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Author |
Mackay, B. |
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Title |
An analysis of innovative roles in primary health care nursing |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Northland Polytechnic Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing |
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Abstract |
An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process. |
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Call Number |
NRSNZNO @ research @ |
Serial  |
1124 |
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Author |
Muir-Cochrane, E.; Holmes, C.; Walton, J.A. |
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Title |
Law and policy in relation to the use of seclusion in psychiatric hospitals in Australia and New Zealand |
Type |
Journal Article |
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Year |
2002 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
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Volume |
13 |
Issue |
2/3 |
Pages |
136-145 |
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Keywords |
Psychiatric Nursing; Law and legislation; Policy; Patient rights; Cross-cultural comparison |
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Abstract |
This paper discusses legal issues associated with the seclusion of acutely disturbed patients in psychiatric hospitals in Australia and New Zealand. There continues to be great variation in opinion and operational definition as to whether seclusion is a medical treatment, nursing intervention and management tool, or merely a form of situational restraint. Reflecting this lack of clarity, mental health acts and policies concerning the regulation and practice of seclusion lack consistency and focus across geographical boundaries and jurisdictions. Australian and New Zealand legislation and institutional policy is discussed in order to shed light on the contemporary issues highlighted by this controversial nursing practice. The authors note that mental health professionals must continue to review the practice of seclusion and to actively promote the use of acceptable alternatives. In addition nurses and other mental health professionals have a responsibility to understand current legislation and policy frameworks and to influence change where this is necessary to ensure the best practice possible in their clinical area. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1074 |
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Author |
Crowe, M.; Carlyle, D. |
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Title |
Deconstructing risk assessment and management in mental health nursing |
Type |
Journal Article |
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Year |
2003 |
Publication |
Journal of Advanced Nursing |
Abbreviated Journal |
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Volume |
43 |
Issue |
1 |
Pages |
19-27 |
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Keywords |
Psychiatric Nursing; Risk management; Policy; Culture |
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Abstract |
The aims of the study were to provide a deconstructive analysis of the concepts of risk and risk management, and to explore the historical context of mental disorder and the concept of risk, the clinical context of risk assessment and management, the cultural, political and economic context of risk, and the impact on mental health nursing and consumers of mental health services. This is undertaken by providing a critical review of the history of mental illness and its relationship to risk, examination of government policy on clinical risk management, analysis of a risk assessment model and a discussion of the political and economic factors that have influenced the use of risk assessment and management in clinical practice. The concept of risk and its assessment and management have been employed in the delivery of mental health services as a form of contemporary governance. One consequence of this has been the positioning of social concerns over clinical judgement. The process employed to assess and manage risk could be regarded as a process of codification, commodification and aggregation. In the mental health care setting this can mean attempting to control the actions and behaviours of consumers and clinicians to best meet the fiscal needs of the organisation. The authors conclude that the mental health nursing profession needs to examine carefully its socially mandated role as guardians of those who pose a risk to others to ensure that its practice represents its espoused therapeutic responsibilities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1069 |
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Author |
Woods, M. |
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Title |
Dissecting a brave new nursing world |
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Journal Article |
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Year |
2002 |
Publication |
Kai Tiaki: Nursing New Zealand |
Abbreviated Journal |
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Volume |
8 |
Issue |
10 |
Pages |
20-22, 36 |
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Keywords |
Nursing; Education; Nursing Council of New Zealand; Policy |
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Abstract |
This article critiques the 'Strategic Review of Undergraduate Education' commissioned by the Nursing Council. The premise of the review is examined, along with the foundations of nursing practice and the role of nursing education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1003 |
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Author |
Stone, P.W.; Tourangeau, A.E.; Duffield, C.M.; Hughes, F.; Jones, C.A.; O'Brien-Pallas, L.; Shamian, J. |
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Title |
Evidence of nurse working conditions: A global perspective |
Type |
Journal Article |
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Year |
