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Mackay, B. (2004). An analysis of innovative roles in primary health care nursing. Ph.D. thesis, , .
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 These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition).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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Kingsbury, K. (2000). The illlusion of separateness, a philosophical study of nursing and naturopathic practice: Healing connections between people. Ph.D. thesis, , .
Abstract: This thesis describes the journey of a practicing independent nurse practitioner and naturopath through the stories of five clients. The thesis is presented as a narrative and begins with an account of the events in the practitioner's life that lead to the specific study of natural therapies and the development of a cohesive practice using holistic health practices from a nursing perspective. The text essentially describes the process of establishing a private practice combining two disciplines of nursing and naturopathy in New Zealand. The study reveals how a nurse and naturopath's practice is based on the premise that it is crucial to recognise that the personal life and professional life of the nurse inform and influence each other and are always part of the process of care in such a practice. Three healing modalities that are central to the practice are described in detail. The description is informed by theory and research from nursing, the social sciences and the natural sciences. The study reveals the practical value of postmodern nurse theorists, Jean Watson and Margaret Newman to this practice. This study also briefly discusses the concepts from quantum theory, evolutionary theory and psychoneuroirnmunology that are used in the practice.
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Pirret, A. M. (2013). Nurse practitioner diagnostic reasoning. Ph.D. thesis, Massey University, Palmerston Nursing.
Abstract: Uses a post-positivist mixed-methods convergent-parallel design to explore nurse practitioner diagnostic reasoning and compare it to that of registrars. Includes 30 nurse practitioners and 16 registrars in a case scenario. Outlines nurse practitioner practice in NZ and how the NZ title of nurse practitioner differs from that used internationally.
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Holloway, K. T. (2011). Development of a specialist nursing framework for New Zealand. Doctoral thesis, University of Technology Sydney, Sydney, Australia. Retrieved June 3, 2024, from http://hdl.handle.net/10453/20322
Abstract: Expresses concern that inconsistent specialist nursing workforce planning and pathways for nursing practice development will adversely affect needed service provision for the population. Reports the outcomes of research, which suggests an alternate approach through the development of a single unified capability framework for specialist nursing practice in NZ. Uses a qualitative descriptive and exploratory multi-method enquiry approach to review extant understandings and develop a consensus framework, identifying the essential elements required for a single national framework for specialist nursing in NZ. Widens the understanding of a more holistic approach to specialist nursing development, which holds great promise for the specialist nursing workforce in NZ and internationally.
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Wilkinson, J. A. (2007). The New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealand. Doctoral thesis, Massey University, Wellington.
Abstract: Traces the development of the nurse practitioner role in NZ since its establishment in 2001, using a discourse analytical approach to examine those discourses that have defined the role. Employs both textual and discursive analysis of texts from published literature and from nine interviews with individuals influential in the evolution of the role. Examines political perspectives and disciplinary practices dating back to the Nurses Registration Act of 1901. Considers the implications of an autonomous nursing profession in both practice and regulation.
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Officer, T. N. (2018). Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience. Doctoral thesis, Victoria University of Wellington, Wellington. Retrieved June 3, 2024, from http://hdl.handle.net/10063/7098
Abstract: Investigates how nurse practitioner and pharmacist prescriber roles are developing in NZ primary health care, and what is needed to better support the future development of these roles. Employs a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health-care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services.
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Gubb, A. (2020). Rural nurse practitioner role to improve outcomes for Thames-Coromandel community. Master's thesis, Auckland University of Technology, Auckland. Retrieved June 3, 2024, from http://hdl.handle.net/10292/13468
Abstract: Maintains that the Nurse Practitioner (NP) role has the potential to achieve more equitable outcomes for rural populations, particularly for older adults in their transition from hospital to the rural setting. Examines how NPs can reduce readmissions, from a thematic analysis of the literature using a realist synthesis approach, focusing on the Thames Coromandel rural community. Derives three themes from the analysis: self-efficacy, holistic care, and care grounded in nursing philosophy.
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Adams, S. (2017). Nurse practitioners in rural primary health care in New Zealand : an institutional ethnography. Ph.D. thesis, Massey University, Auckland. Retrieved June 3, 2024, from http://hdl.handle.net/10179/12816
Abstract: Critically examines the work required to establish nurse practitioner (NP) services in rural primary health care in NZ, using the institutional ethnography approach to the inquiry. Explores the work and experiences that nurses undertook to become NPs delivering rural primary health care services. Considers how these were institutionally-shaped and coordinated. Conducts interviews with a total of 13 NPs and four NP candidates.
