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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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Patel, R. (2022). Nurse expertise saves lives through early recognition of patient deterioration. Master's thesis, University of Auckland, Auckland. Retrieved July 2, 2024, from https://hdl.handle.net/2292/62214
Abstract: Explores and identifies factors associated with nurse concern when patient deterioration is recognised in the absence of an emergency activation score such as early warning scoring (EWS) or the physiologically-unstable patient (PUP) tool. Describes the two phases of the multi-site and mixed-methods study: retrospective chart review of 19,326 referrals for emergency assistance; and seven focus group discussions with 29 nurses about what they do when concerned about patient deterioration in the absence of an EWS. Highlights the role of nurse expertise, knowledge and skill in identifying patient deterioration prior to the activation score on an EWS.
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Holbrook, P. (2005). Nurse initiated analgesia in an emergency department: Can nurses safely decrease door to analgesia times by providing analgesia before medical assessment? Ph.D. thesis, , .
Abstract: Pain management practices within emergency departments require a more patient focused approach due to extended waiting times for analgesia. This dissertation questions current methods of providing timely and appropriate delivery of analgesia. Nurses represent the biggest resource in emergency departments therefore are in a position to be able to access patients in a timely fashion. A review of the literature pertaining to nurse initiated analgesia protocols has been evaluated and information relating to efficiency and safety utilised to discuss the processes for planning and implementation of a similar protocol. The author finds that the literature provides no evidence that nurse initiated analgesic practices prior to medical assessment compromises patient safety or delays diagnosis. A discussion of the benefits to patients, nurses and the institution has been included to highlight the appropriateness of extending nursing roles.
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Fitzpatrick, A. (1997). Nurse meeting another: cultural safety in nursing practice. Ph.D. thesis, , .
Abstract: This research project, a descriptive study using narratives, explored the application of cultural safety theory and philosophy to clinical nursing practice. This application was illustrated through the stories of four experienced Pakeha,Tauiwi registered nurses in Aotearoa/New Zealand, who described their realities of applying cultural safety to daily clinical practice. The incentive for this study had been identified in light of the current political climate, pragmatic realities and in keeping with the current state of knowledge.Cultural safety was first identified by Maori nursing students and subsequently described and articulated by Maori nurses, as being a potential solution to improving Maori health statistics in Aotearoa/New Zealand. Many Maori and Pakeha/Tauiwi in this country accept that the Treaty of Waitangi, a covenant signed between Maori and the Crown in 1840, is the incentive for giving cultural safety status and credibility. While the Nursing Council of New Zealand has supported this concept and made it a requirement for all nursing education, there is little literature written concerning its application to practice from a Pakeha/Tauiwi perspective.The perceptions and insights of these nurses were heard when they were invited to describe how they saw cultural safety as part of their daily clinical practice and recount their struggles, realities, practice and experience. The literature review supported the use of narratives as an appropriate method for this study. The philosophy and assumptions of narrative appear to match the oral tradition of nursing and thus it was considered possible to contemplate the fit of narrative to nursing research.The stories of these nurses, gave examples of best nursing practice in which cultural safety was integral to practice, and provided exemplars of possible beginnings and possible endings. The depiction of cultural safety in practice surfaced as the weaving of four themes which were consistent in all the stories – themes of reflection, reverencing, the environment, and hidden blessings and healing. The research evidence suggested that cultural safety was visible in practice in many diverse ways; it emphasised the complexity of the concept; accented its evolving status; and identified a relative consistency in defining cultural safety despite the varied contexts of practice.Although this study was limited by the small sample, the findings indicated that there were potential implications for nursing education, research, nurses and nursing practice as well as for other health care providers working in the current health care system. They suggested that actions from nurse educators, nurse managers, health care managers and clinical nurses themselves, would be needed to ensure that cultural safety continued to be part of nursing practice and contribute to the improvement of all health statistics in this country as well as to encourage an increased development in the focus on Maori health issues.Further nursing research suggested by the findings include studies to appraise cultural safety from a patient's perspective, and consideration given to the evaluation and assessment of nurses and their culturally safe practice. In addition, exploration and research could ascertain the benefits and rewards of culturally safe practice and identify ongoing educational needs as well as examining the views of other members of the multi-discipline team
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Donkin, A., Lesa, R., & Seaton, P. (2022). Nurse perceptions of implementing stroke guidelines in an acute stroke unit. Kai Tiaki Nursing Research, 13(1), 32–37.
Abstract: Identifies nurse perspectives on the barriers and facilitators to implementing the nationally-endorsed stroke guidelines. Conducts a focus group with four nurses working in an acute stroke unit at a single hospital in 2021. Considers that nursing experience can act as both a barrier and a facilitator of guideline use.
