The impact of comprehensive licensure review on nursing students' clinical competence, self-efficacy, and work readiness.

This study aims to assess the effectiveness of comprehensive licensure reviews and adaptive quizzing assignments on nursing students' clinical competence, self-efficacy, and work readiness-an under-researched topic. Additionally, it seeks to explore the mediating effect of self-efficacy in the relationship between students' clinical competence and work readiness. A quasi-experimental (pre- and post-test), single-group design was employed. The study was conducted in a public university in Saudi Arabia and included a total of 293 senior nursing students in their last year of the bachelor program. An intervention was developed based on the blueprints of the Saudi Nursing Licensing Exam and NCLEX-RN and consisted of a weekly 3-h synchronous comprehensive licensure review bundled with 23 adaptive quizzing assignments over 15 weeks. Data were collected prior to and after the intervention using three scales: clinical competence, self-efficacy, and work readiness. The mean scores of clinical competence, self-efficacy, and two subscales of work readiness (work competence and social intelligence) increased significantly post-intervention. Self-efficacy (ß = 0.353, p < 0.001) and clinical competence (ß = 0.251, p < 0.001) influenced work readiness (F [5, 226] = 21.03, p < 0.001) and accounted for 31.8% of the explained variability in work readiness. In the mediation analysis, clinical competence had a significant and indirect effect on work readiness through self-efficacy (B = 0.464, p < 0.001, 95% CI 0.250 to 0.699). The proportion of mediation indicated that 37.2% of the total effect of clinical competence on work readiness was due to the indirect effect of self-efficacy. Comprehensive licensure review and adaptive quizzing assignments improve students' perceptions of clinical competence and self-efficacy. Such interventions could ease the transition of senior nursing students to clinical practice.

Comprehensive licensure review and adaptive quizzing assignments for enhancement of end-of-programme exit examination scores in Saudi Arabia: a quasi-experimental study.

OBJECTIVE: This study explores the effectiveness of a comprehensive licensure review and adaptive quizzing assignments intervention in improving the performance of undergraduate senior nursing students on the end-of-programme exit exam. DESIGN: A quasi-experimental single-group design was used to compare pretest and post-test scores through computerised adaptive tests. SETTING: The setting was a nursing college in Saudi Arabia. PARTICIPANTS: The study included 292 senior nursing students enrolled in the Bachelor of Science in Nursing programme. INTERVENTION: A comprehensive licensure review bundled with adaptive quizzing assignments was delivered over 15 weeks in the academic year 2021-2022. The bundle was guided by the elaboration theory, and it included 3-hour synchronous lectures every week and 23 adaptive quizzing assignments that covered weekly content. PRIMARY AND SECONDARY OUTCOME MEASURES: Students' mastery scores and the percentage of correct answers were the primary and secondary measures, respectively. Both measures were collected in the pretest and post-test (exit examination). Additionally, demographic characteristics were collected in the pre-test using an online survey. RESULTS: The overall mean of the mastery score was statistically significantly higher in the exit exam (M=2.51, SD=1.70) than in the pretest (M=1.45, SD=0.44; p<0.001). Although the overall mean of the mastery score in the exit exam did not reach the cut-off score, students who demonstrated the required knowledge and satisfactory performance in the pretest achieved a mastery score above the cut-off. The percentage of correct answers was statistically significantly higher in the exit exam (M=58.59%, SD=9.50) than in the pretest (M=49.32%, SD=9.78; p<0.001). A statistically significant difference in students' performance based on gender, age and grade point average was observed. CONCLUSIONS: A comprehensive licensure review and adaptive quizzing assignments intervention bundle fostered the performance of undergraduate nursing students in the end-of-programme exit exam.

Effects of mindfulness-based childbirth education on prenatal anxiety: A quasi-experimental study.

