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Wood, P. J., & Schwass, M. (1993). Cultural safety: a framework for changing attitudes. Nursing Praxis in New Zealand, 8(1), 4–14.
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Clendon, J. (1999). The Nurse Practitioner-led Primary Health Care Clinic; A Community Needs Analysis. Ph.D. thesis, , .
Abstract: Aim: To determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a primary school environment as an alternate or complementary way of addressing the health needs of 'at risk' children and families to the services already provided by the public health nurse.Method: Utilising needs analysis method, data was collected from three sources – known demographic data, 17 key informant interviews and two focus group interviews. Questions were asked regarding the health needs of the community, the perceptions of participants regarding the role of the public health nurse in order to determine if a public health nurse would be the most appropriate person to lead a primary health care clinic, and the practicalities of establishing a clinic including services participants would expect a clinic to provide. Analysis was descriptive and exploratory.Results: A wide range of health needs were identified from both the demographic data and from participant interviews. Findings also showed that participant's understanding of the role of the public health nurse was not great and that community expectations were such that for a public health nurse to lead a primary health care clinic further skills would be required. Outcomes from investigating the practicalities of establishing a nurse practitioner-led clinic resulted in the preparation of a community-developed model that would serve to address the health needs of children and families in the area the study was undertaken.Conclusion: Overall findings indicated that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment is feasible. While a public health nurse may fulfil the role of the nurse practitioner, it was established that preparation to an advanced level of practice would be required. It is likely that a similar model would also be successful in other communities in New Zealand, however the health needs identified in this study are specific to the community studied. Further community needs assessments would need to be completed to ensure health services target health needs specific to the communities involved.
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Spence, D. (1999). Prejudice, paradox and possibility.
Abstract: This study explores the the experience of nursing a person, or people, form cultures other than one's own. Informed by the tradition of philosophical hermeneutics, and drawing specifically on some of the notions articulated by Hans-Georg Gadamer and Charles Taylor, it seeks to understand everyday nursing practices within their cultural and historical context.Against a background of Maori resurgence, nurses in New Zealand have been challenged in Aotearoa-New Zealand to recognise and address racism in their practice. Meeting the health needs of all people has long been important in nursing yet the curricular changes implemented in the early 1990s to enhance nursing's contribution to a more equitable health service created uncertainty and tension both within nursing, and between nursing and the wider community.In this study, I have interpreted the experiences of seventeen nurses practising in an increasingly ethnically diverse region. Personal understandings and those from relevant literature have been used to illuminate further the nature of cross-cultural experience from a nurse's perspective. The thesis asserts that the notions of prejudice, paradox and possibility can be used to describe the experience of nursing a person from another culture. Prejudice refers to the prior understandings that influence nursing action in both a positive and a negative sense. Paradox relates to the coexistence and necessary interplay of contradictory meanings and positions, while possibility points to the potential for new understandings to surface from the fusion of past with present, and between different interpretations. As New Zealand nurses negotiate the conflicts essential for ongoing development of their practice, the play of prejudice, paradox and possibility is evident at intra-personal and interpersonal levels as well as in relation to professional and other social discourses. This thesis challenges nurses to persist in working with the tensions inherent in cross-cultural practice. It encourages continuation of their efforts to understand and move beyond the prejudices that otherwise preclude the exploration of new possibilities.
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Spence, D., & Smythe, E. (2007). Courage as integral to advancing nursing practice. Nursing Praxis in New Zealand, 23(2), 43–55.
Abstract: This paper focuses on the illumination of courage in nursing. The authors suggest it is a fundamental component of nursing, yet it is seldom mentioned or recognised in the literature, or supported in practice. Data from a hermeneutic analysis of nurses' practice stories is integrated with literature to assist deeper understanding of the meaning of courage in contemporary nursing practice. The purpose is to make visible a phenomenon that needs to be actively fostered if nursing is to effectively contribute to an improved health service.
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Woodward, J. (1999). Nurse case management: A review of the literature. Ph.D. thesis, , .
Abstract: This literature review is an exploration of nurse case management and it will provide the background for the introduction of a nursing case management model in the acute surgical environment at Western Bay Health. Case management is a collaborative process which assesses, plans, implements, co-ordinates, monitors and evaluates options and services to meet an individual's health needs through communication and available resources to promote quality, cost-effective outcomes (Newell, 1996:.3). In undertaking this review it was the author's intention to include the findings as background to a business case seeking the introduction of a surgical nurse case management model within the surgical service.
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Davies, D. C. (2006). Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions. Ph.D. thesis, , .
Abstract: Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions.
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Blanchard, D. L. (2006). Developing the place and role of family within the culture of critical care nursing: An action research approach. Ph.D. thesis, , .
Abstract: This research examines how nurses negotiate the context of the Intensive Care Unit (ICU) while working with families. The action research described in this thesis developed through a series of meetings and conversations where the conversations supported the reflexive intent of the research. In commissioning the research, the design of the meetings and conversations were as a series of overlapping actions. Data collection and data analysis occurred in the action research by meetings, reflective conversations, ad libitum observations, and in a research journal. Conceptual maps explain the progress and findings of the research in this thesis while categories distilled from the conversations also support the findings in the research. The Family Action Research Group that was established within this project proposed a Family Assessment Form for the family to provide an assessment of themselves and the patient. Implementing this assessment tool demonstrated that clear information was needed for the family in the ICU. Findings in this research focus on developing action research and family care in ICU. Findings also focused on the role of the researcher being of and not being of the context where action research is undertaken. Recommendations include staff examining relationships for potential asymmetries and seeking ways to address these to support families and staff. Suggested strategies for developing action research in a clinical context include detailed planning, clear focusing, transparency of data, and working to explain change initiatives through the research are also included.
