Abstract: The aim of this research was to describe the changing role of school nurses in eight New Zealand secondary schools from low socio-economic areas with high Pacific Island and Maori rolls. An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland(2002-05) was made. Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. The researchers conclude that school nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. The researchers go on to say that co-ordination of school nurses either at a regional or national level is required.

Abstract: The objectives of this study were to explore the concept of the 'health-promoting school' in a specific New Zealand context; to develop and use appropriate research methods to assess a single low decile school in relation to World Health Organization health-promoting school components and checkpoints; to work with the school community to identify health issues; and, to record external and internal changes that could impact on school health over a finite time period. Case study was selected as the most appropriate method to collect both quantitative and qualitative evidence with the aim of providing a clear understanding of the particular case. Results confirmed that the school was working appropriately within the scope of their educational practice to provide a health-promoting school environment for the school community. Gaps and issues identified included an element of talking past each other between the cultures of the education organisation and the nominated health service provider respectively that contributed to a lack of appropriate and accessible health service delivery for the school population. Teaching staff considered that they had insufficient access to health knowledge, and input from health service staff did not meet health education requirements for the school. Staff preference for increased school nurse involvement was not realised. The consequence was that two outside agencies (KiwiCan and Life Education Trust) delivered the bulk of the Health and Physical Education curriculum which resulted in a degree of fragmentation of health education for students. The issues that were identified demonstrated that health services in the area were not satisfactorily meeting the needs of the community and were not addressing the health inequities for the predominantly Pacific Island and Maori students and of their families that formed the school community. The researcher concluded that a full-service school approach should be considered by the school and the local district health board as one way to overcome the current lack of access to health services for the school community. Assertions included the potential integration of locally available services by a school-based nurse coordinator supported by health professionals (nurse practitioner and Pacific Island Community Health Worker) and social workers. The vision included professionals working within their professional scopes of practice as part of a Primary Health Organisation with the aim of appropriately addressing the health inequities experienced by the school population.

Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.

Abstract: Examines whether a postgraduate programme for Well Child/Tamariki Ora (WCTO) nurses prepares nurses new to child health to understand primary health care, health promotion, community nursing and nursing theory. Uses on online survey devised by Plunket National Educators to evaluate the (WCTO) strand of the Postgraduate Certificate in Primary Health Care Specialty Nursing curriculum against the delivery of the programme. Assesses student experience and student perceptions of the impact of their learning on their nursing practice. Considers whether it enables nurses to consider the specific populations in their care, or to encourage individuals, families and communities to increase their skills in health-focused daily living. Seeks to ascertain whether the structure of the programme, based on the clinical integration approach, supports nursing practice and academic study.

Abstract: This observational study analyses the responses of 38 nurses from two similar units that use different patient handling systems to test the reliability and validity of the Safe Patient Handling Survey (TM) SPH Survey(TM), a perception survey and improvement tool for employees and employers. Currently there is a lack of tools for evaluating patient handling systems. The survey contains 55 questions divided into 6 clusters, staff and patient injury and violence questions, and picture questions depicting unsafe techniques. The data were analysed to see how the SPH Survey(TM) scores correlate with incidents, and its ability to detect differences between the two units. The results of the Pearson and Cronbach(TM) alpha tests show strong reliability, validity and consistency of the SPH Survey(TM). ANOVA comparison of means and Spearman(TM) rho tests shows that higher (better) scores on the SPH Survey(TM) clusters correlate with lower numbers of patient injuries, lower reports of verbal and physical violence episodes, and lower staff injuries. Differences were detected between the units with Unit 2 scoring higher than Unit 1 in all SPH Survey(TM) clusters and scoring lower in staff and patient injuries and violence incidents. Although the analysis was limited by the small sample size, the study has created a sound basis for further investigation. The SPH Survey(TM) is shown to be an easy way to reliably evaluate patient handling systems and workplace culture, target improvement initiatives, and continually monitor the level of patient handling risk in the workplace. Low-risk patient handling gives health care providers the means to focus on delivering high quality patient care, without endangering their own health and well-being.

Abstract: This research explored the relationship between entry criteria and academic performance in the first and second year bioscience papers at Otago Polytechnic School of Nursing. The School's inclusion of a bioscience requirement varies from the Nursing Council criteria for acceptance into undergraduate nursing programmes. Six hundred and nineteen academic records of 1994-2002 graduates were sampled. Chi-square and correlational analyses found a relationship between entry qualifications and students' academic performance in the two papers. The entry criteria had a stronger relationship with the students' performance in the first year bioscience paper than the second year paper. Performance in the first year was predicative of second year performance. Age was also found to be a useful predictor of grades. These findings support the School's Bioscience entry criteria and provide important information for admission committees.

Abstract: The author notes that learning nurses require real clinical experiences in order to apply learnt theory to actual practice. Clinical learning environments have consistently been found to function variably and sub-optimally for both learners and teachers. In order to improve the quality of the clinical learning environment it is necessary to first evaluate how effectively a clinical learning environment is functioning. A number of different methodologies have been used to evaluate clinical learning environments, a recent and successful method being the use of questionnaires or clinical learning environment evaluation tools. The objective of the present study was to develop clinical learning environment evaluation tools for use in a New Zealand hospital health service. Four tools appropriate to evaluate the clinical learning environment from the different perspectives of any type of clinical learner, clinical teacher, clinical manager and programme co-ordinator or nurse lecturer were developed. Six newly graduated nurses, three senior nurses, and the researcher were involved in the development of the evaluation tools over a five month period. A participatory action research methodology was employed. The resultant tools had a unique local focus and were suitably similar to other internationally developed tools. After testing the clinical learning environment evaluation tools, it is hoped that the implementation of the tools will support all stakeholders to understand and consequently optimise the functionality of their clinical learning environment.