Assessment of patient safety culture in an adult oncology department in Saudi Arabia

Objectives: The aim of this research was to evaluate patient safety culture across different healthcare professionals from different countries of origin working in an adult oncology department at King Fahad Medical City. Methods: This was a cross-sectional survey of 130 healthcare staff (doctors, pharmacists, nurses) working in an adult oncology department in Saudi Arabia. We used the Hospital Survey of Patient Safety Culture (HSOPSC) to examine perceptions of safety culture during the month of February 2017. Data were analysed using SPSS v24 for descriptive statistical analysis, calculating composite positivity, and running t-test, ANOVA test, and linear regression to identify factors influencing the patient safety culture. Result: 127 of 130 questionnaires were returned, yielding a response rate of 97.7%. Eight out of the twelve HSOPSC composites were considered as areas for improvement (percent positivity < 50%). Significantly different mean scores were observed across the three professional groups in all twelve HSOPSC composites. Doctors tended to rate patient safety culture significantly more positively than nurses or pharmacists. Nurses scored significantly lower than pharmacists in the majority of HSOPSC composites. No significant differences in patient safety culture composite scores were observed between Saudi/Gulf Cooperation Council (GCC) and non-Saudi/GCC groups. Regression analysis showed that frequency of reported events is predicted by feedback and communication about errors, and teamwork across units, while perception of patient safety is associated with respondents’ profession and teamwork across units. Conclusion: This study brings to the fore the assumption that all healthcare professionals have a shared understanding of patient safety. We urge healthcare leaders and policy makers to look at patient safety culture at this granular level in their contexts, and use this information to develop strategies and training to improve patient safety culture

Exploring healthcare professionals’ perceptions of medication errors in an adult oncology department in Saudi Arabia: A qualitative study

Objective: Adverse events which result from medication errors are considered to be one of the most frequently encountered patient safety issues in clinical settings. We undertook a qualitative investigation to identify and explore factors relating to medication error in an adult oncology department in Saudi Arabia from the perspective of healthcare professionals.\ud Methods: This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining required ethical approvals and written consents from the participants, semi-structured interviews and focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive thematic analysis was adopted in the primary coding of data while secondary coding of data was carried out deductively applying the Hospital Survey of Patient Safety Culture (HSOPSC) framework. Result: The total number of participants were 38. Majority of the participants were nurses (n = 24), females (n = 30), and not of Saudi nationality (n = 31) with an average age of 36 years old. Causes of medication errors were categorized into 6 themes. These causes were related teamwork across units, staffing, handover of medication related information, accepted behavioural norms, frequency of events reported, and non-punitive response to error. Conclusion: There were numerous causes for medication errors in the adult oncology department. This means substantive improvement in medication safety is likely to require multiple, inter-relating, complex interventions. More research should be conducted to examine context-specific interventions that may have the potential to improve medication safety in this and similar departments

Delivery of inhibitory signalling via co-crosslinking of FcεRI and FcγRIIB with engineered micro-surfaces as a new therapeutic concept

Mast cell and basophil mediators play a major role in the development of immunoglobulin E (IgE)-dependent allergic disorders. One of these mediators is histamine, which is released by activation of inflammatory cells through cross-linking of the high affinity IgE receptor (FcεRI). The current immunotherapies are accompanied by major drawbacks, such as an increase the risk of anaphylaxis and systemic reaction, difficulties in allergen extract standardisation of allergen-specific immunotherapy (SIT), and a small but worrying increase in the incidence of cancer with omalizumab. It is known that co-aggregation of immunoglobulin G (IgG) low-affinity receptor (FcγRIIB) with FceεRI can lead to inhibition of mast cell degranulation, thus inhibiting production of pharmacological mediators. The potential underlying this principle has been highlighted by many approaches published in the literature. In this study, we designed a novel immunotherapy vector that takes advantage of the most recent advances in drug delivery systems using microparticles. This micro-carrier will carry the Fc parts of both IgG and IgE in defined stoichiometric ratios to be directed towards the allergic inflammatory cells (mast cells and basophils). Fcγ receptors have different binding affinities for IgG1, either with high affinity in the case of FcγRI, or low as with FcγRIIB. We engineered mutant IgG-Fc fragments with increased binding affinity for FcγRIIB. These recombinant Fc-genes were successfully transfected, expressed and purified from the cell supernatant of a high yield HEK293- 6E cell line mammalian expression system. To obtain a site-specific conjugation between the recombinant Fc proteins and microparticles, a novel 15 amino acid peptide tag known as Avi-Tag was used. Both particle size and Fc density have an effect on the level of the immune response. On the reporter cell lines derived from the parental RBL-2H3 cell lines (RS-ATL8 and NFAT-DsRed), a 0.5μm particle coated with IgE Fc significantly affected the activation response compared to other particles sizes (1,2 and 6 μm). Cell activation was also affected by the density of IgE Fc, and a lower dilution ratio of added IgE Fc to particles (1:50) showed the highest activation value. Unexpectedly, the preliminary data for the release of histamine from purified human peripheral blood basophils treated with different Fc-particle conjugate formulations did not show any effect for the suggested therapy