Pregnancy and childbirth represent a sequence of challenging events, and adaptive coping strategies are necessary to maintain emotional wellbeing. The present study aimed to assess the effectiveness of applying a mindfulness-based intervention (MBI) for pregnant Saudi women with anxiety in the third trimester. A quasi-experimental, within- and between-subject design was used for this study. Data were collected at two points between February and August 2021 from 88 participants using the Pregnancy-Related Anxiety Questionnaire and the Five Facet Mindfulness Questionnaire. A large, statistically significant reduction was observed in the mean scores of participants' anxiety post-intervention. Furthermore, the anxiety level in the intervention group was very low post-intervention compared to that in the control group. Level of education and spontaneous or medically necessary abortion significantly influenced participants' anxiety. The MBI sessions helped nulliparous women experience less anxiety during pregnancy. Healthcare providers' awareness about the importance of incorporating mindfulness in childbirth education should be increased. Future research should examine the long-term effects of mindfulness-based techniques on maternal health.

Patient activation, adherence to hypertension treatment plans and blood pressure control in Saudi Arabia: a cross-sectional study.

OBJECTIVES: To explore the relationship between patient activation, adherence to hypertension treatment plans, blood pressure control and other important demographic factors. DESIGN: A cross-sectional study. SETTING: Primary healthcare centres in Riyadh province, Saudi Arabia. PARTICIPANTS: A total of 114 adults with hypertension, including 68 men and 46 women. OUTCOME MEASUREMENTS: Blood pressure control is achieved if (a) patients under 80 years of age with treated hypertension have blood pressure under 140/90 mm Hg or (b) patients aged 80 years or over with treated hypertension have blood pressure under 150/90 mm Hg. Secondary outcomes included patient activation, adherence to hypertension treatment plans and demographic factors (age, gender, education, income and comorbidity). Data were analysed using Pearson's correlation and multiple regression models. RESULTS: 57% (n=66) of participants did not achieve the ideal blood pressure target. Perfect adherence to hypertension treatment plans was significantly associated with lower systolic (r=-0.38, p<0.01) and diastolic blood pressure (r=-0.50, p<0.01). Age was significantly correlated with patient activation (r=-0.20, p<0.05) and diastolic blood pressure (r=-0.33, p<0.01). There was no statistically significant association between Patient Activation Measure, systolic blood pressure and diastolic blood pressure. In the hierarchical regression analysis, adherence to hypertension treatment plans was found to be a significant predictor and explained 15% of the variance in systolic blood pressure (ß=-0.36, p<0.001) and 26% of the variance in diastolic blood pressure (ß=-0.51, p<0.001). CONCLUSION: The individual and family self-management theory can serve as an effective theory for understanding the key factors in achieving ideal blood pressure target. The majority of patients with hypertension reported lower levels of activation and poor blood pressure control. Inadequate adherence to treatment plans was related to poor blood pressure control. This work is pivotal in devising self-management interventions to assist patients in the management of hypertension disease, especially in Saudi Arabia.

The mediating role of E-learning motivation on the relationship between technology access and satisfaction with E-learning.

AIM: To examine the e-learning motivation mediating role on the relationship between technology access and satisfaction with e-learning among nursing students during COVID-19 pandemic. DESIGN: This is a cross-sectional, descriptive design. METHODS: A convenience sample of students (N = 139) from public and private nursing colleges was recruited in this study. Data were collected using students' satisfaction, motivation and access to technology tools. RESULTS: Nursing students in the study were somewhat satisfied with e-learning, had access to the required technology for e-learning and had moderate levels of e-learning motivation. The multiple regression analysis showed that technology access and e-learning motivation influenced and explained 30.4% of the variance in satisfaction with e-learning. Previous experience with e-learning was associated with satisfaction with e-learning. A series of regression analyses revealed that e-learning motivation partially mediated the relationship between technology access and satisfaction with e-learning.

Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence.

