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Author Mackay, B.
Title An analysis of innovative roles in primary health care nursing Type
Year 2004 Publication Abbreviated Journal Northland Polytechnic Library
Volume Issue Pages
Keywords Nurse practitioners; Primary health care; Maori; Policy; Careers in nursing
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 These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition).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.
Call Number NRSNZNO @ research @ Serial (down) 1124
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Author Kinealy, T.; Arroll, B.; Kenealy, H.; Docherty, B.; Scott, D.; Scragg, R.; Simmons, D.
Title Diabetes care: Practice nurse roles, attitudes and concerns Type Journal Article
Year 2004 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 48 Issue 11 Pages 68-75
Keywords Diabetes Type 2; Practice nurses; Attitude of health personnel; Primary health care
Abstract The aim of this paper is to report a study to compare the diabetes-related work roles, training and attitudes of practice nurses in New Zealand surveyed in 1990 and 1999, to consider whether barriers to practice nurse diabetes care changed through that decade, and whether ongoing barriers will be addressed by current changes in primary care. Questionnaires were mailed to all 146 practice nurses in South Auckland in 1990 and to all 180 in 1999, asking about personal and practice descriptions, practice organisation, time spent with patients with diabetes, screening practices, components of care undertaken by practice nurses, difficulties and barriers to good practice, training in diabetes and need for further education. The 1999 questionnaire also asked about nurse prescribing and influence on patient quality of life. More nurses surveyed in 1999 had post-registration diabetes training than those in 1990, although most of those surveyed in both years wanted further training. In 1999, nurses looked after more patients with diabetes, without spending more time on diabetes care than nurses in 1990. Nevertheless, they reported increased involvement in the more complex areas of diabetes care. Respondents in 1999 were no more likely than those in 1990 to adjust treatment, and gave a full range of opinion for and against proposals to allow nurse prescribing. The relatively low response rate to the 1990 survey may lead to an underestimate of changes between 1990 and 1999. Developments in New Zealand primary care are likely to increase the role of primary health care nurses in diabetes. Research and evaluation is required to ascertain whether this increasing role translates into improved outcomes for patients.
Call Number NRSNZNO @ research @ Serial (down) 1100
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Author Gohns, A.
Title Management of opioid substitution treatment in the primary health care setting: A national training course for service providers Type Journal Article
Year 2002 Publication New Zealand Family Physician Abbreviated Journal Full text online from the Royal New Zealand College of General Practitioners' website
Volume 29 Issue 3 Pages 172-175
Keywords Pharmacology; Evaluation; Primary health care
Abstract The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it.
Call Number NRSNZNO @ research @ Serial (down) 1099
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Author O'Brien, A.P.; Boddy, J.M.; Hardy, D.J.; O'Brien, A.J.
Title Clinical indicators as measures of mental health nursing standards of practice in New Zealand Type Journal Article
Year 2004 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 13 Issue 2 Pages 778-788
Keywords Psychiatric Nursing; Professional competence; Administration; Quality of health care; Mental ealth
Abstract This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
Call Number NRSNZNO @ research @ Serial (down) 1059
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Author Neville, S.J.; Henderson, H.M.
Title Perceptions of lesbian, gay and bisexual people of primary healthcare services Type Journal Article
Year 2006 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 55 Issue 4 Pages 407-415
Keywords Sexuality; Attitude of health personnel; Primary health care
Abstract This paper reports a study exploring people's perceptions of disclosure about lesbian, gay and bisexual identity to their primary healthcare providers. Disclosure of sexual identity to healthcare professionals is integral to attending to the health needs of lesbian, gay and bisexual populations, as non-disclosure has been shown to have a negative impact on the health of these people. From April to July 2004, a national survey of lesbian, gay and bisexual persons was carried out in New Zealand. Participants were recruited through mainstream and lesbian, gay and bisexual media and venues, and 2269 people completed the questionnaire, either electronically or via hard copy. The 133-item instrument included a range of closed-response questions in a variety of domains of interest. In this paper, we report results from the health and well-being domain. More women than men identified that the practitioner's attitude toward their non-heterosexual identity was important when choosing a primary healthcare provider. Statistically significantly more women than men reported that their healthcare provider usually or always presumed that they were heterosexual and in addition more women had disclosed their sexual identity to their healthcare provider. The authors advise that nurses reconsider their approach to all users of healthcare services by not assuming everyone is heterosexual, integrating questions about sexual identity into health interviews and ensuring that all other aspects of the assessment process are appropriate and safe for lesbian, gay and bisexual people.
