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Author |
Shaw, S. |
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Title |
Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
1 |
Pages |
16-18 |
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Keywords |
Drug administration; Interprofessional relations; Professional competence; Nursing; Eucation; Quality of health care |
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Abstract |
This research presents a discourse analysis of articles published in the New Zealand Herald between October 1999 and September 2005. The terms “nurse prescribing” and “prescribing fights” identified seven articles published which referred specifically to this issue. They were predominantly editorial comments and statements attributed to senior doctors. Examples of comments from these articles are presented and discussed in this article, and three inter-related themes are identified – competence, responsibility and competition. Discussion on competence centred on education, skill and experience level of nurses, as described by editorial comment and senior doctors. Positive international research and experience of nurse prescribing did not feature. A number of comments in the articles analysed could be seen to represent concerns about competition between medicine and nursing. One interpretation of the comments contained in these articles is to see medical practitioner groups defending their status and desire to define and control nursing practice. The media has the power to select the information conveyed and, in these instances, appears to have demonstrated a bias towards the medical community's perspective. |
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Call Number |
NRSNZNO @ research @ |
Serial |
979 |
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Author |
Evans, S. |
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Title |
Silence kills: Challenging unsafe practice |
Type |
Journal Article |
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Year |
2007 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
13 |
Issue |
3 |
Pages |
16-19 |
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Keywords |
Medical errors; Organisational change; Organisational culture; Patient safety; Interprofessional relations |
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Abstract |
The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals. |
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Call Number |
NRSNZNO @ research @ |
Serial |
994 |
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Author |
Litchfield, M. |
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Title |
Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 |
Type |
Manuscript |
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Year |
2006 |
Publication |
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Abbreviated Journal |
Held by the Ministry of Health, publication pending |
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Volume |
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Issue |
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Pages |
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Keywords |
Evaluation; Community health nursing; Nursing models; Interprofessional relations |
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Abstract |
This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1178 |
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Author |
Ryder-Lewis, M. |
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Title |
Reliability study of the Sedation-Agitation Scale in an intensive care unit |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Interprofessional relations |
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Abstract |
This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1203 |
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Author |
Thompson, L.E. |
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Title |
Profession and place: Contesting professional boundaries at the margins |
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Year |
2006 |
Publication |
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Abbreviated Journal |
UC Research Repository |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
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Abstract |
Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural. |
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Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
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Author |
Maw, H. |
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Title |
The challenge of developing primary health care nurse practitioner roles in rural New Zealand |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 201-214) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Rural health services; Interprofessional relations; Policy |
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Abstract |
The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues. |
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Call Number |
NRSNZNO @ research @ |
Serial |
762 |
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Author |
Higgins, A. |
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Title |
Collaboration to improve health provision: Advancing nursing practice and interdisciplinary relationships |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 215-223) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural health services; Nursing; Policy |
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Abstract |
This chapter introduces national policies and strategies that promote interdisciplinary collaboration as a means of providing better access to health care for all communities. It identifies a role for advancing nursing practice as part of a collaborative approach to healthcare in rural areas. An increasing focus on collaboration as a concept within health practice during the last 10 years has become evident in policy documents from the Report of the Ministerial Taskforce on Nursing (Ministry of Health, 1998) to the Working Party for After Hours Primary Health Care (Ministry of Health, 2005). The emphasis would seem to be in response to political pressure to address health inequalities and an apparent assumption that interprofessional collaboration results in improved communication, fewer gaps in provision of care and more effective use of the limited health funds. |
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Call Number |
NRSNZNO @ research @ 779 |
Serial |
763 |
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Author |
Armstrong, S.E. |
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Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
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Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
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Volume |
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Issue |
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Pages |
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Keywords |
Interprofessional relations; Rural nursing; Primary health care |
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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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Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
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Author |
Richardson, S.; Ardagh, M.; Hider, P. |
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Title |
New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department |
Type |
Journal Article |
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Year |
2006 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
119 |
Issue |
1232 |
Pages |
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Keywords |
Hospitals; Clinical assessment; Interprofessional relations |
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Abstract |
This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept. |
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Call Number |
NRSNZNO @ research @ |
Serial |
526 |
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Author |
Mackay, B. |
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Title |
General practitioners' perceptions of the nurse practitioner role: An exploratory study |
Type |
Journal Article |
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Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
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Volume |
116 |
Issue |
1170 |
Pages |
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Keywords |
Nurse practitioners; Physicians; Interprofessional relations; Primary health care |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
557 |
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Author |
Pullon, S.; McKinlay, E.M. |
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Title |
Interprofessional learning: The solution to collaborative practice in primary care |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
6 |
Pages |
404-408 |
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Keywords |
Interprofessional relations; Education; Primary health care; Communication |
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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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Call Number |
NRSNZNO @ research @ |
Serial |
458 |
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