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Journal: Western journal of nursing research


The purpose of this study is to examine the effectiveness of surgical safety checklists on teamwork, communication, morbidity, mortality, and compliance with safety measures through meta-analysis. Four meta-analyses were conducted on 19 studies that met the inclusion criteria. The effect size of checklists on teamwork and communication was 1.180 (p = .003), on morbidity and mortality was 0.123 (p = .003) and 0.088 (p = .001), respectively, and on compliance with safety measures was 0.268 (p < .001). The results indicate that surgical safety checklists improve teamwork and communication, reduce morbidity and mortality, and improve compliance with safety measures. This meta-analysis is limited in its generalizability based on the limited number of studies and the inclusion of only published research. Future research is needed to examine possible moderating variables for the effects of surgical safety checklists.

Concepts: Gene V. Glass, Medical statistics, Effectiveness, Effect, Effect size, Meta-analysis


Barcode medication administration (BCMA) systems can reduce medication errors, but sociotechnical issues are quite common. Although crucial to nurses' work, few usability evaluations are available for electronic medication administration record (eMARs) screens. The purpose of this research was to identify current usability problems in the Veterans Administration’s (VA) eMAR/BCMA system and explore how these might affect nurses' situation awareness (SA). Three expert evaluators used 10 tasks/elements, heuristic evaluation techniques, and explored potential impacts using a SA perspective. The results yielded 99 usability problems categorized into 440 heuristic violations with the largest volume in the category of Match With the Real World. Fifteen usability issues were rated as catastrophic with the Administer/Chart medications task having the most. Situational awareness was affected at all levels, especially at Level 2, Comprehension. Usability problems point to important areas for improvement, because these issues have the potential to affect nurses' SA, “at a glance” information, nurse productivity, and patient safety.

Concepts: The Real World, Affect, Nurse, Pharmaceutical drug, Patient safety, Usability, Heuristic evaluation, Evaluation


Cultural diversity in health care settings can threaten the well-being of patients, their families, and health care providers. This psychometric study evaluated the construct validity of the recently developed four-factor, 43-item Critical Cultural Competence Scale (CCCS) which was designed to overcome the conceptual limitations of previously developed scales. The study was conducted in Canada with a random sample of 170 registered nurses. Comparisons with the Cultural Competence Assessment instrument, Scale of Ethnocultural Empathy, and Cultural Intelligence Scale provided mixed evidence of convergent validity. Modest correlations were found between the total scale scores suggesting that the CCCS is measuring a more comprehensive and conceptually distinct construct. Stronger correlations were found between the more conceptually similar subscales. Evidence for discriminant validity was also mixed. Results support use of the CCCS to measure health care providers' perceptions of their critical cultural competence though ongoing evaluation is warranted.

Concepts: Measurement, Logic, Nursing, Health care provider, Construct validity, Health care, Validity, Psychometrics


The Kidney Disease Quality of Life-36 Questionnaire (KDQOL-36™), modified by RAND, has been widely used for measurement of quality of life among hemodialysis or peritoneal dialysis patients. The purpose of this study was to refine and evaluate, by using confirmatory factor analysis, the structure of the KDQOL-36™ when the questionnaire was used to evaluate chronic kidney disease patients in Stages 1 to 5 in Taiwan. The psychometric properties of the translated version were determined among Mandarin-speaking adults (N= 428). Because the sample data did not fit the hypothetical model, one item was deleted and nine error terms were estimated. After improving the model fit, the modified model was presented as follows: χ(2)= 1390.903, χ(2)/df= 2.711,p< .001, goodness-of-fit index = .833, adjusted goodness-of-fit index = .806, root mean square error of approximation = .063. According to the study results, the researchers suggest that because of content overlap, some items may be deducted from the KDQOL-36™.

Concepts: Peritoneal dialysis, Kidney, Root mean square, Factor analysis, Peritoneum, Nephrology, Dialysis, Chronic kidney disease


This study explored using big data, totaling 66 terabytes over 10 years, captured from sensor systems installed in independent living apartments to predict falls from pre-fall changes in residents' Kinect-recorded gait parameters. Over a period of 3 to 48 months, we analyzed gait parameters continuously collected for residents who actually fell (n = 13) and those who did not fall (n = 10). We analyzed associations between participants' fall events (n = 69) and pre-fall changes in in-home gait speed and stride length (n = 2,070). Preliminary results indicate that a cumulative change in speed over time is associated with the probability of a fall (p < .0001). The odds of a resident falling within 3 weeks after a cumulative change of 2.54 cm/s is 4.22 times the odds of a resident falling within 3 weeks after no change in in-home gait speed. Results demonstrate using sensors to measure in-home gait parameters associated with the occurrence of future falls.

