Assessment of Patient Safety Culture Among Nurses Working at Tertiary Care Hospitals in Aljouf Region, Saudi Arabia.

INTRODUCTION: Patient safety is a fundamental element in healthcare quality and a major challenge in achieving universal health coverage, especially in low- and middle-income countries. The first step to improve patient safety is to evaluate the safety culture in hospitals. This study aimed to investigate the patient safety culture among nurses and determine the factors affecting it. METHODS: This cross-sectional study was conducted among 423 nurses working at tertiary care hospitals in the Al-Jouf region in Saudi Arabia. RESULTS: The highest score for patient safety among nurses was for teamwork within units (16.41 ± 2.44). The lowest score was for nonpunitive response to errors (5.87 ± 1.92). In addition, 83% of the participants did not report any events in the past 12 months. More perception of patient safety was significantly higher among females than males in dimensions of teamwork within units, frequency of events reported, and staffing. Furthermore, teamwork within units, management support for patient safety, staffing, non-punitive response to errors, and handoffs and transitions were significantly higher among participants in direct contact with patients. The Hospital Survey on Patient Safety Culture (HSOPSC) scale is significantly higher among non-Saudi nurses, nurses with bachelor's education, nurses with less working hours per week, and those who had training on patient safety. CONCLUSION: The current study showed that the majority of the participants did not report any events in the past 12 months. The highest score for patient safety culture dimensions among nurses was for teamwork within units while the lowest score was for nonpunitive response to errors.

Metastasis of Clear Cell Renal Cell Carcinoma to the Parotid Gland: A Case Report.

Parotid gland metastases from distant primary malignancies are uncommon and present diagnostic challenges for clinicians. We present the case of a 65-year-old male with a history of clear cell subtype of renal cell carcinoma who presented with a painless swelling in the right parotid region. His medical history was significant for a right-sided renal cell carcinoma, for which he had undergone a radical nephrectomy five years ago. The patient's physical examination revealed a firm, non-tender mass in the right parotid gland region. Imaging studies, including ultrasound and contrast-enhanced computed tomography, confirmed the presence of a solid-enhancing lesion within the parotid gland. Fine-needle aspiration biopsy provided histological evidence of malignant cells with features consistent with a clear renal cell carcinoma cell subtype. This is consistent with diagnosing metastatic renal cell carcinoma to the parotid gland. This case highlights the significance of considering metastatic disease in the differential diagnosis of parotid swellings, particularly in patients with a history of remote malignancy. Systemic targeted therapy, with a tyrosine kinase inhibitor, emerged as an effective treatment option, emphasizing the importance of personalized approaches in managing rare clinical scenarios. Tailored management is crucial in optimizing outcomes for patients with parotid gland metastases, improving their overall prognosis and quality of life.