Farmer, D. (2008). Wairarapa Primary Health Care Nursing Workforce Survey – 2007: A replication. Ph.D. thesis, , .
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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Ferguson, K. M. (2021). The appropriation of cultural safety: A mixed methods analysis. Ph.D. thesis, University of Otago, Dunedin.
Abstract: Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.
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Field, J., McClunie-Trust, P., Kearney, C., & Jeffcoat, J. (2020). Language and communication: a vital component of health for people with refugee backgrounds. Kai Tiaki Nursing Research, 11(1), 42–49.
Abstract: Reports on a collaborative project that explores trans-disciplinary understanding of the implications of learning English for the health and well-being of refugees. Argues that English literacy is a significant factor in health literacy and access to health care. Uses secondary analysis to analyse primary research with 60 predominantly female adult refugees aged 18 to 64 years. Highlights the experiences of these English language learners and reflects on their relevance for primary health care and nursing practice.
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Findlay, W. (2006). The effect of peer learning and review groups on practice nurses' clinical practice: A mixed method survey. Ph.D. thesis, , .
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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Finlayson, M., & Gower, S. E. (2002). Hospital restructuring: Identifying the impact on patients and nurses. Nursing Praxis in New Zealand, 18(2), 27–35.
Abstract: The authors report a survey of all nurses working in hospitals included in the International Hospital Outcomes Study of staffing and patient outcomes in New Zealand's secondary and tertiary hospitals from 1988-2001. The survey examines the way in which the hospitals have been restructured and analyses patient outcomes. Research has identified links between how nursing is organised in a hospital and that hospital's patient outcomes.
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Fletcher, S. (2021). “It's one less thing I have to do” : does referring patients to a co-located psychology service impact on the well-being of primary care health providers?.
Abstract: Investigates wheether the impact of a co-located psychological service to which Primary Care Providers cn refer patients with mild to moderate mental health needs, would impact on the well-being of the providers at work. Describes Focused Acceptance and Commitment Therapy (FACT) services delivered by psychologists working in a a large primary care practice in the lower North Island. Conducts interviews with GPs, nurse practitioners (NP) and registered nurses (RN), analysing the data using thematic analysis. Finds an inverse relationship between the FACT service and the well-being of staff.
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Floyd, S., & Meyer, A. (2007). Intramuscular injections: What's best practice? Kai Tiaki: Nursing New Zealand, 13(6), 20–22.
Abstract: The aim of this research project was to explore issues around preferred injection site, intramuscular injections injection technique, particularly Z-tracking, and the wearing of gloves while administering intramuscular injections. The researchers conducted a literature search which revealed little published information on the use of intramuscular injections, despite them being part of everyday nursing practice. The guidelines for evidence-based practice in relation to intramuscular injections are reviewed and discussed. A survey of registered nurses on intramuscular injections sites and technique was conducted. An anonymous questionnaire, accompanied by an explanatory letter, was sent to 173 registered nurses working in general practice, prisons, and to community and inpatient mental health nurses. Response questionnaires were collated and a thematic analysis was undertaken. This research findings show that, despite the known iatrogenic complications which could occur when administering intramuscular injections, some registered nurses' practice does not appear to take this in to consideration. Furthermore, the majority of registered nurses did not use gloves and Z-tracking was not widely used among the sample group. The researchers conclude that although intramuscular injections are a fundamental skill, there appears to be limited research and evidence to support best practice. Education and support to change practice to reflect current research is paramount, if registered nurses are to remain competent.
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Gibbons, V., Rice, S., & Lawrenson, R. (2010). Routine and rigidity: Barriers to insulin initiation in patients with Type 2 Diabetes. NZNO Library, 1(1), 19–22.
Abstract: It has been shown that intensive management of diabetes with type 2 diabetes is effective and has led to wider use of insulin. The conversion of patients from oral medication to insulin is usually managed in primary care. The study discussed here aimed to explore how patients with type 2 diabetes mellitus (T2DM) perceived insulin. The study was conducted in 2009 in an urban general practice in a large town in New Zealand with more than 300 patients with type 2 diabetes. A qualitative study was conducted with face-to-face interviews with 13 participants. The question focused on insulin initiation, lifestyle and routine. The transcribed responses were subject to thematic anaylsis. Interviews showed participants felt restricted by the prospect and eventuality of the routine and restrictions of being on insulin. Results show there needs to be a greater emphasis on the disease being progressive. This study provides the ground work for developing resources that will benefit patients with T2DM.
