Nursing faculty perceptions of simulation culture readiness in Saudi universities: a cross-sectional study

BACKGROUND

Academic programs are increasing simulation-based learning in Saudi Arabia during COVID-19 pandemic; however, there is limited knowledge about these universities' simulation culture readiness. Thus, the purpose of this study was to explore faculty perceptions of the readiness to integrate simulation into nursing programs.

METHODS

This cross-sectional correlational study recruited faculty members in four nursing colleges at Saudi universities using the simulation culture organizational readiness survey 36-item questionnaire. A total of 88 faculty members from four Saudi universities were included. Descriptive, Pearson's correlation, independent sample t-test, and analysis of covariance analysis were utilized in this study.

RESULTS

Nearly 39.8% and 38.6% of the participants had Moderately and Very Much overall readiness for the simulation-based education (SBE), respectively. There were significant correlations between the summary impression on simulation culture readiness measures and simulation culture organizational readiness survey subscales (p < 0.001). Three simulation culture organizational readiness survey subscales (defined need and support for change, readiness for culture change, and time, personnel, and resource readiness) and the overall readiness for SBE were correlated with age, years since highest degree, years of experience in academia, and years using simulation in teaching (p < 0.05). The sustainability practices to embed culture subscale and summary impression were only correlated significantly with the number of years using simulation in teaching (p = 0.016 and 0.022, respectively). Females had a significantly higher mean in the sustainability practices to embed culture subscale (p = 0.006) and the overall readiness for simulation-based education (p = 0.05). Furthermore, there were significant differences among the highest degree in the overall readiness for SBE (p = 0.026), summary impression (p = 0.001), the defined need and support subscale (p = 0.05), the sustainability practices to embed culture subscale (p = 0.029), and the time, personnel, and resource readiness subscale (p = 0.015).

CONCLUSIONS

Favorable simulation culture readiness results suggest great opportunities to advance clinical competencies in academic curricula and optimize educational outcomes. Nurse academic leaders should identify needs and resources to enhance simulation readiness and encourage the integration of simulation in nursing education.

Assessment of nurses' knowledge, attitude and implementation of skin-to-skin care within the perinatal setting in Saudi Arabia: Survey study

AIM

To evaluate knowledge, attitude and implementation of Skin-to-Skin Care (SSC) among nurses and to assess the implementation of SSC in the perinatal setting.

DESIGN

A cross-sectional study design was implemented utilizing survey distributed among critical care paediatric and neonatal nurses.

METHODS

The data collection form was pre-structured validated tool consisted of two main sections; socio-demographic characteristics and Likert scale of 20 items covering four main domains in; knowledge, attitude, education and implementation of SSC.

RESULTS

The vast majority of the sample 91 (98%) were females with mean age and mean years of experience 33.5 ± 6.5 and 9.7 ± 6.5 years respectively. Almost half of them 45 (48.4%) work in obstetric and labor and delivery units. Correlation coefficient revealed a significant association between the total educational years of nursing degree and SSC. The results showed nurses with bachelor or master significantly more knowledgeable and skilled in implementing SSC compared to others.

A comparison of three thromboprophylaxis regimens in critically ill COVID-19 patients: An analysis of real-world data

Introduction

Thrombotic complications of coronavirus disease 2019 (COVID-19) have received considerable attention. Although numerous conflicting findings have compared escalated thromboprophylaxis doses with a standard dose to prevent thrombosis, there is a paucity of literature comparing clinical outcomes in three different anticoagulation dosing regimens. Thus, we investigated the effectiveness and safety profiles of standard, intermediate, and high-anti-coagulation dosing strategies in COVID-19 critically ill patients.

Methodology

This retrospective multicenter cohort study of intensive care unit (ICU) patients from the period of April 2020 to August 2021 in four Saudi Arabian centers. Inclusion criteria were age ≥ 18 years, diagnosis with severe or critical COVID-19 infection, and receiving prophylactic anticoagulant dose within 24–48 h of ICU admission. The primary endpoint was a composite of thrombotic events, with mortality rate and minor or major bleeding serving as secondary endpoints. We applied survival analyses with a matching weights procedure to control for confounding variables in the three arms.

