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Issue 168 - 3 Feb 2011

Alcohol Free Month - February 2011

Press the pause button this February, to take a month off the booze and make a healthy start to the year ahead.
Signup to FebFast - Give your body a break, while also raising funds to support much needed programs that support young people with alcohol and other drug problems.
Recipients for 2011 are He TaumataToa - Growing Chapions, Whakaata Thou Tohu/Mirror Services, Amplify! at Odyssey House and Adventure Therapy at Waipuna Trust.

Articles - Journal of Advanced Nursing

1. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus (pages 228–250)
By Brenda Roe, Lisa Flanagan, Barbara Jack, James Barrett, Alan Chung, Christine Shaw and Kate Williams. JAN, Vol 67, Number 2, February 2011

Aim. This is a review of descriptive studies with incontinence as the primary focus in older people in care homes.
Background. Incontinence is prevalent among residents of care home populations.
Data sources.  MEDLINE and CINAHL were searched from 1996 to 2007 using the highly sensitive search strings of the Cochrane Incontinence Review Group for urinary and faecal incontinence including all research designs. Search strings were modified to enhance selectiveness for care homes and older people and exclude studies involving surgical or pharmacological interventions. Searching of reference sections from identified studies was also used to supplement electronic searches. The Cochrane Library was searched for relevant systematic reviews to locate relevant studies from those included or excluded from reviews. The search was limited to English-language publications.
Methods. A systematic review of studies on the management of incontinence, promotion of continence or maintenance of continence in care homes was conducted in 2007–2009. This is a report of descriptive studies.
Results. Ten studies were identified that reported on prevalence and incidence of incontinence (urinary with or without faecal), policies, assessment, documentation, management or economic evaluation of its management. Use of incontinence pads and toileting programmes comprised the most common management approaches used. No studies were identified that attempted to maintain continence of residents in care homes.
Conclusions. Studies on maintaining continence and identifying components of toileting programmes that are successful in managing or preventing incontinence and promoting continence in residents of care home populations along with their economic evaluation are warranted.

2. Computer- and web-based interventions to increase preadolescent and adolescent physical activity: a systematic review (pages 251–268)
By Lauren M. Hamel, Lorraine B. Robbins and JoEllen Wilbur. JAN, Vol 67, Number 2, February 2011

Aim.  This review examined evidence regarding computer- or web-based interventions to increase preadolescent and adolescent physical activity.
Background.  Today’s youth are less active and more overweight than their counterparts from 25 years ago. Overweight youth tend to become overweight adults with weight-related maladies, including type 2 diabetes and cardiovascular problems. Interventions to increase physical activity that reach a large audience are needed. Computer- and web-based physical activity interventions are an appealing means to influence physical activity in preadolescents and adolescents. However, their effectiveness must be determined.
Data sources.  The following electronic databases were searched for studies published from 1998 through 2010: CINAHL, PubMed, PsycINFO, Sociological Abstracts, SportDISCUS and Proquest.
Review methods.  A systemic review was conducted. Fourteen randomized control trials or quasi-experimental studies were reviewed to: (1) determine the effect of computer- or web-based interventions on increasing physical activity and/or improving body mass index, weight, percent body fat or waist circumference as a result of increasing physical activity; and (2) examine if additional components associated with these interventions increased success.
Results.  Although most interventions demonstrated statistically significant increases in physical activity or positive health changes related to physical activity, findings were small or short-lived. The value of conducting the interventions at school, using a theory or model as a framework, and supplementing with individual tailoring and parental involvement, is discussed.
Conclusion.  Computer- and web-based interventions can promote physical activity among preadolescents and adolescents, particularly in schools. However, further efforts are needed to sustain positive changes.


