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Biomedical subjects

Sandra Richardson

Publications and source records attributed to Sandra Richardson.

9 recordsLinked to original sources
PubMed2006

New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department.

AIMS: Emergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. METHODS: An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of ED patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. RESULTS: There are significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the ED. CONCLUSIONS: While there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.

Adult↗
PubMed2005

Toxic effects of BZP-based herbal party pills in humans: a prospective study in Christchurch, New Zealand.

AIM: This study describes patterns of human toxicity related to the use of 1-benzylpiperazine (BZP)-based 'herbal party pills'. METHODS: From 1 April 2005 to 1 September 2005 all presentations associated with party pill use were captured on a prospective data collection form. RESULTS: There were 61 patients who presented on 80 occasions to the Emergency Department of Christchurch Hospital, New Zealand. Patients with adverse effects took an average of 4.5 tablets/capsules. Patients with mild to moderate toxicity experienced symptoms such as insomnia, anxiety, nausea, vomiting, palpitations, dystonia, and urinary retention. Some adverse reactions persisted up to 24 hours after ingestion. Fifteen toxic seizures were recorded. Two patients suffered life-threatening toxicity with status epilepticus and severe respiratory and metabolic acidosis. CONCLUSIONS: Herbal party pills have been sold without regulation since 2000, and are now widely used by young New Zealanders. The principal ingredient of these pills is 1-benzylpiperazine (BZP). They appear to have a narrow safety margin when used recreationally by some humans, possibly because of intrinsic pharmacodynamic properties, self-dosing variability, or genetic polymorphism. Those with seizure disorders or coronary disease should avoid BZP as should those taking prescription sympathomimetics or anticholinergics. Coingestion with MDMA or amphetamine should also be cautioned against. The results of this study indicate that BZP can cause unpredictable and serious toxicity in some individuals. Furthermore, the results of this study should be carefully considered in any discussion on the legal status of piperazine-based party pills.

Adolescent↗
PubMed2005

The forensic nurse practitioner role (emergency nursing)--potential response to changing health needs in New Zealand.

There is little existing policy related to Forensic Evidence collection in the Emergency Department environment within New Zealand (NZ). A case study based on the Christchurch Hospital Emergency Department (ChCh ED) environment is presented, which outlines the need to develop a specialised nursing role, that of Forensic Nurse Practitioner (emergency care). The role of nursing input in the field of Forensic Medicine in NZ is essentially limited to the psychiatric focus. While roles such as those of the Forensic Psychiatric Nurse are relatively well established, there is an apparent absence of other 'forensic' functions, in particular those related to victims or perpetrators of crime. It is an accepted feature of emergency care that serious injuries and deaths do occur despite intervention. In addition, there are significant numbers of patients who present as a result of assault or in suspicious circumstances. Awareness of the importance of forensic evidence collection, appropriate storage and disposal of material is growing. Legal implications have significance for nurses, in particular with the movement towards Advanced Nursing Practice with its focus on increasing autonomy, accountability and independent practice. In order to achieve holistic healthcare and to provide appropriate and effective interventions, forensic emergency nursing skills need to be developed.

Emergency Nursing↗
PubMed2005

Incorporation of research into clinical practice: the development of a clinical nurse researcher position.

The role of research within nursing is gaining a higher profile, as nurses move towards advanced practice roles, and concepts such as evidence based practice and clinical governance are accepted. Research has long been incorporated in both undergraduate and post graduate nursing education, but has often been viewed by nurse clinicians as too difficult and expensive, with little direct clinical relevance. The current focus on developing Nurse Practitioners has emphasised the need for a research component in such practice, but it is not only the 'advanced' practitioners who can benefit from a greater understanding and involvement with the research process. The development of an innovative research role in Christchurch Hospital has the potential to demonstrate that research can be incorporated and accepted into a clinical area. The role of Clinical Nurse Researcher in the Emergency Department has resulted in a higher profile for research, and the gradual integration of research as a clinical skill with direct practical relevance.

Clinical Nursing Research↗
PubMed2002

Advanced nursing practice--evolution or revolution?

This article has been written to challenge the seemingly unquestioning acceptance of changing roles in New Zealand nursing. It is evident in nursing history that a number of issues, such as community versus hospital services and generalist versus specialist practice, tend to resurface in a cyclic manner. Characteristics that are currently associated with 'advanced' nursing roles can be recognised when the origins and development of nursing in New Zealand are traced. This gives rise to speculation that changes to nursing scope of practice are not so much revolutionary as evolutionary, and can perhaps be viewed as a reclaiming rather than a redefining of nursing roles.

Attitude of Health Personnel↗