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Litchfield, M. (2002). The successful design and delivery of rural health services: The meaning of success. Christchurch: Centre for Rural Health.
Abstract: A report on the analysis of data from an in-depth survey designed by Sue Dawson, previously Rural Health Researcher in the Centre for Rural Health, and follow-up interviews. The study purpose was to construct a definition of ?successful design and delivery of rural health services? as a step towards a measurement tool. Participants were grouped as general practitioners (GPs), nurses and community representatives. A format for a participatory approach to evaluation of rural health services is derived from the criteria of success identified, with its relevance for the implementation of the new Government primary health care strategy explicit. This format provided the basis for a subsequent evaluation case study undertaken in a small rural forestry township by the Centre for Rural Health.
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Litchfield, M. (2007). The innovation effort: ?Are you in or are you out??.
Abstract: A graphic presentation in PDF format (April 2007) of the findings and policy implications of the developmental evaluation research programme for the Turangi Primary Health Care Nursing Innovation.
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Litchfield, M., & Ross, J. (2000). The role of rural nurses: National survey. Christchurch: Centre for Rural Health.
Abstract: A survey was used to reach as many nurses as possible involved with nursing in “rural” areas throughout New Zealand and to build a profile of nurses involved in the provision of healthcare beyond the urban centres. The contact also sought to inform nurses of the rural healthcare project and encourage them to contribute their experience to the development of health services in the new health service structure. Data is presented on the characteristics and employment conditions of nurses and access to resources including information technology. The inadequacy of information on the rural nurse workforce is identified: nurse roles are historically defined yet employment patterns are changing according to the workforce demands of new structures, and the existing definitions of rural health service design and delivery are only in terms of general medical practices and on-call coverage. Recommendations are made for definitions of “rurality” and “rural nurse” that will allow a more useful depiction of the nurse workforce.
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Macfie, B. (2003). The exploration of primary health care nursing for child and family health : Margaret May Blackwell Travel Study Fellowship, 2002. Margaret May Blackwell Travel Study Fellowship Reports. New Zealand: Nursing Education and Research Foundation (NERF).
Abstract: Reports the approach to child and family health nursing in Canada, the US, and the UK. Divides the report into health policy, primary health care services, nursing education and the development of primary health care nurse practitioners, and nursing leadership in primary health care. Part of the Margaret May Blackwell Scholarship Reports series.
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Mackay, B. (2002). Leadership development: Supporting nursing in a changing primary health care environment. Nursing Praxis in New Zealand, 18(2), 24–32.
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.
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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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Mackay, B. (2004). An analysis of innovative roles in primary health care nursing. Ph.D. thesis, , .
Abstract: An analytical tool of Force Field Analysis was used to identify and describe forces influencing the development of innovative roles, including the nurse practitioner role, in primary health care nursing. At the commencement of the study an initial analysis of research, literature and policy identified forces driving or restraining the development of innovative roles. A mixed research method of surveys and focus group interviews with key stakeholders, namely nurses in innovative roles, general practitioners and nurse leaders, was then used to identify factors influencing development within the Northland District Health Board. Descriptive statistics and interpretative methods were used to analyse the data. A final analysis enabled a picture of forces influencing innovative role development to be presented. Driving forces reflected international trends and were strongly influenced by economics and a political imperative to reconfigure health care services towards a primary health focus. The Treaty of Waitangi was also a key influence. Driving forces had greatest impact on the development of new roles. Forces were identified as drives towards cost-effective evidence-based health care (effective services), equity for Maori, response to local needs and workforce reorganisation. The major forces restraining the development of innovative roles were reinforced by attitudes, customs and support systems. These forces were identified as poor professional identity and support, an outdated nursing image, inadequate education and training and slow transition from traditional practices and structures (tradition). These forces had a negative influence on support for innovative roles. Promotion of kaupapa Maori, involvement of the local community, local Maori and nursing in decision-making and promotion of a team culture have the potential to support further development of innovative roles. Political ideology and the Treaty of Waitangi will continue to be major influences directed through policy and the contracting and funding process.
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Mackay, B. (2007). Leadership strategies for role development in primary health care nursing. coda, An Institutional Repository for the New Zealand ITP Sector, 11, 31–39.
Abstract: This paper has been developed from part of the writer's doctoral thesis on forces influencing the development of innovative roles in primary health care nursing. The focus of this paper is leadership strategies designed to reduce the issue of poor professional identity and support.
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Macklin, N. (2018). Hearing the patient voice: the importance of caring in care. Master's thesis, Dunedin, University of Otago.
Abstract: Backgrounds the primary health care initiative, the Transitional Care Nursing service, which aims to facilitate integrated care between primary, secondary and community health care services. Explores whether support in the form of the Transitional Care Nursing service influences the experience of patients who receive assistance during the transition between hospital and home. Conducts qualitative, semi-structured interviews with 12 patients whose responses are thematically analysed. Highlights the characteristics of care offered by Transitional Care nurses that describe the person-centred care patients received.
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Magrath, K. L. (2005). From chrysalis to butterfly: Transition experiences of new graduates in primary health care nursing practice in New Zealand. Ph.D. thesis, , .
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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Mason, B. (2002). An analysis of the role of the practice nurse in primary health care, 2000/2001. Ph.D. thesis, , .
Abstract: In 1999 primary health care in New Zealand was in the process of change from the current personal health care model, which focuses on general practitioner based care, to a population and community based health care programme. Carryer, Dignam, Horsburgh, Hughes and Martin (1999) submitted a report to the National Health Commission entitled “Locating Nursing in Primary Health Care”. This report envisaged that nurses in primary health care would be part of interdisciplinary teams, act autonomously and undertake community consultation and education. The submission suggested that nurses, currently working in primary health care, were alraedy prepared and able to move across into the new form of primary health care, without further education or training.
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Maw, H. (2005). The challenge of developing primary health care nurse practitioner roles in rural New Zealand. Ph.D. thesis, , .
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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McElroy, J. Maternity outcomes and access following regulatory changes for Isotretinoin prescribing in New Zealand (Vol. 2017). Master's thesis, University of Otago, . Retrieved April 27, 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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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. (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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