Introducing Te Wāhanga Rangahau Tapuhi – NZNO’s Nursing Research Section

‘The section’s mission is to advance nursing practice and improve patient outcomes through rigorous research and evidence-based strategies relevant to Aotearoa, New Zealand.’

THE NZNO NURSING Research Section – now also known as Te Wāhanga Rangahau Tapuhi – began life almost 50 years ago, in 1975. It was one of NZNO’s first sections (known then as special interest groups) for professional nursing members (Litchfield, 2009).

Mission

The section’s mission is to advance nursing practice and improve patient outcomes through rigorous research and evidence-based strategies relevant to Aotearoa, New Zealand.

Membership and evolution

The Nursing Research Section has always attracted nurses interested in research, whether as active researchers themselves or as readers who wished to learn more about the research process and apply research findings to their nursing practice.
Initially, the section’s members were primarily academics and educators. While this group remains, the membership is now broader and more democratic, as research is recognised as part of every nurse’s role in caring for patients.

Aims

The section’s aims are to:

• Promote cooperation and collaboration between nurse researchers, both nationally and internationally.
• Liaise with authorities on social, health and eductional issues relevant to nursing research in Aotearoa, New Zealand.
• Facilitate links between Te Wāhanga Rangahau Tāpuhi and other NZNO colleges and sections.
• Provide a platform to bring together nurses interested in sharing knowledge and ideas to enhance evidence-based nursing practice across Aotearoa, New Zealand.

Membership growth and stability

Te Wāhanga Rangahau Tāpuhi membership has grown over the years and now remains relatively stable at around 377 members. While the goals of valuing, promoting, and encouraging research and researchers have never changed, the way these goals are met has evolved.

Honouring Te Tiriti o Waitangi and embracing change

An example of this evolution happened in 2021 when the section was honoured with a new name, Te Wāhanga Rangahau Tāpuhi, gifted by NZNO kaumātua Keelan Ransfield. The new name was developed in consultation with the kaumātua to reflect the goals of the section, and the mana of the new name was passed on to the section’s new logo. The new logo was created by design student Ying Zhou following a national public competition. It features a rito (the young shoot of the harakeke – New Zealand flax), a koru symbolising the eye of a ruru (morepork owl), and a magnifying glass in green.

Also in 2021, the section’s then-chair, Louise Chan, led a discussion on equity, kaupapa Māori research, and the section’s commitment to giving effect to Te Tiriti o Waitangi through its work. This led to the section developing a partnership with Te Poari – the committee which administers the Māori wing of NZNO – and since 2023 the section committee has included a permanent representative of Te Poari.

Recent activities and future plans

Te Wāhanga Rangahau Tapuhi’s committee comprises eight dedicated volunteers. A highlight of this year’s work was a research forum held in Tamaki Makaurau, Auckland, in early October with the theme, Hoki whakamuri, kia anga whakamua – “Look at the past to help forge the future.” This means understanding that older knowledge still has relevance and can evolve for use in the future. The hui attracted 50 participants who came to hear a wide variety of current nursing research from Aotearoa. The abstracts from many of these research projects are featured below.

In keeping with the hui theme of evolving knowledge, the committee has some fresh and exciting ideas for 2025 and beyond – further hui and mentorship, among others.

Report by Te Wāhanga Rangahau Tapuhi’s committee

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Reference

Litchfield, M. (2009). To advance health care. The origins of nursing research
in New Zealand. New Zealand Nurses Organisation.

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Featured abstracts from the forum

The following abstracts showcase the work of five researchers who presented their work at Te Wāhanga Rangahau Tapuhi’s recent research forum:

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• Achieving whanaungatanga-centred care in the acute mainstream hospital:
  A culturally informed grounded theory study

Author: Bobbie Pene
Bobbie Pene is a part-time nurse consultant in cultural safety in practice at Health NZ, Te Whatu Ora – Counties Manukau, and a PhD candidate at the University of Auckland. Her research interests are in the relational aspects of health care, where she has explored patient and whānau experiences of care, and Māori staff experiences of working in a mainstream health-care service. Her PhD focuses on reorienting relational practice with a te ao Māori lens.
Supervisors: Assoc Prof Julia Slark, Prof Merryn Gott, Prof Terryann Clark.

