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Adams, S., Carryer, J., & Wilkinson, J. A. (2015). Institutional ethnography : an emerging approach for health and nursing research. Nursing Praxis in New Zealand, 31(1), 18–26.
Abstract: Introduces institutional ethnography as an approach to sociological inquiry for health and nursing research in NZ. Provides an overview, introducing key concepts, and describing how institutional ethnography is used in research on the establishment of nurse practitioners and their services in rural primary health care.
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Holloway, K. T. (2011). Development of a specialist nursing framework for New Zealand. Doctoral thesis, University of Technology Sydney, Sydney, Australia. Retrieved May 21, 2024, from http://hdl.handle.net/10453/20322
Abstract: Expresses concern that inconsistent specialist nursing workforce planning and pathways for nursing practice development will adversely affect needed service provision for the population. Reports the outcomes of research, which suggests an alternate approach through the development of a single unified capability framework for specialist nursing practice in NZ. Uses a qualitative descriptive and exploratory multi-method enquiry approach to review extant understandings and develop a consensus framework, identifying the essential elements required for a single national framework for specialist nursing in NZ. Widens the understanding of a more holistic approach to specialist nursing development, which holds great promise for the specialist nursing workforce in NZ and internationally.
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McElroy, J. Maternity outcomes and access following regulatory changes for Isotretinoin prescribing in New Zealand (Vol. 2017). Master's thesis, University of Otago, . Retrieved May 21, 2024, from http://hdl.handle.net/10523/7538
Abstract: Analyses retrospective prescription data for the years 2007-2015 to determine how access to isotretinoin altered before and after funded access was extended from dermatologists to include GPs and nurse practitioners who obtained a Special Authority. Assesses maternity outcomes for females dispensed the drug with regard to pregnancy terminations and isotretinoin-exposed live births. Examines outcomes based on type of prescriber and use or otherwise of the Best Practice Advocacy Centre (BPAC) electronic isotretinoin decision-support tool.
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Wilkinson, J. A. (2007). The New Zealand nurse practitioner polemic : a discourse analysis : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing, Massey University, Wellington, New Zealand. Doctoral thesis, Massey University, Wellington.
Abstract: Traces the development of the nurse practitioner role in NZ since its establishment in 2001, using a discourse analytical approach to examine those discourses that have defined the role. Employs both textual and discursive analysis of texts from published literature and from nine interviews with individuals influential in the evolution of the role. Examines political perspectives and disciplinary practices dating back to the Nurses Registration Act of 1901. Considers the implications of an autonomous nursing profession in both practice and regulation.
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Rook, H., Hales, C., Milligan, K., & Jones, M. (2021). Dr Jill Wilkinson's discourse analysis of the sources of power and agency for nursing. Nursing Praxis in New Zealand, 37(1). Retrieved May 21, 2024, from http://dx.doi.org/https://doi.org/10.36951/27034542.2021.012
Abstract: Highlights two articles written by Jill Wilkinson in 2008 pertaining to the Ministerial Taskforce on Nursing in 1998, in which she discusses the conflict between autonomy and unionism in nursing and the development of the nurse practitioner (NP) role. Considers the ongoing challenges to establish NP toles in mainstream health services.
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Officer, T. N. (2018). Nurse practitioners and pharmacist prescribers in primary health care: A realist evaluation of the New Zealand experience. Doctoral thesis, Victoria University of Wellington, Wellington. Retrieved May 21, 2024, from http://hdl.handle.net/10063/7098
Abstract: Investigates how nurse practitioner and pharmacist prescriber roles are developing in NZ primary health care, and what is needed to better support the future development of these roles. Employs a qualitative research design involving semi-structured interviews of (1) policy, training, and advocacy stakeholders; (2) primary health-care nurse practitioners, pharmacist prescribers, and general practitioners; and (3) patients of advanced practitioners and carers of patients using such services.
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Gubb, A. (2020). Rural nurse practitioner role to improve outcomes for Thames-Coromandel community. Master's thesis, Auckland University of Technology, Auckland. Retrieved May 21, 2024, from http://hdl.handle.net/10292/13468
Abstract: Maintains that the Nurse Practitioner (NP) role has the potential to achieve more equitable outcomes for rural populations, particularly for older adults in their transition from hospital to the rural setting. Examines how NPs can reduce readmissions, from a thematic analysis of the literature using a realist synthesis approach, focusing on the Thames Coromandel rural community. Derives three themes from the analysis: self-efficacy, holistic care, and care grounded in nursing philosophy.
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Mustafa, M., Adams, S., Bareham, C., & Carryer, J. (2021). Employing nurse practitioners in general practice: an exploratory survey of the perspectives of managers. Journal of Primary Health Care, 13(3). Retrieved May 21, 2024, from http://dx.doi.org/10.1071/hc21036
Abstract: Explores the perspectives of practice managers on employing nurse practitioners (NP) in general practice. Uses an electronic survey to collect demographic and numerical data, which were analysed descriptively and analytically using SPSS (version 26). Written answers to open-ended questions were analysed qualitatively.
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Adams, S., Boyd, M., Carryer, J., Bareham, C., & Tenbensel, T. (2020). A survey of the NP workforce in primary healthcare settings in New Zealand. New Zealand Medical Journal, 133(1523). Retrieved May 21, 2024, from https://hdl.handle.net/2292/54716
Abstract: Describes the demographics, distribution, clinical settings and employment arrangements of the NZ nurse practitioner (NP) workforce in primary healthcare settings, and organisational factors limiting their practice. Surveys 160 NPs and finds that general practice and aged residential care were the most common clinical settings.