AIMS: To assess nursing students' attitudes, professional roles, perceived knowledge and preparedness in managing intimate partner violence. DESIGN: A cross-sectional descriptive study design was used. METHODS: The sample consisted of 191 nursing students from 14 universities in Saudi Arabia. Data were collected from November to December 2021 using the Inventory of Beliefs about Intimate Partner Violence, Nursing Roles and Values, Educational Preparedness and Self-Efficacy scales. RESULTS: The students' attitudes, professional roles, perceived knowledge and preparedness were moderate. When nursing students perceived themselves as knowledgeable, they rejected intimate partner violence, were in favour of their roles in managing intimate partner violence and were confident in their abilities to deal with this issue in practice. Only a quarter of the participants had received education on intimate partner violence although more than half of them were in their fourth year. Female participants had experienced domestic violence/intimate partner violence at a greater rate than male participants. Nursing students who had been exposed to education on intimate partner violence rejected intimate partner violence, but those who experienced domestic violence/intimate partner violence had more tolerant attitudes. CONCLUSION: This study helps identify potential barriers to preparing nursing students for providing care for victims of intimate partner violence. There is a lack of adequate intimate partner violence educational content in nursing curricula. Establishing effective intimate partner violence education that integrates clinical training in nursing schools is crucial for enhancing students' attitudes and confidence in managing intimate partner violence. IMPACT: Intimate partner violence (IPV) against women is a major global health problem leading to serious long-term physical and mental health consequences. Nurses have professional roles to fulfil in preventing and managing IPV. Little is known about the attitudes and preparedness of nursing students to manage IPV, especially in the Middle East. Nursing students neither tolerated nor justified IPV and possessed moderate views about the role of nurses in managing it. The students believed that they had adequate knowledge, but their preparedness to manage IPV was lower than their perceived knowledge. A positive and significant relationship was found between IPV education and students' attitudes, although IPV education was not adequately established in undergraduate nursing programs in Saudi Arabia. The prevalence of domestic violence/IPV experiences among the participants was considerable and was higher among female participants. Personally experiencing violence had a significant negative influence on the students' attitudes toward IPV. Nursing curricula should include IPV education that offers training opportunities where the students are able to apply theory in practice. Nursing schools must provide support and consultation for students who are victims or survivors of domestic violence/IPV. Further studies are needed to investigate the effects of IPV on students' attitudes and preparedness for managing it in clinical settings.

The impact of a 12-hour educational program on nurses' knowledge and attitudes regarding pain management: a quasi-experimental study.

BACKGROUND: Proper pain assessment is fundamental to effective pain management. Training nursing staff is critical for improving pain assessment competence and patient clinical outcomes. However, there is a dearth of research examining interventions that can enhance nurses' knowledge and attitudes toward pain management, especially in Saudi Arabia. Thus, this study aimed to evaluate the effectiveness of a structured education program on nurses' knowledge and attitudes towards pain management. METHODS: A quasi-experimental design was used. The study sample included 124 registered nurses working in intensive care or inpatient units in Saudi Arabia. Data were collected between March and September 2021 using a knowledge and attitudes survey regarding pain, satisfaction with and self-confidence in learning, and the learning self-efficacy scale for clinical skills. RESULTS: Nurses showed moderate levels of knowledge and attitudes regarding pain before (M = 20.3, SD = 4.80) pain management education, which were significantly higher after the intervention (M = 22.2, SD = 5.09, t = 2.87, p < .01). Before the intervention, nurses with a baccalaureate degree had more knowledge and better attitudes regarding pain management than diploma nurses (t = 3.06, p < .01). However, there was no significant difference between the two groups after the intervention (p > .05), indicating that the education was effective in enhancing nurses' knowledge and attitudes, regardless of nursing education level. Nurses in this study had high mean scores for self-confidence in learning (M = 35.6, SD = 4.68, range = 18-40), self-learning efficacy (M = 52.9, SD = 7.70, range = 25-60), and satisfaction with learning (M = 22.2, SD = 3.24, range: 10-25). CONCLUSION: Regular pain education programs can improve nurses' knowledge and attitudes. Increasing the breadth and depth of educational courses, alongside appropriate training, competency-based assessment, and pain education programs, is also recommended. Future research should consider the subjectivity and individualized nature of nursing by including patient satisfaction surveys to measure the improvement in nurses' knowledge and attitudes from the patient perspective.

