Search

Aims and objectives: To investigate the impact of workplace factors on burnout in New Zealand registered nurses (RNs). Background: Nursing is characterised by chronic workplace stress. Research examining the role of workplace factors (ie practice environment and bullying) in shaping burnout is scarce. Methods: A cross-sectional survey was conducted among 480 New Zealand RNs. Burnout was self-reported using the CBI, while practice environment and negative acts in the workplace were selfreported using PES-NWI, and NAQ-R respectively. The STROBE checklist was used for this paper. Results: For every point increase in PES-NWI, there was a decrease of 6.82, 12.62, and 9.86 points in personal burnout (PB), work-related burnout (WRB), and client-related burnout (CRB) respectively after controlling for demographic and job-related characteristics. For every point increase in NAQ-R, there was an increase of 0.47, 0.50, and 0.20 points in PB, WRB, and CRB respectively after controlling for sample characteristics. These two factors explained for 18.4 percent, 27.6 percent and 12.4 percent of the variation in PB, WRB and CRB respectively. The prevalence of high PB, WRB and CRB was 50.8 percent, 46.5 percent and 16.0 percent respectively. Conclusion: Workplace factors are associated with burnout in RNs. Health-care organisations and nurse leaders have a duty to provide safe and healthy workplaces that cultivate positive outcomes for nurses and patients. Future efforts to reduce workplace stress and burnout in nurses will need to include initiatives that reduce high workloads, provide greater job flexibility and autonomy, increase collaboration and reduce bullying and harassment. [ABSTRACT FROM AUTHOR]

Aims: The first aim of this study was to measure the extent of care planning and support for health goals within a sample of Māori/non-Māori people with long-term conditions (LTCs). The second aim was to compare those with and without care plans, and those with and without support for health goals, with respect to health and experiences with general practice. Background: Collaborative care planning, resulting in a written care plan, and providing support for patient-identified goals are important aspects of LTC management. In the MidCentral District Health Board region, primary care practitioners have had help to achieve this through the introduction of comprehensive assessment and care-planning tools. Methods: 569 people with at least one LTC, who had recently enrolled in a local EnhancedCare+ programme or were receiving care from an LTC community clinical nurse, were recruited into the region's "Talking about Health" study, designed to explore LTC care from patient and provider perspectives. Consenting participants chose to complete a paper (by post) or electronic (email link) questionnaire, which included measures of health, healthy behaviours, experiences with doctors and nurses in general practice, patient activation, care planning/goal support and demographics. Results: People with written care plans were more active self-managers, reported better interactions with primary-care doctors and nurses, and perceived receiving more support from the general practice team than those without. Results were similar for people receiving support for their health goals, but differences in mental and physical health were also evident. More Māori than non-Māori reported having a written care plan, and support for health goals in the absence of a written care plan. A slightly broader range of benefits was evident for non-Māori than Māori, but the different sample sizes need to be taken into account when drawing conclusions. Conclusions: Written care plans and practitioner support for health goals appear to benefit people with LTCs. Support for health goals is important as, even without a written care plan, it was associated with better health and more positive ratings of practitioner interactions. Challenges for the region are to involve more people/whanau in collaborative care planning and to address system-wide barriers to embedding care-planning practices into routine care. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine whether reasons reported in the international "intention to leave nursing" literature match those given by New Zealand nurses who left the profession before retirement age. Background: Concerns about nursing shortages have produced a rich literature on early nurse retirement. While causes of intention to leave have been reported previously, understanding more about the impact of these could guide retention strategies. Method: An online survey of nurses who had left the New Zealand Nurses Organisation (NZNO), citing they were leaving the profession, was conducted in September/October 2016, asking them about the factors leading to their decision, their decision-making processes, and workplace changes that may have helped them remain. Results were analysed by age cohort. Results: This paper reports results from 459 nurses aged 55-65 who had left nursing before the official retirement age. Issues previously reported in the literature also emerged as factors among this cohort. Key among these were workplace/organisational issues, and personal challenges related to health or burnout. Although reported by small numbers of respondents, previously unreported issues of loss of confidence, over-onerous professional development requirements and intergenerational tensions were also described. Conclusion: Issues identified in the "intention to leave" literature also figured highly as contributing to New Zealand nurses' decisions to actually leave. Many of these issues relate to the intensification of nursing (higher acuity and bed occupancy), and the need for sufficient nursing resources, flexible management and better support for older nurses. Implications for nursing management: Retaining, or delaying the retirement of older nurses could lessen impending nursing shortages. Adequate staffing, flexible working conditions, attending to difficulties with shift work requirements, and good nursing leadership to support a positive work culture, are required. [ABSTRACT FROM AUTHOR]

