Evaluation of academic nurses performance at critical care unit in Hillah City/Iraq

Nurses performance is the basis of patient safety as nurses can prevent, protect and avoid harm to patients by providing good performance that prevents medical errors in critical care units. The role of nurses is also affected by many of the specific requirements of the work that they need to provide the best nursing performance. The study aimed to assess performance of academic nurses at the point of care. A cross-sectional quantitative study, with non-probability purposive sampling, was adopted and recruited (91) critical-care nurses at Hillah City/Iraq, the data was collected during a period of time that began on July 10, 2021, and finished on September 20, 2021. Data was collected through using the questionnaire format and top up by the researcher and analyzed data through using (SPSS -version 25). The majority of the study sample (56.0%) is within the second age group (25-29) years old, (61.5%) are female, single, have a Baccalaureate degree in nursing, within (1-5) years graduate from nursing, with (1-5 years) experience in nursing, and most of them are living in urban areas. The results indicated that the majority of participants had a good performance, overall mean (2.52)

Evaluating of academic nurses' clinical judgement skills in a critical care unit at Babylon City, Iraq

Clinical judgement is the foundation of nursing practices and recognized as essential skills for all nurses and serves as a distinguishing factor between professional nurses and those in strictly technical roles. Hence, the goal of this study was to evaluate of academic nurse’s clinical judgement skills. A cross-sectional quantitative design is used to conduct this study. The data was gathered during a period of time that started on July 10, 2021, and ended on September 20, 2021, using a non-probability purposive sampling approach that recruited (ninety-one) critical-care nurses from three public governmental hospitals in Babylon City, Iraq. The data was obtained through using a questionnaire format and amended by the researcher, data analyzed was through using (SPSS -version 25). More than half (56.0 %) of the study's participants are between the ages of 25 and 29, and more than two-thirds (61.5 %) are female, single, have a degree of Baccalaureate in nursing, within (1-5) years graduated from nursing, experience in nursing was (1-5 years), and live in urban regions. The results indicated that the majority of participants had average clinical judgement abilities, overall mean was (1.56)

Nursing communication skills in preoperative care: Nurses’ feedback

Nursing communication skills are critical. As most patients have little understanding about the medical procedures, many patients may feel confused about what is happening around them.  Nurses with excellent communication skills can help reassure patients, understand their needs during preoperative care.Objectives: The purpose of this study is to assess nursing communication skills in preoperative care and to look at disparities in nurses' communication skills based on sociodemographic factors.Methods: A descriptive study with a purposive sample of (N=104) nurses was conducted. This sample is distributed throughout two hospitals regarding to the Babylon Health Directorate. The questionnaire consists of )45 (items. The reliability of the questionnaire was verified by conducting a pilot study and submitting it to a list of experts in nursing field. Data was obtained using self-report and a questionnaire, then analyzed using descriptive and inferential statistical methods.Results: The findings revealed that (45.2%) of nurses’ expressed a moderate level of communication skills with the surgical patients. The nurses’ communication skills are significantly associated with their gender (p=0.000), education level (p=0.000), years of experience in surgical wards (p=0.007) and number of training sessions (p=0.000)

Assessment of patients adherence to therapeutic recommendations after percutaneous coronary intervention in Al-Najaf Al-Ashraf governorate

Cardiac catheterization (CC) is a technique in which a symptomatic patient with heart disease undergoes a routine that necessitates hospitalization. This study aims to assess patients’ adherence to therapeutic recommendations after percutaneous coronary intervention. Cross-sectional quantitative descriptive design carried out in Al-Najaf Governorate. Non-probability purposive sampling consisted of 120 patients with coronary artery disease for at least six months after percutaneous coronary intervention. The start date was from October 1st, 2020 and last to May 1th, 2022. The data gathered via interview method by Adhrerence questionnaire which include 54 items. This study finds that from sample 40.8% were within 51-60 years old, 65.8% were male, 20.8% were intermediate school graduated, 59.2% were rural residence, 90% were married, 72.5% experienced CAD for less than 6 years, 98.3% received therapeutic recommendations, 38.3% admitted for the second time, and 70.8% have fair level of adherence. In turn Age, level of education, disease duration significantly associated with adherence variable. Patients’ adherence to therapeutic recommendations is moderate after PCI. As age increases, adherence to therapeutic recommendations decreases. Good level of adherence accelerates among patients with high educational level.Longer disease duration accompanying with poor adherence

The relationship between locus of control orientation and patients’ adherence to therapeutic recommendations after percutaneous coronary intervention

As life expectancy has increased and the global population has aged, the global burden of chronic diseases has risen alarmingly. This study aims to determine if there is any significant correlation between adherence to therapeutic recommendations and locus of control orientation. Cross-sectional quantitative correlational design carried out in Al-Najaf City. Non-randomized purposive sampling consisted of 120 patients with coronary artery disease after percutaneous coronary intervention. The date collected from June 20th, 2021 and last to November 27th, 2021 through interview method by Multi-dimensional health locus of control questionnaire form (C) which include 18 items, and adherence questionnaire which include 54 items in addition to multi-dimensional health locus of control instrument which include 18 items regarding internal, chance, and power full others domains. This study finds that patients adherence to therapeutic recommendations and their locus of control orientation is significantly correlated through statistical indicator of Pearson correlation of 0.539 at probability value of less than 0.05. The study findings also reveals that it is possible to predict patient’s adherence to therapeutic recommendations through their locus of control orientation. Internal LOC. Orientation appear to be associated with disease prevention and control in addition to health promotion.&nbsp

Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care