Towards a multidimensional approach to measure quality and safety of care in maternity units in Oman

Improving the quality and safety of maternity services is an international top agenda item. This thesis describes the progress towards the development of a multidimensional approach to measure the quality and safety of care in ten maternity units in Oman based on three of the five dimensional Patient Safety Measurement and Monitoring Framework (PSMMF) which include measuring "past harm" and "anticipation and preparedness”. The three monitoring approaches used in this research are: (1) measuring the patient safety culture (2) measuring patient satisfaction (3) and monitoring caesarean section rates. The specific objectives of the research are to (1) measure patient safety culture level, (2) examine the association between nurse’s nationality and patient safety culture, (3) validate an Arabic language survey to measure maternal satisfaction about the childbearing experience, (4) measure patient satisfaction about the childbearing experience, and (5) to examine caesarean section rates across maternity units using statistical process control charts. This thesis started with four systematic reviews that focused on (1) the use of patient safety culture for monitoring maternity units (2) the available interventions to improve patient safety culture (3) Arabic surveys available for measuring maternal satisfaction and (4) the use of statistical process control charts for monitoring performance indicators. The overall conclusion from these reviews that these approaches are being increasingly used in maternity, found feasible and useful, and there are areas that need attention for future work. Five field studies were conducted to address the research aim and objectives. Patient safety culture was measured by a cross-sectional survey of all staff in the ten maternity units. It was found that safety culture in Oman is below the target level and that there is wide variation in the safety scores across hospitals and across different categories of staff. Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses in all domains except in respect of stress recognition and this difference need further investigation and needs to be considered by designers of interventions to enhance patient safety culture. Using two existing validated English surveys, an Arabic survey was developed, validated, and used to measure maternal satisfaction with childbirth services. It was found that the new survey has good psychometric properties and that in all the ten hospitals, mothers were satisfied with the care provided during child delivery but satisfaction score varied across hospitals and groups of participants. Caesarean section rate in the last 17 years was examined using statistical process control charts to understand the variation across the ten hospitals. It was found that caesarean section rate is above the rate recommended by the World Health Organisation. Special cause variations were detected that warrant further investigation. In conclusion, the field studies demonstrated that it is feasible to use the three approaches to monitor quality and safety in maternity units. However, further work is required to use these data to enhance the quality and safety of care. Additionally, future work is needed to cover the other three dimensions of the PSMMF.Ministry of Health in Oman

Patient satisfaction of primary care services in Gulf Cooperation Council countries: a scoping review

Patient satisfaction (PS) is an essential element in evaluating and improving healthcare systems. Few studies have gathered evidence about patient satisfaction with primary care (PC) services in the Gulf Cooperation Council (GCC) countries. Therefore, it is important to review the existing literature examining PS with PC services in the GCC countries. This scoping review was conducted for primary data studies published between 2000 to March 2022. Out of 4461 screened articles, 37 met the inclusion criteria. Most studies were conducted in Saudi Arabia and were of cross sectional methodology. PS with primary care in the GCC is affected by multiple provider-related and patient-related factors and users are generally satisfied with the service provided. Future research should focus on the effects of the factors that were not explored and validate the existing results

Stock Assessment of the Blue Swimmer Crab Portunus pelagicus (Linnaeus, 1766) from the Oman Coastal Waters

Abstract: The stock assessment of the blue swimmer crab, Portunus pelagicus was made based on monthly length frequency data collected from four landing sites along the Oman coasts on both Arabian and Oman Seas from January, 2011 to May, 2012. Age and growth have been estimated from the length-frequency distribution of up to 1000 specimens. Age composition was determined using Bhattacharya's method and the results showed that the maximum life span of P. pelagicus was about 15 months. Bertalanffy (1938) growth parameters didn't differ significantly between sexes and the obtained values of K were K = 1.85, 1.68 and 1.68 y -1 and CL values were 102.83, 109.57 and 108.46 mm for male, female and sexes combined, respectively. The values of total mortality coefficient (Z), natural mortality coefficient (M) and fishing mortality coefficient (F) were 7.85, 3.15 and 4.7 y -1 . The yield per recruit and SSB analysis showed that the crab stock is being exploited beyond its maximum biological limit, but the increasing of fishing mortality to the level which gives the maximum Y/R (83% of its current value) will accompanied with a negligible increase in Y/R (2.7%) and a considerable decrease in both biomass per recruit (21.1%) and spawning stock biomass (37.6%)

