Role delineation of advanced practice nursing: A cross-sectional study.

AIMS: To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. METHODS: A descriptive cross-sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. RESULTS: Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. CONCLUSION: Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national-level APN scope of practice. IMPACTS: Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Work readiness of newly graduated nurses transitioning to practice in Saudi Arabia: A cross-sectional study.

AIMS: To explore work readiness among newly graduated nurses transitioning to practice in Saudi Arabia. BACKGROUND: Many challenges encounter newly graduated nurses when transitioning to practice. Higher work readiness has been associated with smooth transitioning to practice. However, little is known about work readiness among newly graduated nurses in Saudi Arabia. METHODS: Cross-sectional convenience sample of 174 participants. RESULTS: The mean score in work readiness was 338.8 (SD = 69.6). Weekly working hours correlated with organizational acumen (r = 0.208, p ≤ 0.01), social intelligence (r = 0. 217, p ≤ 0.01), work competence (r = 0.173, p ≤ 0.05) and the number of weeks since the start of internship training (r = 0.180, p ≤ 0.05). There were significant mean differences in a) personal work characteristics based on the country (t = 5.582, p < 0.001) and university from which they graduated (f = 15.618, p < 0.001); b) organizational acumen based on having a second job (t = -2.18, p = 0.03), university from which they graduated (f = 1.837, p = 0.002) and whether the hospital was the first-choice preference (t = - 2.837, p = 0.005) and nursing was the first choice of study (t = -2.879, p = 0.005); and c) work competence based on the university from which they graduated (f = 5.267, p = 0.006). CONCLUSIONS: The findings showed the work readiness of newly graduated nurses in Saudi Arabia's context. IMPLICATIONS FOR NURSING MANAGEMENT: Findings have important implications for nurse managers to better design and implement a transition to practice programs for newly graduated nurses to improve their preparedness in their nursing careers.

Development of advanced practice nursing core competencies in Saudi Arabia: A modified Delphi study.

BACKGROUND: Advanced practice nursing requires a diverse set of competencies that define what advanced practice nurses need to know and be able to do to deliver safe, effective, and high-quality healthcare. Given the lack of evidence regarding core competencies and the evolution of advanced practice nursing roles in Saudi Arabia, it is becoming increasingly important to develop core competencies to standardize educational and clinical training programs. OBJECTIVE: To define the core competencies of advanced practice nursing in Saudi Arabia. DESIGN: Utilizing a modified Delphi design and snowball sampling technique, data were collected between April and July 2023 using an online questionnaire consisting of 28 core competencies that was developed based on an in-depth literature review and a critical analysis of advanced practice nursing core competencies published by leading professional organizations. Two rounds of Delphi surveys were conducted. SETTINGS: The study was set in clinical and academic settings in Saudi Arabia. PARTICIPANTS: Nursing experts with graduate degrees as advanced practice nurses. RESULTS: In Round 1, 34 advanced practice nursing experts reached full consensus on 24 of the 28 core competencies, and four core competencies reached partial consensus. Based on suggestions and feedback from the experts, the investigators revised ten core competencies to reflect the improvement suggestions and created three new core competencies. A total of 26 core competencies were used in Round 2, which achieved a full consensus among the 34 advanced practice nursing experts, under the following six core competency domains: knowledge of advanced practice nursing, person-centered care, professional improvement, professionalism, communication and interprofessional partnership, and leadership and system-based practice. CONCLUSIONS: Given the need for a standardized competency framework, the 26 core competencies proposed in our study have the potential to guide education and training in academic programs and facilitate the implementation of advanced practice nursing in clinical settings.

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.

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.

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.