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Author |
Davies, D.C. |
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Title |
Practice nurses' perceptions of their contribution to the care of individuals with chronic health conditions |
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Year |
2006 |
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Abbreviated Journal |
Massey University Library |
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Keywords |
Primary health care; Chronic diseases; Patient satisfaction; Nursing |
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Abstract |
Table of Contents: 1. Background and overview; 2. Research design and method; 3. Literature review; 4. Preparation of the individual for an appointment at the general practice; 5. Care provided by the practice nurse at the general practice; 6. The giving of information; 7. A discussion of the dualities of the contribution of practice nurses to the care of individuals with chronic conditions; 8. Study summary and conclusions. |
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Call Number |
NRSNZNO @ research @ 492 |
Serial |
478 |
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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 |
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Abbreviated Journal |
University of Otago Library |
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Keywords |
Mentoring; Students; Registered nurses; Primary health care |
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Call Number |
NRSNZNO @ research @ 505 |
Serial |
491 |
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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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Keywords |
Nurse-family relations; Immunisation; Primary health care; Nursing |
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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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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 |
Miles, M.A.P. |
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Title |
A critical analysis of the relationships between nursing, medicine and the government in New Zealand 1984-2001 |
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Year |
2005 |
Publication |
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Abbreviated Journal |
NZNO Library, University of Otago Library |
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Keywords |
Primary health care; Interprofessional relations; Policy |
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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. |
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Call Number |
NRSNZNO @ research @ 1146 |
Serial |
1131 |
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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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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 |
Findlay, W. |
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Title |
The effect of peer learning and review groups on practice nurses' clinical practice: A mixed method survey |
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Year |
2006 |
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; Education; Clinical supervision |
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Abstract |
The aim of the study was to explore how practice nurses perceive engagement in Peer Learning and Review Groups impacts personally and professionally on their clinical practice. An anonymous self-administered postal questionnaire was completed by 55 practice nurses who attend Peer Learning and Review Groups in the South Island. A mixed method design was utilised to obtain both qualitative and quantitative data. Practice nurses considered group attendance was important for professional development with the majority perceiving that their attendance had a positive effect on their clinical practice. The nurses perceived clear linkages between the significant learning that occurred in the groups and changes in delivery of patient care. Additional benefits included improved collegial relationships, professional awareness and personal growth. The author concludes that, together, these findings underline the importance of Peer Learning and Review Groups as an effective tool for ongoing personal and professional development within nursing. |
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Call Number |
NRSNZNO @ research @ |
Serial |
490 |
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Author |
Lesa, R. |
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Title |
Advanced physical assessment skills: Factors that influence registered nurses' use of skills in the clinical setting, on completion of an advanced health assessment course |
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Year |
2007 |
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 |
Nursing; Primary health care; Nursing specialties; Education |
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Abstract |
Traditionally the use of advanced physical assessment skills when assessing a patient or client has been the domain of the medical profession. The last few decades has seen many changes in health provision that have influenced nursing practice, as a result of the social and economic trends impacting on New Zealand society. A notable change in nursing practice has been an increased emphasis on the use of advanced physical assessment skills by registered nurses, as an expected part of the registered nurse's health assessment. Nurses in the United States, and more recently Canada and Australia, readily include these skills as an expansion of their health assessment into their nursing practice. The purpose of this research is to investigate whether New Zealand registered nurses have done the same. The factors that influence the registered nurses' use of these skills are also explored. This descriptive design was chosen in order to focus on exploring and describing this phenomenon in a holistic fashion. Data collection involved one hour semi- structured interviews with seven participants who all completed the same postgraduate advanced health assessment educational course. Three themes were identified as influencing the use of advanced physical assessment skills; the registered nurse's work environment, the registered nurse's attributes and the registered nurse's original nursing education. The findings from this research have implications for nurses in practice and nurse educators, in both undergraduate and postgraduate education. |
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Call Number |
NRSNZNO @ research @ |
Serial |
498 |
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Author |
Dillon, D.R. |
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Title |
Islands, islandness and nursing: Advanced nursing practice in rural remote and small island areas |
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Year |
2006 |