Patient safety culture in maternity units: a review

YesPurpose: To summarize studies that have examined patient safety culture (PSC) in maternity units and describe the different purposes, study designs and tools reported in these studies, whilst highlighting gaps in the literature. Methodology: Peer-reviewed studies published in English during 1961-2016 across eight electronic databases were subjected to a narrative literature review. Findings: Among 100 articles considered, 28 met the inclusion criteria. The main purposes for studying PSC were: (a) assessing intervention effects on PSC (n= 17); and (b) assessing PSC level (n=7). Patient safety culture was mostly assessed quantitatively using validated questionnaires (n=23). The Safety Attitude Questionnaire was the most commonly used questionnaire (n=17). Intervention varied from a single action lasting five weeks to a more comprehensive package lasting more than four years. The time between the baseline and the follow-up assessment varied from six months up to 24 months. No study reported measurement or intervention costs, and none incorporated the patient’s voice in assessing PSC. Practical Implications: Assessing PSC in maternity units is feasible using validated questionnaires. Interventions to enhance PSC have not been rigorously evaluated. Future studies should report PSC measurement costs, adopt more rigorous evaluation designs, and find ways to incorporate the patient’s voice. Originality/Value: This review summarized studies examining PSC in a highly important area and highlighted main limitations that future studies should consider

Features of an online English language testing interface

This paper describes an online English language proficiency testing platform that uses Moodle- hosted selected and open response questions along with other useful features. These features include enhanced test security settings aided by the Safe Exam Browser; an embedded MP3 player for listening skills; and a split screen mode for reading tests. The paper highlights significant elements of this particular approach to testing as they apply to formal high-stakes e-exams (testing of learning) and for continuous assessment (testing for learning). Snapshots of sample online test materials illustrate these features. Issues of concern in the field of web-based, computer-assisted assessment will be discussed in light of experience gained from a recent pilot study in which this interface was used in a series of mock exams in 2015

Quasi dynamic simulation for the voltage control in the active networks, Oman Case Study

The transition of passive distribution network towards being active network results in many operation challenges. Voltage control is one of these challenges. This paper has studied the effectiveness of four voltage controlling techniques in a real 132/33/11kV distribution network from Oman which are on-load tap changer control, energy storages installation, transformer tap staggering and power curtailment control. The network has been stressed by large penetration of solar photovoltaic and wind farm power plants. Each techniques have performed differently in maintaining the voltages profile within the statutory limits ±6%. The lowest effectiveness level is the power curtailment, and that is due to the high X/R ratio, as the studied network constitute of overhead lines more than cable lines. Regarding losses reduction effects, energy storage was the highest efficient method whereas the transformer tap staggering control was the lowest efficient method. Moreover, Quasi Dynamic simulation method was used for variable load modeling which has increased the opportunity of large DGs accommodation compared to the static load simulation

The challenges of using video conferencing in educational supervision in the Sultanate of Oman: educational supervisors’ perspectives - تحديات استخدام مؤتمرات الفيديو في الإشراف التربوي من وجهة نظر المشرفين التربويين بسلطنة عمان

