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Author Pullon, S.; McKinlay, E.M.
Title Interprofessional learning: The solution to collaborative practice in primary care Type Journal Article
Year 2007 Publication New Zealand Family Physician Abbreviated Journal The Royal New Zealand College of General Practitioners website
Volume 34 Issue 6 Pages 404-408
Keywords Interprofessional relations; Education; Primary health care; Communication
Abstract In this paper the authors outline the basis of interprofessional education, which occurs when members of two or more professions are engaged in learning together. They describe its relationship to primary care clinical practice, where it can lead to collaborative problem-solving approaches, mutual decision making and interdisciplinary teamwork. A New Zealand model of postgraduate interprofessional education is presented. Barriers to the implementation of interprofessional education in New Zealand are identified along with possible solutions.
Call Number (up) NRSNZNO @ research @ Serial 458
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Author Richardson, S.; Ardagh, M.; Hider, P.
Title New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department Type Journal Article
Year 2006 Publication New Zealand Medical Journal Abbreviated Journal Access is free to articles older than 6 months, and abstracts.
Volume 119 Issue 1232 Pages
Keywords Hospitals; Clinical assessment; Interprofessional relations
Abstract This study aims to examine the concept of 'inappropriate' emergency department attendances in relation to the emergency department at Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. An exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of emergency department patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'. The researchers found significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the emergency department. This has implications for any interventions aimed at addressing emergency department 'overcrowding' that assume the presence of a consensus understanding of this concept.
Call Number (up) NRSNZNO @ research @ Serial 526
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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 (up) NRSNZNO @ research @ Serial 557
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Author Brasell-Brian, R.; Vallance, E.
Title Clinical practice/education exchange: Bridging the theory-practice gap Type Journal Article
Year 2002 Publication Nursing Praxis in New Zealand Abbreviated Journal
Volume 18 Issue 1 Pages 17-26
Keywords Education; Interprofessional relations
Abstract This article positions clinical practice/education exchange (CPEE) within nursing literature and presents narrative accounts from a nurse educator and clinician who exchanged jobs for one year. This type of exchange, between education institutes and service areas where students are placed, is a new concept. The aim is to enhance student learning and facilitating meaningful links between theory and practice for them.
Call Number (up) NRSNZNO @ research @ Serial 613
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Author Horsburgh, M.; Lamdin, R.; Williamson, E.
Title Multiprofessional learning: The attitudes of medical, nursing and pharmacy students to shared learning Type Journal Article
Year 2001 Publication Medical Education Abbreviated Journal
Volume 35 Issue 9 Pages 876-883
Keywords Nursing; Education; Students; Interprofessional relations
Abstract This study has sought to quantify the attitudes of first-year medical, nursing and pharmacy students' towards interprofessional learning, at course commencement. The Readiness for Interprofessional Learning Scale (RIPLS) (University of Liverpool, Department of Health Care Education), was administered to first-year medical, nursing and pharmacy students at the University of Auckland. Differences between the three groups were analysed. The majority of students reported positive attitudes towards shared learning. The benefits of shared learning, including the acquisition of teamworking skills, were seen to be beneficial to patient care and likely to enhance professional working relationships. However professional groups differed: nursing and pharmacy students indicated more strongly that an outcome of learning together would be more effective teamworking. Medical students were the least sure of their professional role, and considered that they required the acquisition of more knowledge and skills than nursing or pharmacy students.
Call Number (up) NRSNZNO @ research @ Serial 719
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Author Evans, S.
Title Silence kills: Communication around adverse events in ICU Type
Year 2006 Publication Abbreviated Journal Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz
Volume Issue Pages
Keywords Intensive care nursing; Communication; Interprofessional relations
Abstract The aim of this dissertation is to assess the preventability or reduction of adverse events in the intensive care unit (ICU) through a literature review. Research shows the ICU is at high risk for errors, nevertheless there is a huge gap between knowing something should be done and applying this knowledge to practice. That being the case, this dissertation identifies and discusses several proven and transferable quality improvement proposals. These include: instituting anonymous error reporting; documentation of a daily goal-of-care; a nurse as ICU team co-ordinator; conflict resolution processes and communication training for all ICU staff. NThe author concludes that nurse-doctor collaboration requires the support of medicine, with recognition of the unique contribution nurses make to patient safety.
Call Number (up) NRSNZNO @ research @ Serial 741
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Author Maw, H.
