scholarly journals The anatomical placement of body organs by Australian and New Zealand patients and health professionals in general practice

2012 ◽  
Vol 4 (3) ◽  
pp. 239 ◽  
Author(s):  
Marjan Kljakovic ◽  
Jo Risk
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Health Professionals ◽  
Health Knowledge ◽  
Doctor Patient Communication ◽  
Correct Placement ◽  
General Practices ◽  
Gp Visits ◽  
Health Administrators ◽  
Better Than

INTRODUCTION: Understanding patients’ awareness of the anatomical placement of their body organs is important for doctor–patient communication. AIM: To measure the correct anatomical placement of body organs by people from Australian and New Zealand general practices METHOD: A questionnaire survey containing drawings of 11 organs placed in different locations within each drawing. RESULTS: Among 1156 participants, there was no difference in the proportion of correct placement of 11 organs between Australian (51.7%) and New Zealand (49.6%) general practices. There was a positive correlation between the proportion of correctly placed organs and the age participants left school (p=0.012) and a negative correlation with the number of GP visits in the previous year (p=0.040). Participants from rural Australia were more likely to correctly place organs than urban participants (p=0.018). The mean proportion of organs correctly placed for doctors was 80.5%, nurses 66.5%, allied health 61.5%, health administrators 50.6% and the remaining consulting patients 51.3%. DISCUSSION: Patients from Australian and New Zealand general practice were poorly aware of the correct placement of organs. Health professionals were moderately better than patients at correct placement. KEYWORDS: Health knowledge; attitudes; practice; anatomy; general practice

scholarly journals A taboo topic? How General Practitioners talk about overweight and obesity in New Zealand

2018 ◽  
Vol 10 (2) ◽  
pp. 150 ◽  
Author(s):  
Lesley Gray ◽  
Maria Stubbe ◽  
Lindsay Macdonald ◽  
Rachel Tester ◽  
Jo Hilder ◽  
...  
Keyword(s):  
New Zealand ◽  
Weight Management ◽  
General Practitioners ◽  
Health Professionals ◽  
Secondary Analysis ◽  
Overweight And Obesity ◽  
Full Potential ◽  
Naturally Occurring ◽  
Interactional Analysis ◽  
General Practices

ABSTRACT INTRODUCTION Obesity is overtaking tobacco smoking in New Zealand as the leading potentially modifiable risk to health. International obesity guidelines recommend that health professionals opportunistically encourage weight management with their patients. However, research shows consistently low rates of weight management discussion, suggesting that health professionals may not be realising their full potential to address obesity. AIM To identify communication strategies used by General Practitioners (GPs) to open the topic of weight and weight management in routine consultations. METHODS A secondary analysis was conducted of 36 video-recorded consultations in general practices, selected for relevance from a database of 205 consultations. Content and interactional analysis was conducted in the context of the entire consultation. RESULTS The topic of weight was initiated more often by GPs than patients and was raised mostly once or twice in a consultation and occasionally as many as six times. GPs employed opportunistic strategies twice as often as they used structured strategies. DISCUSSION This study of naturally occurring consultations confirmed GPs do engage in opportunistic discussions about weight. However, such discussions are challenging and interactionally delicate. Highlighting the clinical relevance of weight appears to be effective. The high frequency of patient contact with GPs provides opportunity to reach and work with people at risk of chronic conditions associated with excess weight. Further research is required to identify suitable training and brief intervention tools for use in routine consultations that may be beneficial for both GPs and patients.

scholarly journals Repeat prescribing policy in New Zealand general practice: making it better

2020 ◽  
Vol 12 (4) ◽  
pp. 373
Author(s):  
Steven Lillis ◽  
Liza Lack
Keyword(s):  
General Practice ◽  
New Zealand ◽  
General Practitioners ◽  
Local Development ◽  
Policy Research ◽  
Practice Research ◽  
Annual Conference ◽  
Protected Time ◽  
Repeat Prescribing ◽  
General Practices

ABSTRACT INTRODUCTIONRepeat prescribing is common in New Zealand general practice. Research also suggests that repeat prescribing is a process prone to error. All New Zealand general practices have to comply with requirements to have a repeat prescribing policy, with the details of the policy to be designed by the practice. AIMTo inform the development of practice policy, research was undertaken with experienced general practitioners to identify and mitigate risk in the process. METHODSAt the 2019 annual conference of the Royal New Zealand College of General Practitioners, a workshop was held with 58 experienced general practitioner participants. The group was divided into six small groups, each with the task of discussing one aspect of the repeat prescribing process. The results were then discussed with the whole group and key discussion points were transcribed and analysed. RESULTSIssues identified included: improving patient education on appropriateness of repeat prescribing; having protected time for medicine reconciliation and the task of repeat prescribing; reducing the number of personnel and steps in the process; and clarity over responsibility for repeat prescribing. DISCUSSIONThis research can inform the local development of a repeat prescribing policy at the practice level or be used to critique existing practice policies. Attention was also drawn to the increasing administrative burden that repeat prescribing contributes to in general practice.

