When Associate Professor Dr Clare Harvey came to EIT from Flinders University of South Australia, she brought funding for several research projects on which she had been previously collaborating with colleagues in Australia and the USA. As well as taking on the role of Postgraduate Programme Coordinator in EIT’s School of Nursing, she gathered together teams of researchers from within the school to further two of those projects and bring a New Zealand focus to each.
The first of these considers the impact of Nurse Practitioners (NP) on primary health care. The New Zealand study sought to measure the impact of NP care on the communities in which they work and to explore the partnerships that NPs develop across health and community boundaries that allow this to occur. Central to this was an examination of how their model supported access to care. Using this information, the study sought to clarify the role that NPs play in lessening system inequity, improving access to care and enhancing existing care provision. Jennifer Roberts and Dr Elaine Papps are co-researchers on this project, some results of which were presented at the Royal College of Nursing International Nursing Research Conference in Glasgow in April 2014.
The second project focuses on the concept of ‘missed care’ within nursing practice. It explores the quality of nursing care offered after hours and on weekend shifts when ancillary services are scaled back and there are typically fewer staff on duty who may also be less experienced and less well supervised.
The study used the MISSCARE tool devised by researchers in Adelaide and adapted to reflect the New Zealand context. A total of 199 registered nurses from throughout the country responded to the online survey, which asked about the after-hours work environment, reports of missed care, factors contributing to these incidents and patient outcomes.
This work builds on research done in the USA and Australia, allowing comparison to be drawn between these countries and New Zealand. Results showed that New Zealand nurses are generally an older and more mobile population than their overseas colleagues. The study also showed that, contrary to expectations, missed care occurs on all shifts. It also highlighted the organisational impediments to effective nursing care.
Clare leads this project as part of a research consortium, the International Network for the Study of Rationalisation of Nursing Care (INSRNC). Others involved from EIT’s School of Nursing include Clare Buckley, Dr Rachel Forrest. Alannah Meyer, Helen Riden, Jennifer Roberts, Judy Searle and Dr Shona Thompson. Associate Professor Harvey presented this work, titled ‘Aberrant Work Environments – Rationed Care as System Failure or Missed Care as Skills Failure’, at the Annual Worldwide Nursing Conference in Singapore in June 2014.