Browsing by Author "Carryer J"

Now showing 1 - 6 of 6
  • Thumbnail Image
    Item
    Attributes of an effective nurse manager in New Zealand: An analysis of nurse manager perceptions
    (Nursing Praxis, 2018-07-01) Hughes K-A; Carryer J; Boldy D; Jones M; Gower S
    Abstract Increasing complexities in healthcare environments require nurse managers to be well equipped to manage change in their workplace environments. This research undertook to analyse nurse manager’s perceptions on what attributes they consider important to achieve managerial effectiveness in the New Zealand context. A quantitative study using a pre-coded survey questionnaire with 149 nurse managers was conducted in New Zealand. Surveys from New Zealand nurse managers were analysed for perceptions of desired managerial effectiveness attributes using a managerial effectiveness dimensions ranking tool. The findings indicated that the respondents rated the skills dimension as the most important dimension and beliefs and values as the least important of the four dimensions. Although there are four groups of skill dimensions ranked on perceived effectiveness, these dimensions are interdependent on each other for managerial effectiveness to occur. The different organisational contexts in which nurse managers operate influence how these skill dimensions interact and appear to impact on the perceptions and rankings of managerial effectiveness. It is important that nurse managers are equipped with tools and knowledge that enable them to manage change. This includes understanding opportunities to develop attributes considered desirable within their organisational contexts to become effective future leaders. Ngā ariā matua Nā te pikinga ake o te matahuhuatanga i ngā horopaki hauora, i tika ai kia whai pūkenga nui ngā kaiwhakahaere tapuhi o ēnei rā ki te whakahaere i ngā āhuatanga hurihuri o te horopaki mahi. Tā tēnei rangahau he tātari i ngā whakaaro o ngā kaiwhakahaere tapuhi ki ngā pūmanawa e whakaaro nei rātou he mea tino nui hei whakaū i te whāinga take o te kaiwhakahaere i te horopaki o Aotearoa. I kawea tētahi rangahau rahinga, mā tētahi puka i āta waeheretia i mua, i te taha o ētahi kaiwhakahaere tapuhi 149 i Aotearoa. I tātaritia ngā rangahau mai i ngā kaiwhakahaere tapuhi o Aotearoa mō ō rātou whakaaro mō ngā pūmanawa kaiwhakahaere whāinga take e hiahiatia ana, mā te whakamahi i tētahi taputapu tautohu i ngā whaitua o te tōtika o te mahi whakahaere. Ki tā ngā kitenga, e mea ana te hunga whakauru o Aotearoa ko te taha ki ngā pūkenga te tino taha matua, ā, ko te taha ki ngā whakapono me ngā kaingākautanga te mea iti rawa o ngā taha e whā. Ahakoa e whā rawa ngā wehenga whaitua pūkenga mō te whāinga take, e ai ki ngā whakaaro, e rīraparapa ana ēnei taha e whā, arā, me pēnei anake ka puta he hua mō te tōtika o te whakahaere. Kei te āhua tonu o ngā horopaki whakahaere rerekē e mahi nei ngā kaiwhakahaere tapuhi i roto te whakatau mō te āhua o te rīraparapa o ēnei taha, te āhua nei ka pā hoki ki ngā whakaaro me ngā tautohutanga mō te tōtika o te mahi whakahaere. He mea tino nui kia whai taputapu, kia whai mātauranga hoki ngā kaiwhakahaere tapuhi, e taea ai e rātou ngā huringa te kawe. Tētahi wāhi hoki o tēnei ko te māramatanga ki ngā whāinga wāhi mō te whakapakari pūkenga e kīa ana he mea nui i ō rātou horopaki whakahaere, kia puta ai rātou hei kaihautū.