Aims: This paper reports the smoking prevalence of nursing students in New Zealand, comparing this with other relevant groups and changes since this was last reported in 2013. Method: In March and April 2017, 917 students completed a national online survey of nursing students. Results: Total smoking prevalence among all respondents to the smoking question (n=850) was 12.1 percent, though only 6.1 percent smoke every day. A total of 17.4 per cent of all nursing students described themselves as ex-smokers. Among the Māori nursing students, 24.3 percent smoke, as do 11.9 percent of non-Māori students. These figures are virtually identical to those reported in 2013. They show a lower smoking prevalence among nursing students than New Zealand adults (17 per cent) or young adults (24 per cent for 18-24 year olds), and 8.5 percent of registered nurses. They also show lower rates than Māori women in the general population (42 per cent), or qualified Māori nurses (19.3 per cent). There is a confounding effect due to the older age of Māori nursing students and a clear reduction in smoking among younger respondents. Conclusions: While it is good to see evidence of a fall in smoking rates among younger students, the persistent disparity in smoking rates of Māori and non-Māori nursing students is concerning, suggesting the continued need for specific smoking cessation and prevention initiatives. There is also a clear need for the smoke-free status of nursing schools to be rigorously enforced, and for policy on the use of electronic cigarettes to be more widely explored and communicated. [ABSTRACT FROM AUTHOR]

This paper explored whether there was a relationship between staffing and quality indicators in residential care for older people, in both rest homes and continuing care hospitals. A longitudinal survey of a sample of residential-care rest homes and continuing-care hospitals explored the relationship between direct-care staffing levels, skill mix and quality indicators. The study was conducted in r est homes (n=18) and continuing care hospitals (n=16) providing long-term care for people 65 years of age and over in the greater Auckland region in New Zealand. Participating rest homes and hospitals collected monthly data on direct-care staffing (registered nurses, enrolled nurses and support workers), quality indicators (falls, new fractures, pressure ulcers, weight loss, urinary tract infections, over nine medications a day, presence of indwelling catheters and use of daily restraints), over a six-month period. Logistic analysis revealed that in continuing care hospitals, as registered nurse/enrolled nurse time increased, there was a general trend of reduction in adverse events: falls, pressure ulcers, and daily restraint use. However , there were no significant associations between registered nurse/ enrolled nurse, or support worker staffing hours in rest homes in relation to the incidence of the five quality indicators: falls, weight loss, urinary tract infections, use of over nine medications, and the use of indwelling catheters. The study, utilising facility-level data, demonstrated a trend that increasing the combined time of registered and enrolled nurses to residents resulted in a decrease in adverse events in continuing-care hospitals. No other trends were identified. [ABSTRACT FROM AUTHOR]

This research aims to design and test the feasibility of an intervention promoting smoking cessation, and reducing smoking relapse, among Māori nurses who smoke. It is being conducted in two phases. Phase one, a national web-based survey, conducted in December 2012, explored the views of Māori nurses (smokers, ex-smokers and non-smokers) regarding smoking. This paper reports on the analysis of qualitative responses from 410 nurses and nursing students identifying as Māori who completed an online survey. Five themes were identified: beliefs about smoking; "for our tamariki"; personal stories of quitting; dissatisfaction with current approaches; and plans for future strategies. The findings confirm that nurses who smoke may experience feelings of conflict, and regard their behaviour as inconsistent with their role as nurses and health promoters. Nurses who smoke must be supported to become, and to stay, smokefree. Tailored Māori-specific cessation initiatives are needed. [ABSTRACT FROM AUTHOR]