| |
Records |
Links |
|
Author |
Higgins, A. |
|
| |
Title |
Collaboration to improve health provision: Advancing nursing practice and interdisciplinary relationships |
Type |
Book Chapter |
| |
Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 215-223) |
Abbreviated Journal |
Ministry of Health publications page |
|
| |
Volume |
|
Issue  |
|
Pages |
|
|
| |
Keywords |
Interprofessional relations; Rural health services; Nursing; Policy |
|
| |
Abstract |
This chapter introduces national policies and strategies that promote interdisciplinary collaboration as a means of providing better access to health care for all communities. It identifies a role for advancing nursing practice as part of a collaborative approach to healthcare in rural areas. An increasing focus on collaboration as a concept within health practice during the last 10 years has become evident in policy documents from the Report of the Ministerial Taskforce on Nursing (Ministry of Health, 1998) to the Working Party for After Hours Primary Health Care (Ministry of Health, 2005). The emphasis would seem to be in response to political pressure to address health inequalities and an apparent assumption that interprofessional collaboration results in improved communication, fewer gaps in provision of care and more effective use of the limited health funds. |
|
| |
Call Number |
NRSNZNO @ research @ 779 |
Serial |
763 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Armstrong, S.E. |
|
| |
Title |
Exploring the nursing reality of the sole on-call primary health care rural nurse interface with secondary care doctors |
Type |
Book Chapter |
| |
Year |
2008 |
Publication |
Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 225-46) |
Abbreviated Journal |
Ministry of Health publications page |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Interprofessional relations; Rural nursing; Primary health care |
|
| |
Abstract |
A qualitative framework was used to explore the nature and the quality of interactions between sole on-call primary health care rural nurses and secondary care doctors. This study is framed as investigating a specific component of rural nursing practice and as being representative of the primary-secondary care interface. The primary-secondary care interface is crucial for the delivery of patient-centered care, and there is an increased focus on preventive primary health care. The New Zealand government sees the repositioning of professional roles and increasing emphasis on collaboration as an opportunity to re-define and address the current constraints to nursing practice. This has resulted in tensions between the medical and nursing professions. These tensions are not new, with the relationship sometimes marred by conflict which has been attributed to historical medical dominance and nursing deference. This study explores some specific areas which affect collaboration and makes recommendations at the national, regional and individual level to address them. |
|
| |
Call Number |
NRSNZNO @ research @ 780 |
Serial |
764 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Thompson, L.E. |
|
| |
Title |
Profession and place: Contesting professional boundaries at the margins |
Type |
|
| |
Year |
2006 |
Publication |
|
Abbreviated Journal |
UC Research Repository |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
|
| |
Abstract |
Based on qualitative research conducted in New Zealand and the Western Isles with rural primary care nurses and Family Health Nurses respectively, this thesis explores the ways that nurses construct flexible generalist professional identities that challenge traditional inter and intra-professional boundaries. Rhetoric of 'crisis' is often utilised to raise political awareness of the problematic, but in fact, rural general practitioner recruitment and retention has been documented for about a hundred years. For about the same length of time nurses have been providing primary health care services in rural and remote places, often working alone. In the New Zealand case, rural primary care nurses negotiate the boundaries between nursing and medicine, those within nursing itself, and also those between nursing a paramedic work. Nurses perform this boundary work by negotiating self-governing 'appropriate' and 'safe' professional identities. In the Western Isles case, the introduction of the newly developed role of Family Health Nurse serves to highlight the problematic nature of inserting an ostensibly generalist nursing role beyond the rural. |
|
| |
Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Herd, C.M.F. |
|
| |
Title |
Is it a dangerous game? Registered nurses' experiences of working with care assistants in a public hospital setting |
Type |
|
| |
Year |
2001 |
Publication |
|
Abbreviated Journal |
Massey University, Palmerston North, Library |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Registered nurses; Personnel; Interprofessional relations |
|
| |
Abstract |
|
|
| |
Call Number |
NRSNZNO @ research @ 1274 |
Serial |
1259 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
741 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
762 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
909 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
1178 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
1203 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
613 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
979 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
|
| Permanent link to this record |
| |
|
| |
|
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 |
NRSNZNO @ research @ |
Serial |
526 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Minto, R. |
|
| |
Title |
The future of practice nursing |
Type |
Journal Article |
| |
Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
|
|
| |
Volume |
33 |
Issue |
3 |
Pages |
169-172 |
|
| |
Keywords |
Primary health care; Interprofessional relations; Professional development; Physicians; Practice nurses |
|
| |
Abstract |
The author describes and discusses the main barriers to practice nurses achieving their potential as a profession. She identifies key obstacles as the funding model, GP attitudes and the current employment model. Shared governance, the development of a patient-centred services, and new employment models are proposed as the basis of a new model of primary care delivery. |
|
| |
Call Number |
NRSNZNO @ research @ 537 |
Serial |
523 |
|
| Permanent link to this record |
