Armstrong, S. E. (2008). Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46). [Dunedin]: Rural Health Opportunities.
Abstract: A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them.
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Parton, B. M. (2015). Maori women, health care, and contemporary realities : a critical reflection. Ph.D. thesis, Massey University, Wellington.
Abstract: Aims to explore the influences on health and health care engagement from the experiences of urban Maori women using Kokiri Marae Health and Social Services (KMHSS), Lower Hutt, NZ. Conducts unstructured interviews which are analysed thematically. Employs the nursing theory of cultural safety, Kawa Whakaruruhau, to inform a qualitative approach to the examination of the historical, social, cultural, economic, political, racial and gendered factors contributing to Maori women's health and health-care engagement. Makes recommendations for nursing practice, research site and research.
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McElroy, J. Maternity outcomes and access following regulatory changes for Isotretinoin prescribing in New Zealand (Vol. 2017). Master's thesis, University of Otago, .
Abstract: Analyses retrospective prescription data for the years 2007-2015 to determine how access to isotretinoin altered before and after funded access was extended from dermatologists to include GPs and nurse practitioners who obtained a Special Authority. Assesses maternity outcomes for females dispensed the drug with regard to pregnancy terminations and isotretinoin-exposed live births. Examines outcomes based on type of prescriber and use or otherwise of the Best Practice Advocacy Centre (BPAC) electronic isotretinoin decision-support tool.
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Macklin, N. (2018). Hearing the patient voice: the importance of caring in care. Master's thesis, Dunedin, University of Otago.
Abstract: Backgrounds the primary health care initiative, the Transitional Care Nursing service, which aims to facilitate integrated care between primary, secondary and community health care services. Explores whether support in the form of the Transitional Care Nursing service influences the experience of patients who receive assistance during the transition between hospital and home. Conducts qualitative, semi-structured interviews with 12 patients whose responses are thematically analysed. Highlights the characteristics of care offered by Transitional Care nurses that describe the person-centred care patients received.
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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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Lally, E. (2014). Symbiotic relationships in patients' engagements with practice nurses. Doctoral thesis, Victoria University of Wellington, Wellington.
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.
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Cavit, L. (2021). Exploring factors that influence vaccination uptake for children with refugee backgrounds: An interpretive descriptive study of primary healthcare providers' perspectives. Master's thesis, Auckland University of Technology, Auckland.
Abstract: Examines those factors associated with access to, and uptake of immunisation services. Conducts semi-structured interviews with primary healthcare nurses and GPs across seven resettlement locations. Proposes strategies to improve age-appropriate vaccination among refugee children after resettlement in NZ, based on five themes from the data: resettlement priorities; knowledge about refugees; learning to use the health system; communication between caregivers and health providers; culturally and linguistically appropriate services.
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Ferguson, K. M. (2021). The appropriation of cultural safety: A mixed methods analysis. Ph.D. thesis, University of Otago, Dunedin.
Abstract: Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.
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Holdaway, M. A. (2002). A Maori model of primary health care nursing. Doctoral thesis, Massey University, Palmerston North.
Abstract: Identifies how traditional nursing practice in Maori communities may be enhanced. Highlights the need for nursing to broaden concepts of health, community, and public health nursing, to focus on issues of capacity-building, community needs, and a broader understanding of the social, political, cultural, and economic contexts of the communities primary health-care nurses serve. Explores how health is experienced by Maori women during in-depth interviews using critical ethnographic method, underpinned by a Maori-centred approach. Articulates a model of health that is a dynamic process based on the restoration and maintenance of cultural integrity, derived from the principle of self-determination.
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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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Norris, K. A. (2022). A position in the making: A Bourdieusian analysis of how RN prescribing influences collaborative team practice in New Zealand. Doctoral thesis, Auckland University of Technology, Auckland.
Abstract: Examines designated registered nurse (RN) prescribing among community health nurses. Aims to understand how RN prescribers interact with other members of the health care team and to identify the social processes at play. Employs Bourdieu's 'Theory of Practice' to explore health care teams as competitive social spaces where health professionals vie to establish social position and authority. Recruits three health care teams representing primary health and specialty practice for interviews and observation. Highlights three themes from the data: social topography, working with an RN prescriber; and patterns of communication.
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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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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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Henty, C., & Dickinson, A. R. (2007). Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study. The Royal New Zealand College of General Practitioners website, 34(5), 335–338.
Abstract: The aim of this small qualitative descriptive pilot study was to describe the experiences of practice nurses delivering the Care Plus programme within the general practice setting. Care Plus was introduced into Primary Health Organisations (PHOs) in 2004. This programme encourages more involvement from practice nurses in chronic care management. For many New Zealand practice nurses this is a new role. This study, carried out prior to the larger Care Plus implementation review (2006), provides an insight into the nursing experience of implementing Care Plus and provides a basis for future studies with regard to the nurse's role within the Care Plus programme.
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McKinlay, E. M. (2007). Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes. New Zealand Family Physician, 34(5), 322–327.
Abstract: This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing.
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