Advances in Nonpharmacological Interventions, 2011–2012

Abstract

In 2011 the National Institute of Nursing Research (NINR) celebrated a quarter century of advancements in nursing science that made an extraordinary impact on the health of our nation. The report, Bringing Science to Life, NINR Strategic Plan (National Institute of Nursing Research, 2011), describes breakthrough research that has vastly improved health outcomes for the most vulnerable patient populations we serve. Research In Gerontological Nursing has made a commitment to publicizing the outstanding work of gerontological nurse scientists in an Annual Commentary on the State of The Science. In this inaugural commentary, we build on the NINR Report by reflecting on critical scientific advances that are currently being made in the area of non-pharmacological interventions for the nursing care of older adults. Effective non-pharmacological nursing interventions are especially appropriate for older adults because of the low cost and low risk of associated side-effects. Non-pharmacological interventions can be considered alone or as a first step in the management of a variety of problems, and should be continued as they are augmented by appropriate pharmacological, surgical or other types of complementary interventions. This focus is quite timely in light of the recent Centers for Medicare & Medicaid Services initiative aimed at improving behavioral health and reducing unnecessary antipsychotic drug use in nursing. This focus is also directly responsive to Americans’ need for safe, accessible, high quality, and affordable care. In this commentary we limited our review to published literature in 2011–2012, and chose a few examples of non-system interventions, i.e., those that are implemented in the context of direct, hands-on-care. In our search strategy we selected areas of intervention science that enjoy a strong basis, built over many years of investigation. These interventions include those that: relieve pain; improve physical function; reduce behaviors associated with cognitive impairment; promote sleep; and enhance end-of-life care. We also highlight examples of research that are currently being conducted, offering exciting and innovative solutions to costly clinical problems. Finally, we outline priorities for future research and address our capacity as nurse scientists to advance the science of nursing care.