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Litchfield, M. (1998). Professional development: Developing a new model of integrated care. Kai Tiaki: Nursing New Zealand, 4(9), 23–25.
Abstract: An overview of the model of nursing practice and nurse roles derived through a programme of nursing research in the context of the policy and strategies directing developments in the New Zealand health system. The emphsis was on the health service configuration model presented diagrammatically to show the position of a new role of family nurse with a distinct form of practice forming the hub.
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Hales, A., & Dignam, D. (2002). Nurse prescribing lessons from the US. Kai Tiaki: Nursing New Zealand, 8(10), 12–15.
Abstract: The researchers present a survey of a sample population of 32 advanced practice nurses (APN) in the US about their experiences of acquiring and implementing prescriptive authority. The issues relevant to nurse practitioners in New Zealand are discussed, around acquiring knowledge and education, relationships with other professionals, establishing the role, and retaining the nursing role. The intent and scope of APN prescribing in the US is also discussed.
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Milligan, K., & Neville, S. J. (2001). Health assessment and its relationship to nursing practice in New Zealand. Contemporary Nurse, 10(1/2), 7–11.
Abstract: This article draws on Australian experience to gain insight to three specific areas of health assessment that are topical in New Zealand, which has recently introduced the concept into nursing training. The issues are annual registration based on evidence of competence to practice, a review of undergraduate curricula, and the development of nurse practitioner/advanced nurse practitioner roles. The meaning of the concept 'health assessment' is also clarified in order to provide consistency as new initiatives in nursing are currently being developed.
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Speed, G. (2003). Advanced nurse practice. Nursing dialogue: A Professional Journal for nurses, 10, 6–12.
Abstract: The concept and characteristics of advanced nursing practice in New Zealand and overseas is compared with the nurse practitioner role. There is an international debate over definitions of advanced nursing and the range of roles that have developed. The rationale for the nurse practitioner role in New Zealand is examined, along with the associated legislation currently before Parliament. Job titles and roles of nurses within the Waikato Hospital intensive care unit are discussed and ways of developing the role of nurse practitioner are presented.
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Mustafa, M., Adams, S., Bareham, C., & Carryer, J. (2021). Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers. Journal of Primary Health Care, 13(3). Retrieved June 3, 2024, from http://dx.doi.org/10.1071/hc21036
Abstract: Explores the perspectives of practice managers on employing nurse practitioners (NP) in general practice. Uses an electronic survey to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively.
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Laidlaw, R., & Mercer, C. (2022). Nurse practitioners: does home visiting improve outcomes for people living with long-term conditions. Kai Tiaki Nursing Research, 13(1), 39–41.
Abstract: Explores the potential for nurse practitioners (NP) in NZ to visit people diagnosed with chronic condiitons at home. Evaluates whether home-visiting NPs could provide primary care in place of GPs. Conducts a review of research comprising three themes: reduced barriers to care, improved health outcomes, and role clarity for NPs.
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Huntington, A. D., & Gilmour, J. A. (2005). A life shaped by pain: Women and endometriosis. Journal of Clinical Nursing, 14(9), 1124–1132.
Abstract: The research aim was to explore women's perceptions of living with endometriosis, its effects on their lives and the strategies used to manage their disease. A qualitative research design informed by feminist research principles was chosen for this project. Eighteen women agreed to take part in the research. The individual, audio taped interviews were semi-structured and interactive. The interviews were analysed using a thematic analysis approach. The dominant feature of data from the interviews was the experience of severe and chronic pain impacting on all aspects of life. Analysis related to pain resulted in four themes: manifestations of pain, the pain trajectory, intractable pain and controlling pain. The diagnostic process typically took 5-10 years indicating that primary health care practitioners need higher levels of 'suspicion' for this condition. Case studies and problem-based scenarios focusing on endometriosis in health professional education programmes would enhance diagnostic skills and knowledge development. No formal pain management follow up after diagnosis and treatment meant women actively sought information from other sources as they made major lifestyle changes in the areas of activity and nutrition. Pain management services specifically for women with endometriosis would provide much needed support with this neglected aspect of the disease. The authors conclude this is an area for the development of the nurse practitioner role which, also drawing on the considerable collective expertise of women with endometriosis, could provide significant information and support for women as they manage this highly complex condition.
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