Nursing praxis in New Zealand inc最新文献

{"title":"\"We Are the International Nurses\": An Exploration of Internationally Qualified Nurses' Experiences of Transitioning to New Zealand and Working in Aged Care","authors":"B. L. Jenkins, A. Huntington","doi":"10.36951/ngpxnz.2016.006","DOIUrl":"https://doi.org/10.36951/ngpxnz.2016.006","url":null,"abstract":"IntroductionWorldwide, a critical nursing shortage is predicted to occur within the next five years. Workforce projections from India, the European Union (EU), and the United States (US) collectively demonstrate approximately four million additional nurses will be required to care for increasingly aged populations (American Nurses Association, 2014; Royal College of Nursing, 2015; Senior, 2010). Traditionally, Western nursing shortages have been managed by recruiting Internationally Qualified Nurses (IQNs), who remain a significant source of labour in Australia, New Zealand (NZ), the United Kingdom (UK), and the US (Aiken, 2007; Brush, Sochalski, & Berger, 2004; Buchan, 2006; Li, Nie, & Lie, 2014). Many of these nurses are employed from India and the Philippines; a competitive process subject to influence from countries such as the US, where small changes in supply, demand, and policy have a substantial impact on the global nursing resource (Aiken, 2007; Aiken, Buchan, Sochalski, Nichols, & Powell, 2004; Aitken, 2006; Ball, 2004; Brush & Sochalski, 2007; Lorenzo, Galvez-Tan, Icamina, & Javier, 2007). Despite this market existing for over 60 years, experiences of IQNs working abroad are not always positive (Bland & Woodbridge, 2011; Daniel, Chamberlain, & Gordon, 2001; DiCicco-Bloom, 2004; Lorenzo et al., 2007). These experiences require consideration, as demand for international nurse labour is expected to continue - especially in smaller countries, such as NZ, where domestic capacity for workforce growth is limited (Nana, Stokes, Molano, & Dixon, 2013).BackgroundInternationally qualified nurses, or nurses who gained their first nursing qualification abroad (Nursing Council of New Zealand, 2013a), are a significant and important section of New Zealand's Registered Nurse (RN) workforce. Since 2010, IQNs have represented approximately 25 percent of this workforce, and in the 2014 to 2015 registration period, 40 percent of newly registered RNs were internationally qualified (Nana et al., 2013; Nursing Council of New Zealand, 2011; 2015). Over time, local IQN profiles have grown to include mostly nurses from India and the Philippines (Nana et al., 2013; Nursing Council of New Zealand, 2013b; 2015), and IQNs have become vital to aged care; comprising about 40 percent of RNs in this setting (Grant Thornton New Zealand Ltd., 2010; Nursing Council of New Zealand, 2013c). This contribution is expected to remain important as New Zealand's ability to increase domestically trained nurses remains constrained while a projected workforce shortage looms (Nana et al., 2013).Internationally, substantial literature explores experiences of IQNs from a range of countries that gain employment abroad (Alexis & Shillingford, 2012; Nichols & Campbell, 2010; Okougha & Tilki, 2010; Smith, Fisher, & Mercer, 2011; Wheeler, Foster, & Hepburn, 2013). Most of this research originates from Australia, Canada, the UK, and the US, and is rarely exclusive to Filipino and Indian nurs","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"24 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74334855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the role of health care assistants as mobility activators for older people in an assessment, treatment and rehabilitation ward","authors":"Rebecca M Mowat, M. Parsons","doi":"10.36951/NGPXNZ.2016.007","DOIUrl":"https://doi.org/10.36951/NGPXNZ.2016.007","url":null,"abstract":"IntroductionAs people live longer, the pressure on an already overstretched healthcare sector increases, and the expectation of an ever-increasing supply of registered health professionals to meet health care demands is unrealistic given workforce shortages. Finding viable alternatives to address workforce shortages is consequently becoming more of a focus for health services and the structure of nursing care delivery is changing to meet workforce demands. Contemporary care models show there is a trend towards a team approach, where the expertise of the registered nurse (RN) is employed in supervisory and delegation roles with second level clinical support from enrolled nurses and health care assistants (HCAs) in some settings (Cassie, 2014). Rehabilitation approaches are also changing to maximise the input and care required by older people. Specialised units in secondary care provide specific rehabilitation programmes designed by interdisciplinary teams focused on outcomes such as longevity, quality of life and even improved cognition (Ellis & Longhorne, 2005). However, when