Call Number NRSNZNO @ research @ 1059 Serial (down) 1043
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Author Horsburgh, M.; Merry, A.; Seddon, M.; Baker, H.; Poole, P.; Shaw, J.; Wade, J.
Title Educating for healthcare quality improvement in an interprofessional learning environment: A New Zealand initiative Type Journal Article
Year 2006 Publication Journal of Interprofessional Care Abbreviated Journal
Volume 20 Issue 5 Pages 555-557
Keywords Quality of health care; Multidisciplinary care teams; Nursing; Education; Maori; Patient safety
Abstract This article describes two interprofessional learning modules offered by the Faculty of Medical and Health Sciences at the University of Auckland to undergraduate medicine, nursing and pharmacy students. The modules, 'Maori Health“ and ”Patient Safety", have a focus on quality improvement in healthcare and are used to bring together students for a shared learning programme.The specific dimensions of healthcare quality covered in the programme are: patient safety, equity, access, effectiveness, efficacy and patient-centeredness.
Call Number NRSNZNO @ research @ Serial (down) 1042
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Author Pearson, J.R.; Holloway, K. T.
Title A postgraduate primary health care programme for experienced registered nurses and newly graduated nurses Type Journal Article
Year 2006 Publication Whitireia Nursing Journal Abbreviated Journal
Volume 13 Issue Pages 44-52
Keywords Primary health care; New graduate nurses; Registered nurses; Nursing; Education
Abstract This paper outlines the historical development of the Postgraduate Certificate in Primary Health Care Specialty Nursing programme. The paper discusses the multiple contextual considerations for the programme in terms of New Zealand health policy direction, academic level, and appropriate level of competency development for nurses new to primary health care and newly graduated nurses.
Call Number NRSNZNO @ research @ Serial (down) 1040
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Author Mackay, B.
Title Leadership strategies for role development in primary health care nursing Type Journal Article
Year 2007 Publication Nursing Journal Northland Polytechnic Abbreviated Journal coda, An Institutional Repository for the New Zealand ITP Sector
Volume 11 Issue Pages 31-39
Keywords Primary health care; Leadership; Professional development
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.
Call Number NRSNZNO @ research @ 1049 Serial (down) 1033
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Author Floyd, S.; Meyer, A.
Title Intramuscular injections: What's best practice? Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 6 Pages 20-22
Keywords Professional competence; Registered nurses; Quality of health care; Evidence-based medicine
Abstract The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
Call Number NRSNZNO @ research @ Serial (down) 986
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Author Shaw, S.
Title Constructing media images of nursing: How does the media represent nurses when reporting on nurse prescribing? Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 1 Pages 16-18
Keywords Drug administration; Interprofessional relations; Professional competence; Nursing; Eucation; Quality of health care
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.
Call Number NRSNZNO @ research @ Serial (down) 979
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Author Goodyear-Smith, F.; Janes, R.
Title New Zealand rural primary health care workforce in 2005: More than just a doctor shortage Type Journal Article
Year 2008 Publication Australian Journal of Rural Health Abbreviated Journal
Volume 16 Issue 1 Pages 40-46
Keywords Personnel; Physicians; Rural health services; Nursing; Primary health care; Pharmacists
Abstract The aim of this study was to obtain a 2005 snapshot of the New Zealand rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. A postal questionnaire was distributed to rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists in November 2005. The self-reported data included information on demographics, country of training, years in practice, business ownership, hours worked including on-call, and intention to leave rural practice.
Call Number NRSNZNO @ research @ Serial (down) 966
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Author Clendon, J.; White, G.E.
