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Aim: Develop evidence‐based recommendations for managers to support primary healthcare nurses to thrive at work. Design: A mixed‐methods sequential explanatory design. Methods: National data were collected in 2020 via an e‐survey based on a meta‐analysis of antecedents of thriving from 213 primary healthcare nurses across New Zealand. Structural equation modelling analysis identified the key factors supporting primary healthcare nurses to thrive. This informed a second open‐ended e‐survey in 2022 of 19 nurses from one primary healthcare organization. The thematic analysis provided recommendations for improving management strategies to support thriving primary healthcare nurses. Results: The vitality component of thriving significantly reduced burnout and intention to leave organization and profession. In contrast, the learning component of thriving had a significant positive effect on burnout. The key factors that support thriving at work are empowering leadership and perceived organizational supports (decreases burnout and intention to leave organization and profession through enhanced vitality). Recommendations for improving thriving were made in eight key areas: communication, effective management, professional development, scope of practice, autonomy, effective orientation, reward and work–life balance. Conclusions: Vitality is important in reducing burnout and turnover intentions. While learning was identified as increasing burnout, professional development and training for managers were identified as essential. Hence, the vitality dimension of the thriving at work construct should be studied at the dimension level, but more research is needed into the impact of learning on thriving over time. Primary healthcare nurses have identified that empowering leadership and perceived organizational support are critical factors in supporting them to thrive, and they provide specific recommendations for managers to improve these factors in the clinical setting. No Patient or Public Contribution: This study collected data from Registered Nurses only. What Is Already Known: A plethora of existing research focuses on resilience in nurses rather than thriving at work.Enabling employees to thrive at work contributes to improved well‐being and sustainable organizational performance. What This Paper Adds: Empowering leadership and perceived organizational support are the key factors that support primary healthcare nurses to thrive at work.The vitality dimension of the thriving at work construct should be studied at the dimension level, and further research is needed into the impact of learning on thriving over time.Primary healthcare nurses recommend that managers focus on improving communication, management efficiency, professional development, scope of practice, autonomy, orientation, reward and work–life balance. [ABSTRACT FROM AUTHOR]

Aim: To explain the process by which nurses' roles are negotiated in general practice. Background: Primary care nurses do important work within a social model of health to meet the needs of the populations they serve. Latterly, in the face of increased demand and workforce shortages, they are also taking on more medical responsibilities through task‐shifting. Despite the increased complexity of their professional role, little is known about the processes by which it is negotiated. Design: Constructivist grounded theory. Methods: Semi‐structured interviews were conducted with 22 participants from 17 New Zealand general practices between December 2020 and January 2022. Due to COVID‐19, 11 interviews were via Zoom™. Concurrent data generation and analysis, using the constant comparative method and common grounded theory methods, identified the participants' main concern and led to the construction of a substantive explanatory theory around a core category. Results: The substantive explanatory theory of creating place proposes that the negotiation of nurse roles within New Zealand general practice is a three‐stage process involving occupying space, positioning to do differently and leveraging opportunity. Nurses and others act and interact in these stages, in accordance with their conceptualizations of need‐responsive nursing practice, towards the outcome defining place. Defining place conceptualizes an accommodation between the values beliefs and expectations of individuals and pre‐existing organizational norms, in which individual and group‐normative concepts of need‐responsive nursing practice are themselves developed. Conclusion: The theory of creating place provides new insights into the process of nurses' role negotiation in general practice. Findings support strategies to enable nurses, employers and health system managers to better negotiate professional roles to meet the needs of the populations they serve, while making optimum use of nursing skills and competencies. Implications for the Profession and/or Patient Care: Findings can inform nurses to better negotiate the complexities of the primary care environment, balancing systemic exigencies with the health needs of populations. Impact: What Problem Did the Study Address?: In the face of health inequity, general practice nurses in New Zealand, as elsewhere, are key to meeting complex primary health needs.There is an evidence gap regarding the processes by which nurses' roles are negotiated within provider organizations.A deeper understanding of such processes may enable better use of nursing skills to address unmet health need. What Were the Main Findings?: Nurses' roles in New Zealand general practice are determined through goal‐driven negotiation in accordance with individual concepts of need‐responsive nursing practice. Individuals progress from occupying workspaces defined by the care‐philosophies of others to defining workplaces that incorporate their own professional beliefs, values and expectations.Negotiation is conditional upon access to role models, scheduled dialogue with mentors and decision‐makers, and support for safe practice.Strong clinical and organizational governance and individuals' own positive personal self‐efficacy are enablers of effective negotiation. Where and on Whom Will the Research Have Impact?: The theory of Creating Space can inform organizational and individual efforts to advance the roles of general practice nurses to meet the health needs of their communities.General practice organizations can provide safe, supported environments for effective negotiation; primary care leaders can promote strong governance and develop individuals' sense of self‐efficacy by involving them in key decisions.Nurses themselves can use the theory as a framework to support critical reflection on how to engage in active negotiation of their professional roles. Reporting Method: The authors adhered to relevant EQUATOR guidelines using the COREQ reporting method. Patient or Public Contribution: Researchers and participants currently working in general practice were involved in the development of this study. By the process of theoretical sampling and constant comparison, participants' comments helped to shape the study design. What Does this Paper Contribute to the Wider Global Clinical Community?: An understanding of the processes by which health professionals negotiate their roles is important to support them to meet the challenges of increased complexity across all health sectors globally. [ABSTRACT FROM AUTHOR]