scholarly journals Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners

2015 ◽  
Vol 7 (3) ◽  
pp. 244 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Dug Yeo Han ◽  
Anne-Thea McGill ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Medical Students ◽  
General Practitioners ◽  
Health Knowledge ◽  
Nutrition Therapy ◽  
Routine Care ◽  
Nutrition Care ◽  
Positive Attitudes ◽  
Health Knowledge Attitudes Practice

INTRODUCTION: Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. AIM: This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. METHODS: A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. RESULTS: All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (p<0.0001) and performing nutrition recommendations (p<0.0001). General practice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (p<0.0001); macronutrients (p=0.030); micronutrients (p=0.010); and women, infants and children (p<0.0001). DISCUSSION: New Zealand medical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted. KEYWORDS: General practitioner; health knowledge, attitudes, practice; medical education; nutrition therapy

scholarly journals The Nursing Presence in General Practice: Revealing Dimensions of Day-to-day Experience of Practice Nurses in New Zealand

2021 ◽  
Author(s):  
◽  
Katrina Fyers
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
New Zealand ◽  
Models Of Care ◽  
Complex Nature ◽  
Practice Nurses ◽  
Nursing Leaders ◽  
Primary Health ◽  
General Practices

<p>This study makes visible and gives value to the day-to-day experience of practice nurses who work in New Zealand general practices. Nursing leaders internationally and locally have highlighted the importance of the Primary Health Care nurse to improving health outcomes, addressing inequalities and implementing new models of care. As one of the largest groups of Primary Health Care nurses, practice nurses have a significant part to play. There is however, no consensus and limited research related to the day-to-day experience of practice nurses. Therefore, the nature, extent, and contribution of nursing in general practice may be overlooked or misunderstood. Furthermore as an autonomous self-regulating profession, nursing has a responsibility to the public to provide understanding of nursing in the present and in the future, particularly when this relates to the care of families and the structure of health systems. Located within the qualitative research paradigm and utilising a narrative inquiry methodology, this study applies a 'supportive voice' to highlight the experience of five practice nurses, and in the process makes visible the dimensions of nursing work in New Zealand general practices. The five constructed narratives particularly draw attention to the complex nature of nursing work that practice nurses engage in daily, the importance of nurse-patient relationships and continuity of care and the significance of autonomous and specialty aspects of nursing practice. Ultimately, the value of the practice nurse in the day-to-day operation of general practice is brought to the fore.</p>

scholarly journals Qualitative study of patient views on a ‘telephone-first’ approach in general practice in England: speaking to the GP by telephone before making face-to-face appointments

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e026197 ◽  
Author(s):  
Sarah L Ball ◽  
Jennifer Newbould ◽  
Jennie Corbett ◽  
Josephine Exley ◽  
Emma Pitchforth ◽  
...  
Keyword(s):  
General Practice ◽  
Qualitative Interviews ◽  
First Language ◽  
Face To Face ◽  
Negative Comments ◽  
Open Plan ◽  
General Practices ◽  
To Come ◽  
New System ◽  
Better Than

ObjectiveTo understand patients’ views on a ‘telephone-first’ approach, in which all appointment requests in general practice are followed by a telephone call from the general practitioner (GP).DesignQualitative interviews with patients and carers.SettingTwelve general practices in England.Participants43 patients, including 30 women, nine aged over 75 years, four parents of young children, five carers, five patients with hearing impairment and two whose first language was not English.ResultsPatients expressed varied views, often strongly held, ranging from enthusiasm for to hostility towards the ‘telephone-first’ approach. The new system suited some patients, avoiding the need to come into the surgery but was problematic for others, for example, when it was difficult for someone working in an open plan office to take a call-back. A substantial proportion of negative comments were about the operation of the scheme itself rather than the principles behind it, for example, difficulty getting through on the phone or being unable to schedule when the GP would phone back. Some practices were able to operate the scheme in a way that met their patients’ needs better than others and practices varied significantly in how they had implemented the approach.ConclusionsThe ‘telephone-first’ approach appears to work well for some patients, but others find it much less acceptable. Some of the reported problems related to how the approach had been implemented rather than the ‘telephone-first’ approach in principle and suggests there may be potential for some of the challenges experienced by patients to be overcome.