Results

A total of 811 patient records were reviewed, with 551 (standard-dose = 192, intermediate-dose = 180, and high-dose = 179) included in the analysis. After using weights matching, we found that the standard-dose group was not associated with an increase in the composite thrombotic events endpoint when compared to the intermediate-dose group {19.8 vs. 25%; adjusted hazard ratio (aHR) =1.46, [95% confidence of interval (CI), 0.94–2.26]} or when compared to high-dose group [19.8 vs. 24%; aHR = 1.22 (95% CI, 0.88–1.72)]. Also, there were no statistically significant differences in overall in-hospital mortality between the standard-dose and the intermediate-dose group [51 vs. 53.4%; aHR = 1.4 (95% CI, 0.88–2.33)] or standard-dose and high-dose group [51 vs. 61.1%; aHR = 1.3 (95% CI, 0.83–2.20)]. Moreover, the risk of major bleeding was comparable in all three groups [standard vs. intermediate: 4.8 vs. 2.8%; aHR = 0.8 (95% CI, 0.23–2.74); standard vs. high: 4.8 vs. 9%; aHR = 2.1 (95% CI, 0.79–5.80)]. However, intermediate-dose and high-dose were both associated with an increase in minor bleeding incidence with aHR = 2.9 (95% CI, 1.26–6.80) and aHR = 3.9 (95% CI, 1.73–8.76), respectively.

Conclusion

Among COVID-19 patients admitted to the ICU, the three dosing regimens did not significantly affect the composite of thrombotic events and mortality. Compared with the standard-dose regimen, intermediate and high-dosing thromboprophylaxis were associated with a higher risk of minor but not major bleeding. Thus, these data recommend a standard dose as the preferred regimen.

Primiparous Adaptation with Postpartum Health Issues in Jeddah City, Kingdom of Saudi Arabia: A Quantitative Study

Background: The postpartum or puerperium period is the first 6 weeks after giving birth to an infant. The postpartum period can have negative implications, especially in first-time mothers. With their transition into motherhood, new mothers adopt new lifestyles, which can affect their physical wellbeing. Childbirth has physical, psychological, and emotional effects on women as they try to adapt to their new roles in order to get through this period with no or minimal health issues. Study Aim: The current study aims to explore primiparous adaptations with postpartum health issues in Jeddah City at Kingdom of Saudi Arabia. Methods: The research design is quantitative cross-sectional. A structured questionnaire was developed to collect data in relation to depression and weight gain, which consider the most common postpartum health issues. The inclusion criteria of the participants are: primipara, 2 to 6 months postpartum, and living in Jeddah. Results: 140 participants were included in the study. Mothers gained approximately 9.2 kg within the fifth to ninth month after giving birth. Discussion: Postpartum weight retention is a primary challenge in the majority of primiparous mothers and results in reduced quality of life. Nurses were always available to answer questions related to the postpartum health issues and explained the expectations to the family members. Conclusions: Childbirth and the postpartum period for first-time mothers are crucial in their lives as they try to adapt to a new way of life. The postpartum period can have negative implications, especially in first-time mothers. With their transition into motherhood, new mothers adopt new lifestyles, which can affect their physical wellbeing. More research is needed to explore the impact of postpartum health issues in Saudi Arabia.

Effectiveness and safety of favipiravir compared to supportive care in moderately to critically ill COVID-19 patients: a retrospective study with propensity score matching sensitivity analysis

INTRODUCTION

Favipiravir is a repurposed drug to treat coronavirus 2019 (COVID-19). Due to a lack of available real-world data, we assessed its effectiveness and safety in moderately to critically ill COVID-19 patients.

METHODS

This retrospective study was conducted in two public/specialty hospitals in Saudi Arabia. We included patients ≥18 years) admitted April-August 2020 with confirmed SARS-CoV-2 diagnosed by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab. Patients received either favipiravir (1800 mg or 1600 mg twice daily loading dose, followed by 800 mg or 600 mg twice daily) or supportive-care treatment. Patients were excluded if they were outside the study period, classified as having a mild form of the disease per WHO criteria, or had an incomplete patient file. Kaplan-Meier (KM) models were used to estimate median time to discharge. Discharge ratios, progression to mechanical ventilation, and mortality outcomes were estimated across the severity spectrum using Cox proportional-hazards models. As a sensitivity analysis, we performed propensity score-matching (PSM) analysis.

