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Davidson, R., Bannister, E., & De Vries, K. (2013). Primary healthcare NZ nurses' experiences of advance directives : understanding their potential role. Nursing Praxis in New Zealand, 29(2), 26–33.
Abstract: Presents results of a qualitative study of the knowledge, attitudes, and experiences of advance directives among 13 senior primary health-care nurses. Analyses participants' understanding of their potential role in this area, supporting the need for open communication in the primary health-care setting.
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Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Spence, D., & Anderson, M. (2007). Implementing a prescribing practicum within a Master's degree in advanced nursing practice. Nursing Praxis in New Zealand, 23(2), 27–42.
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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Lyford, S., & Cook, P. (2005). The Whanaungatanga model of care. Nursing Praxis in New Zealand, 21(2), 26–36.
Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.
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Roud, D., Giddings, D. L. S., & Koziol-McLain, J. (2005). A longitudinal survey of nurses' self-reported performance during an entry-to-practice programme. Nursing Praxis in New Zealand, 21(2), 37–46.
Abstract: The researchers conducted a study to compare self-reported changes in both frequency and quality of performance of nursing behaviours in a cohort of recently graduated nurses undertaking a one year entry to practice programme. Thirty-three nurses were surveyed, seven weeks after beginning the programme and again seven months later, using a modified version of Schwirian's (1978) Six-Dimension Scale of Nursing Performance (6-DSNP). Over the study period participants reported significant increases in frequency of performance for the domains of leadership, critical care, teaching/collaboration, and planning/evaluation. Significant increases in the quality of nurse behaviours in the domains of critical care, planning/evaluation and interpersonal relations/communication were also reported. The modified Schwirian 6-DSNP was found to be a useful instrument for measuring nurses' self reporting of performance during periods of transition.
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.
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Clendon, J., & Krothe, J. (2004). The nurse-managed clinic: An evaluative study. Nursing Praxis in New Zealand, 20(2), 15–23.
Abstract: Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.
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Day, D. R., Mills, B., & Fairburn, F. (2001). Exercise prescription: Are practice nurses adequately prepared for this? New Zealand Journal of Sports Medicine, 29(2), 32–36.
Abstract: This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription.
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Clendon, J., & McBride, K. (2001). Public health nurses in New Zealand: The impact of invisibility. Nursing Praxis in New Zealand, 17(2), 24–32.
Abstract: This research study examined the role of the public health nurse. Utilising community needs analysis method, 17 key informants and two focus groups were asked questions to determine perceptions of the public health nurse. Findings indicated that participants lacked knowledge regarding the role. Additional findings intimated that participants had difficulty in accessing public health nurse services and that 'knowing the system' was beneficial to receiving needed care. One of the major conclusions of this study was that many facets of care managed by public health nurses were invisible to the communities in which they work. Conclusions suggest that public health nurses need to enhance their service by improving accessibility to services and promoting their service in a more visible manner.
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Richardson, S. (1999). Emergency departments and the inappropriate attender: Is it time for a reconceptualisation of the role of primary care in emergency facilities? Nursing Praxis in New Zealand, 14(2), 13–20.
Abstract: This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK.
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Nicol, M. J., Manoharan, H., Marfell-Jones, M., Meha-Hoerara, K., Milne, R., O'Connell, M., et al. (2002). Issues in adolescent health: A challenge for nursing. Contemporary Nurse, 12(2), 155–163.
Abstract: This review provides an overview of the health issues for adolescents, and the implications for nursing practice, particularly around health promotion. It looks at the social context of adolescents including peer pressure, along with health issues such as suicide, mental health, sexual health, and smoking.
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Wilson, D., & Neville, S. J. (2008). Nursing their way not our way: Working with vulnerable and marginalised populations. Contemporary Nurse, 27(2), 165–176.
Abstract: This paper uses the findings of two studies to explore the nature of nurses' practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. The first study was with the elderly with delirium and used a critical gerontological methodology informed by postmodernism and Foucault's understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The findings show that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people's lives outside of the health care environment is ignored. Consequently, the foundations of nursing practice, that of holism, is found to be merely a rhetorical construct.
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McBride-Henry, K., & Foureur, M. (2006). Organisational culture, medication administration and the role of nurses. Practice Development in Health Care, 5(2), 208–222.
Abstract: This research study was designed to identify ways of enhancing patient safety during the administration of medications within the New Zealand context. The researchers employed a multi-method approach that included a survey using the Safety Climate Survey tool, focus groups and three clinical practice development groups. The authors conclude that the outcomes of this study indicate that practice development initiatives, such as the ones outlined in this project, can have a positive effect on nurses' perceptions of organisational safety, which in turn has been demonstrated to have a positive impact on patient safety.
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Lesa, R., & Dixon, D. A. (2007). Physical assessment: Implications for nurse educators and nursing practice. International Nursing Review, 54(2), 166–172.
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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Walsh, K., Moss, C., Lawless, J., McKelvie, R., & Duncan, L. (2008). Puzzling practice: A strategy for working with clinical practice issues. International Journal of Law and Psychiatry, 14(2), 94–100.
Abstract: The authors share the evolution of innovative ways to explore, 'unpack' and re-frame clinical issues that exist in everyday practice. The elements of these processes, which they call 'puzzling practice', and the techniques associated with them, were delineated over a two year period by the authors using action theory based processes. The authors have evolved several different frameworks for 'puzzling practice' which they draw on and use in their practice development work and in research practice. This paper pays attention to a particular form of puzzling practice that they found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. In this example 'puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle; exploring the heart of out practice; formulating the puzzle question; visualising the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored.
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