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 |
Rural nursing; Primary health care |
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Abstract |
This dissertation focuses on the concepts of island, island-ness, and isolation. It aims to further advance the national and international literature relating to the health beliefs of island people as linked to the provision of primary health care services within New Zealand. New Zealand is an island nation made up of two main islands and numerous outlying islands, relatively isolated from the rest of the world by water. This geography means going anywhere from New Zealand involves traveling either “over” or “on” the sea. All people of New Zealand since the first inhabitants, whether residents or visitors, have arrived to New Zealand either by sea or more recently by plane. The population of New Zealand is 25% rural, with most of these rural dwellers residing in the South Island, and several of the smaller off shore Islands. This builds a sense of culture of the people, or tangata whanua (the people of the land), for whom there are degrees of island-ness, and the characteristics of this can be seen amongst the people of New Zealand. A further challenge which is discussed comes in the form of the “island penalty” which encompasses high transport costs, long distances to travel to main centres, lack of specialists and trained health workers, effects of migration and tourism, and communication difficulties. The more isolated people are, the tougher the challenges become. Most rural island populations are served by lay care workers, volunteers, and rural and remote nurses. Nurses are often the main health care providers to small island populations, and they demonstrate advanced nursing practice which is acknowledged internationally as meeting Nurse Practitioner competencies. As a group these nurses possess knowledge of the extrinsic and intrinsic factors involved in the health needs and health determinants of these island communities. Researching these advanced nursing roles adds to the body of knowledge around isolated and island communities. The author suggests that studying the concepts of islands, islandness, and isolation in relation to health beliefs will bring more understanding of services for the advanced rural nurse to consider in developing appropriate, accessible, affordable and adaptable Primary Health Care which is fair and equitable. |
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Call Number |
NRSNZNO @ research @ |
Serial |
507 |
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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 |
Maw, H. |
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Title |
The challenge of developing primary health care nurse practitioner roles in rural New Zealand |
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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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Volume |
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Issue |
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Pages |
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Keywords |
Nurse practitioners; Rural health services; Primary health care |
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Abstract |
When the New Zealand Nursing Council introduced the nurse practitioner as a new level of nurse in 2001, the opportunity arose for the introduction of primary health care nurse practitioners into the rural practice arena in this country. This dissertation explores the influences on the development of rural nursing in the last decade in New Zealand including the role of the Centre for Rural Health in advancing rural nursing education, as well as the impact the shortage of health professionals in rural New Zealand has had on the development of the rural primary health care nurse practitioner concept. For pioneering primary health care nurse practitioner roles to be successfully implemented in rural communities in New Zealand, several challenges need to be faced; the creation of roles and employment opportunities, community acceptance of the role, medical and nursing acceptance of the role and the establishment of independent nurse prescribing within the constraints imposed by current legislation. The dissertation explores the current literature in an attempt to offer solutions to the identified challenges. With the creation of primary health care nurse practitioner roles and the establishment and acceptance of these roles in rural communities, a new mode of health service delivery in rural New Zealand will begin. |
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Call Number |
NRSNZNO @ research @ |
Serial |
576 |
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Author |
Magrath, K.L. |
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Title |
From chrysalis to butterfly: Transition experiences of new graduates in primary health care nursing practice in New Zealand |
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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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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; New graduate nurses; Mentoring |
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Abstract |
Primary health care is a dynamic and ever-changing area of practice which has undergone many changes in the last ten years. Traditionally, primary health care was not a routine choice for new graduate nurses as they were encouraged to work in a hospital setting before seeking a position in the community. Bachelor of Nursing programmes emphasise primary health care practice and increasingly nurses and their employers are moving away from the traditional belief of 'doing your time in the hospital' before contemplating the move to primary health care. Currently in New Zealand increasing numbers of graduates from Bachelor of Nursing programmes want to begin their working life as registered nurses in this area. A constructivist approach was taken to explore the experience of five nurses who entered primary health care practice as new graduates. Participants were interviewed using a semi-structured format. They constructed their experience as role transition and identified a number of significant factors which had impacted on their practice. These factors included both the personal and practice challenges they experienced and the strategies they used to address them. Further research findings were a transition time of one year, the importance of both formal and informal support, planned orientation and opportunities for reflection. A number of mediating factors including new graduate programmes, peer support and mentorship were also discussed. Key implications for practice, education, employers and future research regarding transition to primary health care for new graduates are discussed. This research emphasised the importance of appropriate resources and support for new graduates from Bachelor of Nursing programmes. These factors are suggested as integral to the development of new graduates' practice in primary health care and reduction of the challenges inherent in this transition. |