Aims: Investigated the experiences of Māori (the Indigenous peoples of Aotearoa, New Zealand) patients and whānau (extended family network) engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. Design: A qualitative Māori-centred research design using a Thought Space Wānanga (learning through in-depth group discussion, deliberation and consideration) approach. Methods: Two wānanga were conducted between May 2022 and June 2022, with 13 Māori patients who had been acutely hospitalized within the past 12 months and their whānau members. The first wānanga utilized storytelling and journey mapping to collect data. The second wānanga refined the initial themes. Wānanga were audiorecorded and then inductively coded and developed into themes. Results: Thirteen patients and whānau attended the first wānanga, while 10 patients and whānau participated in the second wānanga). Four themes were developed: (1) Whakawhanaungatanga (establishing connections and relationships), (2) Whakamana (uplifting the status and esteem of Māori), (3) Whakawhitiwhiti kōrero (the importance of communicating, discussing and deliberating) and (4) Kotahitanga (working together with purpose) all provide insights into the importance of effectively engaging and connecting with Māori patients and whānau when acutely hospitalized. Conclusions: The experiences and priorities of Māori patients and whānau affirm the international literature, suggesting that Indigenous relational concepts are critical to building relationships, connections and trust. Despite existing healthcare models for working with Indigenous peoples, their poor application contributes to sub-optimal healthcare experiences at all points of their healthcare journey. A relational mode of practice focused on engagement and forming connections better meets the needs of Indigenous peoples engaging with inpatient health services. Implications for the profession and/or patient care: Despite the existence of Indigenous models of care, Indigenous peoples consistently report a lack of engagement and connection when accessing inpatient health services. Without establishing relationships, applying models of care is challenging. Impact (Addressing): • What problem did the study address? Internationally, healthcare systems are consistently ill-equipped to deliver culturally safe care for Indigenous and marginalized peoples, evident in ongoing health inequities. Like other reports of Indigenous experiences of health services, Māori express dissatisfaction with care delivery in an acute inpatient setting. This study investigated Māori patients and whānau experiences engaging with acute hospital inpatient services and their priorities for a Māori-centred model of relational care. • What were the main findings? Māori patients and whānau recounted negative experiences with healthcare professionals lacking effective relationships and trust. Satisfaction occurred when engagement with health care professionals resembled Indigenous cultural rituals of encounter that considered their holistic, collective and dynamic worldviews. Previous models of relational care, while helpful, are not Indigenous and so do not address their needs, such as engagement as a mode of practice (how) to achieve this. • Where and on whom will the research have an impact? This research impacts Indigenous peoples' health outcomes, particularly Māori, and nurses and clinicians working and interacting within acute inpatient and other hospital settings. Indigenous research methods support co-constructing knowledge for translation into practical outcomes through transformational practices, policies and theory development. Reporting method: We used the Consolidated Criteria for Strengthening the Reporting of Health Research Involving Indigenous Peoples (CONSIDER) statement (see File S2—CONSIDER Checklist) and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (see File S3—COREQ Checklist). [ABSTRACT FROM AUTHOR]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [ABSTRACT FROM AUTHOR]

