Patients Safety Culture: A Baseline Assessment Of Nurses\u27 Perceptions In A Saudi Arabia Hospital

ABSTRACT PATIENT SAFETY CULTURE: A BASELINE ASSESSMENT OF NURSES\u27 PERCEPTIONS IN A SAUDI ARABIA HOSPITAL by AHMAD E. ABOSHAIQAH May 2010 Advisor: Dr. Stephen J. Cavanagh Major: Nursing Degree: Doctor of Philosophy Patient safety (the avoidance and prevention of patient injuries or adverse events resulting from the processes of health care delivery) has become a major academic and public concern in healthcare. In order to promote and sustain a culture of safety in a healthcare organization, healthcare professionals stress the need to understand both individual and system contributions to error events. However, in Saudi Arabia, little is known about nurses\u27 perceptions of patient safety culture. The purpose of this research is to identify the systems factors that Registered Nurses (RNs) perceive as contributing to a culture of patient safety and to study the effects these perceptions have on nurses\u27 participation and engagement in the patient safety culture at King Fahad Medical City (KFMC), Saudi Arabia. King\u27s conceptual system was utilized as the theoretical framework for this study. This study used a quantitative research methodology with a descriptive/correlation design. The sample of this study was registered RNs at KFMC, Saudi Arabia. The Hospital Survey on Patient Safety Culture (HSOPSC) instrument was used to measure perceptions of nurses on patient safety culture. Copies of the surveys were distributed to 600 RNs. A total of 500 questionnaires were returned. Among these returned questionnaires, 55 were excluded because they had missing responses on more than one complete section of the questionnaire. The total response rate for this study was 83%. Overall, 52% of the nurses positively perceived patient safety culture at KFMC, which is considered an opportunity for improvement according to AHRQ\u27s definition of areas needing improvement. Nurses responded most positively to two dimensions, hospital management support for patient safety and organizational learning. Nurses responded most negatively to the dimensions of hospital handoffs and transitions, communication openness, non-punitive response to error, and supervisor/manager expectations and actions promoting patient safety. There were significant differences between nurses\u27 perceptions of patient safety culture and gender, age, years of experience, Arabic vs. non-Arabic speaking, and length of shift; but astonishingly, for level of education, the results were not significantly correlated to any of the HSOPSC dimensions. Findings from this study provide a description of the current status of patient safety at King Fahad Medical City from the nurses\u27 perspective. The findings will not only provide a baseline from which to work, but they will help raise safety awareness throughout the organization and identify areas most in need of improvement. Findings will lead to the development of interventions to improve patient safety in Saudi Arabia hospitals

The Effects of Quinacrine, Proglumide, and Pentoxifylline on Seizure Activity, Cognitive Deficit, and Oxidative Stress in Rat Lithium-Pilocarpine Model of Status Epilepticus

The present data indicate that status epilepticus (SE) induced in adult rats is associated with cognitive dysfunctions and cerebral oxidative stress (OS). This has been demonstrated using lithium-pilocarpine (Li-Pc) model of SE. OS occurring in hippocampus and striatum of mature brain following SE is apparently due to both the increased free radicals production and the limited antioxidant defense. Pronounced alterations were noticed in the enzymatic, glutathione-S transferase (GST), catalase (CAT), and superoxide dismutase (SOD), as well as in the nonenzymatic; thiobarbituric acid (TBARS) and reduced glutathione (GST), indices of OS in the hippocampus and striatum of SE induced animals. Quinacrine (Qcn), proglumide (Pgm), and pentoxifylline (Ptx) administered to animals before inducing SE, were significantly effective in ameliorating the seizure activities, cognitive dysfunctions, and cerebral OS. The findings suggest that all the drugs were effective in the order of Ptx < Pgm < Qcn indicating that these drugs are potentially antiepileptic as well as antioxidant; however, further studies are needed to establish this fact. It can be assumed that these antiepileptic substances with antioxidant properties combined with conventional therapies might provide a beneficial effect in treatment of epilepsy through ameliorating the cerebral OS