RESULTS

Overall, median time to discharge was 10 days (95%CI = 9-10) in the favipiravir arm versus 15 days (95%CI = 14-16) in the supportive-care arm. The accelerated discharge benefit was seen across the COVID-19 spectrum of severity. The adjusted discharge ratio was 1.96 (95%CI = 1.56-2.46). Progression to mechanical ventilation was slower with favipiravir (HRadj = 0.10, 95%CI = 0.04-0.29). There was no significant effect on mortality (HRadj = 1.56, 95%CI = 0.73-3.36). There was a statistically non-significant trend toward worse outcomes in the critical category (HRadj = 2.80, 95%CI = 0.99-7.89). Age was an independent risk factor for mortality in mechanically ventilated patients. PSM analyses confirmed these findings.

CONCLUSION

Favipiravir was associated with clinical benefits, including accelerated discharge rate and less progression to mechanical ventilation; however, no overall mortality benefits were seen across the severity spectrum.

The Perceptions of Nurses and Nursing Students Regarding Family Involvement in the Care of Hospitalized Adult Patients

Over the past few decades, there have been concerns regarding the humanization of healthcare and the involvement of family members in patients' hospital care. The attitudes of hospitals toward welcoming families in this respect have improved. In Arab culture, the main core of society is considered to be the family, not the individual. The objective behind involving family in patient care is to meet patients' support needs. Consequently, this involvement affects nurses and their attitudes toward the importance of family involvement in patient care.

OBJECTIVES

To describe nurses' and nursing students' perceptions of family involvement in the care of hospitalized adult patients in Saudi Arabia.

DESIGN

This study used a quantitative descriptive cross-sectional design. The data were collected using a convenience sampling survey via social media.

RESULTS

A total of 270 participants (staff and students) took part in this study, including 232 (85.9%) females and 38 (14.1%) males. Moreover, a high percentage of participants (78.8%) acknowledged that family presence strongly affected the improvement of the patient's condition. However, 69.3% of participants thought that involving family members during special care processes or cardiopulmonary resuscitation (CPR) would be traumatizing for these individuals. Moreover, there was a significant diffidence between the attitudes of the nurses and nursing students toward family involvement and the number of years of employment (F = 3.60, p < 0.05). On the contrary, there were insignificant differences between the attitudes of the nurses and nursing students toward family involvement and their gender, nationality, age, education level, and years of work experience in Saudi Arabia (p > 0.05). Furthermore, the regression analysis showed a significant negative correlation between nurses' years of employment and their support of family involvement in patient care (ß = -0.20, SE = 0.08, t = -2.70, p = 0.01).

CONCLUSIONS

Nurses with more experience showed no support for family involvement in patient care. We have to consider the clinical barriers that affect nurses' support for family involvement in patient-centered care, such as hospital polices, guidelines, and the model used for family-centered care integration in the hospital system to facilitate the interaction between healthcare providers and family members.

The Level of Lymphedema Awareness among Women with Breast Cancer in the Kingdom of Saudi Arabia

BACKGROUND

Lymphedema is a condition in which excessive fluid accumulates in soft tissues. It is a common complication of breast cancer treatments. It can lead to serious consequences and interfere with the activity of daily living. This study aimed to determine the level of awareness of breast-cancer-related lymphedema (BCRL) among women with breast cancer in the Kingdom of Saudi Arabia. This was a descriptive quantitative cross-sectional design that included a convenience sample of women diagnosed with breast cancer in the Kingdom of Saudi Arabia. Data were collected by distributing a self-administrated online questionnaire consisting of four parts, including demographic data (five items), the status of education about BCRL (three items), basic medical history of breast cancer (six items), and BCRL level of awareness of risk factors and management (nine items).

RESULTS

In total, 95 out of 135 of participants did not know about lymphedema, 119 of the participants (88.1%) did not receive any explanation about the possibility of lymphedema from their medical team before surgery, and 121 of them (89.6%) did not receive it after surgery. The most significant factor affecting participants' level of awareness regarding BCRL was the lack of information about the possibility of BCRL occurrence, which was not provided to them by the medical team.

RECOMMENDATION

Early and continuous education for future management is essential to prevent problems related to BCRL and improve quality of life.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].