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.

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.

Abstract: This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP.

Abstract: The aim of the study was to explore how practice nurses perceive engagement in Peer Learning and Review Groups impacts personally and professionally on their clinical practice. An anonymous self-administered postal questionnaire was completed by 55 practice nurses who attend Peer Learning and Review Groups in the South Island. A mixed method design was utilised to obtain both qualitative and quantitative data. Practice nurses considered group attendance was important for professional development with the majority perceiving that their attendance had a positive effect on their clinical practice. The nurses perceived clear linkages between the significant learning that occurred in the groups and changes in delivery of patient care. Additional benefits included improved collegial relationships, professional awareness and personal growth. The author concludes that, together, these findings underline the importance of Peer Learning and Review Groups as an effective tool for ongoing personal and professional development within nursing.

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.

Abstract: Records from patient perspectives the nature of the engagements patients have with practice nurses which influence patients' health and well-being. Posits this mutually-beneficial close association as a form of symbiosis. Surveys 15 patients from seven rural and urban general practices in NZ about aspects of the participants' relationships and engagements with nurses, analysing the results using Narrative Inquiry methodology.

Abstract: There is a considerable body of literature discussing the stressors experienced by nurses and other health professionals when caring for those who are terminally ill and dying. Also, a number of articles offer suggestions, including the views of staff, as to what type of professional and organisational support is required when working in this often demanding specialty. There are, however, very few reports of assessment of the effectiveness of such supportive interventions and in particular, the impact of such support on the quality of patient care. This literature review examines any reported relationships between the quality of nursing provided by palliative care nurses and the staff support received by those nurses.

Abstract: The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.