  • Thumbnail Image
    Item
    Consulting with māori experts to ensure mainstream health research is inclusive of Māori Te toro whakaaro ki ngā mātanga Māori kia noho tonu ngāi Māori i roto i ngā rangahau hauora auraki
    (Nursing Praxis, 2019-11-01) Francis H; Carryer J; Cram F
    Abstract Understanding the lived realities of Māori patients with long-term health conditions (LTCs) is essential if the health system in Aotearoa New Zealand is to eliminate current Māori health disparities and support Māori patients appropriately. Culturally responsive researchers can gain insights by ensuring the inclusion of Māori participants in research on LTCs. To strengthen her capability to be culturally responsive, a tauiwi (non-Māori) health researcher consulted Māori experts throughout her in-depth research with 16 people with long term conditions, including six Māori participants. The trust built during consultation aided the recruitment of Māori participants through experts’ networks. Advice received about culturally responsive engagement with Māori participants helped the researcher safeguard participants’ mana (dignity and status) during and after the research and ensured their voices were heard accurately and represented well. The research findings consequently offered guidance for the transformation of health services to facilitate positive Māori health development. Ngā ariā matua He mea tino nui kia mārama te tangata ki ngā āhuatanga o te noho o ngā tūroro Māori whai ngoikoretanga hauora wā-roa (LTC) kia whakakorea atu ngā rerekētanga o ngā āhuatanga hauora Māori ki ō te nuinga i raro i te pūnaha hauora o Aotearoa, kia tika hoki te tautoko i ngā tūroro Māori. Ka āhei ngā kairangahau mārama ki te ahurea te katokato māramatanga mā te whakauru i a ngāi Māori kia whai wāhi ki ngā rangahau mō ngā LTC. Hei whakapakari i tōna māramatanga ki ngā āhuatanga ahurea, i toro atu tētahi kairangahau ehara i te wahine Māori ki ētahi mātanga Māori, nā roto i āna rangahau hōhonu ki ētahi tāngata 16 whai ngoikoretanga hauora wā-roa, ā, e 6 o rātou he Māori. Nā te whakapono i hua ake i te torotoronga i ngāwari ake ai te kimi tāngata whai wāhi Māori, nā roto i ngā kupenga tāngata o ngā mātanga. Nā ngā tohutohu mō te tūhono i runga i te whakaaro-nui ki te ahurea ki te hunga Māori whai wāhi mai i āwhina te kairangahau ki te tiaki i te mana o te hunga whai wāhi mai i roto, i muri hoki i te rangahau, i tino rangona ai ō rātou reo, kia tika, kia pai. Nā ngā kitenga o te rangahau ka puta ake ētahi aratohu mō te whakaumutanga o ngā ratonga hauora hei whakangāwari i te whanaketanga hauora Māori takatika.
  • Thumbnail Image
    Item
    Integrating nurse practitioners into primary healthcare to advance health equity through a social justice lens: An integrative review
    (John Wiley and Sons Ltd, 2024-02-06) Adams S; Komene E; Wensley C; Davis J; Carryer J
    AIM: To develop a framework to guide the successful integration of nurse practitioners (NPs) into practice settings and, working from a social justice lens, deliver comprehensive primary healthcare which advances health equity. DESIGN: Integrative review. METHODS: The integrative review was informed by the Whittemore and Knafl's framework and followed the Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. Quality was assessed using the Johns Hopkins Research Evidence Appraisal Tool. Findings were extracted and thematically analysed using NVivo. A social justice lens informed all phases. DATA SOURCES: Databases, including CINAHL, PubMed, Scopus and Web of Science, were searched for peer-reviewed literature published in English between 2005 and April 2022. RESULTS: Twenty-eight articles were included. Six themes were identified at the individual (micro), local health provider (meso), and national systems and structures (macro) levels of the health sector: (1) autonomy and agency; (2) awareness and visibility; (3) shared vision; (4) leadership; (5) funding and infrastructure; and (6) intentional support and self-care. The evidence-based framework is explicitly focused on the components required to successfully integrate NPs into primary healthcare to advance health equity. CONCLUSION: Integrating NPs into primary healthcare is complex and requires a multilevel approach at macro, meso and micro levels. NPs offer the potential to transform primary healthcare delivery to meet the health needs of local communities. Health workforce and integration policies and strategies are essential if the contribution of NPs is to be realized. The proposed framework offers an opportunity for further research to inform NP integration. IMPACT STATEMENT: \ - Nurse practitioners (NPs) offer the potential to transform primary healthcare services to meet local community health needs and advance health equity. - Globally, there is a lack of guidance and health policy to support the integration of