Kelly, S., Domdom, J., Murray, J., & Ulloa, M. (2020). Weaving professional practice with interprofessional education for real praxis outcomes. Whitireia Journal of Nursing, Health and Social Services, 27, 33–37.
Abstract: Suggests that health, social-service and education delivery are increasingly required to be inter-professional. Advises that such professionals use an integrative and inter-professional approach to navigate the complexities of their practice environments in order to improve outcomes for their service users.
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O'Brien, A. P., O'Brien, A. J., Hardy, D. J., Morrison-Ngatai, E., Gaskin, C. J., Boddy, J. M., et al. (2003). The New Zealand development and trial of mental health nursing clinical indicators: A bicultural study. International Journal of Nursing Studies, 40(8), 853–861.
Abstract: This paper describes the development and validation of bicultural clinical indicators that measure achievement of mental health nursing practice standards in New Zealand (ANZMCHN, 1995, Standards of practice for mental health nursing in New Zealand). A four-stage research design was utilised including focus groups, Delphi surveys, a pilot, and a national field study, with mental health nurses and consumers as participants. Results revealed a variation in the mean occurrence of the clinical indicators in consumer case notes of 18.5-89.9%. Five factors with good internal consistency, encompassing domains of mental health nursing required for best practice, were derived from analysis of the questionnaire. This study presents a research framework for developing culturally and clinically valid, reliable measures of clinical practice.
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Gaskin, C. J., O'Brien, A. P., & Hardy, D. J. (2003). The development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. International Journal of Mental Health Nursing, 12(4), 259–270.
Abstract: This paper reports the three-stage development of a professional practice audit questionnaire for mental health nursing in Aotearoa/New Zealand. In Study 1, clinical indicator statements (n = 99) generated from focus group data, which were considered to be unobservable in the nursing documentation in consumer case notes, were included in a three-round Delphi process. Consensus of ratings occurred for the mental health nurse and academic participants (n = 7) on 83 clinical indicator statements. In Study 2, the clinical indicator statements (n = 67) that met importance and consensus criteria were incorporated into a questionnaire, which was piloted at a New Zealand mental health service. The questionnaire was then modified for use in a national field study. In Study 3, the national field study, registered mental health nurses (n = 422) from 11 New Zealand district health board mental health services completed the questionnaire. Five categories of nursing practice were identified: professional and evidence-based practice; consumer focus and reflective practice; professional development and integration; ethically and legally safe practice; and culturally safe practice. Analyses revealed little difference in the perceptions of nurses from different backgrounds regarding the regularity of the nursing practices. Further research is needed to calibrate the scores on each clinical indicator statement with behaviour in clinical practice.
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Carryer, J. B., Gardner, G., Dunn, S., & Gardner, A. (2007). The core role of the nurse practitioner: Practice, professionalism and clinical leadership. Journal of Clinical Nursing, 16(10), 1818–1825.
Abstract: This article draws on empirical evidence to illustrate the core role of nurse practitioners in Australia and New Zealand. A study jointly commissioned by both countries' Regulatory Boards developed information of the newly created nurse practitioner role, to develop shared competency and educational standards. This interpretive study used multiple data sources, including published and grey literature, policy documents, nurse practitioner programme curricula and interviews with 15 nurse practitioners from the two countries. The core role of the nurse practitioner was identified as having three components: dynamic practice, professional efficacy and clinical leadership. Nurse practitioner practice is dynamic and involves the application of high level clinical knowledge and skills in a wide range of contexts. The nurse practitioner demonstrates professional efficacy, enhanced by an extended range of autonomy that includes legislated privileges. The nurse practitioner is a clinical leader with a readiness and an obligation to advocate for their client base and their profession at the systems level of health care.
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Walker, J., & Bailey, S. (1999). The clinical performance of new degree graduates. Nursing Praxis in New Zealand, 14(2), 31–42.
Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.
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Tustin-Payne, W. (2008). Self esteem, competence assessment and nurses ability to write reflectively: Is there any connection? Ph.D. thesis, , .