Introduction: The global nursing workforce is predominantly female, with a large proportion working in the 45–55 age group. Menopause is a transition for all women, and; therefore needs recognition as it can impact work performance and consequently staff turnover. Background: Women will go through the menopause, but not all women are affected. The menopause transition presents a range of signs and symptoms both physical and psychological which can impact the quality of life and individuals' work/life balance. The nursing workforce is predominantly women that will work through the menopause transition. Objectives: The study explored perspectives on digital health interventions as strategies to support menopausal women and to understand the requirements for designing health interventions for support in the workplace. Design: A qualitative explorative design. Settings: Nurses working in a range of clinical settings in England, Finland, Denmark, New Zealand, Australia and USA. Methods: Nurses (n = 48) participated in focus groups from six different countries from February 2020–June 2022 during the pandemic from a range of acute, primary care and education settings. Nurses were invited to participate to share their experiences. Thematic analysis was used. Results: All participants were able to describe the physical symptoms of menopause, with some cultural and possible hemisphere differences; more noticeable was the psychological burden of menopause and fatigue that is not always recognized. Four themes were identified: Managing symptoms in the workplace; Recognition in the workplace; Menopause interventions; and Expectation versus the invisible reality. These themes revealed information that can be translated for implementation into digital health interventions. Conclusions: Managers of nursing female staff in the menopausal age range need greater awareness, and menopause education should involve everyone. Finally, our results demonstrate design attributes suitable for inclusion in digital health strategies that are aligned with likely alleviation of some of the discomforts of menopause. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

gilmour j.a., huntington a., broadbent r., strong a. & hawkins m. (2012) Nurses' use of online health information in medical wards. Journal of Advanced Nursing 68(6), 1349-1358. Abstract Aim. This paper is a report of a study of nurses' access, use and evaluation of online health information in medical wards. Background. Online health information is commonly used by patients with chronic illness to support their education needs. Nurses have a critical role in assisting patients to access and use this information. Method. This descriptive cross-sectional survey of a random sample of 540 nurses employed in medical wards was carried out in 2009. The response rate was 58·7% (293). The analytical approach included descriptive statistics and non-parametric tests of correlation and differences between groups. A content analysis was performed on the qualitative data. Results. Most respondents (78·6%) were satisfied with work Internet access and 58·2% believed that the use of online information improved care delivery. Nearly half the group was aware of patient misconceptions about their illness due to incorrect interpretations of online information, but only 24·4% checked if patients used online information. There was a significant association between assessing patients use and awareness of patient misconceptions. Conclusion. The findings of this study highlight that while online resources add to education opportunities, the ongoing nursing assessment required to determine online information needs is not always incorporated into nursing practice. Patient misunderstandings of online material were also identified; developing patient competency in evaluating open access health information should now be recognized as an integral aspect of illness management education. [ABSTRACT FROM AUTHOR]

