Abstract
Nursing research develops knowledge about health and the promotion of health over the full life span and care of persons with health problems and disabilities. This includes all aspects of the caring continuum including extended care, acute hospital care, ambulatory care, home care, outreach, wellness, and housing. Healthcare design nurses understand the opportunity for education and alignment with current nursing research to expand the research agenda to include the physical environment as a vital aspect of the domain in nursing and the continuum of care. This article will present studies from two recent Nursing Research Conferences and an upcoming agenda for elevating nursing research in the healthcare environment.
2022 Sigma Theta Tau International Research Congress
The first conference to highlight is the Sigma Theta Tau International Research Conference in Edinburgh, Scotland. Sigma Theta Tau is an international community of nurses, dedicated to the advancement of knowledge, teaching, learning, and service through the cultivation of communities of practice, education, and research. The conference theme was transforming global nursing knowledge through research, scholarship, and innovation. Hundreds of nurse researchers from around the globe came to present their evidence-based research through presentations and posters. Here are samples of three research projects that related to the environment.
First, Annie George, PhD, RN, from Adelphi University College of Nursing, presented “An Inquiry into to the Lived Experience of Tele-ICU Nurses’ Practice.” Tele-ICU is considered a collaborative interprofessional care model that has expanded and grown 14% since 2000. Since the COVID-19 pandemic, telehealth has increased 50%. The American Academy of Colleges of Nursing (AACN) has developed a practice model framework to incorporate true collaboration, skilled communication, and practice excellence. George noted limited qualitative research studies in this area. She describes five research gaps that include, clinician factors, studies did not describe the events in the tele-ICU settings, no descriptions or experiences of nurses, transition of roles to and ICU telehealth nurse, and perspective of RNs. George’s study focused on the experience of the tele-ICU nurses’ practice using qualitative and Heideggerian Interpretive Phenomenology with van Manen’s method. George’s research findings and implications include ergonomic standards for implementation, technology training, enhancing, and strengthening the AACN model, and nurses need training and education to transition to virtual practice. It was brought up in the discussion that the physical environment should be addressed related to windows in the room, access to nature, and the amount of screen time for the nurse.
The second presentation showcased Gibran Mancus PhD, MSN, RN, from University of Alabama Birmingham. He reported on his findings related to changes in cortisol levels immediately after an urban park visit. The participants were adults entering the park where they were given a pretest upon entering and a posttest upon leaving. The brief subjective well-being questionnaire was given along with gathering a passive drool saliva sample. The park visit duration of 21.8 min showed an increase in cortisol level. Dr. Mancus focuses on factors of the built and social environment that intersect with violence as a factor of health. He is currently developing interventions utilizing green spaces to mitigate community violence and promote resilience to climate change at Department of Nursing, College of Health and Human Services, University of New Hampshire.
The third presentation was in poster format. Sahar Mihandoust, PhD, MArch; Jamie Roney, DNP, RN; and Stephanie Dunkle, MSN, RN presented exploring relations between exposure to nature and nurse burn out. In the introduction, the presenters described the lack of peer-reviewed literature on the environmental and physical design of features such as nature and the impact on burnout. Researchers sought to understand the relationship between the visual and physical connection to nature and stress reduction. They utilized simulation theory as the framework for the study to describe environments as sources of sensory arousal originating from vision, smell, touch, and sound. Six nurse break rooms were selected based on nurse exposure to nature including nurse break area with window access to nature and art containing nature; break rooms with no nature views but containing art with nature content; and nurse break room with no nature and no artwork with nature content. The results demonstrated that higher durations of times with nature created lower emotional exhaustion and depersonalization. They concluded that while extending views of nature may add to cost, doing so may decrease nurse burnout. These researchers recommend including window, balconies, and indoor/outdoor hospital gardens.
2022 International Nursing Conference for Excellence in Healthcare Design
The next conference to highlight is the 2022 International Nursing Conference for Excellence in Healthcare Design hosted by Dr. Kathleen Valentine of Clemson University School of Nursing. The theme, “Reimagining the Unimaginable: Designing for Readiness, Rapid Response, and Resilience” brought architects, planners, designers, technology planners, and design nurses together to discuss and learn from industry experts.
