Nurses' Perception of Safety Culture in Medical-Surgical Units in Hospitals in Saudi Arabia.

Introduction: Patient safety captures the essence of the primary principle of medical ethics, primum non nocere, first do no harm; this is an important concern in the health care system. Nurses are indispensable members of this system and are the largest group of health care providers involved in the direct delivery of patient care. As an integral part of the health care system, it is important to know nurses' opinions on patient safety culture. Objectives: First, to evaluate and measure the existing safety culture and safety of patients in medical-surgical wards (MSW) in hospitals located in the Qassim region, in the Kingdom of Saudi Arabia. Second, to survey the opinion of registered nurses and supervisors/managers about safety culture and issues concerned with safety in hospitals in the region. Materials and Methods: A validated cross-sectional survey, namely the Hospital Survey on Patient Safety Culture (HSOPSC), was used. This survey queried 300 nurses in different MSWs in four hospitals in the Qassim Region. Results: Overall, a positive culture of safety exists in MSWs, with 69% of RNs rating their wards as having great/excellent safety culture. Notably, some participants felt it was problematic that blame was assigned to nurses for reported errors. While 55.9% of participants noted that all errors or narrowly avoided errors had been reported, less than half actually reported errors in the last year. Conclusion: The perceived safety culture was largely positive; however, the results also indicated that a culture of safety comes with some risk and blame.

Scope of Nursing Practice as Perceived by Nurses Working in Saudi Arabia.

The absence of scope of practice guidelines may lead to role ambiguity and legal consequences in nursing practice. This study measures the scope of practice of nurses in Saudi Arabia. The study utilized a descriptive cross-sectional design using an electronic version of the Arabic Actual Scope of Nursing Practice (A-ASCOP) questionnaire among 928 nurses. Descriptive analysis was followed by a t-test and an analysis of variance (ANOVA). Significance was assured through the Bonferroni test; the effect size was measured through partial η2 when appropriate. The A-ASCOP mean score of each dimension ranged from 4.29 to 4.72 (overall mean = 4.59). Significant overall ASCOP score variations were evident, with higher ASCOP among expatriate nurses, females, Hospital Operation Program (HOP) nurses, and nurses with postgraduate qualifications. Partial η2 showed a small effect of <0.016. Low-complexity nursing tasks showed insignificant differences no matter the nurse's position, but were less practiced by Bachelor of Science in Nursing (BSN) and advanced-degree nurses than by those with a diploma education. High complexity of ASCOP was practiced significantly more often by postgraduate-prepared nurses than by diploma-educated nurses. The study showed that there is a range of variation in nursing practice, but that the lack of internal regulations (nursing scope of practice) has no effect on nursing duties. In a country such as Saudi Arabia, where massive national improvement initiatives are frequent, clearly defining the scope of practice for nurses is essential and needs to be done through government mandates. Further studies are essential to define what the scope of practice should include.

Exploring nurses' work-related stress in an acute care hospital in KSA.

OBJECTIVES: This study aimed to assess the perceived work-related-stress of staff nurses and determine the relationship between work-related stress and demographic profile. METHODS: This study used a descriptive cross-sectional design and was conducted in a secondary public hospital (staff nurses = 178, bed capacity = 225) in Riyadh, KSA. The hospital provides medical and surgical services that are important to achieve optimum quality patient care and services. In total, 178 staff nurses were interviewed, but 15 responses were excluded because of missing data (response rate: 92.52%). RESULTS: Nurses reported a moderately stressful work environment. Nationality was found to be a significant predictor of nurses' stress levels. Indian nurses had higher stress levels compared with nurses of other nationalities. Working hours per week was another significant predictor of stress. CONCLUSION: This study highlighted perceived work-related stress of staff nurses and determined the relationship between work-related stress and demographic profile. Most nurses were moderately stressed. Working hours were associated directly with stress level. The study findings can serve as a guide for establishing human resources policies aiming at reducing nurses' stress and, thereby, promoting improved health care and task force work performance.

