Nurse visit utilization and blood pressure control: A multi-cohort study in New Zealand.

OBJECTIVE: This study aimed to retrospectively examine the contribution of nurses to population health outcomes with reference to nurse visits and blood pressure measurement in primary health settings. DESIGN: A retrospective study was conducted using New Zealand Health Survey (NZHS) from 2012 to 2017. SAMPLE: Adult population who are 18 years old and over living in New Zealand. MEASUREMENTS: Age, gender, and ethnicity, the service utilization of primary health care nurse visit and blood pressure measurement were extracted from the NZHS (2012-2017) to compare with the service utilization of primary health care nurses by different demographic groups. RESULTS: Females who have treated hypertension shows higher utilization of nurse visit than males. From 2015 to 2017, the participants in this cohort have visited a primary health care nurse at least more than once within a year. With blood pressure control, the overall pooled results show the impact of visiting primary health nurses on systolic and diastolic blood pressure control. CONCLUSION: Our study at a national scale, demonstrated the impact of nurse's contribution to population health outcomes among people living with hypertension in New Zealand. Nurses are key to improving population health outcomes and to achieve universal health coverage.

Final-year undergraduate nursing students' perceptions of general practice nursing: A qualitative study.

AIM: To explore final-year nursing students' perceptions of general practice nursing. BACKGROUND: The need for general practice nurses has increased due to growing demands for health care in the community. This demand is exacerbated by a shortage in the general practice nursing workforce. Understanding final-year nursing students' perceptions of general practice nursing is important as these may influence career choices. DESIGN: Qualitative descriptive study within a mixed methods project. METHODS: Telephone interviews were conducted with sixteen final-year nursing students. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Reporting follows the COREQ checklist. RESULTS: Perceptions of general practice nursing varied between participants and related to three main themes; ways of working; a broad role to meet diverse health needs; and relationships with patients. General practice nurses were seen to have stable and collaborative working relationships, with their role ranging from supporting general practitioners to being autonomous professionals. The nurse's broad role was associated with diverse presentations and was considered interesting and challenging. Participants perceived that general practice nurses had more time to spend with patients, and this helped establish trust, and facilitated patient-centred care. CONCLUSION: Participants' perceptions of general practice nursing varied, with some students recognising the diversity of the role and others perceiving it as limited. These views were often impacted by others experiences rather than personal experience. These variations underscore the need for students to receive greater exposure to general practice nursing. Review of undergraduate curricula to increase focus on preparing nursing students to work in general practice may help shape students' interest to seek employment in this setting. RELEVANCE TO CLINICAL PRACTICE: Students perceptions of a clinical setting can influence their career decisions. Understanding these perceptions can inform clinicians and managers and highlight areas that may need to be addressed to promote career opportunities.

An exploration of the experiences of Australian Grey Nomads travelling with chronic conditions.

Internationally, the population is ageing and people are living well, longer. In Australia, extended travelling has gained popularity among older Grey Nomads due to time and opportunity post retirement. However, there is limited research available focusing on older Australians' health while travelling. This paper reports the qualitative phase of a larger mixed-method project that explores the experience of Australian Grey Nomads travelling with chronic conditions. Eight Grey Nomads participated in telephone interviews. Data were analysed using inductive thematic analysis. Two themes emerged, namely: continuity of care while travelling and experts on the road. Participants described encountering a fragmented health system, with challenges regarding finding health services; a lack of shared medical records; and difficulties accessing regular medications. Despite these challenges, participants demonstrated health preparedness, an ability to accommodate health on the road, and were all travelling for their health. This study highlights key systems issues that challenge health care while travelling, and identifies opportunities for both usual practices and rural health services to enhance the care provided to this group.

Strengthening primary health care: contributions of young professional-led communities of practice.

