title: When things go wrong: An exploration of the effectiveness of Te Whatu Ora – Waikato ‘Patient-at- Risk’ service, from the perspective of healthcare professionals

authors: Harrison , Rangi Marie

subjects: Patient at Risk

abstract: Abstract:

Background: Within an acute hospital, critically ill patients are not always located in the intensive care or high dependency unit. Most often, deteriorating patients are managed in the emergency department or wards (Jevon et al., 2012). Signs of decompensation are subtle, but often occur prior to deterioration or an acute event. Therefore, early recognition and timely management improve patient outcomes and reduce admission into critical care services (Jevon et al., 2012). Internationally, acute care teams have been developed to improve patient outcomes through early identification and escalation. The Waikato Hospital Patient-at-Risk (PaR) team is a wraparound service that act as a safety net to support staff during this time. Conflicting evidence is found in the literature that debates the effectiveness of acute care teams, part of this is due to the composition of acute care teams that differ worldwide, and this study sought to explore the value of the Waikato service.

Objective: To explore the perceived value of the Waikato Hospital Patient-at-Risk service from the perspectives of those who utilise this service and those who provide the service. Furthermore, the study seeks to identify the characteristics of patients treated by the PaR service.
Participants: Interviews were held with a total of 13 participants (Ward Registered Nurses = 7; PaR service Registered Nurses = 5; Medical doctors = 1). Medical notes for 1,212 PaR patients were analysed.

Methods: A mixed method research over two phases. Phase one involved matching medical notes with routinely collected hospital data to explore the correlation between PaR patient characteristics and outcomes. Phase two involved 13 semi-structured interviews with staff from the PaR team and in the wards. Findings from phase one, informed the questions in phase two and interviews underwent a thematic analysis employing a general inductive method of inquiry.

Results: This study identified that patients who are seen by the Waikato hospital Patient-at-risk service experience greater complexities contributing to increased length- of-stay. In addition, this service contributes to increased feelings of safety for staff.

Conclusion: This study identified that there was significant value of the PaR service in relation to teaching and training of junior nurses as well as reassurance of ward staff when patients began to deteriorate.

text: When things go wrong: An exploration of the effectiveness of Te Whatu Ora – Waikato ‘Patient-at- Risk’ service, from the perspective of healthcare professionals Abstract:

Background: Within an acute hospital, critically ill patients are not always located in the intensive care or high dependency unit. Most often, deteriorating patients are managed in the emergency department or wards (Jevon et al., 2012). Signs of decompensation are subtle, but often occur prior to deterioration or an acute event. Therefore, early recognition and timely management improve patient outcomes and reduce admission into critical care services (Jevon et al., 2012). Internationally, acute care teams have been developed to improve patient outcomes through early identification and escalation. The Waikato Hospital Patient-at-Risk (PaR) team is a wraparound service that act as a safety net to support staff during this time. Conflicting evidence is found in the literature that debates the effectiveness of acute care teams, part of this is due to the composition of acute care teams that differ worldwide, and this study sought to explore the value of the Waikato service.

Objective: To explore the perceived value of the Waikato Hospital Patient-at-Risk service from the perspectives of those who utilise this service and those who provide the service. Furthermore, the study seeks to identify the characteristics of patients treated by the PaR service.
Participants: Interviews were held with a total of 13 participants (Ward Registered Nurses = 7; PaR service Registered Nurses = 5; Medical doctors = 1). Medical notes for 1,212 PaR patients were analysed.

Methods: A mixed method research over two phases. Phase one involved matching medical notes with routinely collected hospital data to explore the correlation between PaR patient characteristics and outcomes. Phase two involved 13 semi-structured interviews with staff from the PaR team and in the wards. Findings from phase one, informed the questions in phase two and interviews underwent a thematic analysis employing a general inductive method of inquiry.

Results: This study identified that patients who are seen by the Waikato hospital Patient-at-risk service experience greater complexities contributing to increased length- of-stay. In addition, this service contributes to increased feelings of safety for staff.

Conclusion: This study identified that there was significant value of the PaR service in relation to teaching and training of junior nurses as well as reassurance of ward staff when patients began to deteriorate.

year: 2022

title: Saturated: a study in fat obsession

authors: Cowley, Natalie Anne

subjects: Fat

abstract: This thesis examines both contemporary and historical meanings surrounding human body FAT in order to illuminate, chiefly, the forces that have rendered it both an omnipresent and negative entity in Western societies.  It explores the apparent contradiction that we must exist amidst hyper-consumptive capitalism yet display no bodily evidence of such consumption.  Along with an investigation into alternative bodily conceptions to that of the hegemonic West, a discourse analysis is employed to challenge the key assumptions that underpin the current 'obesity epidemic' and its ensuing 'war on obesity' so that body FAT may be configured differently.  

It is shown that, because bodily conceptions and ideals are complex cultural constructions, body FAT, as a substance, is not the scourge it is presently portrayed, but rather a substance that signifies most of what consumer society despises and fears.  It is argued that the 'war on obesity' has not been successful, and will continue to be ineffective, because the focus should not be on losing body FAT but rather on the conditions of poverty that generate overall ill-health.  It is concluded that such a 'war', if sustained in its current fashion, will only serve to further malign the situations of those deemed 'overweight and obese'.

text: Saturated: a study in fat obsession This thesis examines both contemporary and historical meanings surrounding human body FAT in order to illuminate, chiefly, the forces that have rendered it both an omnipresent and negative entity in Western societies.  It explores the apparent contradiction that we must exist amidst hyper-consumptive capitalism yet display no bodily evidence of such consumption.  Along with an investigation into alternative bodily conceptions to that of the hegemonic West, a discourse analysis is employed to challenge the key assumptions that underpin the current 'obesity epidemic' and its ensuing 'war on obesity' so that body FAT may be configured differently.  

It is shown that, because bodily conceptions and ideals are complex cultural constructions, body FAT, as a substance, is not the scourge it is presently portrayed, but rather a substance that signifies most of what consumer society despises and fears.  It is argued that the 'war on obesity' has not been successful, and will continue to be ineffective, because the focus should not be on losing body FAT but rather on the conditions of poverty that generate overall ill-health.  It is concluded that such a 'war', if sustained in its current fashion, will only serve to further malign the situations of those deemed 'overweight and obese'.

year: 2006

title: Lake weed and the Rotorua Te Arawa Lakes then and now

authors: Burton, Tracy

abstract: This afternoon we will be looking beneath the surface of the Rotorua
Te Arawa lakes at the submerged aquatic plants that grow within them – the good the bad and the ugly. We will have a look at the special native aquatic plants that occur naturally in the lakes, familiarise ourselves with the weed species that have invaded them and look at how these weeds have (and are) changed the natural condition of the lakes. We will also look at how submerged plants are being used to report on the condition of our lakes and what these plant communities can tell us about the state of the lakes yesterday and today.

text: Lake weed and the Rotorua Te Arawa Lakes then and now This afternoon we will be looking beneath the surface of the Rotorua
Te Arawa lakes at the submerged aquatic plants that grow within them – the good the bad and the ugly. We will have a look at the special native aquatic plants that occur naturally in the lakes, familiarise ourselves with the weed species that have invaded them and look at how these weeds have (and are) changed the natural condition of the lakes. We will also look at how submerged plants are being used to report on the condition of our lakes and what these plant communities can tell us about the state of the lakes yesterday and today.

year: 2017