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Author |
Farmer, D. |
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Title |
Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication |
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Year |
2008 |
Publication |
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Abbreviated Journal  |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Primary health care; Nursing |
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Abstract |
The introduction of the 2001 New Zealand Primary Health Care Strategy has seen increased emphasis on the development of the national primary health care nursing workforce. National and local nursing workforce development initiatives, in response to the strategy, have seen evolving models of primary health care nursing practice in New Zealand. Research was undertaken in 2007 to review the current position of the Wairarapa primary health care nursing workforce. Quantitative, descriptive data was generated through the application, at a local level, of the 2001 Ministry of Health Primary Health Care and Community Nursing Workforce survey tool. Many of the regional challenges highlighted by survey respondents in 2007 are similar to those identified in the national 2001 survey. These include predominantly low numbers of Maori, Pacific and male primary health care nurses and a fragmented, part-time and aging workforce with many respondents indicating they undertake more than one nursing role in their organisation. Respondents were similarly unsure or did not have clear clinical career pathways available to them, a mechanism by which nurses can advance their clinical practice. Some unique service provision and workforce development issues related to Wairarapa's rural context include: geographical barriers, population spread and the high health needs of its rural population. Some unique regional differences compared to the 2001 data are: lower numbers of nurses studying toward further qualifications and specific barriers to accessing education opportunities that can be linked to living in a rural region. More respondents indicated they could work collaboratively with other nurses and health professionals within their own and other organisations. While many respondents were able to provide insightful examples of specific nursing strategies in their practice targeted towards reducing inequalities for groups at risk, others could not. Enrolled nurses remain part of the Wairarapa primary health care nursing workforce. Ten percent of the respondents were actively practising enrolled nurses with an average of 24 years experience in primary health care nursing. Direction and delegation requirements by registered nurses for this group and national attrition trends with corresponding loss of workforce experience of enrolled nurses highlight an area in the Wairarapa primary health care nursing workforce that requires further consideration. Overall this study contributes to current knowledge by establishing a regional nursing workforce baseline from which to measure and enable focused future workforce development initiatives and research. Regional findings can be used to inform recommendations within the Wairarapa Primary Health Care Nursing Action Plan 2006-11 to enhance the delivery of well-developed primary health care nursing services with benefits for the Wairarapa community. |
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Call Number |
NRSNZNO @ research @ |
Serial |
913 |
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Author |
Dennis, J. |
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Title |
How will transformative primary health care nursing leadership facilitate better health outcomes for Southlanders? |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
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Issue |
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Pages |
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Keywords |
Leadership; Nursing; Primary health care |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
920 |
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Author |
Alcorn, G. |
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Title |
Giving voice to school nursing as a primary health care specialty |
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Year |
2001 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Pages |
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Keywords |
School nursing; Primary health care; Cross-cultural comparison |
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Abstract |
The purpose of this thesis is to give voice to school nursing as a primary health care specialty, and to promote the development of school nursing in New Zealand. School nursing is an invisible practice specialty that is largely funded from within the education sector, to address the health needs of student clients. School nursing is a significant primary health care initiative that can positively influence student health outcomes. The author presents her own school nursing practice experience and philosophy, prior to reflecting upon the history of school nursing, and the health concerns present within the student population. The work then moves to review and critique school nursing literature from New Zealand, Australia, the United Kingdom, and the United States. This thesis highlights the need for collaborative policy and practice development initiatives including a legislative requirement for school nurses, school nursing competencies and standards, school nurse to student ratios, postgraduate training, professional liaison, practice funding, and research. A discourse on the reflective topical autobiographical method introduces autobiographical poetry from school nursing practice and reflective inquiry, as the central research endeavour of this thesis. Autobiographical poetry is offered as a window to this specialty practice, and accompanying reflections allow access to a further layer of practice knowledge. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1143 |
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Author |
Clissold, C. |
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Title |
How discourses stifle the Primary Health Care Strategy's intent to reduce health inequalities |
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Year |
2006 |
Publication |
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Abbreviated Journal |
ResearchArchive@Victoria |
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Volume |
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Issue |
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Pages |
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Keywords |
Community health nursing; Policy; Primary health care |
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Abstract |
