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Author Litchfield, M.; Connor, M.; Eathorne, T.; Laws, M.; McCrombie,; Smith, S.
Title Direction for nursing practice and service delivery in the New Zealand health reforms. Report of the pilot study of the Wellington professional nurse care management project Type
Year 1993 Publication Abbreviated Journal Nursing Library. Victoria University, Wellington
Volume Issue (up) Pages
Keywords
Abstract Nursing practice as the process of health patterning with families in complex health circumstances was made explicit through a method of research praxis. Findings include cost in relation to quality of Nursing care. The research provides direction for development of integrated health care with the introduction of the family Nurse in a Nurse Care Management Scheme
Call Number NRSNZNO @ research @ 48 Serial 48
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Author Litchfield, M.
Title The process of health patterning in families with young children who have been repeatedly hospitalised Type
Year 1993 Publication Abbreviated Journal Author, University of Minnesota Library
Volume Issue (up) Pages
Keywords
Abstract An exploration of the nature of nursing knowledge in practice. The praxis methodology was inspired by the Newman's theory of health as expanding consciousness and evolved through the process of the research. The methodology was eventually presented as both the process of research and practice. Five families were visited in their homes five times to talk about what was going on for them. All were experiencing a time of great upheaval in family life. After three visits a summary text was constructed merging researcher statements and parent quotes and given to the families. Through the subsequent reflective discussion significant insights into family pattern were shown in statements of intended action to change how health matters were managed with greater facility in family living. The process was presented as five themes with descriptors representing a non-linear, discontinuous progression: A moment of partnership: parameters of entry and closure, a timing of upheaval in family life, and an in-forming capacity through the bringing together of family story-telling and researcher's theory. An evolving dialogue: a progressive flow of enfolding and unfolding, and its embeddedness in contexts of socio-economic status, gender and health care culture. Recognising pattern: incidental revelations and an all-encompassing insight as the potential for action. Expanding horizon: moving from being on a treadmill trapped in the present without vision to having a view to a future, the presence of past and future. Increasing connectedness: a sense of inclusion, inter-dependence and generally, transformation in family life. This was a framework for personal practice
Call Number NRSNZNO @ research @ 121 Serial 121
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Author Litchfield, M.; McCombie, M.-L.
Title The introduction of an advanced nurse practitioner role in mental health: report of the evaluation research undertaken for the Mental Health Service of Capital Coast Health Ltd Type
Year 1994 Publication Abbreviated Journal Chief Nurse Advisor, Ministry of Health, PO Box 50
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Keywords
Abstract The study was commissioned to define the role of Advanced Nurses Practitioner to inform the establishment of a clinical career pathway. Four new, loosely defined ANP positions were created and the role evolution over three months was described. The impact on the multidisciplinary team functioning was to be given particular attention. The research design was developed in collaboration with the ANP Project Team of the service. Data were derived from surveys of nurses in the units and other staff before and at the end of the 3 months period; interviews with the ANPs and official client advocates; daily journals and weekly logs kept by the ANPs; statistical records of patient loads and staffing. The findings presented the role as the interface of unit management and direct client care, with the ANPs orchestrating the activities of the unit. The ANPs developed the role differently according to quite distinct conceptualisations of nursing which influenced whether direct client care was pivotal or peripheral to the role. This had an effect on whether the strains of the service were seen as inhibitory of focal to the development of the ANP practice. There was little change in unit staff satisfaction. Attempts to incorporate client advocacy to determine change in client satisfaction were unsuccessful. The ANPs used the research as a process of role development
Call Number NRSNZNO @ research @ 386 Serial 386
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Author Litchfield, M.; Connor, M.; Eathorne, T.; Laws, M.; McCombie, M.-L.; Smith, S.
Title Family nurse practice in a nurse management scheme: a pilot service study for the health reforms Type
Year 1994 Publication Abbreviated Journal Centre for Initiative in Nursing & Health Care, P.
