ABSTRACT
Merger and acquisition activities in health care are increasing in both the number and cumulative value of transactions in recent years, creating new and dynamic pressures on health care systems and current operating environments. These industry shifts, coupled with crises such as the COVID-19 global pandemic, create opportunities for innovation to increase capacity, improve productivity, achieve economies of scale, and positively impact health care quality, safety, access, and cost. However, neither consolidation nor innovation in and of themselves will yield sustainable clinical best practices nor achieve the desired quality, financial, efficiency, retention, or engagement outcomes. This article describes the approach used by one system-level Doctor of Nursing Practice prepared nurse executive to leverage evidence-based decision-making to guide, lead, and support the innovation needed to address first-year new graduate nurse turnover in a multistate not-for-profit health care system.
ABSTRACT
Introduction: The determinants of Veterans’ and their family members’ health and well-being are compromised by sleep deficiency (SD). The use of long-term drug therapies for treatment is controversial, and the evidence to support positive outcomes is limited. Instead, guidelines recommend non-pharmacological sleep interventions for SD. Hand self-shiatsu (HSS) is a drug-free, pragmatic, easy-to-learn self-management technique that provides patients with an intervention they can actively control, thus contributing to feelings of self-efficacy. The objective of this work was to examine whether a prescribed HSS intervention would result in improved objectively and subjectively measured sleep. Methods: This was a non-randomized controlled study. Objective (actigraphy) measures and standardized self-report questionnaires were applied at baseline and at four and eight weeks post-intervention. Participants also completed a detailed sleep log. Results: No significant differences were found in the actigraphy sleep dimensions across the three measurement time points in either the intervention or the control group. With respect to the self-report measures, a significant change was detected for sleep disturbance (χ22 = 10 [n = 25], p = 0.007) for the intervention group, and 77% stated they would recommend HSS to others. A significant change in two self-report measures was noted in the control group, a potential artifact of the sub-optimal recruitment to this group imposed by the COVID-19 restrictions. Discussion: Although actigraphy data did not support the hypothesis, the self-report measures and qualitative information from participants’ end-of-study interviews indicated endorsement of HSS for the management of sleep difficulties and increased self-efficacy. © 2021 Izvestiya of Saratov University. New Series. Series: Mathematics. Mechanics. Informatics. All rights reserved.