roy d.e. & giddings l.s. (2012) The experiences of women (65-74 years) living with a long-term condition in the shadow of ageing. Journal of Advanced Nursing 68(1), 181-190. Abstract Aims. This paper reports on a study that explored experiences of women (65-74 years) as they grow older while living with a long-term condition. The phenomenon of focus was 'ageing with a long-term condition', rather than the experience of developing a long-term condition after reaching older adulthood. Background. People with long-term conditions are living into older age. There is limited literature on the nexus of ageing with a long-term condition. It is known that ageing shapes and is shaped by women's experiences of living with a long-term condition. Methods. In this interpretive descriptive study, nine women participated in a series of three focus groups held in 2007 and 2008. Transcripts were analysed thematically and participants given the opportunity to respond to the analysis. Findings. 'In the shadow of ageing' was the overarching theme. The women reported that although their long-term condition remained the referent point in their daily lives, for others including health professionals, the focus was on their appearance and the effects of older age. To overcome the back-grounding of their long-term condition, the women used 'strategies already-in-place'; it became 'just another thing to deal with'. Ageing, however, remained 'a privilege'. Conclusion. If health professionals focus on age and its concomitant effects, rather than a woman's long-term condition, they are at risk of delivering inappropriate care. They need to be prepared to advocate for the special needs of older women who live with a long-term condition and remain cognizant of the women's resourcefulness and expertise developed over time. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the experiences of alcohol and other drug nurses transitioning to telehealth due to the COVID‐19 pandemic. Background: COVID‐19 has caused immense disruption to healthcare services, and to reduce viral transmission, many services moved to off‐site care delivery modalities such as telehealth. Design: We used a qualitative descriptive design for this study. Methods: Secondary analysis of semistructured interviews with alcohol and other drug nurses from Australia and New Zealand (n = 19) was conducted in July and August 2020. Data were analysed using thematic analysis and reported using COREQ guidelines. Results: Three were identified: '"All our face‐to‐face contact ceased with clients": Changing service delivery', '"How do I do my job when I can't see you?": An anxious shift in service delivery' and '"A lot of Indigenous people don't like the FaceTiming and all that": Challenges to delivery of services through telehealth'. Conclusion: Participants in our study reported challenges in transitioning to telehealth modalities. The perceived loss of therapeutic communication, difficulties in assessing risks to healthcare consumers such as domestic violence and challenges delivering telehealth care to a marginalized consumer cohort need to be overcome before telehealth is considered successful in alcohol and other drug treatment. However, telehealth was a successful adjunct to existing practices for nurses working with consumers in regional or remote areas or where consumers preferred this method of service delivery. Impact: Nurses in this study described substantial issues with the delivery of alcohol and other drug treatment via telehealth, including a perception that telehealth was a barrier to addressing risks to consumers who use alcohol and other drugs, and difficulties working in a therapeutically beneficial way via telehealth. Telehealth is a means to reduce viral transmission through a reduction in face‐to‐face contact, and although it may be useful for some service functions, it may be detrimental to the clinical services nurses provide. [ABSTRACT FROM AUTHOR]

Aims: To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. Background: The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. Design: A cross-sectional survey design. Method: Data were collected in 2014-2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Results: Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources' variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater selfefficacy also have strong effects in lowering intentions to leave through higher engagement. Conclusions: Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To determine which aspects of primary nurse–patient telephone communication are viewed positively or negatively in terms of meeting the older persons’ needs. Background: Health professionals are increasingly being called on to develop different ways of working and increase their capacity to meet the needs of an ageing population. In some countries, telephone communication between primary nurses and patients in General Practice is already seen as a routine practice, but determining the value of this type of communication as a specific health service needs more understanding. Design: A qualitative exploratory study as the aim was to explore the older person's experiences. Methods: Semi‐structured interviews were conducted with 21 older people from General Practices in New Zealand during 2014–2015. Thematic analysis was informed by a constructivist grounded theory approach. Findings: The overarching theme was the difficulties older people face in making decisions about whether to contact a health professional by telephone and whether this should be the Primary nurse. Accounting for some of their symptoms as age related added to the uncertainty of decision‐making. Importantly, some older people were not raising concerns e.g. emotional state. Conclusion: Decision‐making by older people around treatment seeking is complex. Increasing the awareness of the nurse role in the General Practice is integral to creating a health system which will meet the needs of a growing older population. Primary care practices can review their systems to better inform older people how the nurse‐telephone role as a specific health service works and what they can expect when using this service. [ABSTRACT FROM AUTHOR]

