One in four American older adults fall every year, resulting in injuries, death, and significant financial burden. Although fall etiology is multifactorial, the medical problems and aging factors that lead to unsteady gait and imbalance represent one of the major fall risks among older adults. A growing number of research studies support the health benefits of regular Tai Chi (TC) practice including improved physical, cognitive, and psychological function. The purpose of this quality improvement project was to assess the feasibility of establishing a 12-week (45 min per session) Tai Chi (TC) program (Sun Style Tai Chi) in a 75 bed assisted living facility as well as to evaluate the potential of the TC program to improve the fear of falling and functional mobility (as proxy for fall risk) and quality of life (QoL). A nurse who was a certified TC instructor taught the program. Twenty-three participants, 96% female and 96% white, mean (SD) age 83 (±7) years, attended one or more TC classes. Class attendance, self-reported questionnaires (e.g., fear of falling, QoL), and objective measure Timed Up and Go (TUG) were used to collect data. Nine participants (39%) completed 9 out of 12 sessions. Eleven participants (48%) completed both pre- and post-intervention measurements and twelve (52%) provided feedback on a post-intervention satisfaction survey. Participants showed 20% improvement in fear of falling (mean relative change) and 21% decrease (mean relative change) in TUG test (p = 0.001) with no clinically important changes in QoL. This quality improvement project suggested that TC is a feasible exercise that might have the potential to reduce risk of falls in older adults, and the program was well accepted with no serious or other adverse events reported. Further research studies are needed to examine the potential effects of TC programs with an appropriately powered RCT and longer intervention period.

Interactive educational sessions on spirituality can improve a health-care team's attitudes, comfort level, and practice of providing spiritually based care. Generalizability is limited to the project site, but the process could be implemented in other facilities to determine if similar results can be achieved.

Nurses have traditionally provided care that is inherently integrative in nature, and they continue to utilize these approaches across contemporary healthcare settings. This chapter explores the state of nursing as an integrative healthcare profession. The American Nurses Association (ANA) has called for nursing to embrace an integrative approach to care, and a comparison of integrative nursing principles and values with the current version of the ANA’s Scope and Standards of Practice reveals significant congruency with several areas calling for increased alignment. Recognizing this alliance strongly suggests that integrative nursing is not a specialty practice and does not merit separate scope and standards statements or additional certification examinations. Additionally, an increasing number of professional organizations and state boards of nursing provide parameters for integrative nursing practice, including guidelines for the safe implementation of specific health promoting and healing modalities.

The use of complementary and integrative health therapy strategies for a wide variety of health conditions is increasing and is rapidly becoming mainstream. However, little is known about how or if complementary and integrative health therapies are represented in the EHR. Standardized terminologies provide an organizing structure for health information that enable EHR representation and support shareable and comparable data; which may contribute to increased understanding of which therapies are being used for whom and for what purposes. Use of standardized terminologies is recommended for interoperable clinical data to support sharable, comparable data to enable the use of complementary and integrative health therapies and to enable research on outcomes. In this study, complementary and integrative health therapy terms were extracted from multiple sources and organized using the National Center for Complementary and Integrative Health and former National Center for Complementary and Alternative Medicine classification structures. A total of 1209 complementary and integrative health therapy terms were extracted. After removing duplicates, the final term list was generated via expert consensus. The final list included 578 terms, and these terms were mapped to Systemized Nomenclature of Medicine Clinical Terms. Of the 578, approximately half (48.1%) were found within Systemized Nomenclature of Medicine Clinical Terms. Levels of specificity of terms differed between National Center for Complementary and Integrative Health and National Center for Complementary and Alternative Medicine classification structures and Systemized Nomenclature of Medicine Clinical Terms. Future studies should focus on the terms not mapped to Systemized Nomenclature of Medicine Clinical Terms (51.9%), to formally submit terms for inclusion in Systemized Nomenclature of Medicine Clinical Terms, toward leveraging the data generated by use of these terms to determine associations among treatments and outcomes.

Purpose The aim of the study was to increase interprofessional functional nutrition and mindful eating education interventions that improve patient-driven/value-based Whole Health care among patients with spinal cord injury and neurologic disorders. Design Pilot quality improvement project, pre–post design was used in the study. Methods Functional nutrition and mindful eating Whole Health interventions were implemented through a preestablished education program over 6 weeks in a Veterans Affairs healthcare facility. Findings An increased level of participants’ self-awareness related to internal (60.6%) and external (54.5%) food environments was apparent. The evaluation of the Personal Health Inventory was indicative of value-based improvement on the “Food and Drink” component (35.7%), whereas 21.4% of participants reported a value-based improvement in “Power of the Mind.” Conclusion Interprofessional nutrition and mindful eating interventions, and personal health assessment tools support Whole Health care for management of chronic disease. Clinical Relevance Nutrition and mindfulness group education can be implemented into clinical care. The project modeled successful interprofessional collaboration.