Effectiveness of an early mobility protocol for stroke patients in Intensive Care Unit.

OBJECTIVE: To evaluate the effectiveness of an early mobility protocol for stroke patients in the intensive care unit. METHODS: Participants were patients with first or recurrent stroke (n=60, age=49.02+/- 6.36 years, body mass index=32.95+/-5.67 kg/m2) admitted to the intensive care stroke unit in general hospitals, Riyadh during October and December 2016. Single group pretest-posttest design involving an early mobility protocol was started within first 24 hours admission. Pre and post measurements of muscle strength, pulmonary function and quality of life were carried out. RESULTS: There were significant improvements in muscle strength of upper and lower extremities` muscles after treatment (p less than 0.05), pulmonary functions including Forced Vital Capacity, Forced Expiratory Volume 1 (p less than 0.05) and quality of life, namely, Barthel Index and modified Rankin Scale (p less than 0.01). CONCLUSION: This study demonstrates that initiating an early mobility protocol is safe and effective for intensive care unit stroke patients and supports introducing the current protocol as a standard protocol in neurogenic Intensive Care Units.

Maternity-ward nurses' kangaroo mother care attitudes and practices: implications and future challenges.

BACKGROUND: Successful implementation of KMC depends on the attitudes and practices of maternity-ward nurses. This study assessed the attitudes and practices of kangaroo mother care (KMC) by maternity-ward nurses in the Eastern Philippines. METHODS: A cross-sectional survey design was used in the study. A convenience sample of 138 maternity-ward nurses working in six rural health units (RHUs), two public hospitals and one private hospital. A questionnaire was used to assess the attitudes and practices of KMC by the recruited maternity-ward nurses. Data were collected from June to July 2017 in maternity-ward nurses' workplace. RESULTS: Maternity-ward nurses have a positive attitude towards KMC. Age is associated with attitudes towards KMC. Married maternity-ward nurses have exhibit better attitudes and practice than single nurses. The attitudes of maternity-ward nurses with master's degrees towards KMC are more positive than those with BSN degrees. Maternity-ward nurses from Rural Health Units have better attitudes but fewer support to practice the KMC skills than those from public hospitals. CONCLUSIONS: Maternity-ward nurses who are married, hold master's degrees and are working in RHUs have better KMC attitudes than their counterparts. Maternity-ward nurses have good KMC attitude but poor KMC practices. The KMC information and skills of maternity-ward nurses should be continuously updated to implement KMC effectively and efficiently.

Assessment of pain. Knowledge, attitudes, and practices of health care providers in Almadinah Almunawwarah, Saudi Arabia.

OBJECTIVE: To present data on knowledge and attitudes toward pain assessment among health care providers in Almadinah Almunawwarah, Saudi Arabia. METHODS: This exploratory study required at least 100 participants to attain an effect size of 0.2 or larger. A convenience sample was recruited from the major hospitals in Almadinah Almunawwarah, Saudi Arabia; King Fahad Hospital, Ohud Hospital, Alansar Hospital, Almeqat Hospital, and the Maternity Hospital. Data collection occurred between January and April 2014. Knowledge of pain assessment was examined by administering the Knowledge and Attitudes Survey Regarding Pain. RESULTS: Data from 105 participants was collected. Seventy-three participants scored 44% or below (69.5%), and 32 participants scored 45% and above (30.5%). Additionally, only 6 participants (5.7%) scored above 60%. There were significant differences between male and female scores (p=0.05), physicians` and nurses` scores (p=0.001), and level of education (p=0.009). There were no significant differences in the passing scores across means of nationality, the department where participants worked, years of experience, and age of participants. CONCLUSION: There is a deficit in pain assessment knowledge, and pain management in the study group. Continuous education on pain assessment is required to increase the health care providers` knowledge, and enhance their practices regarding pain assessment and treatment.