Innovation isn’t new to nurses. And it certainly didn’t start with Covid-19. In fact, nurses are naturals when it comes to innovation, albeit often in ways that go unrecognized and under-appreciated, except perhaps by those who benefit from their brilliant problem-solving abilities.
Take Florence Nightingale, the founder of nursing. Based on data she collected and analyzed, Nightingale implemented significant improvements in sanitation in military hospitals during the Crimean War. This included making “handwashing, bathing, and other principles of asepsis and infection control mandatory,” helping reduce infection rates by two thirds.
Less well known is Nightingale’s use of statistics to further improve patient care and reduce mortality rates. She referred to statistics as “the most important science in the world,” using “her version of root cause analysis” to identify that British soldiers were more likely to die from diseases linked to unsanitary conditions such as typhoid and cholera than battle injuries.
Many of Nightingale’s healthcare principles including handwashing, sanitation, and aseptic technique continue as cornerstones of high-quality healthcare in hospitals today.
Several other nursing innovations since then have significantly improved patients’ quality of life including:
- Sister Jean Ward’s discovery (1958) that sunlight was effective in dramatically improving neonatal jaundice as she took newborns with jaundice outside, often against physicians’ wishes. Her discovery led to the research of phototherapy for neonatal jaundice, still used today.
- Anita Dorr’s invention of the first “Crisis Cart” (1967) for responding to medical emergencies in the emergency department she worked in. Her prototype is the basis for today’s modern-day “crash cart”, used in hospitals around the world.
- Brian Mohika’s design and creation of medical underwear known as CathWear (2012) for patients suffering with the difficulties of wearing and managing a leg bag for urine collection.
- Rebecca Koszalinski’s development of the Speak for Myself® mobile app (2016) designed to help voiceless patients express their needs.
Nurses are ‘naturals’ at innovation
When the pandemic hit in early 2020, nurses found themselves working during a global healthcare crisis filled with unknowns and not enough material or human resources to meet the ever-growing need. Not surprisingly, this created the perfect storm for nursing innovation to emerge full force—out of necessity.
As researchers point out, “Nurses are pragmatic by nature and, both before and during the pandemic, have demonstrated their capacity for designing technologies and products for optimal user-friendliness, adoption and clinical use” including “entirely new models of care delivery”.
As healthcare systems have been stretched to their breaking point, nurses have been left to rely on themselves, each other, and the healthcare team if they and their patients are to make it through this ordeal. Since the pandemic began, nurses knew they had to take matters into their own hands which meant relying on their expertise and innate creativity to come up with solutions to problems, many that didn’t previously exist.
Roadblocks to nursing innovation
Despite being “naturals” at innovation, nurses encounter many barriers when trying to implement new ideas.
A recent study shows that “While nurses have high-potential ideas with the power to change healthcare delivery in significant ways,” a lack of time, significant nursing responsibilities, and not knowing the available “channels” to bring their ideas forward to, results in many nurses abandoning their idea or giving it to someone else to develop.
However, these barriers often begin with nursing education that focuses its attention on clinical experience without encouraging the development of new ideas and ways of “doing” nursing. Coupled with this is the expectation of healthcare leaders that nurses will address patients’ “pain points” without asking for their help in formulating a solution. As Handzel (2021) explains, “Organizational hierarchies tend to use nurse engagement for buy-in instead of fostering and implementing problem solving solutions.”
When a nurse does manage to overcome these challenges and get their idea off the ground, they encounter other hurdles such as lack of funds for developing a prototype or piloting their idea. An often lengthy “trial and error” period implementing the new concept with patients and their caregivers then follows. And obtaining agreement on best practices from colleagues and healthcare team members for a new idea can be difficult, as is attempting to bring a product to market “when nurses just want to see it ‘get out there’.”
Recommendations for fostering future nursing innovation
In the first of 3 research papers titled Accelerating Nursing, Transforming Healthcare: Chapter 1 – Care Delivery, nurse researchers and nurse leaders from Johnson & Johnson (J&J), the American Nurses Association (ANA), and the American Organization for Nursing Leadership (AONL) partnered together to complete research about frontline nurses and nurse leaders during the Covid-19 pandemic. Their goal was to “capture the critical lessons learned” so they could be used “as the world moves into a new normal.”
Researchers found that new nursing ideas and strategies were welcomed and tested more quickly as pre-pandemic organizational barriers were removed, out of necessity. “In many cases, these shifts in strategies resulted in improved patient outcomes as well as organizational efficiencies.”
