Clendon, J., & White, G. E. (2001). The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis. Journal of Advanced Nursing, 34(2), 171–178.
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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O'Brien, A. P., Boddy, J. M., Hardy, D. J., & O'Brien, A. J. (2004). Clinical indicators as measures of mental health nursing standards of practice in New Zealand. International Journal of Mental Health Nursing, 13(2), 778–788.
Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
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Vernon, R. A., Jacobs, S., & Papps, E. (2007). An innovative initiative for advanced nursing practice roles. Available online from Eastern Institute of Technology, 14(2), 16–17.
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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Connor, M. J., Nelson, K. M., & Maisey, J. (2009). Impact of innovation funding on a rural health nursing service : the Reporoa experience. Nursing Praxis in New Zealand, 25(2), 4–14.
Abstract: Examines the impact of innovation funding through the MOH primary health-care nursing innovation funding scheme on Health Reporoa Inc, which offers a first-contact rural nursing service to the village of Reporoa and surrounding districts. Looks at funding impact during the project period of 2003-2006, and in the two years that followed.
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Prior, P., Wilkinson, J., & Neville, S. (2010). Practice nurse use of evidence in clinical practice : a descriptive survey. Nursing Praxis in New Zealand, 26(2), 14–25.
Abstract: Describes nurses' perceptions of their use of evidence-based practice, attitudes toward evidence-based practice and perceptions of their knowledge/skills associated with evidence-based practice. Determines the effect of educational preparation on practice, attitudes, and knowledge/skills toward evidence-based practice. Utilises a descriptive survey design to poll 55 West Auckland practice nurses working the general practice setting.
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McLelland, H., Hindmarsh, J. H., & Akroyd, S. (2021). Effective HPV vaccination with Maori male students: Evaluation of a Kaupapa Maori primary-health-care initiative. Nursing Praxis in Aotearoa New Zealand, 37(2).
Abstract: Reports on a local multi-component initiative to improve local Human Papillomavirus (HPV) vaccination coverage among Maori male students aged 13-17 years in a rural location in Aotearoa New Zealand. Backgrounds the initiative co-designed by the rural health nurse from a community clinic of the Hauora (Maori health provider) and the principal of the local area school, in order to improve health literacy and provide an environment to support student consent to vaccination. Undertakes an evaluation of the initiative in 2018, comprising 10 key informant interviews and a group discussion with eight male students. Identifies the factors associated with the success of the initiative.
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Adams, S., Boyd, M., Carryer, J., Bareham, C., & Tenbensel, T. (2020). A survey of the NP workforce in primary healthcare settings in New Zealand. New Zealand Medical Journal, 133(1523).
Abstract: Describes the demographics, distribution, clinical settings and employment arrangements of the NZ nurse practitioner (NP) workforce in primary healthcare settings, and organisational factors limiting their practice. Surveys 160 NPs and finds that general practice and aged residential care were the most common clinical settings.
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(2001). Dementia care: A literature review. Vision: A Journal of Nursing, 7(13), 33–36.
Abstract: This article defines dementia, and explores recent trends in relation to why it is such a misunderstood condition in the health care setting. Within a theoretical framework of literature development, nurse client relationships, and quality of care and attitudes are analysed. Gaps, inconsistencies and consistencies are outlined, with the implications for nursing practice and education explored.
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Vernon, R. A. (2001). Clinical case study: Acute traumatic head injury. Vision: A Journal of Nursing, 7(12), 3–9.
Abstract: This clinical case study takes an integrated approach to investigation and critical analysis of the complex physiological and pathophysiological treatment modalities instigated when a patient presents following acute traumatic head injury. A broad overview of the developmental physiology of the brain and an explanation of the mechanism of traumatic brain injury as it relates to alterations in cerebral blood flow, intracranial pressure and cerebral metabolism is presented. The author describes in narrative form the clinical presentation of a patient, her symptoms and initial treatment rationale. It concludes with analysis of the patients initial treatment priorities and symptom management during the first 48 hours of her care.
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Mackay, B. (2003). General practitioners' perceptions of the nurse practitioner role: An exploratory study. Access is free to articles older than 6 months, and abstracts., 116(1170).
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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Kinealy, T., Arroll, B., Kenealy, H., Docherty, B., Scott, D., Scragg, R., et al. (2004). Diabetes care: Practice nurse roles, attitudes and concerns. Journal of Advanced Nursing, 48(11), 68–75.
Abstract: The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care. Questionnaires were mailed to all 146 practice nurses in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organisation, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life. More nurses surveyed in 1999 had post-registration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999. Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
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Clendon, J. (2004). Demonstrating outcomes in a nurse-led clinic: How primary health care nurses make a difference to children and their families. Contemporary Nurse, 18(1-2), 164–176.
Abstract: The study outlined here explored outcomes from the provision of primary health care to children aged 5-13 years in a nurse-led clinic based in a primary school in Auckland. This multi-faceted study collected both qualitative and quantitative data, however it is the results of the quantitative arm of the study that are presented here. Data were collected from a variety of sources concerning conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage. Findings demonstrate that the provision of comprehensive primary health care by the nurse at the clinic impacts positively on hospital visitation by children from the area where the clinic is located.
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Hoare, K., Fairhurst-Winstanley, W., Horsburgh, M., & McCormack, R. (2008). Nurse employment in primary care: UK and New Zealand. The Royal New Zealand College of General Practitioners website, 35(1), 4–10.
Abstract: The researchers evaluate and compare the organisation of general practice in the UK and New Zealand. A key aim of the Primary Health Care Strategy is a reduction in health inequalities. Locally, some nurse leaders suggest that changing nurse practice employment from general practitioners to Primary Health Organisations will achieve this aim. The authors take lessons from the UK and suggest that nurses organising themselves into peer groups, remuneration of general practices for the attainment of positive patient outcomes, and a statutory duty of clinical governance, all contributed to the development of practice nurses' roles and expansion of numbers of nurse practitioners in general practice. Nurses have become partners with general practitioners in general practice in the UK, which the authors suggest is a much preferable alternative for some than employment by a Primary Health Organisation.
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O'Brien, A. J., Hughes, F., & Kidd, J. D. (2006). Mental health nursing in New Zealand primary health care. Contemporary Nurse, 21(1), 142–152.
Abstract: This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care.
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Strickland, A. (2006). Nurse-initiated retinoblastoma service in New Zealand. Insight: The Journal of the American Society of Ophthalmic Registered Nurses, 31(1), 8–10.
Abstract: This article describes the implementation of a nurse-led, dedicated support network and service for children with a diagnosis of retinoblastoma and their families. Nurses with an interest in retinoblastoma at an Auckland Ophthalmology Department realised that the service provided was not meeting the needs of patients and families, particularly since the numbers had increased over the past two years. This article outlines the development of a cost-effective approach that improved the service.
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