Nurse practitioner standards : an Australian and New Zealand research collaboration

This paper will report the findings from research conducted in Australia and New Zealand to inform development of standards for nurse practitioner education and practice competencies. In New Zealand and Australia the nurse practitioner is a new and unique level of health-care provider. The shifting boundaries caused by health-care reform have created impetus and demand for development of new models of health-care, but have also created some uncertainty regarding nurse practitioner standards, education and models of care. The title, Nurse Practitioner, is now legislated in New Zealand and most jurisdictions in Australia but there is scant research to inform development of nurse practitioner standards. This research, sponsored by the Australian Nursing Council and the Nursing Council of New Zealand, was conducted to develop generic standards that could be applied for the education, authorisation and practice of nurse practitioners in both countries. The study involved collection and triangulation of data from a range of sources across Australia and New Zealand including: in-depth interviews with 15 nurse practitioners from different geographical and clinical contexts; curriculum survey of all nurse practitioner courses in the two countries and interview with convenors of these courses; collation of the authorisation/registration processes and policies from states and territories in Australia, New Zealand and internationally. These data were analysed within and across the data modalities to provide information on standards for nurse practitioner practice and education. Findings from the study included identification of the core role of the nurse practitioner as it is expressed in New Zealand and Australia and generic standards for nurse practitioner competencies, education and authorisation. These findings will standardise expectations, support mutual recognition of nurse practitioner authorisation across the two countries and make an important contribution to the current international debate on nurse practitioner standards and scope of practice.

The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster

Emerging methodological issues in environmental education research

This presentation draws on recent experience in the “Environment and School Initiatives” (ENSI) project to explore emerging issues in the methodology of action research in environmental education. The ENSI project has been operating for close to twenty years, involving some twenty (mainly European) countries in the conduct and reporting of attempts to adopt an action research perspective in environmental education curriculum development and professional development. The presentation will locate the project within an historical perspective on research in environmental education before considering differing interpretations of the action research methodology in a range of different (country-based) professional settings. With examples from case studies of action research in environmental education, the presentation suggests that action research is best characterised by adoption of certain principles such as deliberate reflection by practitioners, respect for „practical knowledge‟ of teachers and teacher-generated narrative data, and recognition of the significance of context, rather than by adherence to any recipe-like methodological formula. A corollary of this is that methodologists need to acknowledge and respect the „exigencies of practice‟ within which practitioners of action research in environmental education conduct their professional work.

Implementing FATF standards in developing countries and financial inclusion : findings and guidelines

This report, emanating from a project commissioned by the FIRST Initiative, considers the impact of the implementation of Anti-Money Laundering (AML) and Combating the Financing of Terrorism (CFT) controls on financial inclusion in five countries (Indonesia, Kenya, Mexico, Pakistan and South Africa). Based on these findings, it develops a set of guidelines to assist the authorities in developing countries to design effective AML/CFT regimes that are compliant with Financial Action Task Force (FATF) standards and supports financial inclusion.
The report and guidelines will be of benefit to countries striving towards the dual goals of protecting their institutions against money laundering and the financing of terrorism as well as extending financial inclusion, irrespective of whether protective measures are being considered in the process of implementing or amending AML/CFT controls to meet the Forty Nine Recommendations of the FATF or in order to meet other, related international requirements, such as those set out in the 2000 United Nations Convention on Transnational Organised Crime or the 2003 United Nations Convention Against Corruption.
The project was supervised and guided by a steering committee consisting of representatives from the FIRST Management Unit, World Bank, International Monetary Fund (IMF), the UK’s Department for International Development (DFID), the Consultative Group to Assist the Poor (CGAP), the South African National Treasury, the FinMark Trust and Professor Nikos Passas, an acknowledged world expert on AML/CFT standards and implementation.

International standards of business conduct: framework and illustration

Purpose: – The purpose of this paper is to describe the insights and a proposal into the structure of standards of business conduct and its intended applications.

Design/methodology/approach: – The case study is based upon an inductive content analysis of corporate ethics artefacts.

Findings: – It is concluded that the standards of business conduct may be highly prescriptive in world wide corporations, but that there should be an explicit commitment to a flexible and dynamic approach to the application of standards of business conduct.

Research limitations/implications: – An examination of the actual behaviour of a corporation's operations was beyond the scope of the present research, but such a study has potential for future research. This would open up the wider question of how corporations can minimise the gap between corporate intentions and actual outcomes in business operations across national and cultural boundaries.

Practical implications: – These diverse national and cultural contexts that world wide corporations encounter must be taken into consideration in the content of their standards of business conduct.

