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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Ross, J. (2001). Role identification: An impediment to effective core primary health care teamwork. Ph.D. thesis, , .
Abstract: This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners and the understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future.
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Holloway, K. T., & Pearson, J. R. (2005). Trailblazers: Primary health care programme evaluation. (Vol. Paper presented June 2004 at Royal New Zealand Plu).
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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Adams, S., Oster, S., & Davis, J. (2022). The training and education of nurse practitioners in Aotearoa New Zealand: Time for nationwide refresh [editorial]. Nursing Praxis in Aotearoa New Zealand, 38(1). Retrieved July 2, 2024, from http://dx.doi.org/https://doi.org.10.36951/27034542.2022.01
Abstract: Argues that the following measures must be taken to ensure the ongoing development and establishment of nurse practitioners (NP) across the health sector: review of NP competencies; support for NPs to undertake the nurse practitioner training programme
(NPTP); formation of nationally-consistent and funded NPTPs; mentoring novice NPs; and a national workforce plan for NPs.
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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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Officer, T. N. (2018). Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience. Doctoral thesis, Victoria University of Wellington, Wellington.
Abstract: Investigates how nurse practitioner and pharmacist prescriber roles are developing in NZ primary health care, and what is needed to better support the future development of these roles. Employs a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health-care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services.
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Mackay, B. (2004). An analysis of innovative roles in primary health care nursing. Ph.D. thesis, , .
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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Mustafa, M., Adams, S., Bareham, C., & Carryer, J. (2021). Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers. Journal of Primary Health Care, 13(3). Retrieved July 2, 2024, from http://dx.doi.org/10.1071/hc21036
Abstract: Explores the perspectives of practice managers on employing nurse practitioners (NP) in general practice. Uses an electronic survey to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively.
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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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Maw, H. (2005). The challenge of developing primary health care nurse practitioner roles in rural New Zealand. Ph.D. thesis, , .
Abstract: When the New Zealand Nursing Council introduced the nurse practitioner as a new level of nurse in 2001, the opportunity arose for the introduction of primary health care nurse practitioners into the rural practice arena in this country. This dissertation explores the influences on the development of rural nursing in the last decade in New Zealand including the role of the Centre for Rural Health in advancing rural nursing education, as well as the impact the shortage of health professionals in rural New Zealand has had on the development of the rural primary health care nurse practitioner concept. For pioneering primary health care nurse practitioner roles to be successfully implemented in rural communities in New Zealand, several challenges need to be faced; the creation of roles and employment opportunities, community acceptance of the role, medical and nursing acceptance of the role and the establishment of independent nurse prescribing within the constraints imposed by current legislation. The dissertation explores the current literature in an attempt to offer solutions to the identified challenges. With the creation of primary health care nurse practitioner roles and the establishment and acceptance of these roles in rural communities, a new mode of health service delivery in rural New Zealand will begin.
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Adams, S. (2017). Nurse practitioners in rural primary health care in New Zealand : an institutional ethnography. Ph.D. thesis, Massey University, Auckland.
Abstract: Critically examines the work required to establish nurse practitioner (NP) services in rural primary health care in NZ, using the institutional ethnography approach to the inquiry. Explores the work and experiences that nurses undertook to become NPs delivering rural primary health care services. Considers how these were institutionally-shaped and coordinated. Conducts interviews with a total of 13 NPs and four NP candidates.
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Desmond, N. (2007). Aspects of nursing in the general practice setting and the impact on immunisation coverage. Ph.D. thesis, , .
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Crowe, M., Jones, V., Stone, M. - A., & Coe, G. (2019). The clinical effectiveness of nursing models of diabetes care: A synthesis of the evidence. International Journal of Nursing Studies, 93. Retrieved July 2, 2024, from http://dx.doi.org/https://doi.org/10.1016/j.ijnurstu.2019.03.004
Abstract: Determines the clinical effectiveness, in terms of glycaemic control, other biological measures, cost-effectiveness and patient satisfaction, of nurse-led diabetes interventions led by primary health care nurses. Uses PRISMA guidelines for reporting the results of a systematic review of the literature. Compares quantitative studies of physician-led care and cost-effectiveness, with qualitative studies of patient experiences of nurse-led care.
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Lesa, R. (2007). Advanced physical assessment skills: Factors that influence registered nurses' use of skills in the clinical setting, on completion of an advanced health assessment course. Ph.D. thesis, , .
Abstract: Traditionally the use of advanced physical assessment skills when assessing a patient or client has been the domain of the medical profession. The last few decades has seen many changes in health provision that have influenced nursing practice, as a result of the social and economic trends impacting on New Zealand society. A notable change in nursing practice has been an increased emphasis on the use of advanced physical assessment skills by registered nurses, as an expected part of the registered nurse's health assessment. Nurses in the United States, and more recently Canada and Australia, readily include these skills as an expansion of their health assessment into their nursing practice. The purpose of this research is to investigate whether New Zealand registered nurses have done the same. The factors that influence the registered nurses' use of these skills are also explored. This descriptive design was chosen in order to focus on exploring and describing this phenomenon in a holistic fashion. Data collection involved one hour semi- structured interviews with seven participants who all completed the same postgraduate advanced health assessment educational course. Three themes were identified as influencing the use of advanced physical assessment skills; the registered nurse's work environment, the registered nurse's attributes and the registered nurse's original nursing education. The findings from this research have implications for nurses in practice and nurse educators, in both undergraduate and postgraduate education.
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Litchfield, M. (2007). The innovation effort: ?Are you in or are you out??.
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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