Advancing nursing practice : the emergence of the role of Advanced Practice Nurse in Saudi Arabia

Background: The roots of advanced practice nursing can be traced back to the 1890s, but the Nurse Practitioner (NP) emerged in Western countries during the 1960s in response to the unmet health care needs of populations in rural areas. These early NPs utilized the medical model of care to assess, diagnose and treat. Nursing has since grown as a profession, with its own unique and distinguishable, holistic, science-based knowledge, which is complementary within the multidisciplinary team. Today Advanced Practice Nurses (APNs) demonstrate nursing expertise in clinical practice, education, research and leadership, and are no longer perceived as “physician replacements” or assistants. Saudi Arabia has yet to define, legislate or regulate Advanced Practice Nursing. Aims: This article aims to disseminate information from a Saudi Advanced Practice Nurse thought leadership meeting, to chronicle the history of Advanced Practice Nursing within the Kingdom of Saudi Arabia, while identifying strategies for moving forward. Conclusion: It is important to build an APN model based on Saudi health care culture and patient population needs, while recognizing global historical underpinnings. Ensuring that nursing continues to distinguish itself from other health care professions, while securing a seat at the multidisciplinary health care table will be instrumental in advancing the practice of nursing

The work engagement of nurses in multiple hospital sectors in Saudi Arabia: A comparative study

Aim: To examine the differences in work engagement among nurses in Saudi Arabia and its relationship with personal characteristics across different hospital affiliations. Background: Quality care requires an adequate supply of engaged nurses who are dedicated, energised and absorbed in their work. In the nursing profession, work engagement is of considerable importance, owing to the shortage of nurses and the continuing reduction in healthcare costs. Method: An analytic comparative cross-sectional design was used. Eight hospitals from three provinces and different affiliation types participated in the study. The Utrecht work engagement scale (UWES) was used to measure 980 nurses\u27 work engagement. Results: The findings indicate that nurses\u27 total engagement scores were closer to the higher end of the Likert scale. The findings indicate generally high levels of work engagement, particularly regarding the element of dedication. Furthermore, the study shows significant differences in nurses\u27 engagement among the various work settings and in nurses\u27 age and experience. Conclusions: A number of nurses\u27 personal characteristics have independent influences on their work engagement. Implications for Nursing Management: Nurse leaders should acknowledge that a statement of professional nursing scope of practice is a necessity to encourage and fulfil engagement

Impact of work environment perceptions and communication satisfaction on the intention to quit: an empirical analysis of nurses in Saudi Arabia

Objective In consideration of the current nursing shortage in Saudi Arabia, we aimed to investigate the association among perceptions of work environment, communication satisfaction, and intentions to quit nursing profession among nurses. In addition, we aimed to investigate the mediating effect of communication satisfaction on the association between nurses’ perception of work environment and their intentions to quit nursing profession. Methods This predictive correlational study was conducted at one of the major hospitals in Saudi Arabia from January 2020 to March 2020. It included a convenience sample of 367 full-time registered nurses who completed three types of close-ended questionnaires. We used IBM SPSS version 24.0 to analyze the collected data. Regression analyses were used to test the study’s hypotheses. All regression assumptions were assessed and confirmed. Significance for all tests was set at p ≤ .05. Results The findings indicated an affirmative association between work environment perception and communication satisfaction (b = .764, p < .05) among nurses. In addition, findings showed that work environment perception (b = −.187, p < .05) and communication satisfaction (b = −.226, p < .05) have negative impacts on the nurses’ intentions to quit; indicating that as work environment perception or communication satisfaction increases, the intention to quit decreases among nurses. Further, a mediation effect of communication satisfaction on the relationship between work environment perception and intention to quit was confirmed. Conclusion This study presents a novel conceptual framework developed based on the literature about the predisposing factors for nurses’ intentions to quit nursing profession. Our results suggest that work environment perception and communication satisfaction among the most contributing factors for nurses resignation. Effective communication was established as a crucial factor for establishing attractive and healthy working environment. Nursing managers can benefit by applying these findings to develop appropriate strategies to inhibit the shortage of nurses in Saudi Arabia