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Adams, S., Oster, S., & Davis, J. (2022). The training and education of nurse practitioners in Aotearoa New Zealand: Time for nationwide refresh [editorial]. Nursing Praxis in Aotearoa New Zealand, 38(1). Retrieved May 21, 2024, from http://dx.doi.org/https://doi.org.10.36951/27034542.2022.01
Abstract: Argues that the following measures must be taken to ensure the ongoing development and establishment of nurse practitioners (NP) across the health sector: review of NP competencies; support for NPs to undertake the nurse practitioner training programme
(NPTP); formation of nationally-consistent and funded NPTPs; mentoring novice NPs; and a national workforce plan for NPs.
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Adams, S. (2017). Nurse practitioners in rural primary health care in New Zealand : an institutional ethnography. Ph.D. thesis, Massey University, Auckland. Retrieved May 21, 2024, from http://hdl.handle.net/10179/12816
Abstract: Critically examines the work required to establish nurse practitioner (NP) services in rural primary health care in NZ, using the institutional ethnography approach to the inquiry. Explores the work and experiences that nurses undertook to become NPs delivering rural primary health care services. Considers how these were institutionally-shaped and coordinated. Conducts interviews with a total of 13 NPs and four NP candidates.
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Laidlaw, R., & Mercer, C. (2022). Nurse practitioners: does home visiting improve outcomes for people living with long-term conditions. Kai Tiaki Nursing Research, 13(1), 39–41.
Abstract: Explores the potential for nurse practitioners (NP) in NZ to visit people diagnosed with chronic condiitons at home. Evaluates whether home-visiting NPs could provide primary care in place of GPs. Conducts a review of research comprising three themes: reduced barriers to care, improved health outcomes, and role clarity for NPs.
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Mackay, B. (2003). General practitioners' perceptions of the nurse practitioner role: An exploratory study. Access is free to articles older than 6 months, and abstracts., 116(1170).
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.
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Mearns, G. (2005). Developing autonomous ownership: A grounded theory study of how registered nurses working in aged care are advancing their nursing practice. Ph.D. thesis, , .
Abstract: The introduction of nurse practitioner registration into New Zealand in 2001 was heralded as a move that would open up a wealth of opportunities for registered nurses to extend their practice into more independent roles and to provide a client-centred health service. It was also seen as a way to retain experienced registered nurses in the clinical practice area by providing a credible clinical career pathway. If nurse practitioner's are to meet these expectations, then, the author suggests, it is important to understand the processes that encourage or discourage nurses from advancing their practice. One of the early scopes of practice to be introduced was nurse practitioner with an endorsement in aged care scope of practice. Grounded theory was the method used to generate an explanation of how registered nurses working in aged care were preparing for the introduction of nurse practitioner roles. An analysis of early data highlighted codes around registered nurses in aged care extending and advancing their practice rather than preparing specifically for the nurse practitioner role. The research question for this study was: 'How are registered nurses in aged care advancing their nursing practice?' Semi-structured interviews were used to collect data from ten experienced registered nurses working in aged care clinical practice settings ranging from secondary hospital facilities, to community settings and residential care villages. Dimensional analysis of the data eventually generated three major conceptual categories: 'ownership of nursing', 'extending practice', and 'moving out of a comfort zone'. Of these, 'ownership of nursing' was identified as the core construct that linked the other categories together. The substantive theory that explains how registered nurses in aged care advance their clinical practice is 'developing autonomous ownership'. Nurses who develop autonomous ownership of nursing are more likely than other nurses to move out of a current comfort zone and advance their practice into more independent roles that suit their autonomous ownership of nursing. This study identified important contextual factors and conditions that support the development of an autonomous ownership of nursing and that subsequently facilitate advancing nursing practice. These include creating supportive environments, organisational commitment to advanced nursing practice roles, visible nursing leadership, congruence between organisational and nursing philosophies, interdisciplinary collaboration and participating in postgraduate education. The author suggests that the significance of this study is that it generated a theory about the processes that encourage or discourage nurses from preparing for, and progressing into, advanced nursing practice roles such as nurse practitioner.
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Gardner, A., Hase, S., Gardner, G., Dunn, S., & Carryer, J. B. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Author copy available 12 months after publication from QUT ePrints, 17(2), 250–258.
Abstract: This research aimed to understand the level and scope of practice of the nurse practitioner in Australia and New Zealand further using a capability framework. The original study, from which the present paper was developed, sought to identify competency standards for the extended role of the nurse practitioner in Australia and New Zealand. In doing so the researchers became aware that while competencies described many of the characteristics of the nurse practitioner they did not manage to tell the whole story. In a search of the literature, the concept of capability appeared to provide a potentially useful construct to describe the attributes of the nurse practitioner that went beyond competence. A secondary analysis of data obtained from the interviews with 15 nurse practitioners working in Australia and New Zealand was undertaken. The analysis showed that capability and its dimensions is a useful model for describing the advanced level attributes of nurse practitioners. Thus, nurse practitioners described elements of their practice that involved: using their competences in novel and complex situations as well as the familiar; being creative and innovative; knowing how to learn; having a high level of self-efficacy; and working well in teams. This study suggests dimensions of capability need to be considered in the education and evaluation of nurse practitioners.
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