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Gohns, A. (2002). Management of opioid substitution treatment in the primary health care setting: A national training course for service providers. Full text online from the Royal New Zealand College of General Practitioners' website, 29(3), 172–175.
Abstract: The aim of this research was to describe a national opioid treatment training programme that was introduced into primary health care, and evaluate its effectiveness following its first year of operation. The programme was introduced as a strategy to recruit, train and support a primary health care workforce in the provision of methadone treatment. For the evaluation a written questionnaire was sent to the general practitioner, practice nurse and pharmacist participants of training programmes held throughout New Zealand in 2000. One hundred and forty-five (98%) participants reported that the overall quality of the course was good or better, and that relevant issues were, in general, covered. However a recurring theme related to difficulties in designing a course relevant to the three different professional groups, with some material not equally applicable to all. Another prominent theme pertained to the issue of funding. general practitioners lamented the failure to address the issue of transferring patients from a free specialist clinic to their practice for care. The evaluation of this pilot programme indicates that this training in methadone maintenance treatment was well-received by primary health care providers. However, the author notes that there is no benchmark with which to compare it.
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Goodyear-Smith, F., & Janes, R. (2008). New Zealand rural primary health care workforce in 2005: More than just a doctor shortage. Australian Journal of Rural Health, 16(1), 40–46.
Abstract: The aim of this study was to obtain a 2005 snapshot of the New Zealand rural primary health care workforce, specifically GPs, general practice nurses and community pharmacists. A postal questionnaire was distributed to rural general practice managers, GPs, nurses, community pharmacy managers and pharmacists in November 2005. The self-reported data included information on demographics, country of training, years in practice, business ownership, hours worked including on-call, and intention to leave rural practice.
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Ha, I., Huggard, P., & Huggard, J. (2013). Staff support and quality of care provided by palliative care nurses: A systematic literature review. Available through NZNO library, 4(1), 25–32.
Abstract: There is a considerable body of literature discussing the stressors experienced by nurses and other health professionals when caring for those who are terminally ill and dying. Also, a number of articles offer suggestions, including the views of staff, as to what type of professional and organisational support is required when working in this often demanding specialty. There are, however, very few reports of assessment of the effectiveness of such supportive interventions and in particular, the impact of such support on the quality of patient care. This literature review examines any reported relationships between the quality of nursing provided by palliative care nurses and the staff support received by those nurses.
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Hansen, S. (2005). The reality: Doctors and nurses in general practice in New Zealand. Ph.D. thesis, , .
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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Heese, N. (2004). Report: Margaret May Blackwell Travel Fellowship 2004. Margaret May Blackwell Travel Study Fellowship Reports. Christchurch: Nursing Education and Research Foundation (NERF).
Abstract: Covers the placements the author visited and the topics learned whilst undertaking travel in the UK after being awarded the 2003 Margaret May Blackwell Travel Study Fellowship. Of specific interest was Well Child Care in Primary Health. Part of the Margaret May Blackwell Scholarship Reports series.
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Henry, P. (2001). 'Coming home safely : a successful transition from hospital to home' : Margaret May Blackwell Study Fellowship for Nurses of Young Children, Nursing Education Research Foundation. Margaret May Blackwell Travel Study Fellowship Reports. Auckland: Nursing Education and Research Foundation (NERF).
Abstract: Investigates programmes to facilitate the transition to home for babies who have had lengthy admission to Neonatal Intensive Care Units. Provides an overview of the transition services at four sites visited in the US and Canada. Highlights the common elements among all four programmes and identifies the components of quality transition services. Evaluates their clinical effectiveness. Part of the Margaret May Blackwell Scholarship Reports series.
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Henty, C., & Dickinson, A. R. (2007). Practice nurses' experiences of the Care Plus programme: A qualitative descriptive study. The Royal New Zealand College of General Practitioners website, 34(5), 335–338.
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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