Abstract
Aim: To explore relational practice in an acute mainstream hospital in New Zealand from the perspective of Māori health-care professionals and recipients of care.
Background: Relational practice is an ethic of care that is often overlooked in time-limited contexts such as acute health-care settings. Local evidence suggests a relational mode of practice is needed to better meet the needs of our Māori community.
Methods: This study used a kaupapa Māori with grounded theory design. We conducted interviews with Māori staff and recipients of care. Data were analysed using Birks and Mills’ (2023) essential grounded theory methods and a concept-mapping approach similar to the whakapapa analytic framework (Ware et al., 2018).
Findings: We identified four themes that lay the foundation for our culturally informed grounded theory: 1) whakapapa (origins), 2) tikanga mahi (work ethic), 3) tikanga manaakitanga (cultural and social responsibility), and 4) tikanga whanaungatanga (belonging and inclusion).
Implications for practice: The culturally-informed grounded theory sets out the aspirations and direction for achieving a culture of whanaungatanga in the acute mainstream hospital. This study has the potential to reorient patient care from being task-driven, to having a relational focus that prioritises the needs of individuals and their whānau.

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• Was virtual communication technology effective in increasing the knowledge and skills of health professionals as part of continuous professional development during the COVID-19 pandemic?

Author: Audrey Gandhi
Audrey Gandhi is an RN of almost 20 years’ experience, working as a surgical nurse educator for outpatients and the elective surgery centre at Counties Manukau Health.
Supervisor: Rosemary Frey was supervisor for the author’s dissertation submitted as part of a masters in nursing qualification.

Abstract
Aim: The research aim was to conduct an integrative literature review on the use of video-conferencing technology during the COVID-19 pandemic by health professionals to continue education or professional development (CPD).
Background: With the need to socially distance due to restrictions during the COVID-19 pandemic, there was a shift in how education was conducted. Most education institutes and organisations switched to online learning to continue education. Health professionals also took part in online learning as part of continuing professional development. This study aimed to identify whether virtual communication technology effectively increased health professionals’ knowledge and skills as part of continuing professional development during the pandemic.
Methods: Databases including CINAHL, ERIC and Medline OVID were searched for relevant articles. The studies were limited to the English language only and within the period between January 2019 and May 2022. Twelve articles were selected for inclusion in the study.
Results: Thematic analysis of the articles led to the following key findings: 1) participants increased their knowledge after online sessions, 2) the importance of the study design when planning online sessions, and 3) the relationship between health professionals’ online learning and patient outcomes.
Conclusions: The evidence indicated that online learning increased participants’ knowledge. However, the evidence also led to the conclusion that face-to-face teaching is required to improve skills. Incorporating the “community of inquiry” framework is also important when planning online content. With increased knowledge, there is an improvement in outcomes for health-care professionals, including job satisfaction and retention, and in patient outcomes, particularly increased quality of care.
Implications for nursing: This review revealed that online learning is not the preferred method of delivery of CPD for students, compared to face-to-face teaching, even though it has many benefits.

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• Implementing the Fundamentals of Care framework in clinical practice

Authors: Kim Monteiro, clinical lead medical devices, PHARMAC
Assoc Prof Dr Julia Slark, head of the School of Nursing, University of Auckland
Assoc Prof Dr Cathleen Aspinall, Peninsular Health and Monash University