The Primary Health Care Strategy (PHCS) has a stated commitment to defined populations who suffer disproportionately from ill health. This thesis examines whether some prevailing discourses actually decrease the focus on health inequalities. A study of the nursing and medical media found that it focused predominantly on professional and industrial issues, leaving health workers focused mainly on their own professional interests, rather than considering the effects on health inequalities. She goes on to suggest that current Ministry of Health discourse values decentralised community health decision making. This may gloss over factors in community health which are affected by Government policy such as employment policy, and thus should be dealt with centrally by legislation. These factors have been found to be the most pertinent in health inequalities. So while models of community partnerships may seem to place communities as agents in their own health, this downplays the determinants of health which are beyond their control. Having shown that discourse can decrease the focus on health inequalities due to other professional and political drivers, the author then looked at health initiative concepts which are effective, efficient and equitable given the current set up of PHOs and nursing innovations. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1196 |
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Author |
Hoare, K.; Fairhurst-Winstanley, W.; Horsburgh, M.; McCormack, R. |
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Title |
Nurse employment in primary care: UK and New Zealand |
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Journal Article |
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Year |
2008 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
35 |
Issue |
1 |
Pages |
4-10 |
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Keywords |
Primary health care; Scope of practice; Nursing models |
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Abstract |
The researchers evaluate and compare the organisation of general practice in the UK and New Zealand. A key aim of the Primary Health Care Strategy is a reduction in health inequalities. Locally, some nurse leaders suggest that changing nurse practice employment from general practitioners to Primary Health Organisations will achieve this aim. The authors take lessons from the UK and suggest that nurses organising themselves into peer groups, remuneration of general practices for the attainment of positive patient outcomes, and a statutory duty of clinical governance, all contributed to the development of practice nurses' roles and expansion of numbers of nurse practitioners in general practice. Nurses have become partners with general practitioners in general practice in the UK, which the authors suggest is a much preferable alternative for some than employment by a Primary Health Organisation. |
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Call Number |
NRSNZNO @ research @ |
Serial |
453 |
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Author |
Henty, C.; Dickinson, A.R. |
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Title |
Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study |
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Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
5 |
Pages |
335-338 |
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Keywords |
Primary health care; Chronic diseases; Nursing; Evaluation |
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Abstract |
The aim of this small qualitative descriptive pilot study was to describe the experiences of practice nurses delivering the Care Plus programme within the general practice setting. Care Plus was introduced into Primary Health Organisations (PHOs) in 2004. This programme encourages more involvement from practice nurses in chronic care management. For many New Zealand practice nurses this is a new role. This study, carried out prior to the larger Care Plus implementation review (2006), provides an insight into the nursing experience of implementing Care Plus and provides a basis for future studies with regard to the nurse's role within the Care Plus programme. |
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Call Number |
NRSNZNO @ research @ 468 |
Serial |
454 |
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Author |
Pullon, S.; McKinlay, E.M. |
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Title |
Interprofessional learning: The solution to collaborative practice in primary care |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
6 |
Pages |
404-408 |
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Keywords |
Interprofessional relations; Education; Primary health care; Communication |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
458 |
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Author |
Alcorn, G. |
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Title |
The youth health specialty in New Zealand: Collaborative practice and future development |
Type |
Journal Article |
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Year |
2007 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
The Royal New Zealand College of General Practitioners website |
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Volume |
34 |
Issue |
3 |
Pages |
162-167 |
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Keywords |
Adolescents; Community health nursing; Primary health care; Nurse practitioners; School nursing |
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Abstract |
This paper details the workforce capacity of youth health nursing and medical staffing required for community-based and school-based youth health services. The author shows how youth health services seek to complement the care delivered by Primary Health Organisations (PHOs) and other allied health care services in the community. She outlines the development and operation at VIBE, a community-based youth health service in the Hutt Valley with school-based youth health services delivered at four low deciles secondary schools. She explains that developing workforce capacity for youth health services is a primary health care priority and an important means to address inequalities and to improve the health services of young people. |
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Call Number |
NRSNZNO @ research @ |
Serial |
518 |
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Author |
Thompson, L.E. |
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Title |
Profession and place: Contesting professional boundaries at the margins |
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Year |
2006 |
Publication |
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Abbreviated Journal |
UC Research Repository |
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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Identity; Interprofessional relations |
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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. |
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Call Number |
NRSNZNO @ research @ 1177 |
Serial |
1162 |
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Author |
Desmond, N. |
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Title |
Aspects of nursing in the general practice setting and the impact on immunisation coverage |
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Year |
2007 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Nurse-family relations; Immunisation; Primary health care; Nursing |
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Abstract |
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Call Number |
NRSNZNO @ research @ 510 |
Serial |
496 |
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Author |
Sheridan, N.F. |
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Title |
Mapping a new future: Primary health care nursing in New Zealand |
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Year |
