Creative Nursing最新文献

Research shows how vital sleep is to total health, with poor sleep having a strong correlation with morbidity and mortality, yet fewer than half of top hospitals have sleep-friendly practices. This article describes a project motivated by the lived experiences of a nurse manager and a hospitalist who partnered to improve the sleep environments on two inpatient units. They used design thinking, empathizing with the patients' experiences with the sleep environment, to design interventions to promote quality sleep. Results showed improvements in patient experience on the Hospital Consumer Assessment of Healthcare Providers & Systems question, "During your hospital stay how often was the area around your room quiet at night?" Patient measures on how well the hospital created conditions for sleep on the unit also showed improvements, as well as the patients' perception of how well they slept. Care teams can use design thinking to replicate this project and listen to their patients to build and deploy interventions on their units to improve sleep environments.

This paper offers a critical discussion of the evolution and impact of an international nursing writing group, developed to support nursing faculty and academics globally. Amid the challenges posed by the COVID-19 pandemic, the writing group adapted and thrived online with a flattened power structure, and shared influence and acknowledgment of mutual capacity and contribution. The writing group attracted participants from various countries, with international members enriching collaboration, and fostering a global network of nursing scholars. By embracing diverse perspectives and promoting nonpatriarchal approaches to scholarly writing, the International Writing Group became a unique and valuable platform for academic growth and cross-cultural exchange in nursing.

Patient experience and team engagement are key performance indicators in organizational strategic planning. Health-care organizations have a seldom-used resource within acute care settings that expands the ability to improve patients' experiences of their care as well as their own team engagement. Environmental services (ES) staff, the second largest health-care workforce, spend an average of 10 min per patient day interacting with patients and families. Few studies highlight how nursing theory may influence patient experience outside of the nursing role. This paper explores how ES staff at a non-profit rural 974-bed academic medical center impacted patient experience using nursing theory to promote a caring environment. Applying Watson's Theory of Human Caring and Caritas Processes^© with ES team members beginning at leadership levels increased team engagement and improved patient experience. ES team members benefited from a professional nursing framework and from being integrated as a valued partner in advancing human caring.

The Centers for Disease Control and Prevention estimates that 34.8% of adults in the United States experience non-restorative sleep. The restorative theory of sleep is based on sleep as a means for the restoration of cellular function that is needed for activities when awake. Non-restorative sleep leads to awakening feeling unrefreshed and not ready for the activities of the day three or more times weekly. Aims: The aim of this quality improvement project was to increase restorative sleep by increasing the average amount of sleep over units of 24 h, decreasing perceived insufficient sleep, and decreasing episodes of unintended daytime sleep among patients with depressive symptoms ages 18 to 80 years in an outpatient mental health clinic. Methods: Ten patients with depressive symptoms and reporting non-restorative sleep volunteered to participate in the project. Participants kept a sleep diary and followed principles of healthy sleep such as limiting time in bed and going to bed at the same time nightly. The change in and the average amount of sleep over 24 h and daytime sleepiness were evaluated using the Behavioral Risk Factor Surveillance System. Results: All participants achieved at least one more day of restorative sleep, with nine increasing restorative sleep by at least 30 min per day, and nine having no episodes of unintentionally falling asleep.

The concept of transforming power over to power with, the theme of this issue of Creative Nursing, comes from Riane Eisler's cultural transformation theory describing a continuum of domination and partnership along which cultures orient themselves. Hierarchies are important organizing principles in many systems; it is not their presence that is inhumane, but how they function. Domination systems display authoritarian rule in both the family and the state or tribe, with strict hierarchies of domination, and narratives that normalize domination and present the violence that maintains it as inevitable. Partnership systems are characterized by egalitarian structures in both the family and state or tribe, with hierarchies of actualization in which power is used to empower others rather than disempower, low levels of sanctioned violence (since it is not needed to maintain power), and narratives depicting mutual respect, accountability, and benefit as natural. All the articles in this issue of Creative Nursing depict empowerment: of patients, parents and other family members, foster parents, children from preschool age to near adulthood, providers of direct patient care at many levels in many areas, nurses seeking to publish their knowledge, and all people who seek to use language that demonstrates respect and value for all people while acknowledging the diverse cultures in which we abide.

The transition from hospital to home after surgery is a vulnerable time for all cardiac surgical patients, particularly older adults. This postoperative phase presents multiple physical, physiological, emotional, and socioeconomic challenges, not only for patients but also for their families and informal caregivers, who often describe this period as stressful and overwhelming. Health-care professionals, particularly nurses, play an integral role in a patient's discharge process; the challenges can be ameliorated through timely discharge planning and effective discharge education. The context-sensitive solutions shared in this paper propose enhancing nurses' discharge practices to provide individualized care and to facilitate the hospital-to-home transition.

Purpose: This study explored barriers and facilitators to utilizing health-care services for foster youth, from the perspective of foster parents. Background: There are nearly 437,283 youths in the United States foster care system. Youths living in locations that are different from their familial home situations have a significantly higher occurrence of physical and mental health illnesses than children who remain in their familial homes, increasing risk for homelessness, substance use and abuse, chronic long-term illnesses, and incarceration, thus placing additional burden on the health-care system. Design and Methods: This study utilized a qualitative descriptive design with purposive sampling, with video focus groups to explore 15 foster parents' experiences in accessing health-care services for foster youth. Results: Barriers and facilitators to accessing health care and care coordination were identified, including logistics, transportation, electronic health record access, location of health care, and the impact of the social worker. Practice Implications: Nurses are well-positioned to aid in closing gaps in care for foster youth. Conclusions: These experiences provide important insights and implications for health-care providers and for future research and policy development.

Design labs are one of the most exciting multidimensional communication and disruption strategies available to health-care teams today. A design lab can be as simple as a gathering of people who use the framework of design thinking to iterate solutions and innovations to problems in their environment. Design labs support teams in exploring solutions for current health-care challenges, in a safe, creative space. They are a place where nurses can explore their own practice and iterate organizational policies and processes.

Gun violence in the United States is a serious problem. Addressing the problem will require not only strong leadership but also a unique approach. One such approach was utilized by U.S. President Abraham Lincoln, who assembled a "Team of Rivals" with positions different than his own that provided helpful perspective in finding solutions to the problems of the time. This article applies the team of rivals approach to the problem of gun violence.

This article explores nursing, patient records, and ideology within the context of the National Socialist "euthanasia" program (Aktion T4) in Germany and Austria from 1939 to 1941, which targeted individuals with mental and physical disabilities for systematic killing. Using Hannah Arendt's concept of the "banality of evil," it examines how ordinary individuals, including nurses, became agents of atrocity by adhering to bureaucratic orders. Jacques Ellul's Ethics of Technology framework is employed to analyze how National Socialist ideology manipulated technological processes to enhance efficiency in genocidal goals. Propaganda was crucial in garnering public support, blurring the lines between technology, ethics, and ideology. Archival research at documentation centers and national archives reveals methods for deciding who was killed, the role of family in medical records, and nurses' involvement in the T4 operation. Three narratives of T4 victims illustrate the personal impacts of these bureaucratic and ideological practices. The article reflects on contemporary nursing, emphasizing the importance of ethical standards and vigilance against data and misuse of technology in health care. This historical examination serves as a reminder of the potential consequences of depersonalization and blind adherence to institutional priorities, underscoring the need for critical engagement with the ethical dimensions of nursing practice.