Abstract
Introduction: Since 2017, fundamental care has been audited at the selected New Zealand regional health services provider using the Fundamentals of Care audit. The Fundamentals of Care framework underpins the Fundamentals of Care audit. Furthermore, the selected regional health services provider proposed having the Fundamentals of Care framework as the conceptual framework underpinning the nursing care delivered there.
Aim: This qualitative study explores the nurses’ perceptions of the Fundamentals of Care framework as the conceptual framework underpinning nursing practice at a New Zealand regional health services provider.
Methods: The study gathered data by interviewing a purposive sample of nurses working at the selected regional health services provider using individual semi-structured interviews and analysed the interview transcripts using Braun and Clarke’s reflexive thematic analysis. Video and poster interventions were used during the research interviews.
Findings: The 16 study participants included bedside nurses, clinical coaches, nurse educators, specialty and specialist nurses, nurse clinicians, and senior nurse leaders. Around 30 per cent of the participants self-identified as New Zealand Māori. The study found that most participants did not know or understand the framework before the intervention. The three central themes generated were a) a useful framework to learn fundamental care delivery, b) a familiar framework, c) supporting the adaptation of the framework for practice.
Conclusion: Adaptation of the Fundamentals of Care framework for use at the studied New Zealand regional health services provider will require addressing gaps in knowledge about the framework. This will involve providing information on the definition and practical application of framework concepts and addressing gaps in the framework by incorporating culture, whānau involvement and spirituality. Integrating the Fundamentals of Care framework into the regional health delivery environment requires the organisation to support the education and practice of fundamental care delivery.

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• Empowering nurses with conceptual clarity: Defining occupational distress to enhance self-assessment

Authors: Jai Chung is a PhD candidate at the University of Otago.
Chris Moir, Department of Nursing, University of Otago and Ryman Healthcare, Christchurch, New Zealand.
Jennifer Jordan, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Abstract
Aims: Nursing research identified occupational distress as a major issue in the nursing workforce, encompassing various concepts and definitions. This integrative literature review explored how nursing research has applied conceptual definitions of occupational distress to assess conceptual clarity.
Background: Research on occupational distress in nursing mainly focused on six concepts: burnout, moral distress, compassion fatigue, moral injury, post-traumatic stress disorder and moral injury. These conditions harm nurses’ well-being and contribute to absence, leading to staffing shortages and potentially nurses leaving their careers. Undermining nursing wellness threatens the quality of care provided to patients and undermines the entire health system.
Methods: The five-stage integrative review process included problem identification, literature searches, data evaluation, analysis and presentation of findings. The author searched for appropriate literature written in English from CINAHL, PsyInfo, Scopus, ProQuest, and Web of Science databases. The search identified 433 articles. After screening and removing duplication, 68 relevant articles were included in the review, covering six different conceptual definitions of occupational distress, from 2000 to 2023.
Findings: Sixty-eight eligible articles represented key themes of occupational distress. The first finding was that the majority of articles used six different occupational distress definitions interchangeably. They also employed signs and symptoms as conceptual definition. Lastly, inconsistent applications of concepts caused challenges in identifying occupational distress accurately.
Conclusion/Implications for nursing: More conceptual consistency is needed to improve understanding of occupational distress. Clear conceptual definitions of specific types of occupational distress can aid nurses in identifying, coping with and preventing it more effectively.

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• Ōritetanga paerewa: Culturally safe communication and de-escalation practices/strategies for clinicians working with tangata whaiora Māori in acute adult mental health inpatient units

Author: Rachelle Weber

Abstract
Aims: The aim was to identify what culturally safe communication and de-escalation strategies are effective for staff working with Māori who are acutely distressed or agitated within adult mental health inpatient units.
Background: Seclusion is the process where mental health consumers who are considered high risk to others are locked in a room alone against their will. This is a traumatising process and Māori consumers are five times more likely to be secluded than non-Māori. Concerns have been raised as to whether unconscious bias and racism may play a part in this. The elimination of seclusion had been identified as a national priority; however there is very limited evidence regarding alternatives to seclusion for Māori, such as culturally safe de-escalation practices.
Methods: This was a kaupapa Māori qualitative study. Nine semi-structured interviews were undertaken with experienced Māori inpatient staff across four adult mental health units. A focus group hui was then held with seven of the original participants.
Results: Five main themes were identified: mana enhancing (personal power), whakawhanaungatanga (relationships), pono (honesty), kanohi ki te kanohi (communication) and huarahi (approaches).
Discussion: Participants felt that there was a better way to work with Māori; however they are hampered by existing attitudes, ward cultures and environments that support the use of restrictive practices.
Conclusion: This study contributes new evidence on culturally safe de-escalation strategies for Māori who are experiencing agitation or distress within inpatient mental health settings. The use of such strategies may contribute to reducing the high seclusion rates for Māori.