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Fail, A. (1999). Ageing in the 21st century. Vision: A Journal of Nursing, 5(9), 24–31.
Abstract: The author looks at demographic and statistical information to extrapolate on trends that will affect the aged through into to the next century. She reviews policy approaches to the issues of a growing aged population combined with social and economic changes that could make this group vulnerable. Effective planning for the provision of quality care is placed in the context of social changes, advances in gerontology, and social theories of ageing.
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Lindsay, N. M. (2007). Family violence in New Zealand: A primary health care nursing perspective. Whitireia Nursing Journal, 14(7), 7–16.
Abstract: This article explores the implications of clinical decision making by primary health care nurses in relation to identifying family abuse, particularly partner abuse. The historical and sociological background to family violence in New Zealand, and government-led strategies are considered, along with issues for Maori and Pacific peoples. The concept of health literacy in relation to family violence is also briefly discussed.
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Pullon, S., & McKinlay, E. M. (2007). Interprofessional learning: The solution to collaborative practice in primary care. The Royal New Zealand College of General Practitioners website, 34(6), 404–408.
Abstract: In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions.
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Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
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Henty, C., & Dickinson, A. R. (2007). Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study. The Royal New Zealand College of General Practitioners website, 34(5), 335–338.
Abstract: The aim of this small qualitative descriptive pilot study was to describe the experiences of practice nurses delivering the Care Plus programme within the general practice setting. Care Plus was introduced into Primary Health Organisations (PHOs) in 2004. This programme encourages more involvement from practice nurses in chronic care management. For many New Zealand practice nurses this is a new role. This study, carried out prior to the larger Care Plus implementation review (2006), provides an insight into the nursing experience of implementing Care Plus and provides a basis for future studies with regard to the nurse's role within the Care Plus programme.
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McKinlay, E. M. (2007). Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes. New Zealand Family Physician, 34(5), 322–327.
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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Bland, M. F. (2007). Betwixt and between: A critical ethnography of comfort in New Zealand residential aged care. Journal of Clinical Nursing, 16(5), 937–944.
Abstract: This research sought to explore the nature of comfort within the context of three New Zealand nursing homes and examine how nursing and other actions contribute to residents' comfort. A critical ethnographic approach was used and fieldwork included 90 days of participant observation, interviews with 27 residents and 28 staff and extensive document examination. Comfort was multidimensional, idiosyncratic, dynamic and context dependent, rather than merely the absence of discomfort. This multidimensional nature meant residents could be 'betwixt and between' comfort and discomfort simultaneously. The constraints of one-size-fits-all care delivery practices and the tensions inherent in communal living compounded residents' discomfort. The findings show that individualised care, based on comprehensive and accurate nursing assessment, is fundamental to the comfort of residents.
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Pirret, A. M. (2003). A preoperative scoring system to identify patients requiring postoperative high dependency care. Intensive & Critical Care Nursing, 19(5), 267–275.
Abstract: The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
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Horsburgh, M., Merry, A., Seddon, M., Baker, H., Poole, P., Shaw, J., et al. (2006). Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative. Journal of Interprofessional Care, 20(5), 555–557.
Abstract: This article describes two interprofessional learning modules offered by the Faculty of Medical and Health Sciences at the University of Auckland to undergraduate medicine, nursing and pharmacy students. The modules, 'Maori Health“ and ”Patient Safety", have a focus on quality improvement in healthcare and are used to bring together students for a shared learning programme.The specific dimensions of healthcare quality covered in the programme are: patient safety, equity, access, effectiveness, efficacy and patient-centeredness.
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MacGeorge, J. M., & Nelson, K. (2003). The experience of the nurse at triage influences the timing of CPAP intervention. Accident & Emergency Nursing, 11(4), 234–238.
Abstract: This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.
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Neville, S. J., & Henderson, H. M. (2006). Perceptions of lesbian, gay and bisexual people of primary healthcare services. Journal of Advanced Nursing, 55(4), 407–415.
Abstract: This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
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Horsburgh, M., Goodyear-Smith, F., Yallop, J., & O'Connor, S. (2008). Implementation of a nursing initiative in primary care: A case report, cardiovascular disease risk reduction. New Zealand Family Physician, 35(3), 183–186.
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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Alcorn, G. (2007). The youth health specialty in New Zealand: Collaborative practice and future development. The Royal New Zealand College of General Practitioners website, 34(3), 162–167.
Abstract: This paper details the workforce capacity of youth health nursing and medical staffing required for community-based and school-based youth health services. The author shows how youth health services seek to complement the care delivered by Primary Health Organisations (PHOs) and other allied health care services in the community. She outlines the development and operation at VIBE, a community-based youth health service in the Hutt Valley with school-based youth health services delivered at four low deciles secondary schools. She explains that developing workforce capacity for youth health services is a primary health care priority and an important means to address inequalities and to improve the health services of young people.
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Minto, R. (2006). The future of practice nursing. New Zealand Family Physician, 33(3), 169–172.
Abstract: The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery.
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McKinlay, E. M. (2006). New Zealand practice nursing in the third millennium: Key issues in 2006. New Zealand Family Physician, 33(3), 162–168.
Abstract: The author looks at the accelerated change in the role of practice nurses, due to factors such as the effects of the Primary Health Care Strategy. She reviews the current role of practice nurses, which is influenced by a population approach and new funding streams that encourage preventative, maintenance and chronic illness management activities. She highlights the positive effects of increased visibility of nursing leaders in the sector, increasing interdisciplinary education, and new career pathways which include advanced roles. She addresses some of the professional and systemic structural barriers which impact on practice nurses' ability to work effectively and equally within a general practice team.
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