Abstract: The aim of this study was to describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand was undertaken, with completed surveys received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The authors conclude that the age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.

Abstract: The authors introduce the Kaupapa nursing service at Te Puna Hauora, Tauranga Hospital. It implements an indigenous health model, the Whanaungatanga Model of Care, to guide nursing practice. This paper describes the concept of care it applies to serving its Maori population and the role of the Kaiawhina Social Worker. The authors highlights the interface between primary and secondary care after patients are discharged. The authors address the shortfall of Maori practitioners in the nursing service and the aims of a year-long pre-entry Kaupapa Health Professional Programme.

Abstract: In New Zealand the clinically focused postgraduate papers and programmes, available through universities and polytechnics, are evaluated from an educational perspective but little evaluation of the implications for practice has been undertaken. This paper is Part One of a report on a study that sought to illuminate the impact of clinically focused postgraduate education on advancing nursing practice. Hermeneutic methodology provided a framework for analysing both the perspectives of nurses who had undergone such education and those who had directly employed and worked alongside these nurses. Emerging themes are described here. In a second article the findings will be discussed in relation to literature. Constraining factors will be identified and strategies designed to maximise the benefits of education for advancing nursing practice will be recommended.

Abstract: The researchers repeat the 1996 audit of stroke care in Auckland Hospital to assess changes in stroke management since the introduction of a mobile stroke team. The audit prospectively recorded information for all patients with stroke from 1 June to 30 September 2001. They describe the work of the stroke team physician and the specialist stroke nurse and allied health staff who coordinate the multidisciplinary care of patients. Variables examined include time to arrival and medical assessment, investigations, acute management, inpatient rehabilitation, and stroke outcome. The researchers then describe recent developments in stroke care and the impact of the stroke service on patient management.

Abstract: Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.

Abstract: This article explores the complex nature of liability in the case of standing orders and vicarious liability by employers, and also when nurses and doctors are in management roles. The authors address misconceptions about medico-legal responsibility for nursing practice with the advent of nurse prescribers and nurse practitioners. They refer to the submission made by the College of Nurses Aotearoa (NZ) on the Health Practitioners Competence Assurance Act (2003), and discuss practice liability and nurse-physician collaboration.

Abstract: The aim of this study was to test the hypothesis that triaging certain emergency department patients through a rapid assessment clinic (RAC) improves the waiting times, and times in the department, for all patients presenting to the emergency department. For ten weeks an additional nurse and doctor were rostered. On the odd weeks, these two staff ran a RAC and on even weeks, they did not, but simply joined the other medical and nursing staff, managing patients in the traditional way. During the five weeks of the RAC clinic a total of 2263 patients attended the emergency department, and 361 of these were referred to the RAC clinic. During the five control weeks a total of 2204 patients attended the emergency department. There was no significant difference in the distribution across triage categories between the RAC and non-RAC periods. The researchers found that the rapid management of patients with problems which do not require prolonged assessment or decision making, is beneficial not only to those patients, but also to other patients sharing the same, limited resources.