analysing how the interdisciplinary team works towards the goal of successful discharge of patients back to their community, the role RNs and HCAs play in enhancing mobility has been undervalued and underutilised (Kearney & Lever, 2010). The importance of mobility rehabilitation is supported by evidence of a positive impact on health outcomes such as increased strength, balance, flexibility and wider implications with reduced hospital stay, improved quality of life and reduction of falls (Atwal et al., 2008; Huijben-Schoenmakers, Gamel, & Hafsteinsdottir, 2009; Pryor, 2005).The HCA spends a significant amount of time with patients in Assessment, Treatment and Rehabilitation (ATR) wards. They are a logical, yet untapped source of contact to perform rehabilitation activities directed by staff who work limited hours such as allied health professionals (Pryor, Walker, O'Connell, & Worrall-Carter, 2009). This paper reports the findings from a research project examining the feasibility of health care assistants' participation in mobility rehabilitation for older people in an ATR ward.Literature reviewMobility is an important part of rehabilitation, and early mobilisation has proven to have significant positive outcomes in reducing length of stay, preventing deep vein thrombosis and pulmonary emboli, and improving overall physical function (Fox, Sidani, & Brooks, 2009; Pryor et al., 2009). Enhanced mobility can also reduce falls, and has a positive impact on aerobic and resistance exercises; a more active lifestyle improves cardiovascular and respiratory system function, and functional musculoskeletal ability well into older age (Intiso et al., 2012).Research on the role of the HCA in patient care, and specifically about mobility, is limited. The practice of HCAs is historically embedded in models of social care, but their scope of practice has changed over time due to public expec","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"91 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84400007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Zealand Nurses' Experience of Tele-Consultation within Secondary and Tertiary Services to Provide Care at a Distance","authors":"Jane Wright, M. Honey","doi":"10.36951/ngpxnz.2016.008","DOIUrl":"https://doi.org/10.36951/ngpxnz.2016.008","url":null,"abstract":"IntroductionHealthcare providers recognise, but continue to be challenged by the demands of providing quality services in a dispersed environment. This issue is compounded by rapid technological advances, increasing public expectations and an aging healthcare workforce (National Health Board, 2010). Information and communication technology (ICT) is recognized as a key component in meeting future healthcare needs (National Health Board, 2010). One of the technology-based approaches gaining recognition as being able to provide more accessible healthcare is telemedicine. Telemedicine is defined as using \"communications networks for delivery of healthcare services and medical education from one geographical location to another, primarily to address challenges like uneven distribution and shortage of infrastructural and human resources\" (Sood et al., 2007, p. 576). Tele-consultation, which is a subset of telemedicine, is described as \"seeking medical advice or information from someone at a distance\" (Kerr & Norris, 2004, p.2). For example, a nurse working in a tertiary service may tele-consult with another nurse or staff in an area where staff do not have specialised knowledge, and this can be with or without the patient being present. How the communication takes place is dependent on the type of interaction needed, but common mediums include telephone, texting, email and videoconferencing. Nurses, as the largest health professional group, are ideally placed to provide healthcare at a distance mediated by ICT. Currently little is known about New Zealand (NZ) nurses experience of using tele-consultation. This study examines the experiences of nine NZ Registered Nurses (RNs) who provide secondary and tertiary services to patients and healthcare teams using tele-consultation as part of their nursing practice. These nurses use tele-consultation in a variety of ways. Some use tele-consultation due to geographic isolation from a tertiary centre and others use tele-consultation because they provide a specialty service to an area that is rural or remote.Telemedicine and tele-consultationTelemedicine has arisen from the advancement of ICT and the application of these technologies to healthcare. The term telemedicine was first mooted in the 1970s (World Health Organisation (WHO), 2010). The last two decades have heralded growth of telemedicine in most countries because of the widespread availability and improved speed of the internet (Bashshur, Shannon, Krupinski, & Grigsby, 2013). Telemedicine services that