Title The feasibility of a nurse practitioner-led primary health care clinic in a school setting: A community needs analysis Type Journal Article
Year 2001 Publication Journal of Advanced Nursing Abbreviated Journal
Volume 34 Issue 2 Pages 171-178
Keywords Primary health care; Nurse managers; Advanced nursing practice; Community health nursing; School nursing
Abstract The aim of this study was to determine the feasibility of establishing a nurse practitioner-led, family focused, primary health care clinic within a New Zealand primary school environment as a means of addressing the health needs of children and families. A secondary aim was to ascertain whether public health nurses were the most appropriate nurses to lead such a clinic. Utilising a community needs analysis method, data were collected from demographic data, 17 key informant interviews and two focus group interviews. Analysis was exploratory and descriptive. Findings included the identification of a wide range of health issues. These included asthma management and control issues, the need to address poor parenting, and specific problems of the refugee and migrant population. Findings also demonstrated that participant understanding of the role of the public health nurse was less than anticipated and that community expectations were such that for a public health nurse to lead a primary health care clinic it would be likely that 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 plan that would serve to address the health needs of children and families in the area the study was undertaken. Services that participants identified as being appropriate included health information, health education, health assessment and referral. The authors conclude that the establishment of a nurse practitioner-led, family focused, primary health care clinic in a primary school environment was 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.
Call Number NRSNZNO @ research @ Serial (down) 952
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Author Clendon, J.
Title Demonstrating outcomes in a nurse-led clinic: How primary health care nurses make a difference to children and their families Type Journal Article
Year 2004 Publication Contemporary Nurse Abbreviated Journal
Volume 18 Issue 1-2 Pages 164-176
Keywords Primary health care; School nursing; Nurse managers
Abstract The study outlined here explored outcomes from the provision of primary health care to children aged 5-13 years in a nurse-led clinic based in a primary school in Auckland. This multi-faceted study collected both qualitative and quantitative data, however it is the results of the quantitative arm of the study that are presented here. Data were collected from a variety of sources concerning conditions seen, age and ethnicity of users, types of services provided and impact on hospital usage. Findings demonstrate that the provision of comprehensive primary health care by the nurse at the clinic impacts positively on hospital visitation by children from the area where the clinic is located.
Call Number NRSNZNO @ research @ Serial (down) 947
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Author DeSouza, R.
Title Transforming possibilities of care: Goan migrant motherhood in New Zealand Type Journal Article
Year 2005 Publication Contemporary Nurse Abbreviated Journal
Volume 20 Issue 1 Pages 87-101
Keywords Pregnancy; Transcultural nursing; Quality of health care; Attitude to health
Abstract This paper reports on a study of the maternity care experiences of women from Goa (India) in Auckland. Multiple research strategies were incorporated into the process to prevent reproduction of deficiency discourses. Interviews were carried out with Goan women who had experiences of migration and motherhood. The findings revealed that as a consequence of motherhood and migration, migrant mothers were able to reclaim and re-invent innovative solutions. Nurses and other health professionals can have a significant role in supporting women and their families undergoing the transition to parenthood in a new country and develop their knowledge and understanding of this dual transition.
Call Number NRSNZNO @ research @ Serial (down) 942
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Author Dennis, J.
Title How will transformative primary health care nursing leadership facilitate better health outcomes for Southlanders? Type
Year 2005 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Leadership; Nursing; Primary health care
Abstract Changes within the New Zealand health system have led to an emphasis on primary health care. The New Zealand government and the Southland District Health Board have identified that nurses can make significant contribution to improving the primary health outcomes for New Zealanders. However, within Southland there exist barriers to nurses influencing health outcomes. A Southland draft Primary Health Care Nursing Strategic Plan 2005 recommended that the employment of a primary health care nursing leader would reduce these barriers and lead to a comprehensive primary health care nursing service. This dissertation argues, using literature, that the employment of a transformative nursing leader, using a facilitative style, would implement changes that would develop a community responsive nursing service, establish a primary health care educational structure and ensure quality nursing care. Successful implementation would occur as the leader facilitates experiential learning within groups and with individuals to review current experiences and implement transformative primary health care nursing changes that improves health for all. The dissertation introduces the background to the changing primary health care environment in New Zealand and to the Southland current situation in chapter one. Chapter two describes the unique features of transformative leadership style and how it is applies to nursing and specifically to Southland's changing primary health care environment. The chapter specifically emphasises the role of and the art of facilitation which is a critical transformative leadership process. Chapter three describes the process of the experiential learning cycle, which the author argues will improve health outcomes, when used by the transformative leader to enable nurses to learn from their experiences and make nursing changes that improve health care. Chapter four addresses the dissertation question by describing how transformative leadership will facilitate the experiential learning process to Southlanders and improve health outcomes, reduce inequalities and increase accessibility through a comprehensive primary health care nursing service.
Call Number NRSNZNO @ research @ Serial (down) 920
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