Preparing the emerging nursing and health care workforce: a case study.

How do we prepare the nursing and health workforce of the future to meet the challenges of the US health system and equip graduates with problem-solving strategies that are scientific, compassionate, and agile? This article provides examples of several approaches for nursing health professions education, including innovation, interprofessionalism, and multiple, simultaneous community collaboratives. Specific examples highlight ways academic nursing programs and practice organizations are working together to provide stimulating, realistic, safe, and effective education while exposing students to the challenges inherent in the health system.

Bringing back the basics of nursing: defining patient care essentials.

Nursing leadership involves creating and sustaining a professional environment where nurses can perform at the highest levels of their preparation and expertise. As the work of nursing becomes increasingly more complex and significantly more technical in nature, nurses are beginning to find that the basic nursing interventions that were once the hallmark of good nursing care are being left behind. The purpose of this article is to describe an initiative to develop a clearly defined set of consensus-driven expectations about those essential, foundational elements of nursing care that nurses strive for and which we wanted to be universal within our organization, no matter where the patient receives care. The leadership challenge was to convey expectations that encompass both the tasks of nursing care and the compassionate environment in which the care is delivered. Adding to the complexity of this goal was the recognition that we would be much more successful in meeting these standards consistently if the expectations were grounded in the experience of direct care nurses, explicitly described and intentionally specified. This article describes the various phases of this initiative and includes the resulting "Patient Care Essentials" document.

Spiritual well-being and quality of life of women with ovarian cancer and their spouses.

BACKGROUND: There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses. OBJECTIVE: We compared the SWB and QOL of these women and their spouses over a 3-year period. METHODS: This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later. All participants completed the Functional Assessment of Chronic Illness Therapy (FACIT)-Spiritual Well-Being-Expanded Version, Symptom Distress Scale, and open-ended questions about changes in their lives. Diagnosed women completed the FACIT-Ovarian and spouses the Caregiver Burden Interview and Linear Analog Self-Assessment scales. RESULTS: Women reported a high level of SWB over time. Spouses' SWB was significantly worse than the women's at 1 and 3 years (P ≤ .05). Insomnia, fatigue, and outlook/worry were problematic across time, with no significant differences between women and spouses except that women experienced more insomnia through 3 months (P = .02). Emotional well-being was compromised over time for the women but not their spouses until year 3. Physical and social well-being were compromised in spouses across time, while women's social well-being remained high and physical well-being was problematic only for the first year. LIMITATIONS: Limitations include a small spouse sample and, due to the disease process, attrition over time. CONCLUSIONS: Ovarian cancer has significant, but different, effects on women and spouses. Some effects are static, while others are not, which underscores the need for continual monitoring.

Rediscovering the art of healing connection by creating the Tree of Life poster.

The goal of this project was to provide a way for hospital staff to form meaningful therapeutic relationships with patients in the fast-paced hospital environment. Watson's Theory of Human Caring was the framework guiding the project. The Lifestory intervention was a Tree of Life poster depicting sources of encouragement and enjoyment, special memories, life lessons, family, and roots. Preintervention and postintervention measures included quality of life (QOL) and spirituality scales with established psychometrics. A one-sample t test was used to analyze data. Mean age of participants (n = 15) was 73.8. Ten (67%) patients reported the intervention positively affected their QOL. Improvements were noted in overall QOL (p = 0.05), as well as emotional (p = 0.005), physical (p = 0.02,) and spiritual well-being, as measured by the Expanded Version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (p = 0.02). This simple Lifestory intervention was feasible and associated with improvement in several QOL dimensions in hospitalized older adults.

Nurse leader mindfulness meditation program for stress management: a randomized controlled trial.