focus on diagnosis and clinical management are now offered routinely in the United Kingdom, Scandinavia, North America and Australia (WHO, 2010). Telemedicine offers a different mode of healthcare delivery, that is of particular interest to health professionals who work in rural settings, as a tool to address health accessibility and equity issues (Di Cerbo, Morales-Medina, Palmieri, & Iannitti, 2015). Teleconsultation is a subset of telemedicine, and when ","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"12 1","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77705852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Power of Normal","authors":"J. Wilkinson, Mark Jones","doi":"10.36951/ngpxnz.2016.005","DOIUrl":"https://doi.org/10.36951/ngpxnz.2016.005","url":null,"abstract":"There is a drive within each of us towards normality. What is usual, typical, standard, average, natural, regular or conventional shapes our lives in many varied and important ways. We have laws, regulations, codes, guidelines and rules (written, spoken and unspoken) that specify in detail what constitutes normal behaviour. There is often a degree of comfort associated with this, even a sense of safety. As nurses we assess growth and development, indicators of health and well-being, and presenting symptoms against established norms. We can describe performance and outcomes statistically using terms such as deviation from the mean on a normal distribution curve. Normality is central to our lives in so many ways and we value the status quo; when it is challenged we tend to want to 'get back to normal'.Normality then is a powerful construct embracing everything and everybody (Rabinow & Rose, 2003). Institutions and groups to which people belong require their members to behave in particular ways. Professional groupings (not only in health contexts) require their members to conform to established norms through regulatory means and the judgement of their peers. Disciplinary measures, both formal and informal, are exercised on members for deviation from accepted practice (Dreyfus & Rabinow, 1983). These measures are essential for a safe and quality health service, but create particular challenges when it comes to transforming the workforce to meet burgeoning population health need.In New Zealand a patient's normal expectation and experience of first contact primary care is to be seen by a general practitioner (GP). It's an expensive model characterised by periodic consultations with attempts at curative medicine and perhaps once did meet most people's immediate health needs. Over recent decades, however, the new normal of population health and socio-economic inequalities has left the traditional GP model wanting. The norm patients should experience for integration of complex health and social needs, is a multidisciplinary approach in which nurses play a central role. Yet where it does exist (usually servicing deprived populations) and where it pushes traditional boundaries, it is tolerated as innovative and subject to funding mechanisms that lack longevity.The Institute of Medicine (2011) report on the Future of Nursing states that nurses have a fundamental role in the transformation of health services, and to advance health, should practice to the full extent of their education and training. Yet transformation of our outmoded system status quo will require a revolution of thought, attitude, custom, practice and policy to properly enable a way of working that should be normal in the first place. The issue of prescriptive authority has perhaps become something of a 'touchstone' in this context with the nurse practitioner (NP) role having made considerable progress in recent years toward disrupting the norm of diagnosis and prescribing as the sole purview","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"326 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76547195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Experiences of Maori with Dementia and Whanau Perspectives - Oranga Waha Mo Nga Iwi Katoa","authors":"J. Gilmour, A. Huntington, B. Robson","doi":"10.36951/ngpxnz.2016.003","DOIUrl":"https://doi.org/10.36951/ngpxnz.2016.003","url":null,"abstract":"IntroductionGood oral health enables full interaction with the social and material world; to have good kai, to speak clearly, to hongl, kiss, smile and laugh, without discomfort or embarrassment. It is also to be free from active disease in the mouth that affects overall health and wellbeing (Robson et al., 2011, p.9). Dementia is associated with poor oral health status (Chalmers, Carter, & Spencer, 2003; Philip, Rogers, Kruger, & Tennant, 2012; Rejnefelt, Andersson, & Renvert, 2006). The term dementia encompasses symptoms such as progressive memory loss, disorientation and problems with cognitive functioning caused by illnesses such as Alzheimer's