Aims To outline the way the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend healthcare budget cuts, through new public management strategies leading to missed nursing care. Background Ten years on the cost of the Global Financial Crisis continues to be borne by tax payers and those employed by the welfare state, yet analysis shows clearly that it was caused by a failure to adequately regulate markets, particularly the banks and multinational corporations. In health care, one of the impacts is increased workload for nurses leading to missed care. Design/Methods Registered Nurses and midwives ( n = 7,302) completed the MISSCARE surveys between 2012 - 2015, in four Australian states and New Zealand providing quantitative and qualitative responses. The qualitative comments were analysed using a template analysis approach based on key features of New Public Management. Findings Sixty-two qualitative responses identified measures in place directly linked to austerity and new public management strategies that impacted on the quality of patient care and nursing work, as well as contributing to missed care. Conclusion Opportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations. [ABSTRACT FROM AUTHOR]

Aim To explore the concept of sustainability in nursing using social media as a vehicle for discussion on the topic. Background There is a need for an increased awareness among nurses of the issues that are crucial for the healthcare sector to prepare for climate change and contribute to sustainable development. However, topics about sustainability and climate change are not a requirement of nursing curricula in Europe; social media provides an opportunity to raise issues and promote discussion. Design A thematic analysis of a Twitter discussion. Methods A Twitter discussion session hosted by @WeNurses took place on 24 March 2015 over 1 hour. Data were gathered via this online discussion hosted on Twitter, a social media platform. Following the discussion a thematic analysis of the posted Tweets was conducted. Findings One hundred and nineteen people posted nine hundred and ninety six Tweets, a reach of 3,306,368. Tweets broadly followed the questions posted by the team. Several threads related to the sustainable use of healthcare resources and the need to reduce waste was evident. A Word Cloud of the Tweets highlighted prominent words in the discussion: sustainability, nursing/nurses, curriculum, important, waste, practice, resources, student, plastic, health, gloves. Conclusion Social media is an effective way of engaging nurses and students in a discussion on challenging issues. Sustainability appears to be important for nurses, with a particular emphasis on resource use and the importance of sustainability topics in nurse education. [ABSTRACT FROM AUTHOR]

Aims To identify why some nurses cope well with continuing to work as they age and others struggle. Background There is a need to understand better the challenges older nurses face and how they manage them. Design Secondary analysis of existing data. Methods Data collected in two separate studies were analysed. The first study (2012) was an online, anonymous survey that collected free text (qualitative) and categorical data ( n = 3273, 57·6% response rate). The second (2014) was an explorative, descriptive study that collected data through focus groups and interviews ( n = 46). Qualitative data from both studies were analysed using David Thomas' () general inductive approach. Research Ethics Committee approval was gained for the 2012 and 2014 studies. Results Data were categorised in two themes: the challenges of ageing and nursing; and factors that enable nurses to continue to practice. Physical challenges, fatigue, guilt, ageism and demands to complete continuing education were considered challenges. Maintaining personal fitness, self care, flexible working and a strong belief in their ability to contribute to the profession were present in older nurses who continued to practice. Conclusion While older nurses face growing physical and cognitive challenges as they age, they demonstrate strong resilience in the face of these challenges. It is recommended nurses seek support from their workplaces early to address challenges. Organisations must address ageism in the workplace and provide practical interventions such as supporting changes to work hours, shifting nurses to less physical roles and providing career planning to support resilience in older workers. [ABSTRACT FROM AUTHOR]

Aims To examine the effects of two factors on the transmission of clinical information at nursing handover. These factors were: (i) an affective statement expressing concern about the information; and (ii) verbal reference to a written summary of the information. Background Quality of communication at patient handover is inconsistent, compromising patient safety. Little is known about the nuances of communication that lead to effective handovers. Furthermore, effective information transmission during handovers is seldom evaluated using experimental research designs. Design A randomized, single-blind, controlled experiment. Methods Postanaesthesia care unit or surgical ward nurses and final-year nursing students were randomly assigned to watch one of four versions of a video-recorded handover. In each version, one piece of information was presented as either a simple statement (control), with an affective qualifier, with a written summary of the information, or with both an affective qualifier and a written summary. Primary outcome was assessed by questionnaire following a task directing attention away from the handover. Data were collected July-October, 2013 and analysed using 2 × 2 anova. Results A total of 157 nurses participated. Successful transmission of the clinical information did not significantly differ across the experimental conditions. Subgroup analysis revealed significantly higher transmission success among more experienced nurses when the affective statement was present compared to when it was absent (Kruskal-Wallis P = 0·002). Conclusions Expressing concern about information or directing attention to written notes may not improve information transfer at handover. However, affective qualifiers may have differential receiver-specific influences on information retention. [ABSTRACT FROM AUTHOR]