3.  External cooling methods for treatment of fever in adults: a systematic review; A comprehensive systematic review of healthcare workers’ perceptions of risk from exposure to emerging acute respiratory infectious diseases and the perceived effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings; The effectiveness of strategies for the management and/or prevention of hypothermia within the adult perioperative environment: systematic review; A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections (pages 269–275) The Joanna Briggs Institute. JAN, Vol 67, Number 2, February 2011


4. Home care nurses’ decisions about the need for and amount of service at the end of life (pages 276–286)
By Kelli I. Stajduhar et al. JAN, Vol 67, Number 2, February 2011
We explore home care nurse decision-making about the need for and amount of service by clients and families at the end of life. We identify factors nurses refer to when describing these decisions, situated within contextual features of nursing practice.
Background.  Home care nurses are often responsible for decisions which have an impact on the access of clients and families to services at the end of life. Understanding how these decisions, are made, factors that are considered, and contextual influences is critical for improving access and enhancing care.
Methods.  Qualitative data were collected between 2006 and 2008 from two samples of home care nurses: the first group (n = 29) recorded narrative descriptions of decisions made during visits to families. The second group (n = 27) completed in-person interviews focusing on access to care and their interactions with clients and families. Data were analysed with thematic coding and constant comparison.
Findings.  Participants described assessing client and family needs and capacity. These assessments, at times integrated with considerations about relationships with clients and families, inform predictive judgements about future visits; these judgments are integrated with workload and home health resource considerations. In describing decisions, participants referred to concepts such as expertise, practice ideals and approaches to care.
Conclusion.  Findings highlight the role of considerations of family caregiver capacity, the influence of relationships and the importance of the context of practice, as part of a complete understanding of the complexity of access to care at the end of life.

5. Temporary nursing staff – cost and quality issues
By Keith Hurst and Adam Smith. JAN, Vol 67, Number 2, February 2011
This paper is a report of a comparative study of temporary and permanent staff work activity, cost and quality of care.
Background.  Temporary nurse staffing can consume significant proportions of the health service wages bill, and this is unlikely to fall owing to recruitment and retention problems, high sickness absence and the tendency for staff to work ‘casually’. If temporary workers are here to stay, then what impact do they have on inpatient care? For example, do ward nursing quality and costs change when temporary staff are employed?
Method.  Ward patient dependency, nursing activity, workload, staffing and data on quality were collected using non-participant observation, document analysis, staff and patient interviews in 605 United Kingdom general and specialist wards between 2004 and 2009. These wards were divided into two groups: 368 employing only permanent staff during data collection and 237 with permanent, and temporary staff in the ward team at the time when the observations were made.
Findings.  Workloads and time out (sickness absence, etc.) in wards employing temporary staff were greater than in units with permanent staff only, thereby justifying hiring short-term staff. Wards with temporary and permanent staff were more expensive to run and working styles were different. Overall quality scores, however, were no different in the two types of ward.
Conclusion.  Ward managers need to monitor temporary staffing and the effect they have on nursing activity and quality. Similar studies in mental health, learning disability and community nursing would generate additional insights.

6. Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers (pages 297–307)
By Mette Fagernes and Egil Lingaas. JAN, Vol 67, Number 2, February 2011
This paper is a report of a study of the impact of finger rings, wrist watches, nail polish, length of fingernails, hand lotion, gender and occupation on hand microbiology of healthcare workers.
Background.  The impact of the above mentioned variables on hand microbiology of healthcare workers is not well defined. Large scale studies suitable for multivariate analysis are needed to elucidate their role.
Methods.  Both hands of 465 Norwegian healthcare workers were sampled by the glove juice method during two study periods (2004 and 2007), and examined for total number of bacteria and presence of Staphylococcus aureus, Enterobacteriacea and non-fermentative Gram-negative rods. Multiple regression analysis was performed.
Results.  The use of a wrist watch was associated with an enhanced total bacterial count on hands compared to hands without a watch [(B) 3·25 (95% CI: 1·73–6·07), P < 0·001], while the use of one plain finger ring increased the carriage rate of Enterobacteriaceae [odds ratio 2·71 (95% CI: 1·42–5·20), P = 0·003]. The carriage rate of Staphylococcus aureus was enhanced with fingernails longer than 2 mm [odds ratio 2·17 (95% CI: 1·29–3·66), P = 0·004] and after recent use of hand lotion [odds ratio 22·52 (95% CI: 4·05–125·30), P < 0·001]. No effect of nail polish was observed. We found an association between occupation and carriage rate of S. aureus and Enterobacteriaceae.
Conclusions.  Health care workers should remove finger rings and watches at work. Fingernails should be shorter than 2 mm, nail polish may be used