disease, vascular dementia and Lewy body dementia (Prince, Albanese, Guerchet, & Prina, 2014). The purpose of this study was to explore the oral health experiences of Maori with dementia and their whanau. In 2008 there was estimated to be at least 1483 Maori with dementia in New Zealand, 3.6% of a total population of 40,746 New Zealanders with dementia (Access Economics, 2008). These numbers are predicted to increase to 4,338 or 5.8% of the total population with dementia in 2026. There appears to be no research published focusing on Maori with dementia and oral health.This research was carried out as a partnership between Te Ropu Rangahau Hauora a Eru Pomare and Alzheimers New Zealand with an overall goal of raising awareness of oral health issues for Maori with dementia. It was part of a larger study funded by the Health Research Council of New Zealand and the Ministry of Health. The study was tasked with the identification of oral health research priorities for three specific groups: low income Maori adults; older Maori adults; and Maori with special needs, disabilities, or who are medically compromised. The full study is reported in Robson et al. (2011). This paper reports in detail the findings from the project on oral health experiences and needs of Maori with dementia and their whanau.BackgroundResearch in a range of settings identified people with dementia as having poorer oral health status than those without dementia. In residential care people with dementia have a higher incidence of caries, reduced saliva flow and poorer oral hygiene (Rejnefelt, Andersson, & Renvert, 2006; Philip et al., 2012; Willumsen, Karlsen, Naess, & Bjprntvedt, 2012). An American study of 21 nursing home residents found significant underdetection and under-treatment of pain and dental problems in people with dementia (Cohen-Mansfield & Lipson, 2002). In community settings an Australian study found dentate people with dementia, as compared to a similar group without dementia, had significantly more oral diseases, decreased denture use over one year, increased denture related ulcers, increased plaque and increased caries (Chalmers, Carter, & Spencer, 2003). The need for assistance with teeth cleaning increased from the baseline 24% to 58.2% at one year. People with dementia were significantly less likely to see the denti","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"91 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82637719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking Back and Looking Forward","authors":"Louise Rummel","doi":"10.7551/mitpress/4171.003.0027","DOIUrl":"https://doi.org/10.7551/mitpress/4171.003.0027","url":null,"abstract":"Emeritus Professor Dr Norma Chick PE RGON RM PhD, FCNA, has been a member of the Editorial Group of Nursing Praxis in New Zealand from the inception of \"Nursing Praxis\" in 1985 to the present day (2016). One can only marvel at this length of service of a great, disciplined and logical mind, and her determination to advance the profession of nursing as a discipline in its own right. Reflecting on the early issues of Nursing Praxis in New Zealand my mind goes back to my early associations with Norma.Alongside Dr Nan Kinross, Norma began the first postregistration, advanced education for registered nurses in New Zealand at Massey University, Palmerston North. In their co-authored book Chalk & Cheese (2006) both wrote of the struggles they experienced to establish nursing in the university environment. Starting in 1973 as a small unit within the Department of Psychology with three students nursing grew quickly, helped by the strong interest shown by New Zealand nurses in furthering their education, and Massey University's mandate to provide extramural studies throughout the country.The entry requirement for university nursing studies in the 1970s was a nursing registration. Local students could study \"internally\", attending weekly classes, but the majority of students, myself included, had to take the extramural option. Our studies were undertaken by mail, with study guides and set readings arriving at regular intervals. The study guide content was comprehensive and it spelt out step by step what was required of the student. They were the forerunners to other types of study at a distance, forecasting contemporary forms such as e-learning. Each \"paper\" included compulsory on-campus courses of intensive lectures, tutorials, group projects and tests. On-campus courses were gruelling but also exciting. Through the paper on Nursing Knowledge Norma introduced me and hundreds of other nurses to nursing theory and research. She can be credited with influencing the mind-set of a whole generation of nurses from thinking of nursing as only a practical occupation supported by procedural knowledge to one that is scientifically based on sound evidence to provide a clear rationale