A key recommendation from the study is that healthcare organizations and those in leadership positions continue to be willing to change by adopting a “risk-friendly” mindset (that) can usher in more innovative models of care moving forward.” This includes “fast-fail” piloting of ideas and greater use of modern healthcare technology that enables nurses to provide more equitable and timely patient care.
And finally, the study concludes that nursing innovation “must be encouraged and facilitated by peers, health systems, regulatory agencies and nursing boards”. Interdisciplinary teamwork is the mechanism for bringing new ideas forward by helping them move through the appropriate channels that allow for them to be trialed and put into practice.
Resources for nurse innovators
Having an innovative idea is one thing; overcoming the barriers to exploring that idea is another. However, if a nurse is fortunate enough to get past some of the initial roadblocks, they’ll need significant help and resources to give their idea legs.
The good news is, the number of resources available to support nursing innovation has grown rapidly over the last 5 years.
Resources such as opportunities to network with like-minded nurses and entrepreneurs, as well as nurse researchers with expertise in data collection and statistical analysis. Facilitation of intersectoral collaboration and access to diverse partnerships crucial for product or concept development are also more readily available.
And, last, but not least—nurses now have access to much-needed and substantial financial support for nurse-led projects in the form of grants, awards, and fellowships.
If you, or a nurse leader or nurse you know, needs help exploring, developing, or launching an innovative nursing idea, the following resources offer some excellent assistance:
- SONSIEL (Society of Nurse Scientists Innovators Entrepreneurs & Leaders) – “the first and only Nursing organization committed to educating and empowering Nurses to discover, invent, and pioneer products, processes, services, and platforms”. – https://sonsiel.org
- Project NeLL (Nurse’s Electronic Learning Library) – a big data tool designed by nurses at Emory School of Nursing for nurses, to “explore vast stores of patient data, extract trends, create engaging data-visualization graphics, and download data sets directly to their computers.” – https://emorynursingmagazine.emory.edu/issues/2020/fall-winter/features/transforming-research/index.html
- American Nurses Association (ANA) Innovation – an initiative of the ANA to help inspire, connect, and provide resources for nurse innovators. – https://www.nursingworld.org/practice-policy/innovation/
- The Nursing Innovations Fund – https://campaignforaction.org/our-network/grantee-and-award-programs/the-nursing-innovations-fund/
- The Future of Nursing: Campaign for Action – founded by the country’s largest philanthropy devoted to health, the Robert Wood Johnson Foundation, along with AARP Foundation, and AARP, this “nationwide initiative” is “designed to harness the power of nursing to help all Americans lead longer, healthier lives.” – https://campaignforaction.org/resource/looking-for-funding/
- Johnson & Johnson Nurse Innovation 101 Hub – provides key resources for and “celebrates” the work of nurse innovators. – https://nursing.jnj.com/nursing-news-events/nurses-leading-innovation/ready-set-innovate-explore-the-nurse-innovation-101-hub-today
One nurse innovator’s journey
Nurses like Becky Cherney, don’t go into nursing to become entrepreneurs. Nurses become nurses first and foremost to help people. Maybe a mom, dad, aunt or someone they know is a nurse. And that nurse leaves the indelible imprint on them that nurses literally change patients’ lives.
But, along the way – helping patients and families through sickness, injury, pain, disease, suffering, birth, and death – they see so many ways to help their patients even more.
They get an idea—a very rough idea, with lots of missing pieces, but still, a much better idea than what’s currently being used or done. They struggle, work hard, and somehow make it happen, with the encouragement and help of many others. This idea then changes the life of one patient, then another, and another.
Becky Cherney’s “innovation journey” began after she lost a patient with a tracheotomy. In her words, she wanted to “learn more about tracheostomies and what critical care interventions are required by healthcare professionals in a tracheostomy emergency.” From this came her work developing Trach Trail, “a standardized tracheostomy pathway that reduces length of stay through tracheostomy education, coordinated care protocols, and tracking patient outcomes.”
As recipient of the 2021 ANA Individual Innovation Award, she explains, “through all the ups and downs of working to bring this innovation to life, my inspiration has continued to be the patients and their caregivers themselves—that first patient of mine with a trach who passed, and all the others I’ve cared for since….Nursing innovation is critical to healthcare and can be the way of the future if we just let our patients, and their families, lead us…”
That’s who nurses are. That’s how nursing innovation happens.
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Leona Werezak MN, BSN, RN is a freelance nurse writer. She has worked as a nurse in a variety of positions at the bedside for 13 years and as a nurse manager. From there, she began teaching nursing in BSN programs for the next 20 years. As a freelance nurse writer, she now writes online content for healthcare and medical businesses, nursing schools and colleges, as well as various nursing sites.