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Desmond, N. (2007). Aspects of nursing in the general practice setting and the impact on immunisation coverage. Ph.D. thesis, , .
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Voice, D. M. (2006). Everyday district nurses' experiences revealed through distillation: Palliative care in the community. Ph.D. thesis, , .
Abstract: This modified action research inquiry focused on the everyday, palliative care practice experiences of a group of district nurses. The intent was to develop an understanding of common issues of concern for this group of district nurses when providing palliative home care in a specific community context and to implement practical, achievable strategies in response to these local issues. Five district nurses identified four broad areas for action through four praxis group meetings and comprising one full cycle. These four areas have been named as methods of enhancing support for people and families, possibilities for creatively managing workloads, mechanisms to enrich working partnership with other palliative care providers and possible vehicles for supporting nurses' self care. Implementation of action from this action research project focused on enhancing care and outcomes for people and family served by this group of district nurses in their local community. This study illuminates everyday essences of the district nurse role and the elements articulated by this group in supporting their practice in one New Zealand community. This study also reveals some of the tensions and messiness when employing an action research methodology with nurses in the workplace. The author notes that this research focused on a little known area (palliative care delivered by district nurses in New Zealand) in a local community (a culturally vibrant and ethnically diverse yet with poor health and socioeconomic statistics). She goes on to say that it has resonance with other nurses, particularly those working in community settings who may experience similar issues and concerns. This research also offers important insights for nurses working in any practice setting.
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Rodgers, V., & Neville, S. J. (2007). Personal autonomy for older people living in residential care: An overview. Nursing Praxis in New Zealand, 23(1), 29–36.
Abstract: This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.
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Marcinkowski, K., & McDonald, B. (2006). Changing blood transfusion practice in elective joint arthroplasty: A nursing initiative. Nursing Praxis in New Zealand, 22(3), 15–21.
Abstract: This study analysed the use of re-infusion drains on 99 consecutive patients undergoing total knee arthroplasty surgery at a large hospital. The primary aim was to ascertain the cost effectiveness of the drains. Secondary aims were to assess safety of the drains, whether or not they reduced the need for allogeneic blood transfusion and whether they decreased the length of stay in hospital. As a control group the records of 99 patients treated without re-infusion were analysed retrospectively. The direct cost of consumables increased for the evaluation period. There was a smaller proportion of allogeneic blood transfusion (27% vs 38%) and a smaller mean number of units transfused (0.92 vs 0.54) in the re-infusion group compared to the control group. Patients benefited directly in that the mean length of stay was also significantly shorter in the re-infusion group. The researchers anticipate more direct cost saving with experience and best practice and conclude that the use of re-infusion drains is a cost effective blood saving method in total knee joint arthroplasty.
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Bolitho, S., & Huntington, A. D. (2006). Experiences of Maori families accessing health care for their unwell children: A pilot study. Nursing Praxis in New Zealand, 22(1), 23–32.
Abstract: The aim of this study was to explore with a small number of Maori families their experiences of accessing health care when their children were unwell with a respiratory condition. A qualitative research methodology was used in the study. Participating families were among those experiencing an admission to a children's ward between July and December 2003. Four families were interviewed. They discussed in depth their experience of accessing health care for their unwell children. Data were analysed using thematic analysis, and three common themes were evident: family resources, choice of health service provider and parents' feelings of vulnerability. The findings highlight that while socio-economic status plays a large part in determining the ease with which families can access the needed health care, there are other barriers within the health system which also pose difficulties for Maori.
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Roud, D., Giddings, D. L. S., & Koziol-McLain, J. (2005). A longitudinal survey of nurses' self-reported performance during an entry-to-practice programme. Nursing Praxis in New Zealand, 21(2), 37–46.
Abstract: The researchers conducted a study to compare self-reported changes in both frequency and quality of performance of nursing behaviours in a cohort of recently graduated nurses undertaking a one year entry to practice programme. Thirty-three nurses were surveyed, seven weeks after beginning the programme and again seven months later, using a modified version of Schwirian's (1978) Six-Dimension Scale of Nursing Performance (6-DSNP). Over the study period participants reported significant increases in frequency of performance for the domains of leadership, critical care, teaching/collaboration, and planning/evaluation. Significant increases in the quality of nurse behaviours in the domains of critical care, planning/evaluation and interpersonal relations/communication were also reported. The modified Schwirian 6-DSNP was found to be a useful instrument for measuring nurses' self reporting of performance during periods of transition.
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Spence, D. (2004). Advanced nursing practice through postgraduate education, part one. Nursing Praxis in New Zealand, 20(2), 46–55.
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.
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Weidenbohm, K. (2006). Pioneering rural nursing practice: An impact evaluation of a preventive home visiting service for older people. Ph.D. thesis, , .
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