for nursing judgements and actions.From the outset, Norma introduced students to the importance of building a distinctive body of knowledge that would establish nursing as a discipline in its own right. Discipline was defined as \"a unique perspective, a distinct way of viewing all phenomena which ultimately defines the limits and nature of its inquiry\" (Donaldson & Crowley, 1978, p.113). Norma taught that received knowledge while it supported a vocational perception of nursing, was inadequate to provide the foundation for a scientific discipline. Thus began our journey of discovery-introduction to philosophy, logic, and exposure to conceptual frameworks and to theories of nursing, mainly those developed by American nurse scholars such as Henderson, Orem, Roy, Rogers, and others, and most ","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"21 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81684274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 'Toolkit' for Clinical Educators to Foster Learners' Clinical Reasoning and Skills Acquisition","authors":"C. Cook","doi":"10.36951/ngpxnz.2016.004","DOIUrl":"https://doi.org/10.36951/ngpxnz.2016.004","url":null,"abstract":"IntroductionTeaching clinical skills, whether at a patient's bedside or in simulated settings, continues to be a mainstay of assisting novice practitioners towards competence and expertise. Quality preceptorship is vital for the retention of new graduates and preceptors' satisfaction (Broadbent, Moxham, Sander, Walker, & Dwyer, 2014; Haggerty, Holloway, & Wilson, 2013; Smedley, Morey, & Race, 2010). The shift of nursing education from hospitals to tertiary settings emphasises theory informing practice (praxis). However, there has not been a matched rigour to ensure that clinical educators engage in sound educational practices when teaching 'hands on' clinical skills. Instead, those undertaking clinical roles such as nurse educators, preceptors or clinical teaching associates, draw primarily from their own tacit knowledge of how to transmit their practice wisdom about skills mastery (Kinchin, Cabot, & Hay, 2009). The 'intuitive' teaching of clinical skills reflects the persistence of a traditional apprenticeship model, whereby learners develop technical competence but might not be able to articulate a critical analysis of whether and why a technique is best practice. Clinical reasoning may lag far behind technical know-how.The focus of this article is the micro-skills of clinical teaching, to make tacit knowledge accessible. There is scant literature that brings together these micro-skills in a way that is readily accessible to nurse educators. What follows is a synthesis of three models and three specific skills, underpinned by theory. Together, these provide a 'toolkit' of teaching approaches, enabling those providing clinical education to plan learners' skills acquisition, maximising efficiency and satisfaction on the part of the educator and the learner. Effective clinical teaching is, of course, also shaped by 'bigger picture' contexts, such as collaboration between clinical institutions and tertiary providers to ensure undergraduate nursing students have optimal learning experiences (see for example Bourgeois, Drayton, & Brown, 2011; Edgecombe & Bowden, 2009). Other important institutional components shape educators' role development. These include an organisational commitment to professional development, mentoring and adequate staffing. Gaberson, Oermann and Shellenbarger (2015) and Rose and Best (2005) usefully provide indepth analyses of the foundations of clinical teaching.BackgroundThe classic work of Patricia Benner, From novice to expert (1984), drew from the work of Dreyfus and Dreyfus (1986) in explaining the progression of novice nurses to becoming expert practitioners. Benner emphasised the importance of novices learning alongside experts. Despite the considerable influence of her research, which shapes the Nursing Council of New Zealand Competencies for Registered Nurses (2012), her early work pays limited attention to the details of how experts transmit knowledge of clinical skills and enable learners to blend holistically psych","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"20 1","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91378189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning to Become a Nurse Prescriber in New Zealand Using a Constructivist Approach: A Narrative Case Study","authors":"Anecita Gigi Lim, M. Honey, N. North, J. Shaw","doi":"10.36951/ngpxnz.2015.009","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.009","url":null,"abstract":"IntroductionMedical prescribing, in terms of both education and practice, has been extensively researched but this has not been the case with nurse prescribing (Coombes, Mitchell, & Stowasser, 2008; Franson, Dubois, de Kam, Burggraaf, & Cohen, 