2003 |
Publication |
Policy, Politics, & Nursing Practice |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
120-130 |
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Keywords |
Nursing; Recruitment and retention; Policy; Cross-cultural comparison; Nursing research |
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Abstract |
The purpose of this article is to review evidence about nurse workload, staffing, skill mix, turnover, and organisational characteristics' effect on outcomes; discuss methodological considerations in this research; discuss research initiatives currently under way; review policy initiatives in different countries; and make recommendations where more research is needed. Overall, an understanding of the relationships among nurse staffing and organisational climate to patient safety and health outcomes is beginning to emerge in the literature. Little is known about nursing turnover and more evidence is needed with consistent definitions and control of underlying patient characteristics. Research and policy initiatives in Australia, Canada, New Zealand, and the United States are summarised. |
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Call Number |
NRSNZNO @ research @ |
Serial |
951 |
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Author |
Hughes, F.; Duke, J.; Bamford-Wade, A.; Moss, C. |
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Title |
Enhancing nursing leadership through policy, politics, and strategic alliances |
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Journal Article |
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Year |
2006 |
Publication |
Nurse Leader |
Abbreviated Journal |
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Volume |
4 |
Issue |
2 |
Pages |
24-27 |
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Keywords |
Policy; Nursing; Leadership |
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Abstract |
This paper looks at the links between nursing roles and health policy in New Zealand. Strategic alliances between key professional leaders in different nursing roles can help the profession by directly influencing policy development and implementation. This form of policy entrepreneurship is an important component of professional leadership. |
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Call Number |
NRSNZNO @ research @ 955 |
Serial |
939 |
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Author |
Hughes, F. |
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Title |
Reconnecting with policy: Requirements for survival as a mental health nurse |
Type |
Journal Article |
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Year |
2006 |
Publication |
Journal of Psychosocial Nursing & Mental Health Services |
Abbreviated Journal |
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Volume |
44 |
Issue |
8 |
Pages |
30-39 |
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Keywords |
Policy; Mental health; Nursing specialties |
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Abstract |
This article discusses the disconnection between mental health nurses and policy, and the importance of reconnecting such relationships. It is suggested this will benefit consumers, provide influence in health care policies and, ultimately, contribute to strategies to improve the health of our nation. In this article, the author draws on her own experiences and applies these to a discussion of how mental health nurses can influence and strengthen their relationships with nursing policy. |
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Call Number |
NRSNZNO @ research @ |
Serial |
938 |
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Author |
Stuart, J. |
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Title |
How can nurses address generalist/specialist/nursing requirements of the urban/rural population of Southland |
Type |
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Year |
2003 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nursing specialties; Policy; Technology; Scope of practice; Community health nursing |
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Abstract |
This study, which is undertaken in the Southland area, explores the effect of the increasing specialisation of nursing services in what is a rural/urban environment. It is indicated in the literature that systemic changes in health, such as the health reforms, and the increase in the use of technology have meant that nurses are required to function in disease oriented roles rather than according to their more traditional generalist roots. A significant event, which also affected nursing scope of practice, was the transfer of nurse education to the tertiary education institutions environment from the hospitals in the mid 1970s. The traditional nursing hierarchy and its nurse leadership role disappeared and the adoption of specialist nurse titles increased, and identified with a disease or disorder, for example 'diabetes' nurse. The increase in specialist categories for patients contributed to the nurse shortage by reducing the available numbers of nurses in the generalist nursing pool. The nurses in this rural/urban environment require generalist nurse skills to deliver their nursing services because of the geographical vastness of the area being a barrier to specialist nurses. Workforce planning for nurses in the rural/urban then must focus on how to reshape the nursing scope of practice to utilise the existing resources. This study explores how key areas of health services could be enhanced by reclaiming the nurse role in its holistic approach, in mental health, public health, geriatric services and psychiatric services. |
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Call Number |
NRSNZNO @ research @ 885 |
Serial |
869 |
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Author |
Honeyfield, Margy |
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Title |
The necessity of effective nursing leadership for the retention of professional hospital nurses |
