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Author |
Mackay, B. |
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Title |
An analysis of innovative roles in primary health care nursing |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal  |
Northland Polytechnic Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing |
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Abstract |
An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1124 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural nursing; Primary health care |
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Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them. |
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Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
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Author |
Davies, D.C. |
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Title |
Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Chronic diseases; Patient satisfaction; Nursing |
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Abstract |
Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions. |
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Call Number |
NRSNZNO @ research @ 492 |
Serial |
478 |
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Author |
Litchfield, M. |
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Title |
The innovation effort: ?Are you in or are you out?? |
Type |
Miscellaneous |
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Year |
2007 |
Publication |
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Abbreviated Journal |
http://www.moh.govt.nz/moh.nsf/pagesmh/7696/$File/mlitchfield.pdf |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing; Primary health care; Policy |
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Abstract |
A graphic presentation in PDF format (April 2007) of the findings and policy implications of the developmental evaluation research programme for the Turangi Primary Health Care Nursing Innovation. |
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Call Number |
NZNO @ research @ |
Serial |
1327 |
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Author |
Adams-Smith, P.H. |
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Title |
An exploration of issues of primary health services for Taranaki Te Atiawa children based on the expectations and perceptions of their female caregivers |
Type |
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Year |
2002 |
Publication |
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Abbreviated Journal |
http://hdl.handle.net/10063/75 |
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Volume |
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Issue |
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Pages |
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Keywords |
Parents and caregivers; Primary health care; Access; Maori; Children |
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Abstract |
The intention of this research is, through collaborative discussion and selective conversations, to explore female caregivers' expectations and perceptions of primary health services for some Te Atiawa Maori children. The research process was developed in a partnership between the Maori women participants and the researcher. In addition, two local kuia actively participated in and supported the process. Emancipatory critical social theory underpinned and informed the project. Power relationships between the researcher and the participants can be overtly explored within this theoretical framework. In terms of this particular exploratory study, participatory research appeared to be applicable. The participants are female caregivers of Te Atiawa children. Data collection was done using group interactions and semi-structured interviews in the winter of the year 2000. A thematic analysis of the data was used, in which common themes were identified, compared and discussed. From the analysis of the data of the participants' conversations, key ideas were identified. The major findings have been identified within two main themes. These are: a concept of health is not the same for Pakeha as for Maori, and access issues are still problematic for the participants in this study. Many quotes from the interview participants are included in order to keep the focus of the project on the voices of the women interviewed. In terms of the significant contribution of this research, this study aims to allow voices of female caregivers of Te Atiawa Maori children to be heard. Individual and collaborative interactions offer insights into what is important to them in terms of Maori child health. Clearly, the primary health initiatives promoted by the New Zealand government are not reaching at least some of the people for whom they are intended. The research participants offered their ideas as to how these deficits could be remedied in their community. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1216 |
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Author |
Gohns, A. |
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Title |
Management of opioid substitution treatment in the primary health care setting: A national training course for service providers |
Type |
Journal Article |
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Year |
2002 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
Full text online from the Royal New Zealand College of General Practitioners' website |
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Volume |
29 |
Issue |
3 |
Pages |
172-175 |
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Keywords |
Pharmacology; Evaluation; Primary health care |
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Abstract |
The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1099 |
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Author |
Mackay, B. |
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Title |
Leadership strategies for role development in primary health care nursing |
Type |
Journal Article |
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Year |
2007 |
Publication |
Nursing Journal Northland Polytechnic |
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
11 |
Issue |
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Pages |
31-39 |
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Keywords |
Primary health care; Leadership; Professional development |
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Abstract |
This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support. |
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Call Number |
NRSNZNO @ research @ 1049 |
Serial |
1033 |
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Author |
Holloway, K. T.; Pearson, J.R. |
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Title |
Trailblazers: Primary health care programme evaluation |
Type |
Conference Article |
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Year |
2005 |
Publication |
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Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
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Volume |
Paper presented June 2004 at Royal New Zealand Plu |
Issue |
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Pages |
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Keywords |
New graduate nurses; Primary health care; Evaluation research; Professional development |
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Abstract |
This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1200 |
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Author |
Ha, I.; Huggard, P.; Huggard, J. |
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Title |
Staff support and quality of care provided by palliative care nurses: A systematic literature review |
Type |
Journal Article |
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Year |
2013 |
Publication |
Kai Tiaki Nursing Research |
Abbreviated Journal |
Available through NZNO library |
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Volume |
4 |
Issue |
1 |
Pages |
25-32 |
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Keywords |
Hospice and palliative nursing; Systematic review; Staff support; Quality of health care |
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Abstract |