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Clendon, J.(and others). (2013). Nurse perceptions of the diabetes Get Checked Programme. Nursing Praxis in New Zealand, 29(3), 18–30.
Abstract: Ascertains the impact of the programme on the practice of nurses and identifies factors that contributed to the success or failure of the programme in their workplaces. Performs an observational study by means of an online survey and descriptively analyses the responses from the 748 respondents. Elicits nurses' suggestions for future improved management and outcomes for people with diabetes.
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Unac, F., Marshall, B., & Crawford, R. (2010). Nurse practitioner access to radiology and laboratory ser. Nursing Praxis in New Zealand, 26(1), 27–37.
Abstract: Reports the findings of a quantitative descriptive survey of all NZ registered nurse practitioners (NPs), exploring NP access to radiology and laboratory services in 2008. Identifies the types of diagnostic tests NPs order from either laboratory or radiology services and the obstacles they face.
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Pirret, A. M. (2013). Nurse practitioner diagnostic reasoning. Ph.D. thesis, Massey University, Palmerston Nursing.
Abstract: Uses a post-positivist mixed-methods convergent-parallel design to explore nurse practitioner diagnostic reasoning and compare it to that of registrars. Includes 30 nurse practitioners and 16 registrars in a case scenario. Outlines nurse practitioner practice in NZ and how the NZ title of nurse practitioner differs from that used internationally.
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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. Retrieved July 2, 2024, from http://hdl.handle.net/10063/7098
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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Adams, S. (2017). Nurse practitioners in rural primary health care in New Zealand : an institutional ethnography. Ph.D. thesis, Massey University, Auckland. Retrieved July 2, 2024, from http://hdl.handle.net/10179/12816
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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Laidlaw, R., & Mercer, C. (2022). Nurse practitioners: does home visiting improve outcomes for people living with long-term conditions. Kai Tiaki Nursing Research, 13(1), 39–41.
Abstract: Explores the potential for nurse practitioners (NP) in NZ to visit people diagnosed with chronic condiitons at home. Evaluates whether home-visiting NPs could provide primary care in place of GPs. Conducts a review of research comprising three themes: reduced barriers to care, improved health outcomes, and role clarity for NPs.
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Lim, A. G., North, N., & Shaw, J. (2014). Nurse prescribing : the New Zealand context. Nursing Praxis in New Zealand, 30(2), 18–27.
Abstract: Examines the introduction of nurse prescribing in NZ with respect to the level of knowledge and skills required of practitioners for safe prescribing. Compares experiences in NZ with those in the US, UK, and Canada. Critiques the higher educational model as the standard for preparation to prescribe, while supporting alternative models for extending prescribing rights.
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Hales, A., & Dignam, D. (2002). Nurse prescribing lessons from the US. Kai Tiaki: Nursing New Zealand, 8(10), 12–15.
Abstract: The researchers present a survey of a sample population of 32 advanced practice nurses (APN) in the US about their experiences of acquiring and implementing prescriptive authority. The issues relevant to nurse practitioners in New Zealand are discussed, around acquiring knowledge and education, relationships with other professionals, establishing the role, and retaining the nursing role. The intent and scope of APN prescribing in the US is also discussed.
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Taylor, B. (Ed.). (2021). Nurse staffing in the operating rooms -- no longer behind closed doors. Master's thesis, University of Auckland, Auckland. Retrieved July 2, 2024, from https://www.nzno.org.nz/resources/library/theses#T
Abstract: Identifies key factors senior perioperative nurses consider when making decisions about nurse staffing and skill mix in the operating room (OR). Uses a qualitative descriptive approach in undertaking semi-structured interviews with 7 senior nurses tasked with decision-making about OR staffing. Analyses the data using Braun and Clarke's thematic analysis process.
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MacDonald, L. M. (2003). Nurse talk: Features of effective verbal communication used by expert district nurses. Ph.D. thesis, , .
Abstract: This thesis represents an appreciative enquiry to identify features of effective verbal communication between nurses and patients. Using a method developed by the Language in the Workplace Project (Stubbe 1998) two nurse participants recorded a small sample of their conversations with patients as they occurred naturally in clinical practice. These six conversations constitute the main body of raw data for the study. The data was analysed using a combination of discourse and ethnographic analysis. Experience in nursing, particularly insider knowledge of the context of district nursing, helped me to uncover the richness of meaning in the conversations. The subtle interconnections and nuances could easily have been missed by an outside observer. The study has shown that in their interactions with patients, expert nurses follow a pattern in terms of the structure and content of the conversations and it is possible to identify specific features of effective nurse-patient communication within these conversations. The most significant of these are the repertoire of linguistic skills available to nurses, the importance of small talk and the attention paid by nurses to building a working relationship with patients, in part, through conversation. The findings have implications for nursing education and professional development.
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