Type |
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Year |
2008 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Volume |
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Issue |
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Pages |
64 |
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Keywords |
Recruitment and retention; Leadership; Nursing; Policy |
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Abstract |
The author notes that it is widely accepted that there is a global shortage of nurses, and there are many studies in the health workforce literature about the negative aspects of nurse work environments, nursing workloads, decreased job satisfaction of nurses and the impact these have on patient health outcomes. In the past five years there has also been international and New Zealand-specific research into the effects of health restructuring on nursing leadership, retention of nurses, and on patient care. Much of this research has shown that countries with very different health care systems have similar problems, not only with retention of qualified nursing staff due to high levels of job dissatisfaction, but also with work design and the provision of good quality patient care in hospitals. This dissertation explores the many detrimental effects on nurses and nursing leadership, of extensive, and continuing, public health restructuring in New Zealand. The context of this dissertation is New Zealand public hospitals, with references pertaining to medical and surgical areas of nursing practice. Health reforms have negatively impacted on patient care delivery systems, patient health outcomes, and retention of educated nurses in the workforce. In order to resolve these issues, coordinated efforts are required in New Zealand district health boards to develop and sustain effective nursing leaders, who will promote and assist in the development of strong, healthy organisational cultures to retain and support professional nurses and the ways in which they wish to practise. |
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Call Number |
NRSNZNO @ research @ |
Serial |
868 |
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Author |
Hamer, H.P.; Finlayson, M.; Thom, K.; Hughes, F.; Tomkins, S. |
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Title |
Mental health nursing and its future: A discussion framework: Report from the Expert Reference Group to the Deputy Director-General Dr Janice Wilson |
Type |
Report |
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Year |
2006 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Mental health; Psychiatric Nursing; Policy; Leadership; Nurse practitioners; Nursing; Education; Careers in nursing |
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Abstract |
This project was initiated by the Ministry of Health to ensure a nationally coordinated approach to mental health nursing. The purpose of the project is to provide a national strategic framework for mental health nursing that will strengthen both nursing leadership and practice within the multi-disciplinary clinical environment. The framework reviews a range of key workforce issues identified by the Ministry of Health and provides strategies to move mental health nursing forward. The framework integrates directions from government mental health strategies, policies and directions, national and international literature as well as professional nursing requirements which aim to create a sustainable mental health nursing workforce using evidence based practice. The framework considers a range of key workforce issues identified by the Ministry of Health including: nursing leadership, nurse practitioners, standards, skill mix, clinical career pathways, professional supervision, education, research and recruitment and retention. |
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Call Number |
NRSNZNO @ research @ |
Serial |
865 |
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Author |
Holloway, K. T. |
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Title |
The future for nursing education: UKCC review has relevance for New Zealand |
Type |
Journal Article |
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Year |
2000 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
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Volume |
16 |
Issue |
2 |
Pages |
17-24 |
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Keywords |
Nursing; Education; Recruitment and retention; Clinical assessment; Policy |
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Abstract |
The author reviews the report 'Fitness for Practice' by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) noting many areas of relevance for New Zealand educators in outlining possible strategies for nursing education. Discussion of some of the recommendations is put in the context of a strategic review of undergraduate nursing education recently commissioned by the Nursing Council of New Zealand. Issues such as recruitment and access to education; retention; clinical assessment and placements; clinical skill acquisition and partnership are valid concerns for educators here also. Internationally, the author suggests, the commonalties in issues of concern lend validity to the concept of the global village and the necessity for a global perspective in health care workforce planning, including educational preparation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
848 |
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Author |
Bailey, A.M. |
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Title |
The New Zealand practice nurse in the primary health environment of the 21st century |
Type |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Practice nurses; Primary health care |
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Abstract |