There is a considerable body of literature discussing the stressors experienced by nurses and other health professionals when caring for those who are terminally ill and dying. Also, a number of articles offer suggestions, including the views of staff, as to what type of professional and organisational support is required when working in this often demanding specialty. There are, however, very few reports of assessment of the effectiveness of such supportive interventions and in particular, the impact of such support on the quality of patient care. This literature review examines any reported relationships between the quality of nursing provided by palliative care nurses and the staff support received by those nurses. |
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Call Number |
NZNO @ research @ |
Serial |
1391 |
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Author |
Vernon, R.A.; Jacobs, S.; Papps, E. |
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Title |
An innovative initiative for advanced nursing practice roles |
Type |
Journal Article |
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Year |
2007 |
Publication |
Vision: A Journal of Nursing |
Abbreviated Journal |
Available online from Eastern Institute of Technology |
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Volume |
14 |
Issue |
2 |
Pages |
16-17 |
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Keywords |
Advanced nursing practice; Primary health care; Nurse practitioners; Nursing models |
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Abstract |
This paper reports an initiative which is an example of partnership between education and health organisations resulting in the implementation of a jointly funded advanced nursing practice role. The model is for community based Nurse Practitioner-managed health care for primary health and disease management. The key partners in this project are the Eastern Institute of Technology, Hawke's Bay District Health Board, and a Primary Health Organisation (Tu Meke – First Choice). This article summarises the objectives, implementation, evaluation and benefits of the programme. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1311 |
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Author |
Litchfield, M. |
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Title |
The successful design and delivery of rural health services: The meaning of success |
Type |
Report |
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Year |
2002 |
Publication |
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Abbreviated Journal |
Accessible from www.moh.govt.nz |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Management; Primary health care |
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Abstract |
A report on the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of ?successful design and delivery of rural health services? as a step towards a measurement tool. Participants were grouped as general practitioners (GPs), nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health. |
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Call Number |
NZNO @ research @ |
Serial |
1328 |
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Author |
Mackay, B. |
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Title |
General practitioners' perceptions of the nurse practitioner role: An exploratory study |
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 |
1170 |
Pages |
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Keywords |
Nurse practitioners; Physicians; Interprofessional relations; Primary health care |
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Abstract |
This study explores perceptions of general practitioners in the Northland District Health Board (NDHB) regarding the nurse practitioner role, identifying their knowledge of and perceived problems with that role, and their experience of nurses in advanced practice. A purposive sample of all 108 general practitioners in NDHB was undertaken, with a response rate of 46.3%. General practitioners favourably viewed nurse practitioner functions traditionally associated with nursing, such as health teaching, home visiting, obtaining health histories, and taking part in evaluation of care, but less favourably viewed those functions associated with medicine, such as prescribing, ordering laboratory tests, and physical assessment. While expecting few problems with patient acceptance, the general practitioners felt that funding and doctors' acceptance would be problematic. Most general practitioners indicated they had knowledge of the nurse practitioner role and had experienced working with a nurse in advanced practice, but some uncertainty and lack of knowledge about the nurse practitioner role was evident. The author recommends more education and discussion with Northland general practitioners to ensure they are fully informed about the nurse practitioner role and its potential positioning in primary healthcare, to reduce uncertainty, minimise role confusion and promote collaboration between general practitioners and nurse practitioners. |
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Call Number |
NRSNZNO @ research @ |
Serial |
557 |
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Author |
McKinlay, E.M. |
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Title |
Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
34 |
Issue |
5 |
Pages |
322-327 |
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Keywords |
Primary health care; Nursing models; Chronic diseases |
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Abstract |
This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
455 |
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Author |
Horsburgh, M.; Goodyear-Smith, F.; Yallop, J.; O'Connor, S. |
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Title |
Implementation of a nursing initiative in primary care: A case report, cardiovascular disease risk reduction |
Type |
Journal Article |
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Year |
2008 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
35 |
Issue |
3 |
Pages |
183-186 |
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Keywords |
Multidisciplinary care teams; Cardiovascular diseases; Case studies; Primary health care |
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Abstract |
The aim was to report on implementation of a nursing initiative of cardiovascular disease (CVD) screening risk assessment at the Mornington Health Centre, Dunedin, with initial outcomes after six months. The practice aim was 80% of their eligible population assessed within three to four years, particularly targeting high-risk groups. The audit indicates that in their first six months, Mornington Health Centre had screened 42% of their eligible patients. This is described as very successful progress towards their goal of 80%. A number of key organisational factors are identified that are likely to have contributed to the development and success of the nurse CVD risk assessment programme at Mornington Health Centre. The authors suggest that this case study demonstrates how organisational change, where the practice nurse role in the multidisciplinary team is clear, can facilitate a practice to meet a population-based goal. |
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Call Number |
NRSNZNO @ research @ |
Serial |
514 |
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Author |
Murrell-McMillan, K.A. |
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Title |
Why nurses in New Zealand stay working in rural areas |
Type |
Journal Article |
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Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
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Volume |
33 |
Issue |
3 |
Pages |
173-175 |
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Keywords |
Rural nursing; Recruitment and retention; Job satisfaction; Teamwork; Primary health care |
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Abstract |
The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues. |
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Call Number |
NRSNZNO @ research @ |
Serial |
530 |
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