Aims (1) to generate in-depth insights into how nurses are working with older people with multiple long term conditions; (2) to gain an understanding of how nurses perceive professional patient navigation; and (3) to explore the barriers and facilitators to nurses adopting a navigation role in the context of Primary Health Care practice. Background Internationally, Primary Health Care has been identified as the main navigation point for older people with multiple long term conditions. Navigation models have been developed in cancer care but there is a lack of research in the context of Primary Care. There is also little evidence about the extent to which current work patterns of nurses providing care for this patient group fit with professional patient navigation models. Design A descriptive exploratory qualitative study. Methods Semi-structured audio recorded telephone interviews were conducted in 2012 with nurses in New Zealand who were working with older people with multiple long term conditions ( n = 42) Interviews were transcribed verbatim and entered into Nvivo 9 for thematic analysis. Findings The key themes represent patterns of nursing work as; system work, relationship work and patient work. While nurses lacked a coherent understanding of patient navigation as a concept, the way they worked had some elements in common with professional navigation models. Conclusion Further research involving older people in co-designing patient navigation approaches in Primary Health Care is needed to inform these types of service development and translate action from existing health policy. [ABSTRACT FROM AUTHOR]

Aim This study analyses discourses that migrant fathers in New Zealand draw on to explain their decision to have a child. Background Little is known about migrant men's reproductive decisions in the context of contemporary/active fatherhood. Design A discourse analytic research study. Methods Qualitative research was conducted in 2009 where Chinese and Indian migrant men took part in focus groups. Results/Findings Fathers drew on two key discourses to understand how they became fathers. The first was fatherhood as a financial decision and the second was fatherhood as a natural process. These two discourses are not always congruent. Conclusion Understanding the discourses that shape men's decisions to have a child, will enhance nurses' capacity to provide appropriate care and support for migrant families. [ABSTRACT FROM AUTHOR]

Aim To develop clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory. Background Numerous studies have reported that nurse-administered procedural sedation and analgesia is safe. However, the broad scope of existing guidelines for the administration and monitoring of patients who receive sedation during medical procedures without an anaesthetist present means there is a lack of specific guidance regarding optimal nursing practices for the unique circumstances where nurse-administered procedural sedation and analgesia is used in the cardiac catheterization laboratory. Methods A sequential mixed methods design was used. Initial recommendations were produced from three studies conducted by the authors: an integrative review; a qualitative study; and a cross-sectional survey. The recommendations were revised according to responses from a modified Delphi study. The first Delphi round was completed by nine senior cardiac catheterization laboratory nurses. All but one of the draft recommendations met the predetermined cut-off point for inclusion with 59 responses to the second round. Consensus was reached on all recommendations. Implications for nursing The guidelines that were derived from the Delphi study offer 24 recommendations within six domains of nursing practice: Pre-procedural assessment; Pre-procedural patient and family education; Pre-procedural patient comfort; Intra-procedural patient comfort; Intra-procedural patient assessment and monitoring; and Postprocedural patient assessment and monitoring. Conclusion These guidelines provide an important foundation towards the delivery of safe, consistent and evidence-based nursing care for the many patients who receive sedation in the cardiac catheterization laboratory setting. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Paediatric Intensive Care Unit-Nursing Knowledge and Skills Test - a multiple-choice test for measuring the key nursing knowledge and skills required for safe, competent practice. Background Intensive care graduate nurse residency or orientation programmes are key strategies in the development of safe and competent practitioners. Essential to these programmes is an evaluation of knowledge and skills. Multiple-choice examinations provide a valuable way of evaluating broad knowledge and skills; however, there has been limited work in this area to date. Design Psychometric evaluation. Methods The instrument was administered to 79 nurses from four paediatric intensive care units in Australia and New Zealand over 18 months between 2008-2010. Internal consistency using Kuder-Richardson 20, item analysis and construct validity using the 'known groups' technique were explored. Results Kuder-Richardson 20 reliability estimate for the 109-item test was 0·85. Instrument scores were significantly higher amongst nurses with postgraduate education and more years of paediatric intensive care experience. Item difficulty indices ranged from 0·08 to 1, with a mean item difficulty of 0·66. Item discrimination ranged from 0·2-0·8. Conclusion Testing of the instrument demonstrated encouraging psychometric properties. With additional refinement, this tool could provide educators and managers with an instrument to assist in the assessment of knowledge and skill acquisition. The instrument requires further testing in different samples of paediatric intensive care nurses to enable validation in other settings and cross-cultural comparisons. [ABSTRACT FROM AUTHOR]