This paper is a culmination of the author's inquiry, reflection and critical thinking on the transitional phase that practice nursing is currently undergoing as part of the New Zealand Primary Health Strategy. The paper utilises both reflection-in-action and reflection-on-action as well as reflection-before-action, as a process. The author's starting point for this inquiry was attending the New Zealand Nurses Organisation Primary Health Conference in Wellington and reading a report from the Expert Advisory Group on Primary Health Care Nursing. Knowing that practice nurses are the majority of nurses working in primary health, she was concerned that changes to primary health were being driven with little reference or participation by them. The paper explores how practice nursing evolved in New Zealand and the developments that have occurred in the 30 plus years since its inception. It describes the role and current work of practice nursing in general practice, and highlights the constraints that have held back development and continue to do so. The 2002 New Zealand Primary Health Strategy is shown to provide an opportunity for development and enhancement, if some of the constraints are removed. As part of looking to the future the possibilities for practice nurses to lead the way in primary health development are explored. |
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Call Number |
NRSNZNO @ research @ |
Serial |
831 |
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Author |
Watson, S.L. |
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Title |
Attitudinal shifting: A grounded theory of health promotion in coronary care |
Type |
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Year |
2007 |
Publication |
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Abbreviated Journal |
AUT University Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Health promotion; Policy; Professional development; Cardiovascular diseases; Nursing; Nurse-patient relations; Education |
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Abstract |
Current New Zealand health policy encourages collaborative health promotion in all sectors of health service delivery. The integrated approach to the acute management of coronary heart disease in a coronary care unit, combining medical therapy and lifestyle change, supports clinical health promotion. The aim of this study was to use the grounded theory approach to discover the main concerns of nurses' promoting health in an acute coronary care setting and to explain the processes that nurses used to integrate health promotional activities into their practice. Seventeen registered nurses from three coronary care units within a large metropolitan city in New Zealand were interviewed. Data were constantly compared and analysed using Glaser's emergent approach to grounded theory.The main concern for nurses promoting health within coronary care was ritualistic practice. In this study, ritualistic practice concerns the medically-based protocols, routines, language and technology that drives nursing practice in coronary care. This concern was resolved via the socio-cultural process of attitudinal shifting that occurs over time involving three stages. The three conceptual categories, environmental pressures, practice reality and responsive action are the main components of the theory of attitudinal shifting. In environmental pressures, nurses experience a tension between specialist medically-dominated nursing practice and the generalist nursing role of promoting health. In practice reality, nurses become aware that the individual needs of patients are not being met. This causes role conflict until the nurse observes colleagues who role model possibilities for practice, working with patients to promote health. Responsive action sees the nurse engaging in self-development, also focusing on the nurse-patient relationship, thereby enabling active patient involvement in individual health-promoting decisions. The author suggests that the findings from this research have implications for nursing practice and education. With the increasing specialisation in nursing practice, these findings may be of interest to nurses working in delegated medical roles where the reality of everyday practice precludes nurses from undertaking their essential nursing role. Health care facilities also need to ensure that there are opportunities for the personal and professional development of nursing staff. The place of health promotion within nursing undergraduate curricula needs to be examined, as many nurses found that they were ill prepared for undertaking health promotional activities. |
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Call Number |
NRSNZNO @ research @ |
Serial |
807 |
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Author |
Hughes, F. |
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Title |
Nurses at the forefront of innovation |
Type |
Journal Article |
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Year |
2006 |
Publication |
International Nursing Review |
Abbreviated Journal |
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Volume |
53 |
Issue |
2 |
Pages |
94-101 |
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Keywords |
Organisational culture; Technology; Policy; Nursing |
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Abstract |
This paper explores the concept of innovation in nursing, the inherent set of characteristics that need to be present in order for innovations to succeed, and the barriers that impede innovation from occurring. Successful innovations developed and implemented by nurses are featured, and organisational factors necessary to support innovation are described. This paper is based on a presentation given by the author at the 23rd Quadrennial ICN Congress and 7th International Regulation Congress in Taipei in May 2005. |
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Call Number |
NRSNZNO @ research @ 796 |
Serial |
780 |
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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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