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Author Pearson, J.R.; Holloway, K. T.
Title A postgraduate primary health care programme for experienced registered nurses and newly graduated nurses Type Journal Article
Year 2006 Publication Whitireia Nursing Journal Abbreviated Journal
Volume 13 Issue Pages 44-52
Keywords Primary health care; New graduate nurses; Registered nurses; Nursing; Education
Abstract This paper outlines the historical development of the Postgraduate Certificate in Primary Health Care Specialty Nursing programme. The paper discusses the multiple contextual considerations for the programme in terms of New Zealand health policy direction, academic level, and appropriate level of competency development for nurses new to primary health care and newly graduated nurses.
Call Number NRSNZNO @ research @ Serial (up) 1040
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Author Horsburgh, M.; Merry, A.; Seddon, M.; Baker, H.; Poole, P.; Shaw, J.; Wade, J.
Title Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative Type Journal Article
Year 2006 Publication Journal of Interprofessional Care Abbreviated Journal
Volume 20 Issue 5 Pages 555-557
Keywords Quality of health care; Multidisciplinary care teams; Nursing; Education; Maori; Patient safety
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.
Call Number NRSNZNO @ research @ Serial (up) 1042
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Author Neville, S.J.; Henderson, H.M.
Title Perceptions of lesbian, gay and bisexual people of primary healthcare services Type Journal Article
Year 2006 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 55 Issue 4 Pages 407-415
Keywords Sexuality; Attitude of health personnel; Primary health care
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.
Call Number NRSNZNO @ research @ 1059 Serial (up) 1043
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Author O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J.
Title Clinical indicators as measures of mental health nursing standards of practice in New Zealand Type Journal Article
Year 2004 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 13 Issue 2 Pages 778-788
Keywords Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth
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.
Call Number NRSNZNO @ research @ Serial (up) 1059
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Author Gohns, A.
Title Management of opioid substitution treatment in the primary health care setting: A national training course for service providers Type Journal Article
Year 2002 Publication New Zealand Family Physician Abbreviated Journal Full text online from the Royal New Zealand College of General Practitioners' website
Volume 29 Issue 3 Pages 172-175
Keywords Pharmacology; Evaluation; Primary health care
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.
Call Number NRSNZNO @ research @ Serial (up) 1099
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Author Kinealy, T.; Arroll, B.; Kenealy, H.; Docherty, B.; Scott, D.; Scragg, R.; Simmons, D.
Title Diabetes care: Practice nurse roles, attitudes and concerns Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 48 Issue 11 Pages 68-75
Keywords Diabetes Type 2; Practice nurses; Attitude of health personnel; Primary health care
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.
Call Number NRSNZNO @ research @ Serial (up) 1100
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Author Mackay, B.
Title An analysis of innovative roles in primary health care nursing Type
Year 2004 Publication Abbreviated Journal Northland Polytechnic Library
Volume Issue Pages
Keywords Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing
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.
Call Number NRSNZNO @ research @ Serial (up) 1124
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Author Mason, B.
Title An analysis of the role of the practice nurse in primary health care, 2000/2001 Type
Year 2002 Publication Abbreviated Journal NZNO Library
Volume Issue Pages
Keywords Primary health care; Practice nurses
Abstract In 1999 primary health care in New Zealand was in the process of change from the current personal health care model, which focuses on general practitioner based care, to a population and community based health care programme. Carryer, Dignam, Horsburgh, Hughes and Martin (1999) submitted a report to the National Health Commission entitled “Locating Nursing in Primary Health Care”. This report envisaged that nurses in primary health care would be part of interdisciplinary teams, act autonomously and undertake community consultation and education. The submission suggested that nurses, currently working in primary health care, were alraedy prepared and able to move across into the new form of primary health care, without further education or training.
Call Number NRSNZNO @ research @ Serial (up) 1130
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Author Miles, M.A.P.
Title A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 Type
Year 2005 Publication Abbreviated Journal NZNO Library, University of Otago Library
Volume Issue Pages
Keywords Primary health care; Interprofessional relations; Policy
Abstract This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions.