OBJECTIVE: The aim of this study was to rigorously evaluate a brief stress management intervention for nurse leaders. BACKGROUND: Despite the nursing shortage, evidence-based workplace approaches addressing nurse stress have not been well studied. METHODS: Nurse leaders (n = 33) were randomly assigned to brief mindfulness meditation course (MMC) or leadership course (control). Self-report measures of stress were administered at baseline and within 1 week of course completion. RESULTS: Among MMC participants, change scores (from baseline to postintervention) on several subscales of the Symptom Checklist 90-Revised showed significantly more improvement in self-reported stress symptoms relative to controls. Mindfulness meditation course participants had significantly more improvement in Positive Symptom Distress Index (P = 0.010; confidence interval [CI] = -0.483 to -0.073) and Global Severity Index (P = 0.019; CI = -0.475 to -0.046) and nearly significantly more improvement in Positive Symptom Total (P = 0.066; CI = -16.66 to 0.581) compared with controls. CONCLUSION: Results support preliminary effectiveness of a 4-week MMC in reducing self-reported stress symptoms among nursing leaders.

Centering prayer for women receiving chemotherapy for recurrent ovarian cancer: a pilot study.

PURPOSE/OBJECTIVES: To explore the feasibility of implementing centering prayer in chemotherapy treatment and assess its influence on mood, spiritual well-being, and quality of life in women with recurrent ovarian cancer. DESIGN: Descriptive pilot study. SETTING: Outpatient chemotherapy treatment suite in a large cancer center in the midwestern United States. SAMPLE: A convenience sample of 10 women receiving outpatient chemotherapy for recurrent ovarian cancer. METHODS: A centering prayer teacher led participants through three one-hour sessions over nine weeks. Data were collected prior to the first session, at the conclusion of the final session, and at three and six months after the final session. MAIN RESEARCH VARIABLES: Feasibility and influence of centering prayer on mood, spiritual well-being, and quality of life. FINDINGS: Most participants identified centering prayer as beneficial. Emotional well-being, anxiety, depression, and faith scores showed improvement. CONCLUSIONS: Centering prayer can potentially benefit women with recurrent ovarian cancer. Additional research is needed to assess its feasibility and effectiveness. IMPLICATIONS FOR NURSING: Nurses may promote or suggest centering prayer as a feasible intervention for the psychological and spiritual adjustment of patients with recurrent ovarian cancer.

Implementing a health system-wide evidence-based practice educational program to reach nurses with various levels of experience and educational preparation.

This article describes a system-wide evidence-based practice (EBP) educational initiative implemented with a geographically, educationally, and clinically diverse group of nurses with the intent of increasing their EBP skill set and efficacy as local change agents and leaders. The overall scope of the larger National Quality Forum Scholar Program is described, and then the focus is narrowed to describe the EBP components of the initiative with case examples and lessons learned.

A prospective descriptive study exploring hope, spiritual well-being, and quality of life in hospitalized patients.

A study evaluating relationships among interventions and outcomes of hope, spiritual well-being, quality of life and length of stay in hospitalized patients at admission, discharge, and 6 weeks after discharge is described. The findings highlight the importance of presence, listening; and other caring behaviors in the patient experience.

Leadership strategies: inspiring evidence-based practice at the individual, unit, and organizational levels.

This article describes innovative educational strategies used by one organization to simultaneously develop leadership skills and evidence-based practice. The methods were theory-driven and designed to positively affect the nursing culture at the individual, unit, and organizational levels. Case studies, outcomes, and lessons learned are also included.

Optimizing nursing care by integrating theory-driven evidence-based practice.

An emerging challenge for nursing leadership is how to convey the importance of both evidence-based practice (EBP) and theory-driven care in ensuring patient safety and optimizing outcomes. This article describes a specific example of a leadership strategy based on Rosswurm and Larrabee's model for change to EBP, which was effective in aligning the processes of EBP and theory-driven care.

Implementing evidence-based nursing practice.

A methodology for establishing and supporting evidence-based nursing practice is examined. Description of a clinical and administrative scenario serves as an example of a systematic appraisal of the relevant literature that had implications for clinical practice.

Implementing evidence-based nursing practice.

A methodology for establishing and supporting evidence-based nursing practice is examined. Description of a clinical and administrative scenario serves as an example of a systematic appraisal of the relevant literature that had implications for clinical practice.