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This article reviews the life course perspective and considers various life course hypotheses such as trajectories, transitions, critical periods, sequencing, duration, and cumulative effects. Hierarchical regression and structural equation modeling are suggested as analyses to use in life course research. Secondary analysis was performed on the Early Head Start Research and Evaluation Study, 1996-2010, to illustrate their strengths and challenges. Models investigated the influence of mother and infant characteristics and of parent-child dysfunction at 14 and 24 months to children's cognitive outcomes at 36 months. Findings were interpreted and discussed in the context of life course hypotheses. [ABSTRACT FROM AUTHOR]

This article describes the development and preliminary evaluation of the Healthy Workplace Index (HWPI), a 37-item scale measuring essential components of healthy workplace (HWP) environments. The HWPI was based on Parsons' Healthy Workplace Intervention framework and is rooted in staff empowerment, shared leadership, and participatory change management. Participants were staff nurses (n = 160) at a large university teaching hospital in the southwestern United States. Preliminary analyses supported the existence of 4 factors on the HWPI, with reliability coefficients for internal consistency ranging from 0.88 to 0.93. Factor scores from the HWPI were correlated to 5 subscale scores of the Practice Environment Scale of the Nursing Work Index (PES-NWI) to determine their degree of shared relationships. Relationships between subscales of PES-NWI and the HWPI factors were strong and positive, suggesting that researchers may be able to substitute the HWPI for the PES-NWI to measure HWP characteristics. Potential advantages for HWPI substitution include the ability to measure different aspects of HWPs and the use of a tool that nurses and staff can complete. [ABSTRACT FROM AUTHOR]

Objective: To validate the defining characteristics of the nursing diagnoses, impaired memory and chronic confusion for older adults, by testing diagnostic concept definitions among expert nurses., Methods: We used a Diagnostic content validation using an online survey of expert clinical nurses., Results: 195 expert nurses performed the diagnostic validations. Findings provided validity of impaired memory with 11 major defining characteristics and chronic confusion, with 11 major and one minor defining characteristics. In both diagnoses, content validity index was 0.85. Factor analysis provided four and five supported factors for impaired memory and chronic confusion, respectively., Conclusion: The study provided evidence of validity of the two diagnoses and made them clearer. Using these updated nursing diagnoses, nurses have the potential to improve accuracy and quality of care for elderly patients, contributing to more accurate nursing gerontological care.

Knowledge of sampling methods is essential to design quality research. Critical questions are provided to help researchers choose a sampling method. This article reviews probability and non-probability sampling methods, lists and defines specific sampling techniques, and provides pros and cons for consideration. In addition, issues related to sampling methods are described to highlight potential problems.

Background: Studies on nurse competence on alarm management are a few and tend to be focused on limited skills. In response to Phase II of implementing the National Patient Safety Goal on clinical alarm systems safety, this study assessed nurses' perceived competence on physiologic monitors use in intensive care units (ICUs) and developed and validated a tool for this purpose., Methods: This descriptive study took place in a Magnet hospital in a Southwestern state of the U.S. A Nurse Competence on Philips Physiologic Monitors Use Survey was created and went through validation by 13 expert ICU nurses. The survey included 5 subscales with 59 rated items and two open-ended questions. Items on the first 4 subscales reflect most common tasks nurses perform using physiologic monitors. Items on the fifth subscale (advanced functions) reflect rarely used skills and were included to understand the scope of utilizing advanced physiologic monitors' features. Thirty nurses from 4 adult ICUs were invited to respond to the survey., Results: Thirty nurses (100%) responded to the survey. The majority of nurses were from Neuro (47%) and Surgical Trauma (37%) ICUs. The data supported the high reliability and construct validity of the survey. At least one (3%) to 8 nurses (27%) reported lack of confidence on each item on the survey. On the first four subscales, 3% - 40% of the nurses reported they had never heard of or used 27 features/functions on the monitors. No relationships were found between subscales' scores and demographic characteristics ( p > .05). Nurses asked for training on navigating the central-station monitor and troubleshooting alarms, and the use of unit-specific super users to tailor training to users' needs., Conclusion: This is the first study to create and test a list of competencies for physiologic monitors use. Rigorous, periodic and individualized training is essential for safe and appropriate use of physiologic monitors and to decrease alarm fatigue. Training should be comprehensive to include all necessary skills and should not assume proficiency on basic skills. Special attention should be focused on managing technical alarms. Increasing the number of super users is a recommended strategy for individualized and unit-specific training. There is a need for a usability testing of complex IT-equipped medical devices, such as physiologic monitors, for effective, efficient and safe navigation of the monitors.

Background: Published studies have supported the implementation of tight glucose control (TGC) programs to improve patient outcomes and reduce mortality rates. However, measuring a program's efficiency is challenging, because of a lack of systems that capture data, allow access to data, and support analysis and interpretation in a near prospective time frame. We hypothesized that providing clinicians access to real-time blood glucose (BG) results reports could improve the efficacy of our TGC program., Methods: We performed a retrospective review of BG data during a 12-month period in a surgical trauma intensive care unit at a level I trauma center. A unit-specific insulin algorithm was used throughout the study. We compared BG values before and after the implementation of a data management software program that allowed clinicians access to real-time BG results reports. Reports were run daily and weekly to monitor the unit's TGC program., Results: A total of 70 616 BG values from 1044 patients were analyzed. An overall decrease was observed in the BG level mean, from 121 mg/dL to 112 mg/dL (P < .001), as well as a decrease in the aggregated mean across patients, from 132 mg/dL to 119 mg/dL (P < .001), after implementation of the software. The percentage of values within the target range of 80 to 110 mg/dL increased from 38.9% to 50.4% (P < .001). The percentage of BG values less than 70 increased from 2.7% to 3.4% (P < .001). However, the percentage of severe hypoglyce-mic episodes (≤ 40 mg/dL) remained unchanged., Conclusions: Access to real-time aggregated BG data reports through the use of a data management software program improved the efficacy of our TGC program.