BACKGROUND: Health systems that have strong primary health care at their core have overall better patient outcomes. Primary health care is key to achieving Universal Health Coverage and the broader health-related Sustainable Development Goals by 2030. In 2018, at the launch of the Declaration of Astana, the World Health Organization formed the inaugural Primary Health Care Young Leaders' Network. OBJECTIVE: This paper aims to demonstrate the scope for young professional-led communities of practice in fostering support systems for young leaders and strengthening the delivery of primary health care at multiple levels. METHODS: A description of the Young Leaders' Network community of practice model is presented, with examples of the work the members are doing, individually and collectively, to advance the science and practice of primary health care. RESULTS: This initiative brought together 21 individuals from across the world, working across disciplines and within an array of socioeconomic contexts to improve primary health care in their respective countries. CONCLUSIONS: This youth-led community of practice is able to share knowledge, evidence and resources to inform clinical and public health activities, policy initiatives, advocacy and research to improve primary health care delivery and health outcomes for communities across the globe.

Understanding nursing students' perceptions of the general practice environment and their priorities for employment settings.

AIM: To explore final year nursing students' perceptions of the general practice environment and their priorities when choosing a workplace. DESIGN: Online survey, reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: The validated Profession Scale from the Scale on Community Care Perceptions (SCOPE) tool was used to identify characteristics within the general practice environment and the importance of these in choosing a workplace. To explore the factor structure, exploratory factor analysis was undertaken which was used to revise the survey language and flow before widespread dissemination. RESULTS: Three hundred and fifty-five responses were received. Factor analysis revealed three factors: Provision of care, Employment conditions and Nature of work. Respondents exposed to general practice in the Bachelor of Nursing program or who had a general practice clinical placement had significantly different perceptions across all factors. Although wages, advancement opportunities, work pressures and the physical nature of work were perceived as important in choosing a workplace, they were seen as only moderately present in general practice.

New graduate employment in general practice: Perceptions of final-year nursing students.

AIM/OBJECTIVE: This paper sought to investigate the perceptions of final-year nursing students regarding general practice nursing as a new graduate career path. BACKGROUND: General practice nurses have become increasingly important in providing community-based care, in response to the growing burden of chronic conditions and the ageing population. To sustain this workforce, there is a need to optimise strategies to promote a consistent supply of new graduate nurses. DESIGN: This qualitative descriptive study was undertaken within a sequential explanatory mixed methods project. METHODS: Data were collected through semi-structured telephone interviews with sixteen final-year nursing students from five Australian universities. Interviews were analysed using thematic analysis. RESULTS: Four main themes were identified, namely; a) general practice is not a priority career path, b) opportunities for skills development and consolidation, c) perceptions of employment conditions, and d) transition support is limited. CONCLUSION: To meet current workforce needs in areas with increasing demand, nurse educators need to support undergraduate nursing students to explore a wide range of career pathways following graduation. Informed career choices and well-structured educational preparation during undergraduate education may be an effective strategy in building a sustainable future workforce in settings such as general practice.

The impact of curriculum on nursing students' attitudes, perceptions and preparedness to work in primary health care: An integrative review.

BACKGROUND: The ageing population and growing burden of chronic disease has increased demands for primary health care services, necessitating growth of this nursing workforce. Studies have explored strategies in retaining nurses, employment conditions in primary health care, and transitioning of acute care nurses to primary health care employment. Few studies have explored how undergraduate nursing students perceive and are prepared to work in this sector. AIM: This review synthesises evidence on the impact of undergraduate curriculum on nursing students' attitudes, perceptions and preparedness to work in primary health care. DESIGN: An integrative literature review guided the synthesis of evidence. DATA SOURCES: Scopus, ScienceDirect, CINAHL and MEDLINE were searched for relevant studies published between 2008 and 2018. REVIEW METHODS: 491 studies were identified from the database searches. Following the removal of duplicates, review of abstracts and keywords against the inclusion and exclusion criteria, 39 papers were subjected to full-text review. Twelve papers, including one thesis, met the inclusion criteria. Using an appraisal system, no paper was excluded based on methodological quality. RESULTS: Three themes were identified, namely: impact of curricula; knowledge and attitudes to primary health care; and students' intention to work in primary health care. The preparation of undergraduate nursing students to work in this area is inconsistent as curricula remain acute-care focussed. Negative perceptions about the primary health care nursing role impact intentions of nursing students to work in primary health care. CONCLUSION: This review highlights a need to implement strategies to improve the understanding of undergraduate nurses around the primary health care nursing role. In particular, providing students with skills, knowledge and an understanding of working in this area through curriculum content and structure may provide undergraduates with the desire and confidence to seek employment in primary health care following graduation.