Title The challenge of developing primary health care nurse practitioner roles in rural New Zealand Type Book Chapter
Year 2008 Publication Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 201-214) Abbreviated Journal Ministry of Health publications page
Volume Issue Pages
Keywords Nurse practitioners; Rural health services; Interprofessional relations; Policy
Abstract The author traces the development of the nurse practitioner role in New Zealand, which was finally introduced in 2001. It traces the key events, from early debates on the issue, the influence of the Centre for Rural Health, and a series of government investigations into nursing which noted the untapped potential of the nursing workforce and the lack of ongoing clinical career pathways. Barriers to rural nurses becoming endorsed as primary health care nurse practitioners are examined, and some of the solutions to this issue are explored. Relationships between nurse practitioners and the local general practitioners, and community resistance are areas that need management. Education is seen as a key response to many of these issues.
Call Number (up) NRSNZNO @ research @ Serial 762
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Author Farrow, T.
Title Owning their expertise: Why nurses use 'no suicide contracts' rather than their own assessments Type Journal Article
Year 2002 Publication International Journal of Mental Health Nursing Abbreviated Journal
Volume 11 Issue 4 Pages 214-219
Keywords Interprofessional relations; Psychiatric Nursing; Community health nursing; Qualiltative research; Suicide
Abstract 'No suicide contracts' are a tool commonly used by nurses in community crisis situations. At times this tool is utilised because the clinician believes that it is beneficial. However, there are other occasions when 'No suicide contracts' are introduced in a manner that runs counter to the clinical judgement of the crisis nurse. This paper discusses the results of a qualitative study that addressed the question of why nurses use 'No suicide contracts' in such situations, rather than relying on their own expertise. This analysis suggests that underlying concerns of clinicians can determentally affect decision-making in such circumstances, and recommends that rather than subjugating nursing expertise, underlying issues be addressed directly.
Call Number (up) NRSNZNO @ research @ Serial 785
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Author Strochnetter, K.T.
Title Influences on nurses' pain management practices within institutions: A constructivist approach Type
Year 2000 Publication Abbreviated Journal Victoria University of Wellington Library
Volume Issue Pages
Keywords Interprofessional relations; Pain management; Nursing
Abstract Alleviating patient suffering, providing comfort and pain relief are all central to the philosophical caring position nurses have always espoused. Despite this, patients continue to suffer pain although we have the means to provide pain relief. The author notes that research has identified that nurses have a knowledge deficit regarding pain and its management, as well an erroneous attitudes, which combined are blamed for an inability to make significant progress in this area. This study was undertaken to uncover the contextual aspects of working within a New Zealand health care institution that affect nurses' ability to manage their patient' pain effectively. It highlights the difficulties and the complicated nature of working within an institution in the 1990's health care environment, where accountability for pain is absent and where pain is often under-assessed and under-treated. By using focus group of nurses, the author notes she was able to uncover constructions on nursing practice, which, she suggests, have been missing from the literature, but prevent nurses from implementing their knowledge. Using a constructivist research, she used nurse's stories and current literature to argue one way forward in, what she terms, the pain management debacle. This study revealed a diverse range of contextual factors that prevent nurses from using their knowledge. Many of the constraints on nursing practice are the results of complex organisational structures within health reform, which have significantly affected the nurse's ability to provide quality-nursing care. One of the most important factors limiting the management of the patient' pain is the inability of the nurse to autonomously initiate analgesia. While nurses are largely responsible for the assessment of pain, they are usually powerless to access necessary analgesia, without a medical prescription. The author argues that once an initial medical diagnosis has been made, nurses are usually left responsible for patient comfort and the management of pain. To do so effectively, nurses need to able to prescribe both pharmacological and non-pharmacological measures for the patient. Presently nurses are prescribing using a variety of illegitimate mechanisms, needing the endorsement of a doctor. To fulfil this role, nurses must be adequately prepared educationally and given the authority to either prescribe autonomously, of provided with extensive “standing orders”. While legislative changes in New Zealand in 1999 extended prescribing right to a few nurses within certain areas of care, the ward nurse is unlikely to gain prescribing rights in the near future. The author concludes that a way forward may be to encourage and further develop the use of protocols for managing pain via standing orders. Standing orders are common place within nursing practice today, have the support of the Nursing Council of New Zealand and are currently under-going legislative review. An institutional commitment to developing pain protocols for nurses would recognise the nurses active role and expertise in the management of pain and facilitate expedient relief for the patient.
Call Number (up) NRSNZNO @ research @ Serial 909
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Author Horsburgh, M.; Perkins, R.; Coyle, B.; Degeling, P.