Ono Day 1, Dr. Karen Hill, DNP, RN, editor-in-chief, The Journal of Nursing Administration (JONA), spoke about how nurses as healthcare design leaders are more important now than ever. After participating in a major construction project at her health system, Dr. Hill’s shared her vast experience which was an inspiration to all conference participants. The morning speakers focus included resilience. Dr. Terri Reed, Design Research Analyst at CAMA and Kimberly Montague, Executive Director of Research, and Insights at Kimball International, discussed how to restore the joy of nursing. Dr. Ursula Lasky, Emergency Department at Erlanger Western Carolina Hospital, spoke regarding the redesign of an emergency department. The next two consecutive speakers discussed resiliency related to the pandemic. Steven Langston, VP of Design at RFL; Jennifer Powers, Director of Medical Planning at RFL; and Brian White, Director of Medical Planning at RFL, spoke about creating a resilient model for Pandemic Care: Conversion of Miami Convention Center. And, Dr. Deborah Wingler, Global Associate Director of Research-Principal at HKS and Brenda McDermott, talked about the analysis of multiple facilities and building for pandemic resilience.
After lunch, Dr. Oriana Beaudet, Vice President of Innovation at the American Nurses Association (ANA), shared about innovation being required to grow, sustain, and reimagine healthcare. Next, students from the Clemson Design and Innovation Certificate program presented their projects. The afternoon wrapped up with two sessions on planning and design around behavioral health. Dr. Elizabeth Johnson, Assistant Professor at Montana State University, and Dr. Kimberly Strauch, nurse practitioner and instructor at The University of Pennsylvania, Care Center for Person with Disabilities, presented on exploring telepresence during mental health visits. The final presenters for Day 1 were Marvina Williams, Senior Medical Planner and Associate Principal at Perkins+Will, and Sabah Mohammed, Healthcare Designer at Perkins+Will. Their presentation was entitled “Operation Studies to Improve Facility Planning and Design for Behavioral HealthCare in the Emergency Department.”
Day 2 began with a panel discussion led by Dr. Carolyn Swinton and Dr. Kathleen Valentine, both from Clemson University School of Nursing entitled “Boots on the Ground: Perspective for Practice and Academics during a Global Pandemic.” Personal stories of the past 2 years shared themes of resilience and innovation. In the next session, Steve Langston, VP of Design at RLF, and Miriam Ganesh, Director of Interior Design at RLF, described the cholera pandemic and similarities and lessons learned related to COVID-19. The final presenters focused on the future of hospitals and the future of healthcare. Jennie Evans, Global Development Director at HKS, shared about Future Proofing hospitals for the next global pandemic, and Dr. Deborah Wingler, Global Associate Director of Research at HKS, described the hospital of the future. The conference concluded with a panel of Clemson Academy of Nursing Members to discuss the future of nursing research and plans for the Academy.
Elevating Nursing Research
Efforts are growing to create a platform for nursing research focused on improving the healthcare work environment. Three ways to elevate the nursing research platform are presentations, publications, and partnerships. First, the Nursing Institute for Healthcare Design Foundation (NIHDF) will be participating in an upcoming conference with Sigma Theta Tau in February 2023. Creating Healthy Work Environments will be in Austin, TX. Presentations will expand the conference theme to include the domain of the built environment. The NIHDF hopes to further advocate and educate about the nursing voice and the importance translating research into practice. Aligning and disseminating research is vital to improving and transforming healthcare.
Second, the Health Environment Research & Design Journal is also seeking more nursing research studies for publication as well. Research from nurses about the environment has not typically crossed to a multidisciplinary platform. Creating a platform for dissemination through publications is an important step in translating research to practice.
And third, partnering with the Department of Nursing Research during a healthcare project is another way to engage nurses and promote research to improve healthcare. Make a point to reach out to those in nursing research and education to determine opportunities for collaboration and evidence-based research during a project.