2009; Garbutt et al., 2006; Gwee, 2009). One reason for this is that internationally, prescriptive authority differs between countries, and hence the educational preparation for nurses to prescribe also varies. This has detracted from consistent research into the educational preparation and practice of nurse prescribing despite the fact that registered nurse prescribing is well established in some countries, notably the United Kingdom and is generally regarded positively (Latter et al., 2010).This article describes the pedagogical underpinnings of one of the first postgraduate programmes developed for nurse practitioners to gain prescriptive authority. Nurses intending to become nurse practitioner prescribers were interviewed to gain an understanding of their experiences of undertaking these postgraduate prescribing programmes.BackgroundNurse prescribing in New Zealand: A brief historyIn New Zealand, the nurse practitioner role was introLim, duced to improve patient access to health care services (National Health Committee, 2000). The introduction of the nurse practitioner role also represented a significant advance for professional nursing and positioned nurses to practice autonomously. Autonomous practice for nurse practitioners includes performing comprehensive health assessments, clinical diagnosis and prescribing treatments. The introduction of nurse prescribing in New Zealand has developed concurrently with the role of the nurse practitioner (Nursing Council of New Zealand, 2005). Since 1999, nurse practitioners in New Zealand can prescribe as long as they have completed the necessary educational preparation (Lim, Honey, & Kilpatrick, 2007).Prescriptive authority in New Zealand is outlined in the Medicines Act of 1981 and in the Medicines Regulation of 1984. Under the Act, health professionals with prescriptive authority (authorised prescribers) can prescribe all medicines from Part 1A or Part 1B of the Schedule 1 of the Medicines Regulations. Three health professional groups were authorised prescribers (doctors, dentists and midwives) until 1999 (Medicines Amendment Act 1999) when prescriptive authority for nurses was considered by the New Zealand government and the legislation was amended.Educational preparation for prescribing was included in the undergraduate programme for doctors, dentists and midwives, which was not the case for nurses. Therefore the term, designated prescribers, was added in the amendments to the Act. Unlike authorised prescribers, designated prescribers are required to undergo additional education in pharmacology and therapeutics to become prescribers. Since 1999, further amendments to the Act (in 2011) extended prescriptive authority to pharmacists and diabetes nurse speciali","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"25 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78034425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion of the Primary Health Care Strategy in a Small District Health Board in New Zealand","authors":"H. R. Robertson, J. Carryer, S. Neville","doi":"10.36951/ngpxnz.2015.008","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.008","url":null,"abstract":"Introduction and BackgroundThe Primary Health Care Strategy (PHCS) declared that a strong primary health care (PHC) system was considered fundamental to improving the health of New Zealanders and for tackling inequalities (Ministry of Health (MoH), 2001). The launch heralded a radical policy change to strengthen service delivery in PHC (Workforce Taskforce, 2008) and provided an opportunity for PHC nurses to engage fully with government and their employers in developing new nursing roles and responsibilities (MoH, 2005). It coincided with an international call for nursing innovation to produce a new form of health service delivery given an increase in health care demand from people with chronic conditions (Halcomb, Patterson, & Davidson, 2006; Temmnink, Francke, Hutten, van der Zee, & Abu Saad, 2000). Changes to service delivery, shorter hospital stays and an increased focus on population health and health promotion, meant that the responsibilities for nurses working in primary health care (PHC) had increased (MoH, 2005).It was imagined that the extensive contribution nursing could make to reducing health inequalities, achieving population health gains and preventing disease, would be fully realised as a result of the PHCS (Expert Advisory Group on Primary Health Care Nursing, 2003). The expert advisory group reported that there was no nursing voice in decision-making, a noticeable lack of nursing leadership infrastructure in PHC settings and an absence of clinical career pathways. They also noted that PHC nurses lacked adequate resources to support their education, autonomy and skill development. This study thus explored and examined the situational and structural