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.

Environmental attitudes and their relation to the dominant social paradigm among university students in New Zealand and Australia

This paper develops a causal model of environmental attitudes using measures of the dominant social paradigm of Western industrial societies. Four components of the DSP framework are examined with regard to environmental attitudes and perception of change using a sample of university students from Australia and New Zealand. The results indicate that one’s belief in the DSP has a negative effect on both environmental attitudes and perception of change necessary to ameliorate degradation of the environment. Thus, while public policy favors increasing awareness of and interest in the environment, policy instruments may remain ineffective in producing lasting change if the components of the DSP remain unchanged. It is argued that public policy ought to be directed at changing the DSP so that its negative effects will be minimized.

Environmental attitudes among university students In New Zealand and Australia

This paper develops a causal model of environmental attitudes using measures of the dominant social paradigm (DSP) of western industrial societies. Two components of the DSP framework beliefs in economic growth and anthropocentrism are examined regards to environmental attitudes using a sample of university students from Australia and New Zealand. The results indicate that one’s belief in the DSP has a negative effect on environmental attitudes and perception of change necessary ameliorate degradation of the environment. Thus, while public policy favors increasing awareness of and interest in the environment, policy instruments may remain ineffective in producing lasting change if the components of the DSP remain unchanged. It is argued that public policy ought to be directed at changing the DSP so that its negative
effects will be minimized.

Description of new species of Setosabatieria and Desmolaimus (Nematoda: Monhysterida) and a checklist of New Zealand free-living marine nematode species

Two new marine nematode species are described from intertidal sediments in southern New Zealand. Setosabatieria australis sp. nov. is characterised by an amphideal fovea with 3.5 turns, 7–9 small pre-cloacal supplements, and 2–5 sub-cephalic setae per file. Setosabatieria australis sp. nov. differs from all known species of the genus in having L-shaped spicules with a hollow median region, in contrast to the typical curved shape. Desmolaimus courti sp. nov. is characterised by the presence of four long (15 µm) cephalic setae, two cuticularised rings in the buccal cavity, and a lightly cuticularised pharyngeal lumen. It differs from other species of the genus by having eight sub-cephalic setae. A total of 116 marine species are included in the checklist of New Zealand free-living nematodes, with the majority of records from the coast of Campbell and Auckland islands from the early part of the 20th century. Most records were from habitats such as seaweed or sponge, which may explain the high proportion (>50%) of cosmopolitan species recorded in New Zealand to date. Little is known about the sediment nematode fauna, particularly in deeper waters (>120 m), from where there are no records to date.

Nutrition and mental health research in Australia and New Zealand: A review of progress and directions for the future

This review summarises nutrition and mental health research in Australia and New Zealand between 1986 and 2006. The method used to identify papers for inclusion was a search of computerised databases: Medline, Cinahl and Meditext 1986–2006, with subsequent bibliographical review. Key search words were nutrition, diet, mental disorder, mental illness, weight, physical health, Australia and New Zealand. Inclusion criteria included: English language, original data in peer reviewed journals, and examination of some component of nutrition in people with a mental illness. The review of thirteen papers found that the evidence base for dietetic practice in mental health has developed through small assessment and interventional research, often with multidisciplinary collaboration. Future research should include quality and outcome measures with intersectoral partnerships. Dietitians are well positioned to lead and participate in mental health research and to implement research findings to improve the nutritional status of this vulnerable group.

Assessing the reliability of the sedation-agitation scale between nurses and doctors in a New Zealand ICU

The aim of the study was to determine whether nurses and doctors rate “real world” intensive care unit (ICU) patients similarly using the Sedation–Agitation Scale (SAS) in a generalist ICU context outside USA

Competition and efficiency : overseas students and technical efficiency in Australian and New Zealand universities

Economic theory suggests that competitive pressures will impact on organisational efficiency. In recent years, universities in Australia and New Zealand have faced increased competition for students. The aim of this paper is to explore the efficiency of Australian and New Zealand public universities and to investigate the impact of competition for students from overseas on efficiency. Output distance functions are estimated using panel data for the period 1995-2002 for Australia and 1997-2003 for New Zealand. The results show that competition for overseas students has led to increased efficiency in Australian universities. However, competition for overseas students appears to have had no effect on efficiency in New Zealand.

Practical application of the Delphi technique in a bicultural mental health nursing study in New Zealand

Background. Numerous studies have employed the Delphi technique to seek expert opinion about aspects of clinical practice. When researching literature on the Delphi technique, however, we discovered discrepancies in its application, and a lack of detail when reporting design, administration, and analysis methods. Such lack of specificity hinders the replicability and assessment of the clinical and cultural validity and reliability of Delphi studies.

Aim. 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.

Methods. 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 summarized 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.

Findings. Consensus occurred overall on 75 statements, and within groups on another 24. Most statements (n = 86) reached the importance benchmark.

Conclusions. 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 prioritizing experts judgements.

New Zealand development and trial of mental health nursing clinical indicators - a bicultural study

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. ANZCMHN, Greenacres). 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. During the national field study, consumer files (n=327) from 11 District Health Boards, and registered nurses (n=422) completed an attitude questionnaire regarding the regularity of specific nursing and service activities. 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.