Abstract: A clinical audit was undertaken to assess the diagnostic skills of the nurse colposcopist measuring colposcopy: histology: cytology correlation. At National Women's Health the first New Zealand nurse colposcopist training programme was developed in 2000. A retrospective audit of the colposcopy clinical records was performed during the nurse's training programme between July 2000 and March 2002. An 82% (82/100) histology: cytology: colposcopy correlation was achieved by the nurse in the third phase of her training programme. The results are comparable with other reported studies involving medical and nurse colposcopists. Expertise in colposcopy examination can be incorporated into the broader role of a Nurse Practitioner working in the area of women's health.

Abstract: The original aim of the study was to find out through a questionnaire what child health/paediatric nurses in New Zealand/Aotearoa saw as their needs for post-registration education. Nurses were completing courses in the United Kingdom and returning to New Zealand/Aotearoa and realising that their nursing capabilities had improved. They became senior nurses with education responsibilities and exhibited political leadership among their colleagues in the field of child health/paediatric nursing. They were becoming increasingly concerned at the lack of any clinical courses in the specialty of child health/paediatric nursing to promote an appropriate standard of practice. It was intended that a research project about post-registration child health/paediatric education would assist concerned nurses to develop a programme. The time needed for such a project did not fit with a limited research paper. It was decided to reduce the project to a review of the literature on competence in nursing, with some comment on the specialty of child health/paediatric nursing. In order for nurses to find what they need to learn and know, an understanding of competence in nursing practice is required. Competence is defined as the ability of the nurse to carry out specific work in a designated area at a predetermined standard. Issues around competence, defining a scope of practice, development and assessment of competence, and regulation of nursing, are part of the context in which accountability for the practice of nurses sits.

Abstract: This qualitative research project explored the experiences of nurse educators who sought to assess aspects, which could be related to facilitation of emotional competence, in nursing students. Focus groups were conducted in three different educational institutions, offering a Bachelor of nursing degree. Each of the participants had a teaching and assessment role within the school of nursing. The contributions of the nurse educators and their interactions were audio taped, transcribed and then later, analysed using thematic and focus group analysis practices. From the analysis of the experiences of the nurse educators, four predominant themes arose which capture the areas of importance to the participants. Student nurses can develop emotional competence by critically reflecting during classroom and clinical experiences. Continuous consideration must be made within each practicing area of nursing, of the environmental and relational challenges which inhibit or facilitate nurse's ability to practice with emotional competence. Educators and practicing nurses, who work alongside students, must uphold the expectation that emotional competence is a requisite ability and provide opportunities to foster emotional growth and skills to resolve conflict within the culture of nursing. A common view shared by the educators was that the profession of nursing needs to have a clear understanding of what constitutes emotional competence. Strategies to realistically incorporate emotional competence into the educational curriculum and competency based assessment opportunities within nursing education are required. Suggestions are presented from which undergraduate nursing education can facilitate development of emotional competence with those students working toward becoming a registered nurse. Emotional competence is suggested as an essential learning outcome in the movement toward transformative nursing education and a collaborative nursing profession.

Abstract: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses' (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses' case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non-Maori mental health nurses, prioritised in a three-round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 district health board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery-focused care. The authors discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.

Abstract: Recent Nursing Council of New Zealand guidelines for competence-based practising certificates and the fact that all nurse educators must have a current practising certificate prompted the Nursing Schools within the Tertiary Accord of New Zealand (TANZ) to explore issues surrounding current competency in practice and how this can be maintained by nurse educators. The authors note that discussions related to competence-based practising certificates generally refer to competence only in terms of direct patient care. They set out to clarify the issue with specific reference to nurse educators who, by the nature of their scope of practice, often do not carry a patient caseload. They review the literature relating to currency of practice and draw on the findings of a survey of TANZ Nursing Schools and provide a position on how currency of practice applies to nurses working in an educational setting. They present strategies to maintain clinical, teaching and scholarly currency and make some suggestions for providing evidence that currency of practice is maintained.

Abstract: Professional development is an ongoing requirement of nurses as a result of the Health Practitioners Competence Assurance Act. The Act?s principal purpose is to protect the health and safety of the public by ensuring health practitioners are fit and competent to practise. This survey was designed to explore the avenues nurses have taken, and would prefer to take, for their professional development. The questionnaire was sent to a random sample of the New Zealand Nurses Organisation's registered and enrolled nurse members. Nurses overwhelmingly favoured professional development in the workplace. More than half the respondents reported a conflict with other time commitments, while a number of respondents wrote of their desire for work-life balance. The cost of fees, ability to take time off work, and time and travelling distance were all hurdles to professional development. Nurses cited information technology, conflict resolution, managing challenging behaviour, and dealing with rostered & rotating shifts as aspects of their current work for which their nursing education (pre and post) had not adequately prepared them. Nurses also indicated that their pre-registration education in health systems and political processes was inadequate for their current work. As nurses aged, their interest in professional development increased, though many still preferred workplace options. The authors conclude that, in order for professional development opportunities to be accessible and relevant, resources and time must be made available. This is vital to achieve ongoing education of nurses and improved patient outcomes. Management support, combined with effective assessment of learning needs guiding professional development opportunities, are fundamental to ensuring nurse competence.

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.