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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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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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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Sheridan, N. F. (2005). Mapping a new future: Primary health care nursing in New Zealand. Ph.D. thesis, , .
Abstract: The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals.
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Mackay, B. (2007). Leadership strategies for role development in primary health care nursing. coda, An Institutional Repository for the New Zealand ITP Sector, 11, 31–39.
Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
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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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Vernon, R. A., Jacobs, S., & Papps, E. (2007). An innovative initiative for advanced nursing practice roles. Available online from Eastern Institute of Technology, 14(2), 16–17.
Abstract: This paper reports an initiative which is an example of partnership between education and health organisations resulting in the implementation of a jointly funded advanced nursing practice role. The model is for community based Nurse Practitioner-managed health care for primary health and disease management. The key partners in this project are the Eastern Institute of Technology, Hawke's Bay District Health Board, and a Primary Health Organisation (Tu Meke – First Choice). This article summarises the objectives, implementation, evaluation and benefits of the programme.
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Litchfield, M., & Ross, J. (2000). The role of rural nurses: National survey. Christchurch: Centre for Rural Health.
Abstract: A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce.
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Litchfield, M. (2002). The successful design and delivery of rural health services: The meaning of success. Christchurch: Centre for Rural Health.
Abstract: This is the report of the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of “successful design and delivery of rural health services” as a step towards a measurement tool. Participants were grouped as general practitioners, nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health.
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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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Primary Health Care Nurse Innovation Evaluation Team,. (2007). The evaluation of the eleven primary health care nursing innovation projects: A report to the Ministry of Health. Wellington: Ministry of Health.
Abstract: In 2003, as part of implementing the Primary Health Care Strategy, the Ministry of Health announced contestable funding, available over three years, for the development of primary health care nursing innovation projects throughout Aotearoa/New Zealand. The Ministry looked for proposals that would: support the development of innovative models of primary health care nursing practice to deliver on the objectives of the Primary Health Care Strategy; allow new models of nursing practice to develop; reduce the current fragmentation and duplication of services; and assist in the transition of primary health care delivery to primary health organisations. This report describes the findings from the evaluation of the 11 primary health care nursing innovations selected for funding by the Ministry of Health. It provides an overview of the innovations' success and of the lessons learnt from this policy initiative.
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Robertson, H., Carryer, J., & Neville, S. (2015). Diffusion of the Primary Health Care Strategy in a small District Health Board in New Zealand. Nursing Praxis in New Zealand, 31(3).
Abstract: Reports the findings of a study examining aspects of the implementation of the Primary Health Care Strategy on primary health care nursing in a small district health board (DHB) in NZ. Conducts an instrumental case study informed by onstructionism and underpinned by a qualitative interpretive design. Collects data from policy documents and strategic plans and by means of interviews with managers at middle and senior levels at the local DHB and two PHOs.
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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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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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