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Author |
Gardner, A.; Hase, S.; Gardner, G.; Dunn, S.; Carryer, J.B. |
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Title |
From competence to capability: A study of nurse practitioners in clinical practice |
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Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal  |
Author copy available 12 months after publication from QUT ePrints |
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Volume |
17 |
Issue |
2 |
Pages |
250-258 |
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Keywords |
Nurse practitioners; Professional competence; Advanced nursing practice; Evaluation |
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Abstract |
This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners. |
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Call Number |
NRSNZNO @ research @ 945 |
Serial |
929 |
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Author |
McArthur, J. |
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Title |
Discursive understanding of knowledge within advanced nursing practice roles: A co-operative inquiry in an acute health care organisation |
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Year |
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Publication |
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Abbreviated Journal |
Auckland University of Technology Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Advanced nursing practice; Organisational culture |
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Abstract |
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Call Number |
NRSNZNO @ research @ 1280 |
Serial |
1265 |
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Author |
Fraser, A.G.; Williamson, S.; Lane, M.; Hollis, B. |
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Title |
Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori |
Type |
Journal Article |
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Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
116 |
Issue |
1176 |
Pages |
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Keywords |
Advanced nursing practice; Hospitals; Clinical assessment; Evaluation |
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Abstract |
Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive. |
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Call Number |
NRSNZNO @ research @ 625 |
Serial |
611 |
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Author |
Spence, D.; Anderson, M. |
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Title |
Implementing a prescribing practicum within a Master's degree in advanced nursing practice |
Type |
Journal Article |
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Year |
2007 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
23 |
Issue |
2 |
Pages |
27-42 |
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Keywords |
Advanced nursing practice; Education; Nurse practitioners; Prescribing; Teaching methods |
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Abstract |
This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles. |
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Call Number |
NRSNZNO @ research @ |
Serial |
457 |
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Author |
Spence, D. |
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Title |
Advancing nursing practice through postgraduate education, part two |
Type |
Journal Article |
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Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
20 |
Issue |
3 |
Pages |
21-30 |
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Keywords |
Advanced nursing practice; Professional development; Education; Research |
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Abstract |
This paper continues presentation of the findings of a North Island based research project that explored the impact of clinically focused postgraduate education on advancing nursing practice. Like their international counterparts, increasing numbers of New Zealand nurses are enrolling in advanced practice programmes. Yet, despite international evidence supporting the usefulness of Masters level preparation for advancing clinical practice, questions about the need for such development persist. This paper argues that postgraduate education contributes to the development of courage and that this, in turn, is essential to overcoming the barriers that currently constrain the advancement of nursing practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
542 |
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Author |
Jacobs, S. |
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Title |
Advanced nursing practice: Time and meaning |
Type |
Journal Article |
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Year |
2003 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
19 |
Issue |
3 |
Pages |
29-39 |
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Keywords |
Advanced nursing practice; Nurse practitioners; Professional development; History of nursing |
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Abstract |
The particular, contemporary meanings ascribed to “advanced nursing practice” in New Zealand have been debated and delineated in the 1990s, culminating in the launch of the nurse practitioner role at a conference sponsored by the Ministry of Health and the Nursing Council of New Zealand in August, 2001. Drawing on archival materials, documents, other texts and voices, this article explores the evolution of connotations and meanings of the word “advanced” as applied to nursing in New Zealand. The focus is on clinical practice, research, teaching, consulting, higher education, and advancement of the profession. Historical aspects of advancement in New Zealand nursing are examined, including registration, unsupervised practice, technical specialisation, and career development. |
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Call Number |
NRSNZNO @ research @ |
Serial |
552 |
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Author |
Connor, M. |
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Title |
Advancing nursing practice in New Zealand: A place for caring as a moral imperative |
Type |
Journal Article |
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Year |
2003 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
19 |
Issue |
3 |
Pages |
13-21 |
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Keywords |
Advanced nursing practice; Ethics; Professional competence; Nurse-patient relations |
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Abstract |