7. Multimedia computer-assisted instruction for carers on exercise for older people: development and testing (pages 308–316)
By Muthita Ponpaipan et al. JAN, Vol 67, Number 2, February 2011
  This paper is a report of a study conducted to develop a multimedia computer-assisted instruction for informal carers and test its content validity, user difficulty and user satisfaction.
Background.  Healthy ageing is an increasingly important public health target globally. Changes in technology offer the opportunity for e-health promotion as a means of educating populations and healthcare staff to meet public health targets.
Methods.  Computer-assisted instruction was developed and tested systematically in four phases during 2008, and these are outlined. Phase 1 consisted of topic and content identification using a literature review. Phase 2 comprised refinement of the content using an academic panel of experts. Phase 3 was the production of computer-assisted instruction comprising problem clarification, algorithm designing with reference to a cognitive theory of multimedia learning and program coding. Phase 4 consisted of testing for content validity, and writing a computer-assisted instruction manual and testing it for user difficulty and satisfaction.
Results.  The data from each phase informed the development and refinement of the computer-assisted instruction. Content validity was confirmed and ‘test’ users reported few difficulties in its use and high satisfaction.
Conclusion.  This e-health promotion initiative is an example of how computer-assisted instruction may be developed to teach carers of older people.


8. Attitudes of paediatric intensive care nurses to development of a nurse practitioner role for critical care transport (pages 317–326)
By Joanna Davies et al. JAN, Vol 67, Number 2, February 2011
  This paper is a report of a descriptive study of the attitudes and opinions of nurses before and after the introduction of independent Retrieval Nurse Practitioners into a critical care transport service for children.
Background.  Little is known about nurses’ attitudes to advanced practice roles, particularly when these function as part of a team in a high-risk, remote setting (distant to the base hospital). Increasing knowledge in this area may give insight into ways of improving team working and enhancing quality of patient care.
Method.  A qualitative questionnaire was sent to nurses pre- (June 2006) and post- (July 2007) retrieval nurse practitioner introduction. Questionnaires were analysed using an adapted phenomenological method.
Findings.  The response rates were 62% (2006) and 48% (2007). The main themes that emerged included fear, communication, trust, team working, role conflict, role division and role boundaries. In the first survey, most nurses anticipated difficulties during retrieval with retrieval nurse practitioners and felt anxious about the prospect of being part of a team with an independent retrieval nurse practitioner. However, by the second survey (after retrieval nurse practitioner introduction), the majority reported confidence in the retrieval nurse practitioners’ knowledge and skills.
Conclusion.  This advanced practice development has been a challenge for the nurses and the retrieval nurse practitioners, but initial anxieties and fears of a host of anticipated problems have been largely dispelled as enhanced communication and team working were reported.


9. Hepatitis C virus infection in primary care: survey of registered nurses’ knowledge and access to information (pages 327–339)
By Kate Frazer et al. JAN, Vol 67, Number 2, February 2011

10. Maintaining patients’ dignity during clinical care: a qualitative interview study (pages 340–348)
By Yea-Pyng Lin and Yun-Fang Tsai. JAN, Vol 67, Number 2, February 2011

11. Hospital environment, nurse–physician relationships and quality of care: questionnaire survey (pages 349–358)
By Hsi-Che Shen, Hsiao-Ting Chiu, Pi-Hsia Lee, Yi-Chun Hu and Wen-Yin Chang. JAN, Vol 67, Number 2, February 2011

12. Clinical management of fever by nurses: doing what works (pages 359–370)
By Hilaire J. Thompson and Sarah H. Kagan. JAN, Vol 67, Number 2, February 2011

13. Job satisfaction and turnover intent of primary healthcare nurses in rural South Africa: a questionnaire survey (pages 371–383)
By Peter Delobelle et al. JAN, Vol 67, Number 2, February 2011

14. Paediatric nurses’ identification of violence against children (pages 384–393)
By Malgorzata Pabis et al. JAN, Vol 67, Number 2, February 2011

15. Impact of communication skills training on parents perceptions of care: intervention study (pages 394–400)
By Jette Ammentorp et al. JAN, Vol 67, Number 2, February 2011