Volume Issue (up) Pages
Keywords
Abstract The independently funded 10 month pilot project demonstrated the autonomy of nursing practice for a new role family nurse. The findings were presented as the health experience of families in strife with complex health circumstances, a description of a beginning model for the nursing practice that addressed the needs of these families as their circumstances changed over time, and its cost-effectiveness. A caseload of nineteen families was found to be optimum. The evaluation research continued throughout as a form of praxis expressed as health patterning, a methodology developed in previous research (Litchfield, 1993). The family nurse'spractice demonstrated qualities common to all nurses: the caring relationship and fiscal responsibility. The unique practice was characterised by a professional partnership of limited duration: the families referred to the service in a predicament of strife, trapped in the immediate present, gained a view to a future, moved towards assuming control over health circumstances, seeking and using services with discernment, and increasing community as family/group members and citizens. Cost containment was achieved through: a) development of a co-operative approach amongst family members, between families and professionals, and amongst all health workers, and b) the families discerning use of services by anticipating a future. Through one family case, cost of saving over the 7 months with the family nurse was estimated as $4000, a possible saving of $16000 over 13 months if the family nurse had been involved earlier, and projected savings in the long term of over a million dollars. The satisfaction of clients, nurses and professionals was shown. The service was positioned within the new health system of health reforms
Call Number NRSNZNO @ research @ 389 Serial 389
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Author Litchfield, M.
Title Achieving health in a rural community: A case study of nurse – community partnership Type Book Whole
Year 2004 Publication Abbreviated Journal University and Polytechnic Libraries, NZNO Library
Volume Issue (up) Pages
Keywords Rural health services; Nursing models; Advanced nursing practice; Health promotion; Organisational change
Abstract This study describes rural, nurse-led health services provided by the Takapau Health Centre (Central Hawkes Bay) and its outreach, Norsewood & District Health Centre. The study looks at its model of service delivery through to 2002. It examines the establishment, development, funding and management of the service, along with the nursing practice and the healthcare people received. The book is a snapshot of nursing initiative and survival through a decade of change in health policy and service funding and delivery. The information was subsequently used to move the health centre service into the new paradigm of primary health care launched in the New Zealand Health Strategy.
Call Number NRSNZNO @ research @ 1183 Serial 1168
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Author Litchfield, M.
Title The nursing praxis of family health Type Book Chapter
Year 2005 Publication Picard, C & Jones, D., Giving voice to what we know (pp.73-82) Abbreviated Journal
Volume Issue (up) Pages
Keywords Nursing research; Nursing philosophy; Nurse-family relations
Abstract The chapter explores the process of nursing practice and how it contributes to health, derived from research undertaken in New Zealand. It presents the nature of nursing research as if practice – the researcher as if practitioner – establishing a foundation for the development of nursing knowledge that would make a distinct contribution to health and health care. It includes the philosophy and practicalities of nursing through the use of a case study of nursing a family with complex health circumstances.
Call Number NRSNZNO @ research @ 1185 Serial 1170
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Author Litchfield, M.; Clarke, M.; Edwards, R.; Richardson, F.; Tansley, R.; Woodman, K.
Title A description of the needs of people with cancer and support people Type
Year 1995 Publication Abbreviated Journal Author, Wellington Division of the Cancer Society
Volume Issue (up) Pages
Keywords
Abstract The report of a research project commissioned by the Wellington Division of the New Zealand Cancer Society to provide a foundation for policy to give direction to development of its services. The research approach and methodology had an ecological theory foundation. It involved a survey and in-depth interviews with people with cancer and those caring for them to understand their experience. Needs were identified from the data and presented according to three distinct phases in the course of living with cancer. People moved from the shock of diagnosis, through the time of treatment when usual living was suspended and focus narrowed on the intensive fight against the disease, then into a very different phase of on-going ?wait-and-see? time requiring a new way of living with uncertainty for both patient and carers. The last phase was where most of the unmet needs lay. Recommendations were made for services to provide a continuous caring relationship for patients and carers with a knowledgeable person from the point of diagnosis.
Call Number NRSNZNO @ research @ Serial 387
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Author Litchfield, M.
Title Computers and the form of nursing to come Type Conference Article
Year 1992 Publication Abbreviated Journal Held by NZNO Library and author
Volume Proceedings of the Inaugural National Nursing Info Issue (up) Pages 81-90
Keywords Nursing: Computers; Technology
Abstract A paper presented at the annual conference of Nursing Informatics New Zealand (subsequently incorporated into the collective organisation, Health Informatics NZ).
Call Number NZNO @ research @ Serial 1317
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Author Litchfield, M.; Laws, M.
Title Achieving family health and cost-containment outcomes: Innovation in the New Zealand Health Sector Reforms Type Book Chapter
Year 1999 Publication Cohen,E. & De Back,V. (Eds.), The outcomes mandate: New roles, rules and relationships. Case management in health care today (pp. 306-316) Abbreviated Journal
Volume Issue (up) Pages
Keywords Advanced nursing practice; Nurse managers; Teamwork; Nurse-family relations; Leadership; Health reforms
Abstract The chapter presents the research findings of the 1992-1993 Wellington Nurse Case Management Scheme Project as a distinct model of nurse case management, which introduced a role and form of practice of a family nurse and a diagram of the service delivery structure required for support and relevant for the New Zealand health system reforms.