scholarly journals Medication risk management and health equity in New Zealand general practice: a retrospective cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sharon Leitch ◽  
Jiaxu Zeng ◽  
Alesha Smith ◽  
Tim Stokes
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Cross Sectional Study ◽  
Alert System ◽  
Cross Sectional ◽  
Aotearoa New Zealand ◽  
Current Medication ◽  
General Practices ◽  
Medication Risk

Abstract Background Despite an overt commitment to equity, health inequities are evident throughout Aotearoa New Zealand. A general practice electronic alert system was developed to notify clinicians about their patient’s risk of harm due to their pre-existing medical conditions or current medication. We aimed to determine whether there were any disparities in clinician action taken on the alert based on patient ethnicity or other demographic factors. Methods Sixty-six New Zealand general practices from throughout New Zealand participated. Data were available for 1611 alerts detected for 1582 patients between 1 and 2018 and 1 July 2019. The primary outcome was whether action was taken following an alert or not. Logistic regression was used to assess if patients of one ethnicity group were more or less likely to have action taken. Potential confounders considered in the analyses include patient age, gender, ethnicity, socio-economic deprivation, number of long term diagnoses and number of long term medications. Results No evidence of a difference was found in the odds of having action taken amongst ethnicity groups, however the estimated odds for Māori and Pasifika patients were lower compared to the European group (Māori OR 0.88, 95 %CI 0.63–1.22; Pasifika OR 0.88, 95 %CI 0.52–1.49). Females had significantly lower odds of having action taken compared to males (OR 0.76, 95 %CI 0.59–0.96). Conclusions This analysis of data arising from a general practice electronic alert system in New Zealand found clinicians typically took action on those alerts. However, clinicians appear to take less action for women and Māori and Pasifika patients. Use of a targeted alert system has the potential to mitigate risk from medication-related harm. Recognising clinician biases may improve the equitability of health care provision.

scholarly journals Pharmacist integration into general practice in New Zealand

2019 ◽  
Vol 11 (2) ◽  
pp. 159 ◽  
Author(s):  
Robert Haua ◽  
Jeff Harrison ◽  
Trudi Aspden
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Online Questionnaire ◽  
District Health ◽  
Long Term Conditions ◽  
The North ◽  
Medicines Reconciliation ◽  
Medication Reviews ◽  
General Practices

ABSTRACT IntroductionPharmacist integration into general practice is gaining momentum internationally, with benefits noted in reducing medication errors, improving chronic disease management and alleviating general practitioner workforce shortages. Little is known about how general practice pharmacists are working in New Zealand. AimThis study characterised the current landscape of pharmacist integration into general practice in New Zealand. MethodsAn online questionnaire was developed, piloted and distributed to all pharmacists in New Zealand. ResultsThirty-six responses were analysed. Respondents were more likely to be female, have been pharmacists for at least 10 years and all but one held formal postgraduate clinical pharmacy qualifications. Seven pharmacists were working as pharmacist prescribers. Primary health organisations (PHOs) were the most common employer, with funding primarily derived from either PHOs or District Health Boards. Pharmacist integration into general practice appears to have progressed further in particular regions of New Zealand, with most respondents located in the North Island. Tasks performed by respondents included medication reviews, managing long-term conditions and medicines reconciliation. Increased job satisfaction compared with previous roles was reported by most respondents. Funding and a general lack of awareness about pharmacists’ professional scope were seen as barriers to further expansion of the role. DiscussionThis study describes the characteristics of pharmacists currently working in general practices in New Zealand and provides insights into key requirements for the role. Understanding the way practice pharmacists are currently employed and funded can inform general practices considering employing pharmacists.

scholarly journals Clinical pharmacist facilitators in primary care: a descriptive study of their roles and services provided in general practices of southern New Zealand

2020 ◽  
Vol 12 (1) ◽  
pp. 88 ◽  
Author(s):  
Sivamanoj Yadav Boyina ◽  
Tim Stokes ◽  
Angela Renall ◽  
Rhiannon Braund
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Retrospective Case ◽  
Primary Health ◽  
General Practices ◽  
Pharmacist Services ◽  
Geographical Locations ◽  
Case Note Review