factors contributing to the implementation of the PHCS in a district health board (DHB) with a particular focus on the utilisation of nurses.BackgroundThere is an abundance of international literature that concentrates on the positive characteristics of PHC (Arford, 2005; International Council of Nurses, 2008; McMurray, 2007; Sloand & Groves, 2005; Starfield & Shi, 2007; Walker & Collins, 2009; World Health Organisation (WHO), 2008). A PHC paradigm privileges a broader remit than the provision of episodic care for ill health. It works toward the development of health by putting the emphasis on prevention, community involvement and working with sectors outside of health (Keleher, 2000; Sweet, 2010). The International Council of Nurses (2008) has said that it is through the principles of PHC that nursing can make an important contribution toward progress in the goal of \"health for all\" noting that nursing is considered the \"very essence of primary health care\" (p.7).Much of the relevant published New Zealand literature focuses on the introduction of primary health organisations (PHOs) and funding models associated with the implementation of the PHCS but makes little mention about the impact on PHC nursing. The PHCS promised the effective deployment of nurses to make the best use of nursi","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"4 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78565238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duty of Care Following Stroke: Family Experiences in the First Six Months","authors":"Andrew Duthie, Dianne Roy, E. Niven","doi":"10.36951/ngpxnz.2015.007","DOIUrl":"https://doi.org/10.36951/ngpxnz.2015.007","url":null,"abstract":"Introduction and BackgroundStroke is the third largest cause of death in New Zealand and is a major cause of disability. An estimated 45,000 people live with a stroke in New Zealand and around 70% are dependent on others to help with their daily activities (Stroke Foundation of New Zealand, 2014; Stroke Foundation of New Zealand and New Zealand Guidelines Group, 2010). While a lot is known about the impact of stroke on the survivor and the primary caregiver little is known about how stroke affects the wider family. Impacts such as financial difficulties, strain and isolation have been seen as significant factors on the primary caregivers' experience (Bulley, Shiels, Wilkie, & Salisbury, 2010; Greenwood, Mackenzie, Cloud, & Wilson, 2009; Lutz, Young, Cox, Martz, & Creasy, 2011). The importance of family in stroke recovery was noted by Vincent et al. (2007) and Brunborg and Ytrehus (2014) who described how important family, friends and other social networks were to the stroke survivor's rehabilitation and well-being.In the New Zealand context Dyall, Feigin, and Brown (2008) and Corbett, Francis, and Chapman (2006) focused their studies on Maori stroke survivors and their caregivers. Dyall et al. (2008), using statistics from Feigin et al. (2006), argued there is greater health disparity and financial impact for Maori whanau than non-Maori families, as Maori have strokes at younger ages; 62 years for Maori compared to 75 years for Europeans.This study is part of a larger longitudinal hermeneutic project (2011-2015) undertaken by researchers from the Department of Nursing, Unitec Institute of Technology and the Waitemata District Health Board, Auckland, New Zealand.Research DesignAimThe aim of this study was to investigate the phenomenon of becoming and being a family member of a stroke survivor over the period of six months after the initial stroke.MethodologyThis was an exploratory study using hermeneutic phenomenological research methodology.Flermeneutic phenomenology aims to understand the significance of practical activities and experiences in everyday lives and is well suited to studying human issues and concerns (Plager, 1994) such as family experiences post-stroke. The processes used in the study were guided by those described by van Manen (1997).MethodsParticipants for the study were recruited from the larger longitudinal project (Northern X Regional Ethics Committee: NTX/11/EXP/062/AM02) using purposive sampling strategies. Inclusion criteria were: (1) family of a person admitted to the Assessment, Treatment and Rehabilitation (ATR) ward following a first-ever stroke where at least two family members agreed to participate; (2) adequate spoken English to complete consent and the interview. Informed consent was obtained in writing at the beginning of the project and on-going verbal consent obtained before each subsequent data collection phase. Consistent with the longitudinal project, 'family' was defined broadly to include people who live in","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"95 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77778275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}