Call Number NRSNZNO @ research @ Serial 1169
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Author Litchfield, M.; Ross, J.
Title The role of rural nurses: National survey Type Report
Year 2000 Publication Abbreviated Journal Online on the Ministry of Health's Centre for Rural Health pages
Volume Issue (up) Pages
Keywords Rural nursing; Personnel; Nursing specialties; Primary health care
Abstract A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce.
Call Number NRSNZNO @ research @ Serial 1175
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Author Litchfield, M.
Title A framework of complementary models of nursing practice: A study of nursing roles and practice for a new era of healthcare provision in New Zealand Type Report
Year 2001 Publication Abbreviated Journal Online on the Ministry of Health's Centre for Rural Health pages
Volume Issue (up) Pages
Keywords Nursing models; Rural nursing; Policy; Scope of practice
Abstract This is the second of a series of research projects undertaken to present the contemporary picture of the nurse workforce and their work in rural settings to inform policy for development of rural healthcare. The document presents the findings of telephone interviews with nurses in different work rural work settings around the country discussing their practice. The analysis identified a framework of four models of nursing practice: two traditional models defined by the institutions employing nurses, and two emerging models defined by the new positions requiring nurses to respond directly to health need.
Call Number NRSNZNO @ research @ Serial 1176
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Author Litchfield, M.
Title The successful design and delivery of rural health services: The meaning of success Type Report
Year 2002 Publication Abbreviated Journal Online on the Ministry of Health's Centre for Rural Health pages
Volume Issue (up) Pages
Keywords Evaluation; Rural health services; Primary health care
Abstract This is the report of the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of “successful design and delivery of rural health services” as a step towards a measurement tool. Participants were grouped as general practitioners, nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health.
Call Number NRSNZNO @ research @ Serial 1177
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Author Litchfield, M.
Title Towards a people-pivotal paradigm for healthcare: Report of the Turangi primary health care nursing innovation 2003-2006 Type Manuscript
Year 2006 Publication Abbreviated Journal Held by the Ministry of Health, publication pending
Volume Issue (up) Pages
Keywords Evaluation; Community health nursing; Nursing models; Interprofessional relations
Abstract This report presents the findings of the developmental evaluation programme for the three-year innovation project. It includes the model of the integrative nursing service scheme with mobile whanau/family nurses as the hub of healthcare provision for a new paradigm of service design and delivery spanning primary-secondary-tertiary sectors. The form of healthcare the local people received, the nature of the nursing practice and role, service delivery and employment parameters required to support the nurses in practice are presented. The service configuration model subsequently gave the structure to Lake Taupo Primary Health Organisation with the hub of family nurses with a mobile comprehensive practice.
Call Number NRSNZNO @ research @ Serial 1178
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Author Litchfield, M.
Title The nation's health and our response Type Conference Article
Year 1992 Publication Abbreviated Journal
Volume Keynote address at the 1992 NERF/NZNZ National Nur Issue (up) Pages
Keywords Nursing; Health reforms; Nurse-family relations
Abstract An analysis of the challenges for the nursing profession of the Government's health reforms. The findings of the 10-month Wellington Nurse Case Management Project 1991-1992, including the description of family nursing practice, what it achieved for health and the service delivery model that would position family nurses in the health reforms were used to provide an exemplar for the nuyrising contribution to health policy for the health reforms. The paper identified a vacum for the reorientating of health care provision to patients/clients and health need and the call to nursesw to take leadership in goving direction to the reorientation.
Call Number NZNO @ research @ Serial 1319
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Author Litchfield, M.
Title The language of nursing practice in hospitals Type Conference Article
Year 1997 Publication Abbreviated Journal held by NZNO Library and author
Volume Proceedings of the National Nursing Informatics Co Issue (up) Pages
Keywords Hospitals; Nurse managers; Advanced nursing practice; Nurse-patient relations; Care plans
Abstract A paper presenting the findings of a small research project involving a group of self-selected senior nurses of Wellington Hospital to explore the nature of nursing practice in the care and management of hospitalised patients and to formalise the language that would acknowledge its significance in the current effort of hospitals to define patient care pathways. The nature of hospital nursing practice was described in themes of a generic process of nurse-patient care that articulates a distinct specialism of hospital nursing, whatever the hospital department in which nurses hold positions.
Call Number NZNO @ research @ Serial 1322
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