US-20 Interchange Design in Thornton, Idaho

Thornton is a small town in Eastern Idaho located approximately five miles from Rexburg. The Thornton Interchange Project replaces an unsafe, at-grade intersection—that currently experiences great number of vehicle accidents—with an overpass and interchange. More than 21 accidents have resulted since 2000 from vehicles attempting to cross four lanes of US-20. The Thornton Interchange project includes a pre-stressed concrete bridge designed to carry US-20 and allow vehicles to safely cross underneath the highway. Other project elements for a new, full interchange—centered on durability and safety—include on-off ramp design, new roadway alignment designs, pavement design, and environmental impact assessment

Practice of wound closure techniques among emergency physicians and surgeons in Makkah City Hospitals in Saudi Arabia

Background: Wound suturing is a procedure performed by medical and surgical specialists. While there are many different suturing techniques and materials used to treat patients, the choice of which to employ depends on different variables that affect the outcome of the procedure.Design and Methods: This is a cross-sectional study conducted to provide descriptive data regarding the practice of wound closure techniques, and to develop an awareness of scar formation factors. A total of 172 general surgery (GS) surgeons and emergency (EM) physicians in Makkah city hospitals in Saudi Arabia participated in the study.Results: More than 50% of the practitioners favored the simple interrupted technique for the treatment of all types of studied wounds. The other most common techniques among participants were the subcuticular and vertical mattress methods, respectively, while the use of a stapler was limited to certain wound types. Regarding suturing material, polyglycolic acid was the most frequent material used by 50.1% of participants, whereas only 22% of the participants selected nylon material for wound suturing. However, this study showed a good level of awareness among participants, with significant p-values (p&lt;0.05) of strongly agree and agree regarding the essential factors affecting wound healing and scar formation.Conclusions: The result provides insight into the most common suture techniques and materials used in wound closure. There are wide variations in selecting these techniques and materials among the participants. Also, we found that there is good awareness among participants about factors that lead to scar formation

Addressing medication errors in an adult oncology department in Saudi Arabia: A qualitative study

Objective: There is a wide range of strategies that could help in minimizing medication errors during healthcare delivery. We undertook a qualitative study to identify recommended solutions to minimize medication errors in an adult oncology department in Saudi Arabia from the perspectives of healthcare professionals. Methods: This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining the required ethical approvals and written consents from the participants, seven focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive content analysis was adopted in the coding of collected data. Result: Our study showed that improving organizational support, staff education, and communication could help in minimizing medication errors in the adult oncology department. Conclusion: The adoption of multiple strategies is required to improve the safety of the medication process in the adult oncology department. We argue that the availability of supportive leadership should be prioritized as it plays a crucial role in determining the effectiveness and efficiency of both staff education and communication

Does dental students' attendance in classroom lectures depend on the mode of attendance tracking?

Purpose: The necessity to attend classroom lectures is a disputable topic among dental schools globally. Since there is an ongoing debate on different aspects of this problem in literature, the purpose of this study was to compare students’ attitudes toward classroom attendance and investigate if stricter attendance tracking methods could lead to better classroom attendance at two dental schools utilising different modes of tracking students’ attendance. Method: This was an observational, cross-sectional survey distributed among dental students enrolled at King Abdul-Aziz University (KAU) and King Saud University (KSU) in Saudi Arabia. The survey included questions on demographics, average travel time, student's attitudes toward classroom lectures and common reasons for absenteeism. Collected data were analysed and summarised as frequencies and percentages and then compared using the Chi-square test for statistical significance. Findings: The study involved 678 participants from KAU and 475 participants from KSU. In general, there was a significant difference in students’ attendance between both schools in which 26.8% of KAU dental students skipped 5 or more lectures/month compared to 11.5% of students at KSU. Among the factors affecting classroom lecture attendance, commuting time was a major one reported by students (44.8% of students at KSU and 51.4% at KAU needed 30-60 min to reach their schools). The availability of lectures through online resources and the necessity to study for exams were additional factors reported by students of both schools. Implications for research and practices: Based on the current data, the school’s method to track students’ attendance may have a role in the pattern of classroom absenteeism

