Macfie, B. (2003). The exploration of primary health care nursing for child and family health : Margaret May Blackwell Travel Study Fellowship, 2002. Margaret May Blackwell Travel Study Fellowship Reports. New Zealand: Nursing Education and Research Foundation (NERF).
Abstract: Reports the approach to child and family health nursing in Canada, the US, and the UK. Divides the report into health policy, primary health care services, nursing education and the development of primary health care nurse practitioners, and nursing leadership in primary health care. Part of the Margaret May Blackwell Scholarship Reports series.
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Litchfield, M. (2007). The innovation effort: ?Are you in or are you out??.
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.
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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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Pullon, S., & McKinlay, E. M. (2007). Interprofessional learning: The solution to collaborative practice in primary care. The Royal New Zealand College of General Practitioners website, 34(6), 404–408.
Abstract: In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions.
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Horsburgh, M., Goodyear-Smith, F., Yallop, J., & O'Connor, S. (2008). Implementation of a nursing initiative in primary care: A case report, cardiovascular disease risk reduction. New Zealand Family Physician, 35(3), 183–186.
Abstract: The aim was to report on implementation of a nursing initiative of cardiovascular disease (CVD) screening risk assessment at the Mornington Health Centre, Dunedin, with initial outcomes after six months. The practice aim was 80% of their eligible population assessed within three to four years, particularly targeting high-risk groups. The audit indicates that in their first six months, Mornington Health Centre had screened 42% of their eligible patients. This is described as very successful progress towards their goal of 80%. A number of key organisational factors are identified that are likely to have contributed to the development and success of the nurse CVD risk assessment programme at Mornington Health Centre. The authors suggest that this case study demonstrates how organisational change, where the practice nurse role in the multidisciplinary team is clear, can facilitate a practice to meet a population-based goal.
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Alcorn, G. (2007). The youth health specialty in New Zealand: Collaborative practice and future development. The Royal New Zealand College of General Practitioners website, 34(3), 162–167.
Abstract: This paper details the workforce capacity of youth health nursing and medical staffing required for community-based and school-based youth health services. The author shows how youth health services seek to complement the care delivered by Primary Health Organisations (PHOs) and other allied health care services in the community. She outlines the development and operation at VIBE, a community-based youth health service in the Hutt Valley with school-based youth health services delivered at four low deciles secondary schools. She explains that developing workforce capacity for youth health services is a primary health care priority and an important means to address inequalities and to improve the health services of young people.
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Minto, R. (2006). The future of practice nursing. New Zealand Family Physician, 33(3), 169–172.
Abstract: The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery.
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McKinlay, E. M. (2006). New Zealand practice nursing in the third millennium: Key issues in 2006. New Zealand Family Physician, 33(3), 162–168.
Abstract: The author looks at the accelerated change in the role of practice nurses, due to factors such as the effects of the Primary Health Care Strategy. She reviews the current role of practice nurses, which is influenced by a population approach and new funding streams that encourage preventative, maintenance and chronic illness management activities. She highlights the positive effects of increased visibility of nursing leaders in the sector, increasing interdisciplinary education, and new career pathways which include advanced roles. She addresses some of the professional and systemic structural barriers which impact on practice nurses' ability to work effectively and equally within a general practice team.
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Murrell-McMillan, K. A. (2006). Why nurses in New Zealand stay working in rural areas. New Zealand Family Physician, 33(3), 173–175.
Abstract: The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues.
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Clendon, J., & Krothe, J. (2004). The nurse-managed clinic: An evaluative study. Nursing Praxis in New Zealand, 20(2), 15–23.
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.
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Mackay, B. (2003). General practitioners' perceptions of the nurse practitioner role: An exploratory study. Access is free to articles older than 6 months, and abstracts., 116(1170).
Abstract: This study explores perceptions of general practitioners in the Northland District Health Board (NDHB) regarding the nurse practitioner role, identifying their knowledge of and perceived problems with that role, and their experience of nurses in advanced practice. A purposive sample of all 108 general practitioners in NDHB was undertaken, with a response rate of 46.3%. General practitioners favourably viewed nurse practitioner functions traditionally associated with nursing, such as health teaching, home visiting, obtaining health histories, and taking part in evaluation of care, but less favourably viewed those functions associated with medicine, such as prescribing, ordering laboratory tests, and physical assessment. While expecting few problems with patient acceptance, the general practitioners felt that funding and doctors' acceptance would be problematic. Most general practitioners indicated they had knowledge of the nurse practitioner role and had experienced working with a nurse in advanced practice, but some uncertainty and lack of knowledge about the nurse practitioner role was evident. The author recommends more education and discussion with Northland general practitioners to ensure they are fully informed about the nurse practitioner role and its potential positioning in primary healthcare, to reduce uncertainty, minimise role confusion and promote collaboration between general practitioners and nurse practitioners.
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Mackay, B. (2002). Leadership development: Supporting nursing in a changing primary health care environment. Nursing Praxis in New Zealand, 18(2), 24–32.
Abstract: The author argues that the involvement of nurses in the decision-making of health organisations is essential to maximise the contribution of nurses and promote positive outcomes for patients. She suggests that development of leadership skills will make nurses aware of power structures in the health system and allow them to become interdependent health professionals in primary health organisations (PHO). The particular competencies discussed are those proposed by Van Maurik (1997), namely ability to understand and manage organisational politics, work facilitatively with people and circumstances, and build a feeling of purpose.
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Day, D. R., Mills, B., & Fairburn, F. (2001). Exercise prescription: Are practice nurses adequately prepared for this? New Zealand Journal of Sports Medicine, 29(2), 32–36.
Abstract: This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription.
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