tyrrell e.f., levack w.m., ritchie l.h. & keeling s.m. (2012) Nursing contribution to the rehabilitation of older patients: patient and family perspectives. Journal of Advanced Nursing 68(11), 2466-2476. Abstract Aims. This article reports a study of the perspective of older patients and their family members on the role of nurses in inpatient rehabilitation. Background. Rehabilitation services are used increasingly by older patients as life expectancy increases. The role of rehabilitation nurses in the multidisciplinary team has, however, yet to be clearly articulated. Previous research has focussed on the views of health professionals about nursing involvement in rehabilitation, but none has sought family members' perspectives. With the expectation of patient-centred care, it is important to consider what older patients and their families expect and require from nurses. Design. Grounded theory was used to collect and analyse data from interviews in an inpatient rehabilitation unit in New Zealand with seven patients, aged 72-89 years, and six family members, during 2009-2010. Findings. A substantive theory was developed which recognizes that the older patient values the relationship they build with nurses more than any specific role nurses perform. Participants acknowledged that rehabilitation nurses' roles included 'looking after', 'stepping in' and 'coaching independence' but 'best fit' nurses were identified by patients based on their 'nature', 'being available' and 'being attuned' to the patient's individual needs. If a 'connection' was formed, then this 'best fit relationship' maximized the older person's motivation to participate in his or her rehabilitation therapy. Conclusion. Patients and family members appreciate 'best fit relationships' where nurses seek to enter into the older person's world of disability to form a partnership which enhances their motivation to achieve independence. [ABSTRACT FROM AUTHOR]

crowe m., burrell b. & whitehead l. (2011) Lifestyle risk management - a qualitative analysis of women's descriptions of taking hormone therapy following surgically induced menopause. Journal of Advanced Nursing 68(6), 1814-1823. Abstract Aim. This article is a report of a study that examined how women describe their decisions in relation to the use of menopausal hormone therapy following surgical menopause. Background. Women who have had a surgically induced menopause generally experience more intense menopausal symptoms than natural menopause and are regularly prescribed menopausal hormone therapy. Since 2002 the risks associated with this therapy have been widely reported. Method. This study is a qualitative analysis of semi-structured interviews between March and May 2009 with 30 participants who had experienced surgical menopause and were, or had in the past, taken menopausal hormone therapy. This was a community sample recruited in Christchurch, New Zealand. A risk management theoretical approach underpinned the analysis. Findings. The womens' descriptions of managing the risks associated with menopausal therapy fell into two main themes: Life has to go on and Waiting for someone to tell me. All these women had either made an active decision to continue on treatment because of the impact of menopausal symptoms or took their doctor's advice to continue. A less dominant theme but one that was also evident was Relying on my body to get me through in which the women had decided to discontinue treatment because they regarded it as unnatural. Conclusion. The study provided insights into how women utilize an experiential reasoning process to manage the health and lifestyle risks associated with taking menopausal hormone therapy. Nurses need to be aware of how this process influences women's reasoning processes when working with women following surgical menopause. [ABSTRACT FROM AUTHOR]