Title The professional subcultures of students entering medicine, nursing and pharmacy programmes Type Journal Article
Year 2006 Publication Journal of Interprofessional Care Abbreviated Journal
Volume 20 Issue 4 Pages 425-431
Keywords Interprofessional relations; Attitude of health personnel; Nurse managers; Nursing; Education; Organisational culture
Abstract This study sought to determine the attitudes, beliefs and values towards clinical work organisation of students entering undergraduate medicine, nursing and pharmacy programmes in order to frame questions for a wider study. University of Auckland students entering medicine, nursing and pharmacy programmes completed a questionnaire based on that used by Degeling et al. in studies of the professional subcultures working in the health system in Australia, New Zealand, England and elsewhere. Findings indicate that before students commence their education and training medical, nursing and pharmacy students as groups or sub-cultures differ in how they believe clinical work should be organised. Medical students believe that clinical work should be the responsibility of individuals in contrast to nursing students who have a collective view and believe that work should be systemised. Pharmacy students are at a mid-point in this continuum. There are many challenges for undergraduate programmes preparing graduates for modern healthcare practice where the emphasis is on systemised work and team based approaches. These include issues of professional socialisation which begins before students enter programmes, selection of students, attitudinal shifts and interprofessional education.
Call Number (up) NRSNZNO @ research @ Serial 937
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Author Murphy, R.
Title A day in the life of an acute hospital psychiatric nurse Type Journal Article
Year 2005 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 11 Issue 9 Pages 24-25
Keywords Nursing; Psychiatric Nursing; Interprofessional relations; Mental health; Multidisciplinary care teams
Abstract A nurse presents a personal account of a typical day at Middlemore Hospital's 50-bed acute inpatient mental health unit Tiaho Mai. The article covers aspects of shift handover, working with multidisciplinary teams, developing care plans, working with families, and responding to emergencies.
Call Number (up) NRSNZNO @ research @ Serial 957
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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 (up) NRSNZNO @ research @ Serial 979
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Author Evans, S.
Title Silence kills: Challenging unsafe practice Type Journal Article
Year 2007 Publication Kai Tiaki: Nursing New Zealand Abbreviated Journal
Volume 13 Issue 3 Pages 16-19
Keywords Medical errors; Organisational change; Organisational culture; Patient safety; Interprofessional relations
Abstract The author reviews the national and international literature on medical errors and adverse events. Contributing factors are identified, such as organisational culture, the myth of infallibility, and a one size fits all approach to health care. Conflict and communication difficulties between different health professionals is discussed in detail, as is the issue of disruptive behaviour, which includes intimidation, humiliation, undermining, domination and bullying. Some strategies for addressing these issues are proposed, such as promoting a no-blame culture, and addressing conflict between health professionals.
Call Number (up) NRSNZNO @ research @ Serial 994
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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 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 (up) NRSNZNO @ research @ Serial 1178
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Author Ryder-Lewis, M.
Title Reliability study of the Sedation-Agitation Scale in an intensive care unit Type
Year 2004 Publication Abbreviated Journal ResearchArchive@Victoria
Volume Issue Pages
Keywords Intensive care nursing; Interprofessional relations
Abstract This study is an extension of a previous study by Riker, Picard and Fraser (1999) to determine whether doctors and nurses rate patients similarly using the Sedation-Agitation Scale (SAS) in a natural Intensive Care Units (ICU) setting. The author notes that it is essential to establish whether these different professionals provide consistent scores and have a mutual understanding of the SAS and its constituent levels. This will help ensure that clinical decisions relating to sedation-needs can be made appropriately and consistently. This quasi-experimental reliability study was set in a 12-bed tertiary general ICU in New Zealand. The SAS had recently been introduced into this unit and a convenience sample of 42 nursing and medical staff performed paired ratings on 69 randomly selected adult ICU patients over an eight week time frame. The mean patient age was 58 years, and 79% of patients were on continuous infusions of Propofol. Intubated patients made up 91% of the sample. 74% of patients were given the same SAS score by the doctor-nurse pair. The weighted kappa score for inter-rater agreement was 0.82 indicating very good agreement. Of the 26% of scores where there was a difference, the two readings were only one score apart. Most of the difference occurred around SAS scores of 1-2 and 3-4. Further analysis found no staff or patient variables to be statistically significant in impacting on the ratings. The SAS was found to be a reliable sedation-scoring tool in a general ICU when used by nurses and doctors of varying experience.
Call Number (up) NRSNZNO @ research @ Serial 1203
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