| Records |
| 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 |
920 |
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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 |
942 |
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| Author |
Miles, M.A.P. |
| Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
Type |
|
| Year |
2005 |
Publication |
|
Abbreviated Journal |
NZNO Library, University of Otago Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Primary health care; Interprofessional relations; Policy |
| Abstract |
This thesis concerns an investigation of the tripartite arrangements between the government, the nursing and the medical sectors in New Zealand over the period 1984 to 2001 with a particular focus on primary health care. The start point is the commencement of the health reforms instituted by the Fourth New Zealand Labour Government of 1984. The thesis falls within a framework of critical inquiry, specifically, the methodology of depth hermeneutics (Thompson, 1990), a development of critical theory. The effects of political and economic policies and the methodologies of neo-liberal market reform are examined together with the concept of collaboration as an ideological symbolic form, typical of enterprise culture. The limitations of economic models such as public choice theory, agency theory and managerialism are examined from the point of view of government strategies and their effects on the relationships between the nursing and medical professions. The influence of American health care policies and their partial introduction into primary health care in New Zealand is traversed in some detail, together with the experiences of health reform in several other countries. Post election 1999, the thesis considers the effect of change of political direction consequent upon the election of a Labour Coalition government and concludes that the removal of the neo-liberal ethic by Labour may terminate entrepreneurial opportunities in the nursing profession. The thesis considers the effects of a change to Third Way political direction on national health care policy and on the medical and nursing professions. The data is derived from various texts and transcripts of interviews with 12 health professionals and health commentators. The histories and current relationships between the nursing and medical professions are examined in relation to their claims to be scientific discourses and it is argued that the issue of lack of recognition as a scientific discourse is at the root of nursing's perceived inferiority to medicine. This is further expanded in a discussion at the end of the thesis where the structure of the two professions is compared and critiqued. A conclusion is drawn that a potential for action exists to remedy the deficient structure of nursing. The thesis argues that this is the major issue which maintains nursing in the primary sector in a perceived position of inferiority to medicine. The thesis also concludes that the role of government in this triangular relationship is one of manipulation to bring about necessary fundamental change in the delivery of health services at the lowest possible cost without materially strengthening the autonomy of the nursing or the medical professions. |
| Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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| Author |
Holloway, K. T.; Pearson, J.R. |
| Title |
Trailblazers: Primary health care programme evaluation |
Type |
Conference Article |
| Year |
2005 |
Publication |
|
Abbreviated Journal |
coda, An Institutional Repository for the New Zealand ITP Sector |
| Volume |
Paper presented June 2004 at Royal New Zealand Plu |
Issue |
|
Pages |
|
| Keywords |
New graduate nurses; Primary health care; Evaluation research; Professional development |
| Abstract |
This report is an evaluation of the academic journey undertaken by a group of newly graduated nurses who were sponsored by a New Zealand district health board to work in a variety of primary health care nursing settings. The impetus for this pilot employment option was the Ministry of Health's focus on primary health care nursing and workforce development for this sector and the Expert Advisory Committee for primary health care nursing's recommendations to district health boards regarding employment of graduate nurses and support for them to engage in post graduate study. Evaluation participants were primarily the graduate nurses who were interviewed at the end of their first year of practice which was following programme completion then again nine to ten months later. Findings include the nurses reflections on what supported them and what acted to impede as barriers to their learning success and practice development. The report concludes with five recommendations that can be used to ensure that the travels of future newly graduated nurses taking this pathway are supported, safe and successful. |
| Call Number |
NRSNZNO @ research @ |
Serial |
1200 |
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| Author |
Clendon, J.; Krothe, J. |
| Title |
The nurse-managed clinic: An evaluative study |
Type |
Journal Article |
| Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
| Volume |
20 |
Issue |
2 |
Pages |
15-23 |
| Keywords |
Evaluation research; Nurse managers; Primary health care; Cross-cultural comparison |
| Abstract |
Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic. |
| Call Number |
NRSNZNO @ research @ |
Serial |
547 |
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| Author |
Bailey, A.M. |
| Title |
The New Zealand practice nurse in the primary health environment of the 21st century |
Type |
|
| Year |
2004 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
| Volume |
|
Issue |
|
Pages |
|
| Keywords |
Policy; Practice nurses; Primary health care |
| 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. |
| Call Number |
NRSNZNO @ research @ |
Serial |
831 |
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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 |
947 |
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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 |
1059 |
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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 |
1100 |
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| Author |
