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Fraser, A. G., Williamson, S., Lane, M., & Hollis, B. (2003). Nurse-led dyspepsia clinic using the urea breath test for Helicobacter pylori. Access is free to articles older than 6 months, and abstracts., 116(1176).
Abstract: Reports the audit of a nurse-led dyspepsia clinic at Auckland Hospital. Referrals to the Gastroenterology Department for gastroscopy were assessed in a dyspepsia clinic. Initial evaluation included consultation and a urea breath test (UBT). Patients given eradication treatment prior to initial clinic assessment were excluded. Patients with a positive UBT were given eradication treatment and were reviewed two months later for symptom assessment and follow-up UBT. Patients with a negative UBT were usually referred back to the GP. There were 173 patients with a mean age 38 years. The urea breath test was found to be useful as part of the initial assessment of selected patients who would otherwise have been referred for endoscopy. It is likely that the need for gastroscopy was reduced, but longer follow up will be required to determine whether or not this effect is simply due to delayed referral. This approach is likely to have value only in patients who have a relatively high chance of being H. pylori positive.
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Ardagh, M., Wells, E., Cooper, K., Lyons, R., Patterson, R., & O'Donovan, P. (2002). Effect of a rapid assessment clinic on the waiting time to be seen by a doctor and the time spent in the department, for patients presenting to an urban emergency department: A controlled prospective trial. Access is free to articles older than 6 months, and abstracts., 115(1157).
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.
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Adams, S., Boyd, M., Carryer, J., Bareham, C., & Tenbensel, T. (2020). A survey of the NP workforce in primary healthcare settings in New Zealand. New Zealand Medical Journal, 133(1523). Retrieved June 3, 2024, from https://hdl.handle.net/2292/54716
Abstract: Describes the demographics, distribution, clinical settings and employment arrangements of the NZ nurse practitioner (NP) workforce in primary healthcare settings, and organisational factors limiting their practice. Surveys 160 NPs and finds that general practice and aged residential care were the most common clinical settings.
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Richardson, S. K., Grainger, P. C., Ardagh, M. W., & Morrison, R. (2018). Violence and aggression in the emergency department is under-reported and under-appreciated. New Zealand Medical Journal, 131(1476). Retrieved June 3, 2024, from www.nzma.org.nz/journal
Abstract: Examines levels of reported violence and aggression within a tertiary-level emergency department (ED) in NZ. Explores staff attitudes to violence and the reporting of it. Conducts a one-month intensive prospective audit of the reporting of violence and aggression within the ED. Compares results with previously-reported data, and finds that failure to report acts of violence is common. Highlights that emergency nurses are the primary targets of abuse and confirms the effect it has on retention.
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Richardson, S. K., Grainger, P.C., & Joyce, L. R. (2022). Challenging the culture of Emergency Department violence and aggression. NZMJ, 135(1554). Retrieved June 3, 2024, from https://journal.nzma.org.nz/
Abstract: Outlines findings from a longitudinal study of the reporting of violence and aggression (V&A) within Christchurch Hospital Emergency Department (ED). Continues a prospective, longitudinal cohort study involving repeated yearly audits of ED staff reporting V&A during the same month each year. Employs an audit approach, focussing on the accuracy of routine reporting. Captures data from 2014-2020,including staff members' professional group, gender, category of V&A (e.g. verbal or physical abuse or threat, and physical or sexual assault), date and location of incident, and the individual who committed the violence.
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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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Pitama, S., Robertson, P., Cram, F., Gillies, M., Huria, T., & Dalla-Katoa, W. (2007). Meihana model: A clinical assessment framework. New Zealand Journal of Psychology, 36(3), 118–125.
Abstract: In 1984 Mason Durie documented a framework for understanding Maori health, Te Whare Tapa Wha, which has subsequently become embedded in Maori health policy. This article presents a specific assessment framework, the Meihana Model, which encompasses the four original cornerstones of Te Whare Tapa Wha, and inserts two additional elements. These form a practice model (alongside Maori beliefs, values and experiences) to guide clinical assessment and intervention with Maori clients and whanau accessing mental health services. This paper outlines the rationale for and background of the Meihana Model and then describes each dimension: whanau, wairua, tinana, hinengaro, taiao and iwi katoa. The model provides a basis for a more comprehensive assessment of clients/whanau to underpin appropriate treatment decisions.
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McKegg, A. H. (1992). The Maori health nursing scheme: an experiment in autonomous health care. New Zealand Journal of History, 26(2), 145–160.
Abstract: Analysis of role of services providers to show discrepancies between formulated policy and implementation. Draws parallels with 1980's Maori health initiatives
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North, N., Rasmussen, E., Hughes, F., & Finlayson, M. (2005). Turnover amongst nurses in New Zealand's district health boards: A national survey of nursing turnover and turnover costs. New Zealand Journal of Employment Relations, 30(1), 49–62.
Abstract: This article reports on the New Zealand part of an international study, using agreed study design and instruments, to determine the direct and indirect costs of nursing turnover. These costs also include the systemic costs, estimated by determining the impacts of turnover on patient and nurse outcomes. It presents the findings from the pilot study conducted in six countries to test the availability of costs and suitability of the instrument. Reports the results from a survey of directors of nursing in 20 of the 21 district health boards on turnover and workplace practices.
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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. (2008). Nursing initiatives in primary care: An approach to risk reduction for cardiovascular disease and diabetes. The Royal New Zealand College of General Practitioners website, 35(3), 176–182.
Abstract: The authors evaluated a nurse-led cardiovascular disease and diabetes (CVD) management project. The Ministry of Health funded the project to implement models of nurse service delivery, with care pathways for risk reduction of CVD and diabetes based on national guidelines, with quality assurance, audit and nurse leadership. The paper presents the components required to implement and sustain a nurse CVD risk assessment and management service, which were identified and clarified through the action research process.
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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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