Carter, H., McKinlay, E. M., Scott, I., Wise, D., & MacLeod, R. (2002). Impact of a hospital palliative care service: Perspective of the hospital staff. JBI Reports, 18(3), 160–167.
Abstract: The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.
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McKinlay, E. M. (2007). Thinking beyond Care Plus: The work of primary health care nurses in chronic conditions programmes. New Zealand Family Physician, 34(5), 322–327.
Abstract: This paper focuses on the work of primary health care nurses on chronic conditions, through both formal chronic care management (CCM) programmes and informal work. The author overviews the key components of CCM and describes Care Plus, a funding stream accessed via PHOs. The author gives examples of nurse led clinics and programmes in the general practice environment, and outlines the structures and processes necessary. A table summarises nurse involvement in several PHOs throughout the country. The author finds that the role of PHC nurses within a framework of inter-disciplinary chronic condition care is diverse and increasing.
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McKinlay, E. M. (2006). New Zealand practice nursing in the third millennium: Key issues in 2006. New Zealand Family Physician, 33(3), 162–168.
Abstract: The author looks at the accelerated change in the role of practice nurses, due to factors such as the effects of the Primary Health Care Strategy. She reviews the current role of practice nurses, which is influenced by a population approach and new funding streams that encourage preventative, maintenance and chronic illness management activities. She highlights the positive effects of increased visibility of nursing leaders in the sector, increasing interdisciplinary education, and new career pathways which include advanced roles. She addresses some of the professional and systemic structural barriers which impact on practice nurses' ability to work effectively and equally within a general practice team.
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McKinlay, E. M. (1998). Within the circle of care: the patient's lived experience of receiving palliative care. Ph.D. thesis, , .
Abstract: The objective of this research was to determine aspects of hospice based palliative care which patients described as being important and valued. This research is to be the basis of future work on the development of consumer generated quality indicators. Palliative care managers could use these to evaluate hospice based care, and provide output measures for health providers. The methodology used by the researcher was qualitative descriptive informed by phenomenology. Six recently discharged hospice patients who had at least two episodes of palliative care were interviewed about their experience of care. The resulting data, after reflection, formed a representation; the circle of care. This included aspects of valued care generated by actions of the interdisciplinary staff, and other aspects of care generated within the palliative care environment which the patient perceived as being meaningful and important. In conclusion, the reality of people receiving palliative care is characterised by a number of supportive traditional and non-traditional aspects of caring. Although some characteristics have been described within general health and the palliative care literature, some appear to have been generated by these particular participants as part their reality. The researcher believes that the resulting representation of care requires further research in other palliative care settings. The process of interviewing terminally ill people although not without concern to the interviewer, and inherently difficult for the patients, appeared to allow the patient to tell the story of both their illness and care
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Pullon, S., & McKinlay, E. M. (2007). Interprofessional learning: The solution to collaborative practice in primary care. The Royal New Zealand College of General Practitioners website, 34(6), 404–408.
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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