Organizational Factors Associated with Evidence-Based Practice Knowledge, Attitudes, and Implementation among Nurses in Saudi Arabia.

Evidence-based practice (EBP) is crucial in keeping nurses aware of the current knowledge and improving clinical decision-making. The integration of nurses' EBP competencies and organizational support has been suggested to create an effective arena in implementing EBP. The purpose of the study was to examine organizational factors influencing nurses' EBP knowledge, attitudes, and implementation and identify staff nurses' perceptions of EBP nursing leadership and hospital supports in Saudi Arabia. Data were collected from a convenience sample of staff nurses (N = 227) working in four hospitals using a cross-sectional, correlational descriptive design. Level of education (p < 0.05), EBP training (p < 0.05), unit type (ICU (p < 0.001) and ER (p < 0.01)), perceived nursing leadership (p < 0.001), and work environment (p < 0.05) supports were found significantly associated with nurses' knowledge. Magnet recognition (p < 0.01) and knowledge (p < 0.001) had significant influence on nurses' attitudes. Unit type (ER) (p < 0.05), knowledge (p < 0.001), and attitudes (p < 0.001) were associated with implementation. Encouragement to attend EBP trainings from nursing leadership was perceived by most nurses (51.1%). Nurses reported their hospitals support EBP through training (68.2%). Findings support the need for healthcare systems to create a culture that facilitates EBP implementation to enhance nurses' EBP competencies and improve patients' outcomes. Nursing managers may consider preparing nurses through education.

Cyberloafing behaviours in nursing: The role of nursing stressors.

AIM: To assess the prevalence of minor and serious cyberloafing behaviours among nurses and examine the impact of the nursing stressors on nurses' cyberloafing behaviours. BACKGROUND: Cyberloafing could have a negative influence on employees' job performance, but it also has been argued that it could serve as a coping mechanism to deal with stressful work environments. DESIGN: A cross-sectional descriptive, correlational design. METHODS: Data were collected between September and December 2020 from a convenience sample of staff nurses (N = 291) providing care at a tertiary hospital in Saudi Arabia. Sample characteristics, nursing stressors and cyberloafing behaviours information were collected using self-reported questionnaires. Descriptive, bivariate and multivariate analyses were performed. FINDINGS: Nurses in Saudi Arabia exhibited low levels of minor and serious cyberloafing behaviours. However, they engaged more frequently in minor cyberloafing behaviours more than serious cyberloafing behaviours. Stressors and Internet usage frequency influenced the frequency of minor and serious cyberloafing behaviours. Level of education and nationality impacted serious cyberloafing behaviours only. CONCLUSION: Nursing stressors were associated with cyberloafing behaviours. Other studies on cyberloafing and job stress yielded inconsistent results. Efforts should be taken to avoid the adverse effects of cyberloafing by establishing a clear policy on using the advanced technology for non-work purposes.

Impact of Behavioral Interventions on Patient Activation in Adults with Hypertension: A Systematic Review and Meta-Analysis.

Introduction: Behavioral interventions assist patients in maintaining optimal self-management of their health, especially in those at risk of certain conditions. Little is known about the effects of self-management interventions on patient activation in adults with hypertension. Therefore, this systematic review and meta-analysis aimed to evaluate how self-management strategies affect changes in activation levels in adults with hypertension. Methods: We searched online databases: PubMed, CINAHL, and Cochrane Central Register of Controlled Trials for studies published between January 2004 and May 2021. We included randomized controlled trials that assessed the effects of self-management interventions on patient activation in adults with hypertension and reported patient activation using the patient activation measure (PAM). Results: 4 Four studies (N = 1415 participants) met the inclusion criteria. In adults with hypertension, self-management interventions improved patient activation with moderate strength of evidence. A community-based self-management program, motivational interviewing strategies, and home-based patient-activated care were associated with better PAM scores than usual care. Conclusion: Our findings reinforce the need for healthcare providers to incorporate these interventions into primary care to support the adoption of recommended hypertension self-management behaviors. Future studies must focus on tailoring support to the patient's level of activation in hypertension self-management.

