The Nursing Practice Environment And Job Outcomes In Saudi Hospitals

The nursing shortage is a challenging problem globally. In Saudi Arabia, the nurse shortage continues to be a critical problem in all healthcare sectors. International nursing research has shown strong relationships between poor practice environments and unfavorable nurse job outcomes, including job dissatisfaction, burnout, and intention to leave, which often precedes turnover, a leading cause of shortage. However, there is scarcity in this area of research in Saudi Arabia. This study aims to describe and compare the nursing practice environments and nurse job-related outcomes of nurses in two types of hospitals in Saudi Arabia. Additionally, the study aims to test a model that links the nursing practice environment to nurse job outcomes using path analysis. A comparative cross-sectional design was employed to examine a sample of nurses (n=404) from inpatient units in a public and a teaching hospital. A survey instrument was designed that included the Practice Environment Scale of the Nursing Work Index, the Emotional Exhaustion subscale of the Maslach Burnout Inventory, and questions related to job dissatisfaction and intention to leave. Results showed that the nursing practice environment and nurse job outcomes in the teaching hospital were more favorable than those in the public hospital. In the entire sample, approximately half (52.7 %) of the participants had a high level of burnout, 38.7% were dissatisfied, and 25.8% intended to leave within a year. In the public hospital, the percentages were 80.8% burned out, 64.7% dissatisfied, and 33.2 intended to leave as compared to 26%, 15.8%, and 19.2% respectively in the teaching hospital. The results of path analysis showed that both nursing practice environments and hospital type (public vs. teaching) have significant effects on burnout and job dissatisfaction, which in turn increase the intention to leave. Hospital type has also a direct effect on intention to leave. This study presents a good- fitted model that provides a better understanding of the relationship between nursing practice environment and nurse job outcomes in Saudi hospitals. This knowledge will help nurse leaders and policy makers develop retention strategies to improve nursing practice environments and job-related outcomes and to reduce turnover

Prevention-Oriented Clinic

Chronic diseases are heavily taxing the American health system. The federal government has implemented new laws, such as the Affordable Care Act (ACA), in order to increase American wellness at no additional cost and to reduce the significant financial burden. Considering the enactment of ACA and cost cutting, it’s an opportune time to explore new approaches to delivering high quality patient care before the start of a disease. Preventative health wellness clinics can serve this purpose. However, preventative care clinics are not without challenges. Modifying patients’ behaviors have proven to be difficult and no research literature exists to provide an evidence-based approach which has a proven record in changing poor patient habits. However, if focus is placed on patients who are at increased risk for developing a chronic illness and tests favorable for behavior modification, the ideal preventative health clinic may set the stage for improved healthcare outcomes and cost reduction

Healthcare providers as patients: COVID-19 experience

There is compelling evidence for the psychological effects of the COVID-19 pandemic and earlier epidemics. However, fewer studies have examined the subjective meaning experience of healthcare providers who have survived COVID-19 as patients. This qualitative study aimed to understand further and describe the life experiences of healthcare providers who have survived COVID-19 as patients in Saudi Arabia. Data was collected using unstructured in-depth individual interviews among n = 10 healthcare providers from public hospitals in Saudi Arabia. Data were analyzed based on a phenomenological approach, which resulted in five themes: (i) physical and psychological signs and symptoms; (ii) self-healing, hiding pain, and family; (iii) fear of complications; (iv) disease stigma & long-term psychological outcomes; (v) emotional support, mental well-being & resignation. The overall synthesis showed that healthcare providers, as patients, experience the same difficulties and stressors as the general public. In some cases, these factors are even worse, as family members, colleagues, and employers develop a new type of stigma. Given the impact of social media and the flow of information of any type, more research is needed to examine the sources used to obtain information by the general public, whether these sources are reliable, and how the public can be taught to use only scientific data and not social data. Understanding the experience of healthcare providers as patients during the pandemic has allowed to look at the feelings and needs of people during illness from a new perspective. As expressed by participants, being a healthcare provider does not reduce the fear of the disease and does not mitigate its consequences in the form of stigmatization and isolation

Nursing Surge Capacity Strategies for Management of Critically Ill Adults with COVID-19