Originality/value: – The authors emphasise the concern of recognising that the contexts surrounding standards of business conduct are dynamic. Corporate codes of ethics should be regarded as dynamic artefacts. A framework of application is proposed.

The curious case of the Occidental and Regal : the evolution of solvency and disclosure standards in the Australian life insurance industry

In 1990, the Australian life insurance industry was rocked by a scandal that threatened to destabilize consumer confidence in the ability of insurance providers to meet policyholder liabilities. The incident highlighted the nature of the agency problems that arise when conditions of asymmetric information exist. It revealed systemic weaknesses in accounting, solvency and disclosure standards as they applied to life insurers. This article uses an evolutionary concept of agency to analyse government and industry responses to this event. It is argued that initial adaptive responses stabilized the industry and averted a more serious crisis. Longer term innovative responses led to the introduction of a new and more rigorous approach to reporting and solvency standards, which has improved information flows and agency outcomes.

Internationalising auditing standards : stakeholder views on Australia's strategic directions

Purpose: – The purpose of this paper is to examine and evaluate the internationalisation of Australian auditing standards by analysing the submissions to the Auditing and Assurance Standards Board's (AUASB) strategic directions paper (SDP) and comparing the proposed and approved strategic directions frameworks of the AUASB.

Design/methodology/approach: – A content analysis of the submissions to the SDP is conducted to identify the extent of support, and arguments for and against the proposed strategic directions. This study attempts to find a link, if any, between the proposed strategic directions, the views expressed by the stakeholders, and the final set of strategic directions issued by Australia's Financial Reporting Council.

Findings: – Overall, the final set of strategic directions released in April 2005 are consistent with the views expressed in the submissions, which support minimal divergence from International Standards on Auditing (ISAs) and using the ISAs as the base for developing Australian auditing standards. Major changes from the SDP include a requirement for the AUASB to undertake research and monitor auditing standards issued by national standard setters. However, the AUASB is no longer obliged to contribute to the international standard arena and need only have regard to any program initiated by the International Auditing and Assurance Standards Board.

Research limitations/implications: – The findings of this study provide an insight into the future of Australia's role in the international arena and increase awareness of stakeholders' views on the international harmonisation of auditing standards.

Originality/value: – While there have been several studies examining the international harmonisation of accounting standards, there is comparatively little research on the international harmonisation of auditing standards. This paper attempts to address this void, in part, and contribute to the literature on the convergence of auditing standards with ISAs.

How prepared was Australia for international financial reporting standards? The case of listed firms

We measure the preparedness of listed firms for international financial reporting standards (IFRS) by changes in explanations from Australian GAAP to IFRS between the half-year and annual accounts. About one-third of sample firms changed their explanations for earnings, cashflows or equity by averages of about −7%, 67% and 3% respectively. Most changes are less than 5% for earnings and equity, and tax is the item most commonly revised. More profitable firms and firms with more reconciling items are most likely to change an explanation. In a telephone survey of chief financial officers, 70% revealed that the change followed an incorrect application of an accounting rule in the half-year accounts.

Nutrition screening in long-term care facilities : an evaluation of the methodological quality of available instruments

A variety of nutrition screening instruments have been developed and implemented for identifying the risk of undernutrition among community and hospitalized older adults. Despite the high prevalence of undernutrition amongst older adults in long-term care, few screening instruments have been developed or evaluated in this setting. This review aims to evaluate the validity, reproducibility and feasibility of nutrition screening instruments developed for use, or described as being used, with older adults in long-term care. Ten publications encompassing nine independent nutrition screening tools were identified using electronic databases and manual searches of reference lists. The Mini Nutritional Assessment-Short Form (MNA-SF) was the most widely evaluated nutrition screening instrument and met the requirements for a valid instrument (sensitivity and specificity >0.9) for use in the long-term care setting. Modified versions of the MNA for use in China and South Africa also demonstrated acceptable levels of sensitivity and specificity. Other nutrition screening instruments were found to have variable levels of sensitivity and specificity and while some demonstrated levels consistent with the MNA-SF, only two were evaluated across more than one study population, Body Mass Index (BMI)+weight loss and BMI+albumin. These same instruments reported the highest levels of inter-rater and test-retest reproducibility, although this was only tested in one other instrument (Chinese Nutrition Screen -modified MNA). In conclusion, it is evident from this review that further work in this area is needed. Based on validity, reproducibility and feasibility it appears that BMI+weight loss is the most suitable nutrition screening instrument for use in the long-term care setting at this time. MNA-SF is promising; however, there is currently no data for inter-rater or test-retest reproducibility in the long-term care setting.