Nurses' perceptions of fall risk factors and fall prevention strategies in acute care settings in Saudi Arabia.

AIM: This study aimed to explore nurses' perceptions of the factors associated with falls and of fall prevention strategies in acute care settings in Saudi Arabia. DESIGN: This is a cross-sectional, correlational, descriptive study. METHODS: Data were collected from 102 nurses using a survey on the risk factors and prevention strategies of injurious falls. RESULTS: We found that impaired balance and muscle strength, limited mobility, and an inability to follow safety instructions were reported as the top factors in falls. Multidisciplinary fall prevention strategies are effective in reducing the prevalence of falls. Nurses with higher levels of education had higher perceptions towards the risk factors of falls. Formal patient safety training, including fall prevention education programmes, were shown to reduce falls by making nurses more aware of fall risk factors and prevention strategies. The findings of this study can be used to inform managers about factors that may contribute to falls in acute care settings.

The Influence of Nurses' Characteristics on Medication Administration Errors: An Integrative Review.

BACKGROUND: Medication administration errors (MAEs) are a frequent cause of morbidity and mortality in acute care settings and can result in a prolonged hospital stay. The WHO estimated that medication errors cost up to $42 billion globally per a year. Therefore, MAEs was among the most common medical errors to occur in acute care settings. Studies of medication error usually focus on system factors, thus creating a gap between what researchers know about the causes of MAEs, and what frontline nurses actually do in the clinical setting. The purpose of this review is to fill a gap in the existing literature by focusing on the relationship between nurses' characteristics and MAEs. METHODS: Online databases were accessed, including CINAHL, PsycINFO, PubMed, Scopus, and Google Scholar from 2007-2020 period. This review was guided by the methods described by Whittemore and Knafl. Studies that addressed the occurrence of medication errors based on RN demographics were included in this review. The included studies were reviewed and analyzed by the two authors. RESULTS: Of the 1141 publications retrieved, 19 studies met inclusion criteria. The result provided strong evidence that nurses' level of education, length of experience, and attendance at training courses, are directly associated with the occurrence of MAEs. There is weak evidence of MAEs being influenced by the age and gender of nurses. Other nurse characteristics, such as cognitive load, frustration with technology, negligence, lack of attentiveness, and nurse ethnicity, are not adequately examined across the reviewed studies necessitates further research. CONCLUSION: Focusing on nurses' characteristics might facilitate other researchers to suggest appropriate interventions that may reduce the incidence of MAEs. Interventional studies may provide convincing evidence as to whether one variable has a causal effect on another variable, and control the influence of confounding variables to enhance the generalizability of the findings.

Virtual Education During COVID-19: Exploring Factors Associated With E-Learning Satisfaction Among Saudi Nursing Students.

BACKGROUND: Because of the COVID-19 pandemic, education and learning processes have been shifted to a completely virtual, online format. Students' satisfaction has been linked to better learning outcomes. PURPOSE: The purpose was to determine factors associated with students' satisfaction with e-learning among Saudi nursing students. METHODS: A cross-sectional, correlational descriptive study was conducted among 139 nursing students from different nursing programs in Saudi Arabia using a self-reported online survey. RESULTS: Previous experience with and readiness for e-learning influenced students' overall satisfaction with e-learning and satisfaction with assessment. Only readiness for e-learning was associated with satisfaction with teaching and generic skills and learning experiences. CONCLUSIONS: This study may enhance faculty members' understandings of factors influencing students' satisfaction with e-learning. Therefore, the urgent national distance education plan may need further development to meet students' needs.