October 2010, 10:00 am
Speech: The Maori Party 
New Zealand Public Health and Disability Amendment Bill, Hon Tony Ryall, 2R; Tuesday 12 October 2010
Rahui Katene, MP for Te Tai Tonga
The Bill amends the New Zealand Public Health and Disability Act 2000 to face the challenge of providing high quality health care and disability support services that are affordable. 

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