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.

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.

Creating a healing environment: an innovative educational approach for adopting Jean Watson'sTheory of Human Caring.

Current focus on empirical data and evidence-driven nursing practice highlights the need to re-examine the importance of nursing theory to guide practice. The purpose of this article is to describe the rationale, approach, and outcomes of an innovative educational approach to teaching Jean Watson's Theory of Human Caring.

A telephone-delivered empowerment intervention with patients diagnosed with heart failure.

BACKGROUND: Heart failure (HF) is a major public health problem. Case management by nurses using telephone follow-up has been suggested as a convenient and effective mechanism to promote the self-management of HF. Similarly, a patient empowerment approach to the management of chronic disease has been suggested as one that may nurture self-management in individuals with chronic illness. OBJECTIVE: The purpose of this study was to examine the effects of a telephone-delivered empowerment intervention (EI) on clinically and theoretically relevant outcomes in patients with HF, including purposeful participation in goal attainment, self-management of HF, and perception of functional health. The EI was guided by Rogers' Science of Unitary Human Beings person-environment process. METHODS: A convenience sample of men and women aged 21 years and older with a clinical diagnosis of HF was obtained from a metropolitan hospital located in the southwestern United States. The participants were randomly assigned to the control group (n = 45) or EI group (n = 45). All participants received standardized HF patient education; the intervention group also received an EI delivered through telephone follow-up calls from a registered nurse. Repeated-measures analysis of variance was used to evaluate intervention effects. RESULTS: The telephone-delivered EI facilitated self-management of HF through self-care activities in EI group members. CONCLUSION: The knowledge gained from this study provides a beginning understanding of strategies to enhance health care providers' ability to facilitate self-management of HF among patients diagnosed with HF.

Use of continuous subcutaneous insulin infusion (insulin pump) therapy in the hospital setting: proposed guidelines and outcome measures.

PURPOSE: Individuals whose diabetes is being treated in the outpatient setting via an insulin pump often wish to maintain this therapy during hospitalization. The authors propose guidelines for management of patients on insulin pumps who require a hospital admission. METHODS: A collaborative interinstitutional task force reviewed current available information regarding the use of insulin pumps in the hospital. RESULTS: There was little information in the medical literature on how to manage individuals on established insulin pump therapy during a hospital stay. The task force believed that a policy that promotes patient independence through continuation of insulin pump therapy while ensuring patient safety was possible. A set of contraindications for continued use of pump therapy in the hospital are proposed. A sample patient consent form and order set are presented. Finally, measures that can be used to assess effectiveness of an inpatient insulin pump policy are outlined. CONCLUSIONS: Patients on established insulin pump therapy do not necessarily have to discontinue treatment while hospitalized. However, clear policies and procedures should be established at the institutional level to guide continued use of the technology in the acute care setting.