Mackay, B. |
| Title |
An analysis of innovative roles in primary health care nursing |
Type |
|
| Year |
2004 |
Publication |
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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 |
1124 |
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| Author |
Heese, Norma |
| Title |
Report: Margaret May Blackwell Travel Fellowship 2004 |
Type |
Report |
| Year |
2004 |
Publication |
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Abbreviated Journal |
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| Volume |
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Issue |
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Pages |
45p. |
| Keywords |
Primary health care; Child health services; Reports |
| Abstract |
Covers the placements the author visited and the topics learned whilst undertaking travel in the UK after being awarded the 2003 Margaret May Blackwell Travel Study Fellowship. Of specific interest was Well Child Care in Primary Health. Part of the Margaret May Blackwell Scholarship Reports series. |
| Call Number |
NZNO @ research @ |
Serial |
1412 |
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| Author |
Mackay, B. |
| Title |
General practitioners' perceptions of the nurse practitioner role: An exploratory study |
Type |
Journal Article |
| Year |
2003 |
Publication |
New Zealand Medical Journal |
Abbreviated Journal |
Access is free to articles older than 6 months, and abstracts. |
| Volume |
116 |
Issue |
1170 |
Pages |
|
| Keywords |
Nurse practitioners; Physicians; Interprofessional relations; Primary health care |
| Abstract |
This study explores perceptions of general practitioners in the Northland District Health Board (NDHB) regarding the nurse practitioner role, identifying their knowledge of and perceived problems with that role, and their experience of nurses in advanced practice. A purposive sample of all 108 general practitioners in NDHB was undertaken, with a response rate of 46.3%. General practitioners favourably viewed nurse practitioner functions traditionally associated with nursing, such as health teaching, home visiting, obtaining health histories, and taking part in evaluation of care, but less favourably viewed those functions associated with medicine, such as prescribing, ordering laboratory tests, and physical assessment. While expecting few problems with patient acceptance, the general practitioners felt that funding and doctors' acceptance would be problematic. Most general practitioners indicated they had knowledge of the nurse practitioner role and had experienced working with a nurse in advanced practice, but some uncertainty and lack of knowledge about the nurse practitioner role was evident. The author recommends more education and discussion with Northland general practitioners to ensure they are fully informed about the nurse practitioner role and its potential positioning in primary healthcare, to reduce uncertainty, minimise role confusion and promote collaboration between general practitioners and nurse practitioners. |
| Call Number |
NRSNZNO @ research @ |
Serial |
557 |
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| Author |
MacGeorge, J.M.; Nelson, K. |
| Title |
The experience of the nurse at triage influences the timing of CPAP intervention |
Type |
Journal Article |
| Year |
2003 |
Publication |
Accident & Emergency Nursing |
Abbreviated Journal |
|
| Volume |
11 |
Issue |
4 |
Pages |
234-238 |
| Keywords |
Emergency nursing; Clinical decision making; Hospitals; Quality of health care |
| Abstract |
This study used a non-experimental correlational design to research the relationship between the experience of the nurse, with the application of continuous positive airway pressure therapy (CPAP) to patients presenting to a metropolitan emergency department with cardiogenic pulmonary oedema (CPO), and to establish what difference, if any, CPAP made to outcomes. A retrospective audit of records was used to extract data on all 54 patients that received CPAP over a 12-month period. The primary outcome measures were off CPAP within two hours, transfer to intensive care unit or cardiac care unit, and secondary outcome measures were length of hospital stay and death. There was a trend towards more experienced nurses attending patients who required immediate treatment or treatment within 10 minutes. These patients were more likely to be recognised at triage as requiring CPAP therapy. The early application of CPAP reduced hospital mortality, length of stay, and the need for intubation and ventilation. Attention needs to be given on how best to educate nurses so that more patients presenting with acute respiratory failure can benefit from nurses' decision-making regarding the commencement of CPAP. |
| Call Number |
NRSNZNO @ research @ |
Serial |
847 |
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| Author |
Pirret, A.M. |
| Title |
A preoperative scoring system to identify patients requiring postoperative high dependency care |
Type |
Journal Article |
| Year |
2003 |
Publication |
Intensive & Critical Care Nursing |
Abbreviated Journal |
|
| Volume |
19 |
Issue |
5 |
Pages |
267-275 |
| Keywords |
Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment |
| Abstract |
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions. |
| Call Number |
NRSNZNO @ research @ 904 |
Serial |
888 |
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| Author |
Macfie, Belinda |
| Title |
The exploration of primary health care nursing for child and family health : Margaret May Blackwell Travel Study Fellowship, 2002 |
Type |
Report |
| Year |
2003 |
Publication |
|
Abbreviated Journal |
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| Volume |
|
Issue |
|
Pages |
103 |
| Keywords |
Primary health care – nursing; Child health services; Family health; Reports |
| Abstract |
Reports the approach to child and family health nursing in Canada, the US, and the UK. Divides the report into health policy, primary health care services, nursing education and the development of primary health care nurse practitioners, and nursing leadership in primary health care. Part of the Margaret May Blackwell Scholarship Reports series. |
| Call Number |
NZNO @ research @ |
Serial |
1424 |
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