There is need for increased and explicit focus on concepts of culture in nursing education programs to prepare nurses for culturally congruent practice with potential to reduce health disparities.

Specialty certification enhances patient safety in health care by validating that practice is consistent with standards of excellence. The purpose of this research was to explore the relationship between direct-care, specialty-certified nurses employed in perioperative units, surgical intensive care units (SICUs), and surgical units and nursing-sensitive patient outcomes in SICUs and surgical units. Lower rates of central-line-associated bloodstream infections in SICUs were significantly associated with higher rates of CPAN (certified postanesthesia nurse) (β = -0.09, P = .05) and CNOR/CRNFA (certified nurse operating room/certified RN first assistant) (β = -0.17, P = .00) certifications in perioperative units. Unexpectedly, higher rates of CNOR/CRNFA certification in perioperative units were associated with higher rates of hospital-acquired pressure ulcers (β = 0.08, P = .03) and unit-acquired pressure ulcers (β = 0.13, P = .00), possibly because of a higher risk of pressure ulcers in the patient population. Additional research is needed to clarify this relationship. Our findings lend credence to perioperative, SICU, and surgical nurses participating in lifelong learning and continuous professional development, including achievement of specialty certification.

Often, research strategies are guided by principles developed based on mainstream U.S. cultural norms. Immigrants, however, may differ in their cultural backgrounds and previous exposure to research. Commonly adopted research procedures, such as the informed consent process, may be culturally inappropriate for research with culturally diverse populations, and hence require cultural adaptations. Based on two qualitative studies, this paper describes the methodological issues encountered in the field when working with Chinese and Kenyan immigrants, and explains how these issues were resolved. Comparing and synthesizing experiences from the two studies, recommendations for methodological adaptations when working with immigrant populations are provided. Specifically, suggestions on how to prepare the research protocol, recruit participants, obtain informed consent, deal with unanticipated incidents during the research process, and choose the interview language(s) are discussed in depth.