the NP workforce. - The developed framework provides guidance to successfully integrate NPs to deliver comprehensive primary healthcare grounded in social justice. - Integrating NPs into PHC is complex and requires a multilevel approach at macro, meso and micro levels. - The framework offers an opportunity for further research to inform NP integration, education and policy. SUMMARY STATEMENT: - What problem did the study address: The challenges of integrating nurse practitioners (NPs) into primary healthcare (PHC) are internationally recognized. Attempts to establish NP roles in New Zealand have been ad hoc with limited research, evidence-informed frameworks or policy to guide integration initiatives. Our review builds on existing international literature to understand how NPs are successfully integrated into PHC to advance health equity and provide a guiding framework. - What were the main findings: Six themes were identified across individual (micro), local health provider (meso) and national systems and structures (macro) levels as fundamental to NP integration: autonomy and agency; awareness and visibility of the NP and their role; a shared vision for the direction of primary healthcare utilizing NP scope of practice; leadership in all spaces; necessary funding and infrastructure; and intentional support and self-care. - Where and on whom will the research have an impact: Given extant health workforce challenges together with persisting health inequities, NPs provide a solution to delivering comprehensive primary healthcare from a social justice lens to promote healthcare access and health equity. The proposed evidence-informed framework provides guidance for successful integration across the health sector, training providers, as well as the NP profession, and is a platform for future research. REPORTING METHOD: This integrative review adhered to the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
  • Thumbnail Image
    Item
    Nurses' work in relation to patient health outcomes: an observational study comparing models of primary care.
    (BioMed Central Ltd, 2024-10-04) Sheridan N; Hoare K; Carryer J; Mills J; Hewitt S; Love T; Kenealy T; Primary Care Models Study Group
    BACKGROUND: Māori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into seven models of primary care: Traditional, Corporate, Health Care Home, Māori, Pacific, Trusts / Non-governmental organisations (Trust/NGOs) and District Health Board / Primary Care Organisations (DHB/PHO). We describe nurse work in relation to these models of care, populations with high health need and patient health outcomes. METHODS: We conducted a cross-sectional study (at 30 September 2018) of data from national datasets and practices at patient level. Six primary outcome measures were selected because they could be improved by primary care: polypharmacy (≥ 65 years), glucose control testing in adults with diabetes, immunisations (at 6 months), ambulatory sensitive hospitalisations (0-14, 45-64 years) and emergency department attendances. Analysis adjusted for patient and practice characteristics. RESULTS: Nurse clinical time, and combined nurse, nurse practitioner and general practitioner clinical time, were substantially higher in Trust/NGO, Māori, and Pacific practices than in other models. Increased patient clinical complexity was associated with more clinical input and higher scores on all outcome measures. The highest rates of preventative care by nurses (cervical screening, cardiovascular risk assessment, depression screening, glucose control testing) were in Māori, Trust/NGO and Pacific practices. There was an eightfold difference, across models of care, in percentage of depression screening undertaken by nurses and a fivefold difference in cervical screening and glucose control testing. The highest rates of nurse consultations afterhours and with unenrolled patients, improving access, were in PHO/DHB, Pacific, Trust/NGO and Māori practices. Work not attributed to nurses in the practice records meant nurse work was underestimated to an unknown degree. CONCLUSIONS: Transferring work to nurses in Traditional, Health Care Home, and Corporate practices, would release general practitioner clinical time for other work. Worse patient health outcomes were associated with higher patient need and higher clinical input. It is plausible that there is insufficient clinical input to meet the degree of patient need. More practitioner clinical time is required, especially in practices with high volumes of complex patients.
  • Thumbnail Image
    Item
    The Relevance of Gender to Nursing
    (Nursing Praxis in Aotearoa New Zealand, 2022-12-22) Carryer J
  • Thumbnail Image
    Item
    Time for a change? Unity not competition for the sake of our communities.
    (CSIRO Publishing, 2024-05-14) Keenan Te Ati Awa Taranaki R; Carryer J; Goodyear-Smith F