The author argues that the framework of competencies required for advanced nursing practice should include a moral dimension in order to take account of relational as well as functional competencies. There is no recognition of the relational competencies required to practice caring as a moral imperative. The Nursing Council of New Zealand expects that nurses will practise 'in accord with values and moral principles'. The paper explores the history of two nursing discourses, that which sees nursing as a functional occupation and that which emphasises the relationship between nurse and patient. A practice exemplar is used to demonstrate positive outcomes from advanced relational competencies. |
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Call Number |
NRSNZNO @ research @ |
Serial |
553 |
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Author |
Jacobs, S. |
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Title |
Credentialling: Setting standards for advanced nursing practice |
Type |
Journal Article |
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Year |
2000 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
15 |
Issue |
2 |
Pages |
38-46 |
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Keywords |
Scope of practice; Advanced nursing practice |
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Abstract |
This article examines professional regulation with particular reference to advanced practice. As well as providing an overview of credentialing and other aspects of professional regulation, including licensure, certification, registration, and titling, the question of how much regulation, and by whom, is explored. |
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Call Number |
NRSNZNO @ research @ |
Serial |
632 |
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Author |
Lesa, R.; Dixon, D.A. |
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Title |
Physical assessment: Implications for nurse educators and nursing practice |
Type |
Journal Article |
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Year |
2007 |
Publication |
International Nursing Review |
Abbreviated Journal |
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Volume |
54 |
Issue |
2 |
Pages |
166-172 |
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Keywords |
Advanced nursing practice; Clinical assessment; Cardiovascular diseases; Nursing; Education |
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Abstract |
In New Zealand, the physical assessment of a patient has traditionally been the domain of the medical profession. Recent implementation of advanced practice roles has expanded the scope of practice and nurse practitioners may now be expected to perform physical assessments. The aim of this literature review was to discover what could be learnt from the experiences of Western countries. Nurses from the USA, Canada and Australia readily incorporate physical assessment skills into their nursing practice as a component of health assessment. The international literature identified that any change to the nurse's role in health assessment, to include physical assessment skills, requires strategies that involve the regulatory, educational and practice components of nursing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
786 |
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Author |
Smythe, E. |
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Title |
Uncovering the meaning of 'being safe' in practice |
Type |
Journal Article |
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Year |
2003 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
14 |
Issue |
2 |
Pages |
196-204 |
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Keywords |
Childbirth; Patient safety; Advanced nursing practice; Midwifery |
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Abstract |
This paper moves away from the prevalent discourse of competence to consider the meaning of the experience of 'being safe' within the context of childbirth. It offers findings from a doctoral study, informed by the philosophies of Heidegger and Gadamer. Following ethical approval, the data was collected in New Zealand by tape-recorded interviews of 5 midwives, 4 obstetricians, 1 general practitioner and 10 women. The method was informed by van Manen. The findings reveal that in seeking the meaning of being safe one needs to be aware that the unsafety may already be present in the situation. Practitioners may be able to do little to rectify the unsafeness. There is, however, a spirit of safe practice, explicated in this paper, that is likely to make practice as safe as it can possibly be. Wise practitioners are ever mindful that a situation may be or become unsafe, and are always aware of their own limitations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
877 |
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Author |
Chadwick, A.; Hope, A. |
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Title |
In pursuit of the named nurse |
Type |
Journal Article |
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Year |
2000 |
Publication |
Australasian Journal of Neuroscience |
Abbreviated Journal |
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Volume |
13 |
Issue |
4 |
Pages |
6-9 |
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Keywords |
Advanced nursing practice; Hospitals; Evaluation; Nurse-family relations; Nurse-patient relations |
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Abstract |
This paper outlines the project outcomes, benefits, impact and constraints of introducing the named nurse concept to a neuro-services department. The concept of the named nurse was first introduced in the UK, in 1992, with the aim of supporting the partnership in care between the patient and the nurse. The evidence for the effectiveness of introducing the named nurse concept is largely anecdotal. In line with the hospital wide policy of implementing the named nurse concept at Auckland Hospital, a six-month pilot study was undertaken within the Neuro-services Department. The aims of the study were to foster a partnership in care with patients / whanau and the multidisciplinary team, to improve the efficiency and effectiveness of delivery of nursing care, and to contribute to continuous quality improvement. The results highlighted that, in theory, the named nurse concept would be effective in providing quality co-ordinated care, however factors were identified that hindered the effectiveness of its implementation. Therefore, further development of the concept was required. |
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Call Number |
NRSNZNO @ research @ |
Serial |
924 |
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Author |
Clendon, J.; White, G.E. |
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Title |
The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis |
Type |
Journal Article |
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Year |
2001 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
34 |
Issue |
2 |
Pages |