Call Number NRSNZNO @ research @ 1146 Serial (up) 1131
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Author Morgan, F.A.
Title Primary health care nurses supporting families parenting pre-term infants Type
Year 2006 Publication Abbreviated Journal NZNO Library, University of Otago Library
Volume Issue Pages
Keywords Primary health care; Community health nursing; Paediatric nursing; Premature infants
Abstract This thesis reviews the role of primary health care nurses, who have an opportunity to play a unique role in teaching, touching and empowering families with newly discharged pre-term babies. Birth of a baby earlier than 37 weeks gestation ushers in a period of uncertainty and stress for parents. Uncertainties may centre on whether their infant will survive and what ongoing growth and developmental issues their infant will face.
Call Number NRSNZNO @ research @ Serial (up) 1132
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Author O'Malley, J.
Title Critical social analysis of acute institutionally based mental health nursing following an action research project Type
Year 2001 Publication Abbreviated Journal NZNO Library, Victoria University of Wellington Library
Volume Issue Pages
Keywords Psychiatric Nursing; Hospitals; Quality of health care
Abstract This study using action research involving twelve registered nurses worked toward improving nursing care in an acute mental health in-patient service. Following focus groups with consumers, families, nurses, doctors, and allied health professionals, the action research group developed projects over eighteen months to improve continuity and consistency of nursing care. There was a subsequent restructuring of nursing service to better define leadership, accountability and to strengthen care delivery. The second half of the thesis involves a critical social analysis of the research data and produces a theory of mental health nursing which, the author suggests, has wide application in practice.
Call Number NRSNZNO @ research @ Serial (up) 1133
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Author Williams, H.
Title One for the boys: An evaluative study of primary health care access by men in Tairawhiti Type
Year 2006 Publication Abbreviated Journal NZNO Library
Volume Issue Pages
Keywords Gender; Primary health care; Access; Male
Abstract
Call Number NRSNZNO @ research @ Serial (up) 1138
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Author Alcorn, G.
Title Giving voice to school nursing as a primary health care specialty Type
Year 2001 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords School nursing; Primary health care; Cross-cultural comparison
Abstract The purpose of this thesis is to give voice to school nursing as a primary health care specialty, and to promote the development of school nursing in New Zealand. School nursing is an invisible practice specialty that is largely funded from within the education sector, to address the health needs of student clients. School nursing is a significant primary health care initiative that can positively influence student health outcomes. The author presents her own school nursing practice experience and philosophy, prior to reflecting upon the history of school nursing, and the health concerns present within the student population. The work then moves to review and critique school nursing literature from New Zealand, Australia, the United Kingdom, and the United States. This thesis highlights the need for collaborative policy and practice development initiatives including a legislative requirement for school nurses, school nursing competencies and standards, school nurse to student ratios, postgraduate training, professional liaison, practice funding, and research. A discourse on the reflective topical autobiographical method introduces autobiographical poetry from school nursing practice and reflective inquiry, as the central research endeavour of this thesis. Autobiographical poetry is offered as a window to this specialty practice, and accompanying reflections allow access to a further layer of practice knowledge.
Call Number NRSNZNO @ research @ Serial (up) 1143
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Author Thompson, L.E.
Title Profession and place: Contesting professional boundaries at the margins Type
Year 2006 Publication Abbreviated Journal UC Research Repository
Volume Issue Pages
Keywords Rural health services; Primary health care; Identity; Interprofessional relations
Abstract Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural.
Call Number NRSNZNO @ research @ 1177 Serial (up) 1162
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Author Litchfield, M.; Ross, J.
Title The role of rural nurses: National survey Type Report
Year 2000 Publication Abbreviated Journal Online on the Ministry of Health's Centre for Rural Health pages
Volume Issue Pages
Keywords Rural nursing; Personnel; Nursing specialties; Primary health care
Abstract A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce.
Call Number NRSNZNO @ research @ Serial (up) 1175
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