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Call Number |
NRSNZNO @ research @ |
Serial |
587 |
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Author |
Hansen, S. |
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Title |
The reality: Doctors and nurses in general practice in New Zealand |
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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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Volume |
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Issue |
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Pages |
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Keywords |
History; Nurse practitioners; Primary health care; Physicians |
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Abstract |
Provision of a primary health care system that delivers timely, appropriate, affordable and effective care is a challenge throughout the world. The purpose of this work is to discuss the realities of collaborative practice in primary health care, where care is delivered by doctors and nurses in general practice settings in New Zealand. The close relationship between the two professions has been historically marked by the dominance of medicine over nursing. Unclear articulation of nursing practice by the nursing profession along with historical gender issues has further hindered a more collegial relationship between medicine and nursing. The author suggests that historical gender inequalities have also contributed to a system which has disadvantaged nurses in the execution of their work. Collaboration occurs when mutual respect is present between two parties intent on furthering mutual goals. Collaboration is not supervision or co-operation. It is therefore, the author suggests, questionable that collaboration exists in the New Zealand system other than through the good will of individual practitioners. An examination of these issues using the work of Jurgen Habermas and Michel Foucault offers insight into how the current working situation between medicine and nursing came about. The author concludes that the emergence of the nurse practitioner role in New Zealand along with a change in the way that primary health care is being managed nationally provides opportunities for the nursing profession to move into emancipatory collaborative practice roles. |
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Call Number |
NRSNZNO @ research @ |
Serial |
676 |
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Author |
Higgins, A. |
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Title |
Collaboration within primary health care in rural New Zealand |
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Year |
2006 |
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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Volume |
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Issue |
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Pages |
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Keywords |
Rural health services; Primary health care; Scope of practice; Practice nurses |
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Abstract |
In November 2005, the Oxford Community Health Centre (OCHC) introduced an innovative way of delivering primary health care to the residents of Oxford. This was in response to the difficulty with recruitment and retention of medical staff for the solo General Practitioner (GP) at OCHC. Primary health care services are now the shared responsibility of the Rural Nurse Specialists (RNS) and the GPs. This initiative is underpinned by a collaborative approach in sharing patient care between the GPs and RNSs to improve access to primary health care and foster staff retention. The team at OCHC is keen to consolidate and enhance the success of collaboration. Therefore, this dissertation has reviewed a range of literature in order to identify lessons that can be learned for the future. Two key factors that have implications for OCHC are the structural effects of the organisation and the interpersonal relationships between the GPs and RNSs. The structural effects include: the structure and philosophy at OCHC, and the social, cultural, and educational influences within the organisation. It is the nature of the interpersonal relationships that can affect the development and success of collaboration through a willingness to collaborate and the existence of mutual respect, trust, and effective communication between the RNSs and GPs. Strategies to foster collaboration at OCHC in the future include: staff participation in making collaboration visible within the philosophy at OCHC, a workshop for staff to further define roles and differentiate activities according to skill-mix; and the involvement of a nurse in decision-making at the organisational level. The author suggests that these strategies could also be beneficial to other rural practices that are striving to maintain a sustainable primary health care service. |
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Call Number |
NRSNZNO @ research @ |
Serial |
726 |
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Author |
Primary Health Care Nurse Innovation Evaluation Team, |
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Title |
The evaluation of the eleven primary health care nursing innovation projects: A report to the Ministry of Health |
Type |
Report |
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Year |
2007 |
Publication |
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Abbreviated Journal |
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Volume |
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Issue |
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Pages |
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Keywords |
Primary health care; Evaluation; Nursing |
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Abstract |
In 2003, as part of implementing the Primary Health Care Strategy, the Ministry of Health announced contestable funding, available over three years, for the development of primary health care nursing innovation projects throughout Aotearoa/New Zealand. The Ministry looked for proposals that would: support the development of innovative models of primary health care nursing practice to deliver on the objectives of the Primary Health Care Strategy; allow new models of nursing practice to develop; reduce the current fragmentation and duplication of services; and assist in the transition of primary health care delivery to primary health organisations. This report describes the findings from the evaluation of the 11 primary health care nursing innovations selected for funding by the Ministry of Health. It provides an overview of the innovations' success and of the lessons learnt from this policy initiative. |
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Call Number |
NRSNZNO @ research @ |
Serial |
819 |
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