171-178 |
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Keywords |
Primary health care; Nurse managers; Advanced nursing practice; Community health nursing; School nursing |
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Abstract |
The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required. |
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Call Number |
NRSNZNO @ research @ |
Serial |
952 |
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Author |
Ross, J. |
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Title |
International perspective: The development of the advanced role of rural nurses in New Zealand |
Type |
Journal Article |
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Year |
1999 |
Publication |
Australian Journal of Rural Health |
Abbreviated Journal |
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Volume |
7 |
Issue |
4 |
Pages |
253-257 |
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Keywords |
Nursing; Education; Rural nursing; Advanced nursing practice |
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Abstract |
This paper offers an insight into the development of the advanced role of rural nursing practice in New Zealand. The concept of advanced nursing practice is discussed within the context of the interdisciplinary healthcare team. It is argued that as nurses take on advanced practice, it is essential they receive appropriate clinical and theoretical skills to ensure they are in a position to provide competent and clinically safe, effective health care in an ethical, efficient manner. A description of a survey, undertaken by the author, studying rural nurses' skills provides the recommendation for the development of an appropriate postgraduate course at Masters level, designed specifically for primary rural nurses for the advanced role. |
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Call Number |
NRSNZNO @ research @ |
Serial |
953 |
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Author |
Rose, L.; Nelson, S.; Johnston, L.; Presneill, J.J. |
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Title |
Workforce profile, organisation structure and role responsibility for ventilation and weaning practices in Australia and New Zealand intensive care units |
Type |
Journal Article |
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Year |
2008 |
Publication |
Journal of Clinical Nursing |
Abbreviated Journal |
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Volume |
17 |
Issue |
8 |
Pages |
1035-1043 |
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Keywords |
Advanced nursing practice; Clinical decision making; Intensive care nursing; Cross-cultural comparison |
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Abstract |
The aim of this research is to provide an analysis of the scope of nursing practice and inter-professional role responsibility for ventilatory decision-making in Australian and New Zealand intensive care units (ICU). Self-administered questionnaires were sent to nurse managers of eligible ICUs within Australia and New Zealand. Survey responses were available from 54/180 ICUs. The majority (71%) were located within metropolitan areas and categorised as a tertiary level ICU (50%). The mean number of nurses employed per ICU bed was 4.7 in Australia and 4.2 in New Zealand, with 69% (IQR: 47-80%) of nurses holding a postgraduate specialty qualification. All units reported a 1:1 nurse-to-patient ratio for ventilated patients with 71% reporting a 1:2 nurse-to-patient ratio for non- ventilated patients. Key ventilator decisions, including assessment of weaning and extubation readiness, were reported as predominantly made by nurses and doctors in collaboration. Overall, nurses described high levels of autonomy and influence in ventilator decision-making. Decisions to change ventilator settings, including FiO(2) (91%, 95% CI: 80-97), ventilator rate (65%, 95% CI: 51-77) and pressure support adjustment (57%, 95% CI: 43-71), were made independently by nurses. The authors conclude that the results of the survey suggest that, within the Australian and New Zealand context, nurses participate actively in ventilation and weaning decisions. In addition, they suggest, the results support an association between the education profile and skill-mix of nurses and the level of collaborative practice in ICU. |
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Call Number |
NRSNZNO @ research @ |
Serial |
962 |
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Author |
McKenna, B.; O'Brien, A.J.; Dal Din, A.; Them, K. |
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Title |
Responsible clinician role offers opportunities for nurses |
Type |
Journal Article |
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Year |
2006 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
12 |
Issue |
11 |
Pages |
12-14 |
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Keywords |
Psychiatric Nursing; Advanced nursing practice; Law and legislation; Mental health |
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Abstract |
The authors report on a recent study investigating the statutory role of responsible clinician. Statutory roles under mental health legislation offer mental health nurses a means of having advanced practice skills recognised, as well as contributing to improved access to services. There is a proliferation of roles intended to develop nursing readership, but in most cases they are not primarily clinical roles. The concept of “advanced practice” has become a means of developing clinical leadership roles in nursing. Research on responsible clinician role is presented along with the results of a survey of the 11 Registered Nurses practicing as responsible clinicians, five senior nurses from each of the 21 district health boards, and the Auckland Regional Forensic Psychiatry Services (n = 121). Respondents were asked whether the responsible clinician role was a legitimate one for nurses and whether they were motivated to attain or maintain that role. They were also asked which competencies for the role they believed they met, their perceptions of credentialing processes and the educational requirements needed to achieve the role. A clear majority of the respondents felt the role of the responsible clinician was a legitimate advanced practice role for mental health nurses. Despite this, some respondents expressed ambivalence about taking on the role. The research highlighted deficits in knowledge and skills that could become a focus of education for advanced practitioners seeking appointment as responsible clinicians. Deficits included some assessment skills, knowledge of a range of interventions and knowledge of other legislation affecting mental health legislation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
992 |
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