Abstract: The Health Practitioners Competence Assurance Act 2003 requires nurses to have evidence to support they are competent to practice. Many nurses have become distraught and / or angry at this prospect, and the researcher suggests that this response appears to be more commonly related to the expectation of undertaking reflective writing, which is a key component of the competence evidence. This study explores the predisposing factors relating to nursing, reflective writing and competence to determine how this may impact on a nurse's self esteem. Utilisation of Critical Social Theory informed by feminist framework allows for exploration of the historical, social, political and cultural factors that shape and form female nurses reality in practice. It is a theory that relates to oppression and power, with the primary intent being to raise consciousness in order to emancipate. Although no definitive findings were made, there are multiple factors relating to nurse's history, socialisation, political imperatives and cultural beliefs that have the potential to impact on their self esteem. Competence, competence assessment and reflective practice are complex, therefore presenting multiple challenges. In order for nurses to understand their contextual reality and opportunities for change there is a need for them to engage in critical reflection.
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Robertson, A. M. (2008). Rural women and maternity services. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 179-97). [Dunedin]: Rural Health Opportunities.
Abstract: The author discusses the roles that nurses undertake in response to rural communities' health needs, focusing on the provision of maternity service. The author reviews structural changes such as the 1990 Amendment to the Nurses Act 1977 which, the author suggests, introduced a climate of professional rivalry, changes in funding that cut back general practitioners in the field, and the development of Lead Maternity Carers. Despite controversial developments, New Zealand maternity services have evolved to include a unique and internationally respected model of midwifery care. However, the author highlights several areas that limit the positive contribution of rural nurses and midwives. These include workforce recruitment and retention, equity of access, and issues around maintaining competency and education.
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Dillon, D. R. (2008). Rural contexts: Islands. In Jean Ross (Ed.), Rural nursing: Aspects of practice (pp. 19-30). [Dunedin]: Rural Health Opportunities.
Abstract: This chapter explores the concept of islands particularly in relation to rurality, individual and community identities, and nursing. The author argues that all New Zealanders are islanders, and considers the implications of this on personal and community values, when they are shaped by geographic isolation and structural separateness. She explores commonalities between islanders and rural peoples in areas such as identity, isolation, and health, and outlines the impacts this has on rural nursing practice and competencies. A case study of a nurse on Stewart Island is briefly discussed.
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Smith, M. C. (2008). Reviewing the role of a mental health nurse practitioner. Kai Tiaki: Nursing New Zealand, 14(3), 20–22.
Abstract: The author describes his experience of five years as a nurse practitioner in mental health at Waikato District Health Board. A recent review of the role gave him the opportunity to reflect on the learning associated with assuming the nurse practitioner role. A key area of learning has been in negotiating the shifting responsibilities and changing relationships associated with his role as an nurse practitioner and also as a Responsible Clinician, a role traditionally held by psychiatrists. The Responsible Clinician role is a statutory one under the Mental Health Act (1992), generally performed by psychiatrists but open to other suitably qualified professionals. He reports the results of a review based on feedback from fellow professionals, clients and their families, along with quantitative data from basic statistics connected to the role, such as a time and motion study. The review asked fellow professionals to rate the performance of the nurse practitioner against the Nursing Council competencies. These results indicate the nurse practitioner role is of some value and that other professionals and clients seem satisfied with the role. There is some evidence it is delivering outcomes acceptable to clients and other professionals. The study has many limitations which are discussed, such as a poor response rate and short time frame. Further research is planned to evaluate this role.
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Peach, J., & Hall, B. (1999). Professional boundaries: Being in relationship 'with' yet remaining separate. Professional Leader, 5(1), 16–18.
Abstract: This article describes the management of the therapeutic relationship, that is set up between nurses or midwives and those in their care. It reviews the responsibilities of the health practitioner, and looks at issues around boundaries, confidentiality and accountability. It also looks at the role senior colleagues can play in ensuring this intentional relationship is managed professionally.
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Hardy, D. J., O'Brien, A. P., Gaskin, C. J., O'Brien, A. J., Morrison-Ngatai, E., Skews, G., et al. (2004). Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand. Journal of Advanced Nursing, 46(1), 95–109.
