| |
Records |
Links |
|
Author |
Primary Health Care Nurse Innovation Evaluation Team, |
|
| |
Title |
The evaluation of the eleven primary health care nursing innovation projects: A report to the Ministry of Health |
Type |
Report |
| |
Year |
2007 |
Publication |
|
Abbreviated Journal |
|
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Primary health care; Evaluation; Nursing |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial  |
819 |
|
| 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 |
Higgins, A. |
|
| |
Title |
Collaboration within primary health care in rural New Zealand |
Type |
|
| |
Year |
2006 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Rural health services; Primary health care; Scope of practice; Practice nurses |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
726 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
O'Brien, A.J.; Hughes, F.; Kidd, J.D. |
|
| |
Title |
Mental health nursing in New Zealand primary health care |
Type |
Journal Article |
| |
Year |
2006 |
Publication |
Contemporary Nurse |
Abbreviated Journal |
|
|
| |
Volume |
21 |
Issue |
1 |
Pages |
142-152 |
|
| |
Keywords |
Mental health; Primary health care; Nursing specialties; Community health nursing |
|
| |
Abstract |
This article describes the move in mental health from institutional care to community arrangements. It draws on international literature and New Zealand health policy, which gives increased emphasis to the role of the primary health care sector in responding to mental health issues. These issues include the need for health promotion, improved detection and treatment of mild to moderate mental illness, and provision of mental health care to some of those with severe mental illness who traditionally receive care in secondary services. These developments challenge specialist mental health nurses to develop new roles which extend their practice into primary health care. In some parts of New Zealand this process has been under way for some time in the form of shared care projects. However developments currently are ad hoc and leave room for considerable development of specialist mental health nursing roles, including roles for nurse practitioners in primary mental health care. |
|
| |
Call Number |
NRSNZNO @ research @ 730 |
Serial |
716 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Hansen, S. |
|
| |
Title |
The reality: Doctors and nurses in general practice in New Zealand |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
History; Nurse practitioners; Primary health care; Physicians |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
676 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Sheridan, N.F. |
|
| |
Title |
Mapping a new future: Primary health care nursing in New Zealand |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
University of Auckland Library |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Primary health care; Chronic diseases; Community health nursing; Nursing models |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ 679 |
Serial |
665 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Richardson, S. |
|
| |
Title |
Emergency departments and the inappropriate attender: Is it time for a reconceptualisation of the role of primary care in emergency facilities? |
Type |
Journal Article |
| |
Year |
1999 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
|
| |
Volume |
14 |
Issue |
2 |
Pages |
13-20 |
|
| |
Keywords |
Emergency nursing; Primary health care |
|
| |
Abstract |
This paper reviews currently identified issues concerning emergency department attendance, and examines the core question of the role of primary care in the emergency department. Asks whether this is an appropriate use of emergency department resources, and if so, what the implications are for the role of the emergency nurse. Suggests the establishment of Minor Injury Units in New Zealand like those in the UK. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
641 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Day, D.R.; Mills, B.; Fairburn, F. |
|
| |
Title |
Exercise prescription: Are practice nurses adequately prepared for this? |
Type |
Journal Article |
| |
Year |
2001 |
Publication |
New Zealand Journal of Sports Medicine |
Abbreviated Journal |
|
|
| |
Volume |
29 |
Issue |
2 |
Pages |
32-36 |
|
| |
Keywords |
Practice nurses; Health education; Primary health care |
|
| |
Abstract |
This study sought to examine whether practice nurses were prepared to provide exercise prescriptions to clients. It involved administering questionnaires to 53 practice nurses in Otago to examine their understanding of green prescriptions and their knowledge and participation in exercise prescription. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
628 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Mackay, B. |
|
| |
Title |
Leadership development: Supporting nursing in a changing primary health care environment |
Type |
Journal Article |
| |
Year |
2002 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
|
| |
Volume |
18 |
Issue |
2 |
Pages |
24-32 |
|
| |
Keywords |
Leadership; Professional development; Primary health care; Nursing |
|
| |
Abstract |
The author argues that the involvement of nurses in the decision-making of health organisations is essential to maximise the contribution of nurses and promote positive outcomes for patients. She suggests that development of leadership skills will make nurses aware of power structures in the health system and allow them to become interdependent health professionals in primary health organisations (PHO). The particular competencies discussed are those proposed by Van Maurik (1997), namely ability to understand and manage organisational politics, work facilitatively with people and circumstances, and build a feeling of purpose. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
619 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Magrath, K.L. |
|
| |
Title |
From chrysalis to butterfly: Transition experiences of new graduates in primary health care nursing practice in New Zealand |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Primary health care; New graduate nurses; Mentoring |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
587 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Maw, H. |
|
| |
Title |
The challenge of developing primary health care nurse practitioner roles in rural New Zealand |
Type |
|
| |
Year |
2005 |
Publication |
|
Abbreviated Journal |
Otago Polytechnic library. A copy can be obtained by contacting pgnursadmin@tekotago.ac.nz |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Nurse practitioners; Rural health services; Primary health care |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
576 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Ross, J. |
|
| |
Title |
Role identification: An impediment to effective core primary health care teamwork |
Type |
|
| |
Year |
2001 |
Publication |
|
Abbreviated Journal |
Victoria University of Wellington Library |
|
| |
Volume |
|
Issue |
|
Pages |
|
|
| |
Keywords |
Multidisciplinary care teams; Teamwork; Primary health care |
|
| |
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. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
571 |
|
| 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 |
Clendon, J.; Krothe, J. |
|
| |
Title |
The nurse-managed clinic: An evaluative study |
Type |
Journal Article |
| |
Year |
2004 |
Publication |
Nursing Praxis in New Zealand |
Abbreviated Journal |
|
|
| |
Volume |
20 |
Issue |
2 |
Pages |
15-23 |
|
| |
Keywords |
Evaluation research; Nurse managers; Primary health care; Cross-cultural comparison |
|
| |
Abstract |
Part of an international project, the aim of this study was to evaluate a nurse managed primary health care clinic (Mana Health Clinic) from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The authors note that the results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. The authors conclude that this paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
547 |
|
| Permanent link to this record |
| |
|
| |
|
Author |
Murrell-McMillan, K.A. |
|
| |
Title |
Why nurses in New Zealand stay working in rural areas |
Type |
Journal Article |
| |
Year |
2006 |
Publication |
New Zealand Family Physician |
Abbreviated Journal |
|
|
| |
Volume |
33 |
Issue |
3 |
Pages |
173-175 |
|
| |
Keywords |
Rural nursing; Recruitment and retention; Job satisfaction; Teamwork; Primary health care |
|
| |
Abstract |
The author investigates why nurses in New Zealand stay working in rural areas when their Australian counterparts and medical colleagues are leaving rural areas at alarming rates. She looks at international recruitment and retention issues, and particularly compares rural nursing in Australia with New Zealand. Local research shows that over 50% of rural nursing is in the practice environment. Practice nurses report high job satisfaction, specifically around working with diverse populations, autonomy, and working with GPs, the local community, and local iwi. The only perceived barrier identified in the New Zealand literature to job satisfaction and collaborative team behaviour has been the funding of nursing services in rural areas. This contrasts with many barriers to rural nursing in Australia, and the author suggests New Zealand policy makers may learn from Australia's retention issues. |
|
| |
Call Number |
NRSNZNO @ research @ |
Serial |
530 |
|
| Permanent link to this record |