16. Improving insight into delusions: a pilot study of metacognitive training for patients with schizophrenia (pages 401–407)
By Jérôme Favrod et al. JAN, Vol 67, Number 2, February 2011

17. Living with advanced Parkinson’s disease: a constant struggle with unpredictability (pages 408–417)
By Anita Haahr et al.JAN, Vol 67, Number 2, February 2011

18. Care-based ethical reasoning among first-year nursing and social services students (pages 418–427)
By Soile Juujärvi et al. JAN, Vol 67, Number 2, February 2011


19. Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing (pages 428–437)
By Gulten Guvence et al. JAN, Vol 67, Number 2, February 2011

20. Scales for assessing self-efficacy of nurses and assistants for preventing falls (pages 438–449)
By Patricia C. Dykes et al. JAN, Vol 67, Number 2, February 2011

21. Adding value to the STRATIFY falls risk assessment in acute hospitals (pages 450–457)
By Anna Barker et al. JAN, Vol 67, Number 2, February 2011

Articles on ALCOHOL

22. Alcohol Retail Density and Demographic Predictors of Health Disparities: A Geographic Analysis
By Berke, Ethan al. American Journal of Public Health, Oct 2010, Vol. 100 Issue 10

23. Screening and Brief Interventions for Alcohol Use in College Health Centers: A Review
By Seigers, Danielle K. L.& Carey, Kate B. Journal of American College Health, Nov/Dec 2010, Vol. 59 Issue 3: p151-158

24. Extreme Ritualistic Alcohol Consumption Among College Students on Game Day
By Glassman, Tavis al. Journal of American College Health, Mar/Apr 2010, Vol. 58 Issue 5: p413-423

25. Efficacy of a Brief Cognitive Behavioral Therapy Program to Reduce Excessive Drinking Behavior Among New Recruits Entering the Irish Navy: A Pilot Evaluation.Full Text Available By: Mc Carthy, Paul M.; O'Sullivan, David. Military Medicine, Nov 2010, Vol. 175 Issue 11: p841-846

26. Anchoring and Estimation of Alcohol Consumption: Implications for Social Norm Interventions
By Lombardi, Megan M.; Choplin, Jessica M. Journal of Alcohol & Drug Education, Aug2010, Vol. 54 Issue 2: p53-71

27. Governments confront drunken violence
By Desai, Angel. Bulletin of the World Health Organization, Sep 2010, Vol. 88 Issue 9: p644-645

28. Substance Abuse Is a Disease of the Human Brain: Focus on Alcohol
By Anton, Raymond. Journal of Law, Medicine & Ethics, Winter 2010, Vol. 38 Issue 4: p735-744

Theses recently received by the NZNO Library

These can be referred to by visiting the NZNO library in Wellington. They can also be requested via the interlibrary loan scheme, so ask your local public library or the library at your workplace to request it from the NZNO library on your behalf.

29. Gibbison, B. (2010).  Are we there yet?: Factors associated with, and experiences of, weight maintenance in the adult weight management programme in the Waikato. A research portfolio submitted in partial fulfilment of the requirements for the degree of Master of Nursing, The University of Auckland

30. Irvine, H.J.(1998). Professional supervision for nurses and midwives. Wellington N.Z. : Winston Churchill Memorial Trust Board 

31. Water, T. (2008). The meaning of being in dilemma in pediatric practice: A phenomenological study. A thesis submitted to Auckland University of Technology in partial fulfilment of the degree Doctor of Philosophy

32. Woods, M. (2007). Parental resistance: Mobile and transitory discourses: A discursive analysis of parental resistance towards medical treatment for a seriously ill child. A thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand

33. Barratt, Ruth. (2008). Behind barriers: patients' perceptions of hospital isolation for methicillin-resistant Staphylococcus aureus (MRSA). Submitted in partial fulfilment of the requirements of the award of Master of Advanced Practice (Infection Control and Prevention) with honours


34. 9th Annual Conference of the Women's Health Section 'Hot & Savvy'
Date: Thursday, 10 March, 2011 - Saturday, 12 March, 2011
Venue: Marlborough Convention Centre
Further information:

35. Level II Neonatal Conference 2011
Friday, 08 April, 2011
Venue: War Memorial Conference Centre, Marine Parade, Napier, New Zealand

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