The Nurse-Managed Clinic: An Evaluative Study  

Abstract
The aim of this study (part of an international project) was to evaluate a nursemanaged primary health care clinic from the perspectives of users, funders, and providers of clinical services in order to identify factors which contribute to success. The method used was Fourth Generation Evaluation (FGE) whereby, consistent with the methodological precepts of the constructivist enquiry paradigm, there was active involvement of clients in the process and outcome of the evaluation. Open-ended interviews were conducted with 13 individuals and one focus group. These were taped, transcribed and analysed. The data yielded four main categories: factors that contribute to success; contrasting past experience of health care with that of nurse-managed care; the effectiveness of nurse-managed care; and suggestions for change in current practice. The results to date support a tentative conclusion of success for the clinic. As the study is on-going, summaries of the four categories were fed back to the participants for further discussion and interpretation and eventual integration with data from the similar study being undertaken in the United States. This paper demonstrates how the use of an appropriate method of evaluation can itself contribute to the success of the nurse managed clinic.   

Keywords
Fourth Generation Evaluation, nurse-managed clinic, evaluation

Introduction
On 1 May, 2001, the doors to the Mana Health Clinic opened for the first time. This was the first nurse managed clinic (NMC) to be established in a New Zealand primary school. Staffed by a public health nurse, the clinic is based in a low decile, Central Auckland primary school and provides services such as health promotion, health education, assessment, referral and the treatment of minor illness and injury. Funded for children aged between five and ten years, the clinic can also be accessed by caregivers, siblings and others in the community who require any of the services provided. The Mana Health Clinic is operated by the Child and Youth Team of the Auckland District Health Board Community Child Health & Disability Service.  cont.