This paper aims to discuss the difficulties of using videoconferencing technology in supervisory practices, from an educational supervisory perspective. Whereas, although video conferencing technology is important; The number of educational supervisors who use it is not commensurate with its value and significance, as studies have reported on this technology, perhaps as a new technology. Therefore, the study aimed: to discuss the technical challenges, and the human challenges facing the use of videoconferencing technology in supervision. The researcher used the descriptive and analytical method, whereby a questionnaire was designed consisting of two axes: The first for technical difficulties consists of (11) phrases, and the second for human difficulties consists of (9) phrases. It was applied to a sample of (322) educational supervisors. The study found the following results: The existence of material obstacles that came to a large extent about the use of videoconferencing technology in supervisory operations, as the weakness of the Internet in some remote areas came in first place with the highest arithmetic average of (4.19), followed by “weak infrastructure of schools and directorates. Educational governorates "with an average of (4.08). Followed by the presence of human obstacles that came with a moderate degree regarding the use of video conferencing technology in supervisory operations. Lack of training in employing videoconferencing technology" came in first place with the highest arithmetic average of (3.96). The study includes a set of recommendations, including preparing an integrated guide to explain the mechanism of activating video conferencing in supervisory work. It includes analyzing and studying the psychological, technical and material factors facing the activation of video conferencing

The association between the nationality of nurses and safety culture in maternity care units of Oman

YesBackground: Patient safety culture/climate in maternity units has been linked to better safety outcomes. Nurses have a crucial role in patient safety and represent the majority of staff in maternity units. In many countries, nurses are recruited from abroad, bringing their own perceptions of patient safety culture. Nonetheless, little is known about the relationship between perceptions of patient safety culture and nurses’ nationality. Understanding this relationship will assist stakeholders in designing a responsive programme to improve patient safety culture. Aims: To investigate the association between nurses’ nationality and their perceptions about patient safety culture in maternity units in Ministry of Health hospitals in Oman. Methods: In 2017, the Safety Attitude Questionnaire (SAQ) was distributed to all staff (892 distributed, 735 returned) in 10 maternity units. Results: About three-quarters (74%, 541/735) of the returned SAQs were completed by nurses, of whom 34% were non-Omani, 21.8% were Omani and 44.7% did not report their nationality (missing). Overall, the mean safety score for non-Omani nurses was significantly higher than for the Omani nurses: 3.9 (SD 1.3) vs 3.6 (SD 1.2) (P < 0.001). The mean safety score for stress recognition was significantly lower for non-Omani nurses: 2.8 (SD 1.5) vs 3.2 (SD 1.3) (P < 0.001). Conclusion: Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses except in respect of stress recognition. Decision-makers, directors, and clinicians should consider these differences when designing interventions to improve patient safety culture.This study is part of a PhD study that was funded by the Ministry of Health in Oma

Patient safety culture in Oman: A national study

NoRational, aim, and objectives: A positive patient safety culture in maternity units is linked to higher quality of care and better outcomes for mothers. However, safety culture varies across maternity units. Analyses of variation in safety culture using statistical process control (SPC) methods may help provider units to learn from each other's performance. This study aims to measure patient safety culture across maternity units in Oman using SPC methods. Methods: The 36-item Safety Attitude Questionnaire (SAQ) was distributed to all doctors, nurses, and midwifes working in ten maternity care units in Oman's hospitals and analysed using SPC methods. The SAQ considers six domains: job satisfaction, perception of management, safety climate, stress recognition, teamwork, and work condition. Results: Of the 892 targeted participants, 735 (82%) questionnaires were returned. The overall percentage of positive safety responses in all hospitals ranged from 53% to 66%, but no hospital had the targeted response of above 75%. Job satisfaction had the highest safety score (4.10) while stress recognition was the lowest (3.17). SPC charts showed that the overall percentage of positive responses in three maternity units (H1, H7, and H10) was above and one (H4) was below the control limits that represent special cause variation that merits further investigation. Conclusion: Generally, the safety culture in maternity units in Oman is below target and suggests that considerable work is required to enhance safety culture. Several maternity units showed evidence of high/low special cause variation that may offer a useful starting point for understanding and enhancing safety culture