Squint Among Adult Population in Hail City, Saudi Arabia

Background: Strabismus, also known as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. If present during a large part of childhood, it may result in amblyopia. If onset is during adulthood, it is more likely to result in double vision. Objective: The aim of the study was to estimate the prevalence of squint, types and treatment characteristics in the studied adults in Hail city, Saudi Arabia. Methods: A cross-sectional study conducted in Hail city, Saudi Arabia. The study included 294 participants; 95 male and 199 female adults aged &gt;20 years. The study period was from 1 January to 30 April 2018. Data collected by personal interview using a pre-designed questionnaire, which distributed among the participants to be self-reported. Results: The prevalence of squint among the studied population was 9.9%. it was more common in females than males. Squint was right sided in 24.1% of the cases, left sided in 51.7% and in both eyes in 24.1% of the studied cases. About half (44.8%) of cases had inward squint (esotropia) and 10.3% outward squint (exsotropia), 24.1% of the cases had Intermittent squint and 6.9% had permanent squint. Most (55.2%) of squint cases use glasses and 34.5% of cases squint affected their visual acuity. In 6.9%, squint causes psychological troubles. As regards treatment, 20.7% received medical treatment and 17.2% received surgical treatment but 62.1% do not seek medical care. Only 10.3% of cases completely cured and 13.8% had recurrence. There was insignificant relation with age, sex, education, squint in parents, chronic diseases, consanguinity or hereditary diseases (P&gt;0.05). Conclusion: in this study, the prevalence of squint in the adult participants in Hail city, Saudi Arabia was 9.9% but 62.1% do not seek medical care. After treatment, only 10.3% of cases completely cured and 13.8% had recurrence. Health education of the public about importance of early treatment is highly recommended. Keywords: Squint; strabismus; adult population; prevalence; types; Hail; Saudi Arabia

Public satisfaction with COVID-19 vaccination program in Saudi Arabia

The challenges posed by the ongoing COVID-19 pandemic have required the introduction of new care delivery models and procedures. For the foreseeable future, vaccine administration will be a key part of the patient experience journey. It is important therefore to understand and evaluate experiences of individuals taking the vaccination, an area which requires considerable attention. To address this, the COVID-19 Vaccination Satisfaction survey was developed and administered at several healthcare facilities across Saudi Arabia. Between January 2021 and end of December 2021, a total of 1,699,177 completed surveys were collected. The survey results suggest high satisfaction among participants taking the vaccine; however, satisfaction with information and communication about the vaccine was relatively low. Results from this survey are updated daily and provide unique insights into the key strengths of the vaccination process, as well as aspects within the process that require improvement. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Inverse Correlation between Stress and Adaptive Coping in Medical Students

BACKGROUND: Medical students in their academic years are generally under stress but very few studies revealed the relationship between the stress and how the students manage to adapt these stressful conditions. AIM: The aim of the study was to investigate the levels of stress and their adaptive coping in the 1st 3 years medical students and also to determine the factors associated with adaptive coping strategies. METHODS: This is a descriptive cross-sectional study conducted on 441 medical students of Qassim University from September-October 2019. First 3 years medical students were randomly selected and their stress levels or adaptive coping strategies were determined by general health questionnaire (GHQ-12) and strategies coping mechanisms (SCM), respectively. The 5-points Likert scale was used for scoring and the data obtained were further validated by DASS and Brief COPE scales. RESULTS: Out of 441 medical students, 39.2% agreed to participate. The data showed that the level of stress among students was highest during their 1st year academic blocks, followed by 2nd and 3rd year students. Interesting, the adaptive coping among them was found highest during the academic blocks of 3rd year students, followed by the 2nd and 1st year students. Importantly, female students showed better adaptation against stress. Students living with their parents avoided stress in better ways as compared to those who were living alone. CONCLUSION: This is the first study that shows an inverse correlation between the stress and adaptive coping in medical students of Qassim University. The data concluded that adaptation of stress in the 3rd-year students was the highest followed by 2nd and 1st year medical students. Moreover, female students adapted well against stress and students living alone showed worse adaptation of stress