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    Changing rooms in NICU : a comparative descriptive study of parental perceptions of the physical environment of neonatal intensive care units : a thesis presented in partial fulfilment of the requirements for the degree in Master of Philosophy in Nursing at Massey University
    (Massey University, 2007) Wilkinson, Robyn Clare
    The physical environment of a neonatal intensive care unit (NICU) is unique and can be challenging and stressful for families. As infant survival rates and technology improved, many NICUs became 'busy', overcrowded, noisy environments. New directions in the design of newborn nurseries highlight the potential for the physical environment to support parental needs and optimise the parenting experience. In October 2004 the NICU at National Women's Hospital (NWH) in Auckland (New Zealand), relocated to a new facility at Auckland City Hospital (ACH). A key principle in the design of the new NICU was improvement of family space at the cot side. This non-experimental study sought to describe and compare parental perceptions of the physical environment of a traditional NICU configuration with a new custom built NICU. A sample of parents with infants hospitalised in NICU from NWH (n = 30) and a different group of parents from ACH (n = 30) completed a self report Likert-type questionnaire (with a scale from 1 = strongly disagree to 7 = strongly agree). Qualitative data was sought using open ended questions. Significant differences were found between the old NWH NICU and the newly designed ACH NICU. Parents perception of the space at the cot-side was more adequate (p = 0.001), lighting levels more comfortable (p = 0.002), the cot-side was quieter (p = 0.02) and technology less intrusive (p = 0.03) at ACH NICU when compared to NWH NICU. Impact of these design changes on privacy, sense of belonging, and socialisation of parents did not show significant differences. Lack of cot-side space for NWH parents was the predominate theme from the open-ended questions. Parents viewed the family space and aesthetics of the new ACH rooms positively. Providers of newborn services contemplating redesign need to consider that increasing cot side space and decreasing infant numbers in clinical rooms can significantly improve a parent's view of NICU and therefore provide an environment that is supportive to parent's needs.
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    A process evaluation of a shared leadership model in an intensive care unit : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 2001) Turner, Clare Lynette Eden
    Shared leadership has been touted in the United States and United Kingdom as a model of staff management that fosters active involvement of staff, in this case nurses as experienced professionals, in patient management. This study uses process evaluation for the examination of a shared leadership model in an intensive care environment following a period of significant change and restructuring. The model was based on the shared leadership literature (porter-O'Grady, 1992) which focuses on clinical practice as a key accountability and on decentralised clinical leadership at the point of service. The model aligned with the skill acquisition framework used by the employer organisation called the Professional Development Programme (PDP). This programme aims at enhancing the development of expertise in clinical practice and supports the principles of shared leadership. This research study was undertaken to evaluate the process of implementation of the model and to discover whether there is evidence nurse involvement in the management of patient care. The results are based on the responses of 104 registered nurse respondents (56%) working in the intensive care unit of a specialised hospital. Documentation was also examined for evidence of nursing input into indirect patient management process development. The results indicate that nurses are becoming more settled in their working environment and feel more confident in their ability to provide an active role in the management of their patients within a multidisciplinary team.