Inspiring a culture of ownership through mutual accountability-A health care system's approach to connecting bedside expertise with boardroom strategy
Nursing Management; by Torry Robinson, Stuart Downs; 8/26
A health care system's approach to integrating the American Association of Critical-Care Nurses Healthy Work Environment (HWE) standards across organizational levels demonstrates a replicable pathway for aligning bedside expertise with boardroom strategy, an essential linkage in organizational strategic planning. This article describes one health care system's 3-year journey in embedding the HWE framework throughout the deployment of the nursing strategy. Following operationalization of HWE as a component of the nursing strategic framework, the health care system achieved sustained improvement across all domains of the Healthy Work Environment Assessment Tool (HWEAT), bolstering an organizational commitment to continuously improve and measure practice-environment health. This transparent, high-visibility approach emphasizes accountability from the Chief Nurse Executive to frontline nurses, underpinning a shared commitment that aligns clinical practice with organizational strategy. Organizations that embed HWE into their nursing strategic plan empower nurses at every level to shape and share ownership of the practice environment.

Narrative review of the US specialty palliative nursing workforce 2025: Measurement for now and the future
Journal of Pain & Symptom Management; by Susan Lysaght Hurley, Morgan E Murphy, Marian Grant, Caitlin Brennan, Joanne Reifsnyder, Joan G Carpenter; 8/26
A robust, expertly trained nursing workforce is needed to care for over 13 million people living with serious illness in the United States (US). Workforce data remain limited due to the diversity of nursing roles in hospice and palliative care. No comprehensive estimate exists for the broader palliative nursing workforce; however, a 2024 national survey estimated 56,619 registered nurses working in hospice. Palliative nursing education was not formally integrated into US nursing curricula until 2021 with the AACN publication of The Essentials, and only 12 healthcare organizations offer specialty nurse residency or fellowship programs. The National Board for Certification of Hospice Nurses was established in 1992 in the US and awarded the first certification to registered nurses in 1994; in 2025 nearly 12,000 nurses are certified.

Digital Deception: Survey Bots and the Ethics of Data Integrity
Ethics & Human Research; by W Frank-Ito, LA Eldridge, J Matthews; 9/26
The rapid growth of artificial intelligence and automated systems has significantly impacted digital survey-based research, particularly when recruitment is conducted via social media platforms. This case study details the erosion of data integrity in a 2025 follow-up survey, originally designed to replicate a successful 2021 study. Despite implementing increasingly sophisticated antifraud mechanisms such as CAPTCHA, IP geo-restrictions, and behavioral validation, survey bots repeatedly infiltrated the study, rendering the dataset unusable. This highlights a critical tension between broad digital accessibility and the vulnerability of online research to fraud. Moreover, the use of financial incentives to participate in research, while effective in increasing response rates, was found to amplify bot activity and raise ethical dilemmas surrounding compensation and data quality... The authors call for the urgent development of fieldwide standards, institutional support, and robust fraud prevention strategies to preserve the methodological and ethical integrity of digital research.

Timing prompts for advance care planning discussions and advance directive completion
JAMA Network Open; by Neil S Wenger, Fernando Javier Sanz Vidorreta, Chi-Hong Tseng, Victor Gonzalez, Ron D Hays, Maryam Rahimi, Lisa Gibbs, Katherine Santos, Rebecca L Sudore, Anne M Walling; 8/26
Objective: To compare the association of an appointment-based ACP [advance care planning] behavioral intervention delivered with the patient just before a primary care visit vs a non-appointment-based intervention. Among patients receiving appointment-based interventions, 1143 (40.2%) had ACP discussion documentation in the EHR [electronic health record] compared with 714 (27.5%) of patients receiving only non-appointment-based interventions ...  Appointment-based interventions were associated with more AD or POLST and documented ACP discussions than non-appointment-based interventions across all 3 ACP intervention groups.

Advance care planning in an urban hospital: Sustainability and growth in documenting care plans over four-years
American Journal of Hospice & Palliative Care; by Khadeja Kausar, Edward Coffield, Sampath Gopalan, Regina Tarkovsky, Sarah Egan, Robert A Press, John Marshall; 8/26
Many acute care patients are admitted without advance care plans (AC-Plans) which may result in patients receiving care misaligned with their preferences. Accordingly, ACP [advance care planning] is needed within hospitals, however, implementation barriers exist. [In this study] the hospital's ACP program components included: primary palliative care, simulation-based training, and ACP and AC-Plan training and education. The percentage of patients with ACPs at discharge increased from 4.4% to 19.1% from the first to fourth program year. The odds of having an AC-Plan at discharge in years 2, three, and four were 3.44, ... 5.87, ... and 8.97 ... times higher than the odds of having one during the first program year. The growth and sustainability of the hospital's ACP program demonstrates that barriers to ACP within hospitals can be overcome and successful programs implemented.

PHarmacist avoidance or reductions in medical costs in PALLiative care inpatient services: PHARM-PALL
Journal of Palliative Medicine; by Celena Wilson, Jennifer Ku; 8/26
Inpatient palliative care (PC) pharmacists have been shown to improve clinical and team outcomes. Objectives: To quantify the cost avoidance (CA) associated with a full-time inpatient PC pharmacist based on clinical interventions. Conclusions: A PC pharmacist may help avoid significant health care costs, particularly in the areas of deprescribing, identifying untreated indications, and using PC expertise to make therapeutic recommendations.

How Latine families navigate pediatric loss amid broken systems: A qualitative study with caregivers and providers using Liberation Psychology
Advances in Nursing Science; by Patricia Buzelli, Tolu O Oyesanya, Angelli Aguilar, Rosa M Gonzalez-Guarda; 8/26
This study explored the challenges and strengths shaping Latine families' experiences of pediatric loss in the United States context. Eighteen semistructured interviews with healthcare providers (n = 7) and bereaved Latine caregivers (n = 11) were carried out using an integrated qualitative descriptive and Liberation Psychology approach. Four themes emerged that are heavily shaped by individual and contextual factors: (1) Unsupportive and hegemonic systems, (2) caregiver and provider discordance regarding end-of-life care, (3) caregiver identity transcendence in the "natural distress of grief," and (4) supportive networks and their limitations. Results highlight sociocultural realities that inform needed structural, policy, and practice changes.

[UK] A policy scoping review of how ‘Hospitals at Home’ can and could support people with dementia 
Age & Ageing; by Anthony Zheng Wang, Anita Wong, Nathan Davies, Sevim Hodge, Elizabeth L Sampson, Victoria Vickerstaff, Kate Walters, Catherine J Evans, Mark James Rawle, Jane Ward, Simon Conroy, Bastien Genet, Claudia Cooper; 8/26
People with dementia are often hospitalised due to comorbidities and superimposed delirium and have poorer outcomes in hospital compared to people without dementia, especially among under-served groups. Hospital at Home (HaH) schemes could reduce these inequalities by facilitating care in a familiar home environment that offers similar outcomes to acute hospital care with lower risks of harms. We developed three themes: (i) benefits of HaH for people with dementia, including more person-centred care and familiar treatment environments; (ii) how HaH can be inclusively designed for people with dementia, accommodating needs and mitigating concerns over digital exclusion and safety; and (iii) the critical role of family carers in enabling HaH, including potential carer burden. Future policies should drive consistent inclusive eligibility criteria and processes for ensuring continuity with primary care, dementia care as a HaH staff core competency.

Success is not the key to happiness. Happiness is the key to success. If you love what you are doing, you will be successful.  ~Albert Schweitzer