Current status and future directions of U.S. genomic nursing health care policy.

BACKGROUND: As genomic science moves beyond government-academic collaborations into routine healthcare operations, nursing's holistic philosophy and evidence-based practice approach positions nurses as leaders to advance genomics and precision health care in routine patient care. PURPOSE: To examine the status of and identify gaps for U.S. genomic nursing health care policy and precision health clinical practice implementation. METHODS: We conducted a scoping review and policy priorities analysis to clarify key genomic policy concepts and definitions, and to examine trends and utilization of health care quality benchmarking used in precision health. FINDINGS: Genomic nursing health care policy is an emerging area. Educating and training the nursing workforce to achieve full dissemination and integration of precision health into clinical practice remains an ongoing challenge. Use of health care quality measurement principles and federal benchmarking performance evaluation criteria for precision health implementation are not developed. DISCUSSION: Nine recommendations were formed with calls to action across nursing practice workforce and education, nursing research, and health care policy arenas. CONCLUSIONS: To advance genomic nursing health care policy, it is imperative to develop genomic performance measurement tools for clinicians, purchasers, regulators and policymakers and to adequately prepare the nursing workforce.

Nightingale's Legacy: Old Holistic Insight Supported by New Science.

Nursing today could benefit from building on Florence Nightingale's legacy. The aim of this article is to describe and discuss how her holistic approach to nursing is supported by scientific discoveries within human ecology, psychoneuroimmunology, and communicology. This combination may bridge the gap between current nursing practices and Nightingale's ethos.

Rationing of nursing care, a deviation from holistic nursing: A systematic review.

BACKGROUND: Rationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding. METHODS: The review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, and literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty-seven quantitative studies were included in the review. FINDINGS: The review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses. DISCUSSIONS: This review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing.

Barbara Dossey, PhD, RN: Expanding Holistic and Integrative Nursing to a Global Scale.

No Abstract Available.

[Problem solving care models for Parkinson's disease]. / Problémamegoldó ápolási-gondozási modell Parkinson-kórban.

INTRODUCTION: Parkinson's disease affects more than 6,3 million people worldwide. Most patients and relatives are left alone to struggle with the symptoms associated with fluctuations in drug levels and the psychotic side effects of the anti-Parkinson's medications. Moreover, quite often even health providers may find difficult to interpret and manage the problems that have been encountered. AIM: The aims of the authors were to analyze systematically the biopsychosocial needs of Parkinson's patients, and to develop a complex, evidence-based Parkinson's-nursing-care model. METHOD: Patients' needs were assessed based on an observational study involving an old patient with Parkinson's disease for more than 28 years. The model has been specified as a multidisciplinary care framework adapted to the special characteristics of Parkinson's disease which transcends the limitations of different standard nursing models. RESULTS: The elaborated model contains a detailed description of cooperative problem solving, which is organized around individual patients along with recommendations for addressing various potential problems that might be encountered. CONCLUSIONS: Implementation of the presented model can improve the life quality of Parkinson's patients and can facilitate the life of affected families provided that these families are well aware about the potential benefits of the novel care delivery system.

Facing dementia: integrating palliation into all aspects of care.

Dementia is fast becoming a serious public health concern. The lack of understanding of the terminal nature of dementia frequently results in overly aggressive treatment during the end stage of the disease. Nurses need to recognize and encourage a paradigm shift in the way dementia is perceived and treated, including promoting early initiation of palliative care services.

The covered wagon journey: student chronicles in advanced holistic nursing.

This article recounts the experiences of a first cohort of graduate students in a newly implemented advanced holistic nursing (AHN) track, one of only a handful in the nation, and the first in Florida. The increasing popularity of complementary and alternative healing processes represents the insufficiency of a health system of fragmented care and a desire for holistic healing that is beyond mainstream allopathic care. Graduate holistic nurse education equips nurses to explore the commitment needed to advance the evolution of health care. The covered wagon journey is a metaphor for this meaningful participation. Students journaled their experiences as cotravelers in a lone wagon: embarking on a courageous journey, forging a path of discovery, and reaching their destination as pioneers. This cohort experience embodied the central tenets of holistic nursing, thus creating conscious change and unity within a learning community. The future of AHN is addressed in the context of the contemporary health care environment.

Global health for nursing...and nursing for global health.

This article draws on the literature to present a conceptualization of global health (GH) that corresponds with the discipline of nursing and defines the contributions of nursing to GH. The author's perspective is that "health" should be defined and considered holistically to reflect the fact that GH involves more than the eradication of disease and that health as a fundamental right of every human being must be made explicit. "Global" refers to the supraterritorial links among the social determinants of health located at points anywhere on earth within a whole-world context. The focus of GH is the supraterritorial determinants and its ultimate objective is health equity for all nations and all people. The contributions of nurses are advocacy, healing and alleviating suffering through caring, and increasing nursing capacity globally. To truly advance the GH agenda, a new world order is needed, one in which political decision-making is guided by our shared humanity.

Palliative care nursing for children in the UK and Ireland.

Currently, there are many changes taking place in the area of paediatric palliative care. These include the role of the nurse, development of national policies, and recommendations for the future of paediatric palliative care. This article discusses palliative care for children with life-limiting conditions in the UK and Ireland, highlights national and international developments in this area, describes current services, and makes recommendations for future developments. Paediatric palliative care should be holistic, family centred and tailored to meet the needs of each child and family. Palliative care should promote autonomy and allow informed choices regarding end-of-life care. Palliative care should begin at the time of diagnosis and continue beyond illness, through the bereavement process. It should be adaptable to allow care delivery in any setting; home, hospice or hospital. Health professionals providing paediatric palliative care should be appropriately trained in this specialist field and the best interests of the child should always be at the forefront of care.