Concepts: Sensor, Independent living, Resident, Future, Probability theory, Gait


As the nursing faculty shortage persists, there is an urgent need to develop emerging nurse scholars into research leaders capable of advocating for the profession and expanding on the mission to improve health. To address this need, the Midwest Nursing Research Society (MNRS) commissioned a student task force that led to the development of the Emerging Scholars Network (ESN). The purpose of this article is to describe how the ESN was developed, integrated, and promoted within the MNRS to advance the overall mission and sustainability of the society. The establishment and success of the ESN is described using the Five Developmental Stages of Organization Evolution. These stages include the following: (a) Developing a Concept; (b) Launching a Start-Up; © Establishing Credibility; (d) Creating Sustainability; and (e) Road to Maturing and Legacy. Recommendations for continued development of the ESN are provided.


This study examined the effects of macronutrient diets on sleep quantity and quality. Using a repeated-measures, randomized crossover study design, 36 young adults served as their own control, and consumed high protein, carbohydrate, fat, and control diets. Treatment orders were counterbalanced across the dietary groups. Following consumption of the study diets, sleep measures were examined for within-subject differences. Fatty acid intakes and serum lipids were further analyzed for differences. Sleep actigraphs indicated wake times and wake minutes (after sleep onset) were significantly different when comparing consumption of macronutrient diets and a control diet. Post hoc testing indicated high carbohydrate intakes were associated with significantly shorter (p < .001) wake times. Also, the Global Pittsburgh Sleep Quality Index© post hoc results indicated high fat intake was associated with significantly better (p < .05) sleep in comparison with the other diets. These results highlight the effects that dietary manipulations may have on sleep.

Concepts: Fatty acid, Diet, Biochemistry, Lipid, Metabolism, Protein, Fat, Nutrition


Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse’s health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample (N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores (p = .002) and lower mental health scores (p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

Concepts: Health, Medicine, Epidemiology, Abuse, Bullying, Health care, Workplace bullying, Nursing


Breastfeeding rates are lowest among Black women than women of other races. An understanding of infant feeding attitudes may help improve breastfeeding rates among Black women. The theory of planned behavior guided this study to explore infant feeding attitudes of Black college students and the contribution of attitudes to breastfeeding intentions after controlling for age, gender, income, and education level. A sample of 348 Black college students below 45 years old with no children and no history of pregnancies were recruited for this study. The Iowa Infant Feeding Attitude Scale and a Demographic Questionnaire were used to collect data. Participants agreed that breast milk is the ideal food for infants and 48% indicated high probability of breastfeeding intentions. Infant feeding attitudes also explained approximately 30% (Nagelkerke R(2)) of the variance in breastfeeding intentions. Therefore, breastfeeding interventions targeting Black women should focus on improving breastfeeding attitudes.

Concepts: Breast milk, Pregnancy, Baby bottle, Race, Childbirth, Milk, Infant, Breastfeeding


The purpose of this study was to examine the nutritional effects on sleep using actigraphy measures. A repeated-measures, counterbalanced, crossover study design was used to administer treatment diets to 44 adult participants. Participants served as their own control and consumed high-protein, high-fat, high-carbohydrate, and control diets. The study participants wore Motionlogger Actigraph sleep watches while consuming weighed food intakes for 4 days over four different treatment periods. Demographic and laboratory data were also analyzed. Actigraph results showed that the wake episodes and sleep latencies were significantly different when comparing the macronutrient intakes of the participants. Post hoc test results showed that high-protein diets were associated with significantly fewer (p = .03) wake episodes and high-carbohydrate diets were associated with significantly shorter (p < .01) sleep latencies than control diets. Thus, consumption of specific macronutrient intakes may have a significant influence on sleep.

Concepts: Tuberculosis, Post-hoc analysis, Clinical research, Polysomnography, Actigraphy, Crossover study, Nutrition, Circadian rhythm