Background: There is a vital need to develop strategies to improve nursing surge capacity for caring of patients with coronavirus (COVID-19) in critical care settings. COVID-19 has spread rapidly, affecting thousands of patients and hundreds of territories. Hospitals, through anticipation and planning, can serve patients and staff by developing strategies to cope with the complications that a surge of COVID-19 places on the provision of adequate intensive care unit (ICU) nursing staff—both in numbers and in training. Aims: The aim is to provide an evidence-based starting point from which to build expanding staffing models dealing with these additional demands. Design/Method: In order to address and develop nursing surge capacity strategies, a five-member expert panel was formed. Multiple questions directed towards nursing surge capacity strategies were posed by the assembled expert panel. Literature review was conducted through accessing various databases including MEDLINE, CINAHL, Cochrane Central, and EMBASE. All studies were appraised by at least two reviewers independently using the Joanna Briggs Institute JBI Critical Appraisal Tools. Results: The expert panel has issued strategies and recommendation statements. These proposals, supported by evidence-based resources in regard to nursing staff augmentation strategies, have had prior success when implemented during the COVID-19 pandemic. Conclusion: The proposed guidelines are intended to provide a basis for the provision of best practice nursing care during times of diminished intensive care unit (ICU) nursing staff capacity and resources due to a surge in critically ill patients. The recommendations and strategies issued are intended to specifically support critical care nurses incorporating COVID-19 patients. As new knowledge evidence becomes available, updates can be issued and strategies, guidelines and/or policies revised. Relevance to Clinical Practice: Through discussion and condensing research, healthcare professionals can create a starting point from which to synergistically develop strategies to combat crises that a pandemic like COVID-19 produces

The effectiveness of pressure ulcer prevention programme: A comparative study

Hospital‐acquired pressure ulcers (HAPUs) affect patients during hospitalisation, putting patients at risk for further complications. HAPU is one of the hospital quality indicators that require quality initiatives or programmes to minimise its occurrence and consequences. The aim of this study was to assess the effectiveness of a developed quality improvement programme in preventing HAPUs. This is a retrospective comparative study, which tracked the outcomes of pressure ulcer prevention programme (PUPP) for 5 years from 2014 to 2018. Data from 50 441 patients were collected from different units in a tertiary hospital in the eastern region of Saudi Arabia. The programme focused on building a wound care team; providing education to hospital staff, patients, and their families; and continuous data monitoring, in addition to follow‐up visits after discharge. Implementation of the programme was successful showing a statistically significant reduction of HAPUs from 0.20% in 2014 to 0.06% in 2018 (P value \u3c.001). The PUPP was effective in reducing the percentage of pressure ulcer cases. The programme can be extended and implemented in other hospitals

Healthcare providers as patients: COVID-19 experience.

There is compelling evidence for the psychological effects of the COVID-19 pandemic and earlier epidemics. However, fewer studies have examined the subjective meaning experience of healthcare providers who have survived COVID-19 as patients. This qualitative study aimed to understand further and describe the life experiences of healthcare providers who have survived COVID-19 as patients in Saudi Arabia. Data was collected using unstructured in-depth individual interviews among n = 10 healthcare providers from public hospitals in Saudi Arabia. Data were analyzed based on a phenomenological approach, which resulted in five themes: (i) physical and psychological signs and symptoms; (ii) self-healing, hiding pain, and family; (iii) fear of complications; (iv) disease stigma & long-term psychological outcomes; (v) emotional support, mental well-being & resignation. The overall synthesis showed that healthcare providers, as patients, experience the same difficulties and stressors as the general public. In some cases, these factors are even worse, as family members, colleagues, and employers develop a new type of stigma. Given the impact of social media and the flow of information of any type, more research is needed to examine the sources used to obtain information by the general public, whether these sources are reliable, and how the public can be taught to use only scientific data and not social data. Understanding the experience of healthcare providers as patients during the pandemic has allowed to look at the feelings and needs of people during illness from a new perspective. As expressed by participants, being a healthcare provider does not reduce the fear of the disease and does not mitigate its consequences in the form of stigmatization and isolation

Sustainable development & the year of the nurse & midwife - 2020

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