ABSTRACT INTRODUCTIONInternationally, the inclusion of pharmacists into general practice as clinical pharmacy facilitators has improved patient outcomes. However, clinical pharmacists are relatively new to southern New Zealand general practices and their range of services has not been studied. AIMSTo describe the implementation of clinical pharmacist services in general practices in the Southern region; to examine the tasks conducted by clinical pharmacy facilitators; and to determine the characteristics of patients who access this service. METHODSThe establishment and development of the clinical pharmacy facilitator role was determined by documentation held within the local Primary Health Organisation. The activities performed by clinical pharmacy facilitators were collected from patient medical records for the period 31 March 2015 to 31 March 2018. To describe the characteristics of patients receiving these services, a retrospective case note review of patients seen by the facilitators was conducted. RESULTSThe clinical pharmacy facilitator role was initiated with three pharmacists in three geographical locations across the region. Within 18 months, the number of facilitators was increased to eight. As a result of collaboration with the general practice team, 42% of referrals came from general practitioners directly. Overall, 2621 medicine-related problems were identified in 2195 patients. Dosage adjustment was the most common recommendation made by pharmacy facilitators. They consulted mostly older patients and patients taking five or more medicines. DISCUSSIONWith effective collaboration, clinical pharmacy facilitators can play a key role in optimisation of medicines therapy.

scholarly journals Prevalence of invasive cancer in a large general practice patient population in New Zealand

2020 ◽  
Vol 12 (3) ◽  
pp. 215
Author(s):  
Dong Hyun Kim ◽  
Lynne Chepulis ◽  
Rawiri Keenan ◽  
Chunhuan Lao ◽  
Fraser Hodgson ◽  
...  
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Patient Population ◽  
Genital Organ ◽  
Ageing Population ◽  
Patients With Cancer ◽  
Skin Cancers ◽  
High Incidence ◽  
General Practices ◽  
Practice Patient

ABSTRACT INTRODUCTIONThe prevalence of cancer in the community is likely to be increasing due to an ageing population, implementation of cancer screening programmes and advances in cancer treatment. AIMTo determine the prevalence of primary invasive cancers in a large general practice patient population in New Zealand and to characterise the health-care status of these cancer patients. METHODSData were sourced from the patient management system of a large general practice (n=11,374 patients) in a medium-sized Waikato town and from the New Zealand Cancer Registry dataset to identify patients diagnosed with cancer between January 2009 and December 2018. RESULTSThere were 206 cancer diagnoses in 201 patients; 35 cancers were diagnosed in 1887 Māori patients (1.9%) and 171 in 9487 non-Māori patients (1.8%). The age-standardised prevalence was 3092/100,000 in Māori patients and 1971/100,000 in non-Māori patients. The most prevalent cancers were breast, male genital organ, digestive organ and skin cancers. In May 2019, 81 of 201 (40.8%) patients with cancer were receiving only usual care from their general practitioner, whereas 66 (32.8%) were having their cancer managed in secondary care. Comorbidities were common, including hypertension (38.8%), gastrointestinal disorders (29.9%) and mood disorders (24.4%). DISCUSSIONResults suggest that there may be disparities in cancer prevalence between Māori and non-Māori patients, although this needs to be confirmed in other general practices. Furthermore, primary care appears to be responsible for most of the care in this patient cohort and workloads should be planned accordingly, particularly with the high incidence of comorbidities.

scholarly journals Study protocol for an observational study to evaluate an accelerated chest pain pathway using point-of-care troponin in New Zealand rural and primary care populations

2020 ◽  
Vol 12 (2) ◽  
pp. 129
Author(s):  
Rory Miller ◽  
Joanna Young ◽  
Garry Nixon ◽  
John W. Pickering ◽  
Tim Stokes ◽  
...  
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Chest Pain ◽  
Point Of Care ◽  
Rural Hospitals ◽  
Low Risk ◽  
Rural Settings ◽  
Pain Pathway ◽  
Risk Patients ◽  
General Practices

ABSTRACT INTRODUCTIONAccelerated diagnostic chest pain pathways are used widely in urban New Zealand hospitals. These pathways use laboratory-based troponin assays with good analytical precision. Widespread implementation has not occurred in many of New Zealand’s rural hospitals and general practices as they are reliant on point-of-care troponin assays, which are less sensitive and precise. An accelerated chest pain pathway using point-of-care troponin has been adapted for use in rural settings. A pilot study in a low-risk rural population showed no major adverse cardiac events at 30 days. A larger study is required to be confident that the pathway is safe. AIMSTo assess the safety and effectiveness of an accelerated chest pain pathway adapted for rural settings and general practice using point-of-care troponin to identify low-risk patients and allow early discharge. METHODSThis is a prospective observational study of an accelerated chest pain pathway using point-of-care troponin in rural hospitals and general practices in New Zealand. A total of 1000 patients, of whom we estimate 400 will be low risk, will be enrolled in the study. OUTCOME MEASURESThe primary outcome is the proportion of patients identified by the pathway as low risk for a 30-day major adverse cardiac event. Secondary outcomes include the proportion of low-risk patients who were discharged directly from general practice or rural hospitals, the proportion of patients reclassified as having acute myocardial infarction by the pathway and the proportion of patients with low and intermediate risk safely managed in the rural hospital.

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