Abstract: The aim of this paper is to detail the practical application of the Delphi technique as a culturally and clinically valid means of accessing expert opinion on the importance of clinical criteria. Reference is made to a bicultural New Zealand mental health nursing clinical indicator study that employed a three-round reactive Delphi survey. Equal proportions of Maori and non-Maori nurses (n = 20) and consumers (n = 10) rated the importance of 91 clinical indicator statements for the achievement of professional practice standards. Additional statements (n = 21) suggested by Delphi participants in round 1 were included in subsequent rounds. In round 2, participants explained the rating they applied to statements that had not reached consensus in round 1, and summarised responses were provided to participants in round 3. Consensus was considered to have been achieved if 85% of round 3 ratings lay within a 2-point bracket on the 5-point Likert-scale overall, or in one of the Maori nurse, non-Maori nurse, or consumer groups. A mean rating of 4.5 after round 3 was set as the importance threshold. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark. The authors conclude that when rigorous methods of participant selection, group composition, participant feedback, and determination of consensus and importance are employed, the Delphi technique is a reliable, cost-effective means of obtaining and prioritising experts' judgements.
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Ross, J. (2001). Perspectives on developing the advanced role of rural nursing in New Zealand. Health Manager, 8(1), 19–21.
Abstract: The author traces the development of rural nursing, which began as an assistant role for general practitioners, to the present role which incorporates advanced nursing practice. She reports the results of two surveys of nurses' roles and skills, from 1996 and 1999-2000. Specific rural competencies are identified, in managing isolation, professionalism in a small community, nurse/patient relationships in a small community, and independence.
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Valette, D. (2002). Nursing an adolescent in an adult inpatient mental health unit. Ph.D. thesis, , .
Abstract: This research paper reports on an exploration of the key elements nurses need to be aware of to effectively nurse adolescents in an adult inpatient unit. It describes the developmental needs and significant influences that affect this age-group, that when incorporated into nursing care, nurses can gain a therapeutic relationship with the adolescent. By means of a literature review, sharing the author's experience in nursing adolescents, and through vignettes of practice, an illustration of some common situations that may occur during the adolescent's inpatient stay are described. These situations are explored and a perspective is offered on how nurses may be effective in their nursing of an adolescent patient from the point of admission through to discharge. More research is needed on adolescent mental health nursing, however the author anticipates that nurses will be able to use this report as a helpful resource in their current practice.
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Carryer, J. B., & Russell, L. (2007). Nurses' understandings of the Professional Development Recognition Programme. Nursing Praxis in New Zealand, 23(2), 5–13.
Abstract: Professional Development and Recognition Programmes (PDRP) for nurses have developed out of the Clinical Career Pathways (CCP) of the 1990s. The Health Practitioners Competence Assurance Act (2003) has now required all health professionals to provide evidence that their practice meets criteria set by the individual regulatory body, which, for nursing, is the Nursing Council of New Zealand. In 2002 a tool was developed to measure knowledge and attitudes of the then CCP which was tested with 239 nurses. This paper is a report on the second application of the tool in the same hospital in New Zealand. Results show that knowledge and attitudes of the PDRP are similar to those found in the previous study. It also suggests that greater understanding of the PDRP and the implementation process increases the likelihood of a positive response to the programme.
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McLauchlan, M. F. (2006). Mobile computing in a New Zealand Bachelor of nursing programme. In Consumer-Centered Computer-Supported Care for Healthy People. Studies in health technology and informatics, 122 (pp. 605-608). IOS Press.
Abstract: Mobile computing is rapidly becoming a reality in New Zealand health care settings. Personal Digital Assistants (PDAs) are the most frequently used of these mobile technologies, giving nurses access to clinical learning resources, including drug references, medical encyclopaedias and diagnostic information. The implementation of mobile computing at Waikato Institute of Technology (Wintec) will ensure graduates of our Bachelor of Nursing Programme are able to meet health care service demands for knowledge in contemporary information technologies as well as the information technology requirements defined by the Nursing Council of New Zealand and the Health Practitioners Competency Assurance Act 2003 for registration as a nurse in New Zealand. This paper presents strategies for the implementation of mobile computing as a core element of the curriculum for the Bachelor of Nursing Programme at Wintec in Hamilton.
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