2005 |
Publication |
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Abbreviated Journal |
University of Auckland Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Chronic diseases; Community health nursing; Nursing models |
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Abstract |
The aim of the study was to determine the practice of nurses employed in integrated care projects in New Zealand from late 1999 to early 2001. Integrated care was a major health reform strategy that emphasised primary health care as a means to improve service provision between the health sectors. An investigation of nurses' practice sought to determine the extent to which primary health care principles had been adopted in practice, as a comprehensive primary health care approach has been advocated globally in the management of chronic conditions; the leading cause of disability throughout the world and the most expensive problems faced by health care systems. The philosophical basis of the research was postpositivism. The study employed a quantitative non-experimental survey design because it allowed numeric descriptions of the characteristics of integrated care projects to be gained for the purpose of identifying nurses' practice. The unit of inquiry was the integrated care project, and 80 comprised the study population. Data were obtained on projects from expert informants (n=27) by telephone survey using a structured interview questionnaire developed by the researcher. Data obtained from interviews were statistically analysed in two stages. First, data were produced to comprehensively describe the characteristics of integrated care projects and nurses practice. The 'Public health interventions model' was used as a framework to analyses the interventions (activities) and levels of population-based practice of nurses. Following this, the social values embedded in nurses' practice were determined using 'Beattie's model of health promotion' as a framework for analysis. A strong association was found between nurses' practice in projects and strategies used in integrated care, such as information sharing, guideline development and promotion, and case management, and projects with an ethnic focus, low income focus, chronic condition focus, and well-health focus. Whilst nurses undertook interventions most frequently at the individual practice level they were also strongly associated with the small proportion of interventions that were undertaken at the community level. The majority of interventions by nurses reflected the health promotion value of health persuasion, indicating a paternalist and individual-oriented philosophy. Nurses were engaged in two interventions that indicated a collective-oriented philosophy – coalition building and community development, the latter reflecting health promotion values of negotiation, partnership and empowerment. The study demonstrated that nurses' practice in projects was predominantly centred on individual-focused population-based practice suggesting the need for a framework to assist nurses to transition their practice to include more activity at the community and systems levels. Without a reorientation of practice, nurses will remain limited in their ability to achieve health gains for populations. In response to this conclusion, and drawing on research results and reviewed literature, a new model, The 'Primary Health Care interventions model' was constructed. Recommendations include advocacy for the acceptance of the model by the health funder, professional nursing bodies, health organisations, educational institutions, nurses, communities, and individuals. |
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Call Number |
NRSNZNO @ research @ 679 |
Serial |
665 |
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Author |
Lilley, S. |
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Title |
Experiences of mentoring in primary health care settings: Registered nurses' and students' perspectives |
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Year |
2006 |
Publication |
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Abbreviated Journal |
University of Otago Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Mentoring; Students; Registered nurses; Primary health care |
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Abstract |
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Call Number |
NRSNZNO @ research @ 505 |
Serial |
491 |
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Author |
Ross, J. |
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Title |
Role identification: An impediment to effective core primary health care teamwork |
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Year |
2001 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Multidisciplinary care teams; Teamwork; Primary health care |
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Abstract |
This study, which is methodologically grounded in qualitative research and philosophically informed by critical social science, explores aspects of the socio-political context in which practice nurses and general practitioners (core primary health care team) work within a team environment. It is indicated in the literature that there are benefits for improved health care through the development of collaborative teamwork. However, there have been many barriers identified which prevent collaborative teamwork. Amongst the many barriers, is the lack of role clarity and attitudinal differences. This thesis explored and highlighted whether the lack of role clarity and attitudinal differences do indeed impede the team's success, and are barriers to teamwork. The views and opinions of practice nurses and general practitioners and the understanding of their own and each other's current roles within the general practice setting were explored. The participants had the opportunity to discuss together, in focus group meetings, their thoughts on the topic. This raised their awareness of their taken for granted ideas on role and teamwork. Focus groups offered the participants the added opportunity to question each other which allowed for a deeper and more fulfilling understanding of role. New understandings that emerged could lead to alternative models of health care and influence the future delivery and planning of general practice. The thesis concludes by offering a potentially suitable model/framework which has been developed to further the understanding of teamwork in the future. |
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Call Number |
NRSNZNO @ research @ |
Serial |
571 |
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Author |
Bailey, A.M. |
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Title |
The New Zealand practice nurse in the primary health environment of the 21st century |
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Year |
2004 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Volume |
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Issue |
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Pages |
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Keywords |
Policy; Practice nurses; Primary health care |
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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. |
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Call Number |
NRSNZNO @ research @ |
Serial |
831 |
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