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.

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis.

Background Body mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. Methodology This cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using self-reported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. Results After controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m2, 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. Conclusions Heart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

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.

Knowledge, beliefs, and practice regarding human papillomavirus (HPV) vaccination among American college students: Application of the health belief model.

Objective: To identify facilitators and barriers to human papillomavirus (HPV) vaccination among college students.Methods: A cross-sectional survey with college students (N = 306) between the ages of 18 and 26 was conducted using a computer-delivered survey via iPad. A survey was designed to assess HPV/HPV vaccine-related knowledge, beliefs, and vaccination practices.Results: Low completion rates for the HPV vaccination series (females: 28.9%; males: 11.5%) were observed among college students. The compliance was lower among students who were black American and did not speak English at home. In contrast, the compliance was higher among those who had received any recommendation for HPV vaccination, those with higher knowledge about HPV and HPV vaccine, and higher perceived benefits of vaccination.Conclusions: Increasing knowledge of HPV infection, including the benefits of HPV vaccination and health care providers recommending the HPV vaccine, may increase HPV vaccination among college students and reduce the incidence of the disease.

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.

Factors Associated with Intensive Care Units' Nurses Frequency of Performing Pressure Injury Prevention: A Cross-sectional Study.

AIM: To explore factors associated with frequency of performing pressure injury prevention measures among a sample of intensive care units' nurses. BACKGROUND: Pressure injuries may be unavoidable in specific circumstances; however, most pressure injuries may be considered preventable. Nursing actions at the point of care play a significant role in shaping pressure injury prevention. METHODS: A cross-sectional, descriptive correlational design was used. Using convenience sampling method, 162 intensive care units' nurses were recruited from three hospitals in Riyadh, Saudi Arabia. The participants completed a survey that included Nurses' Practice of Pressure Ulcer Prevention Questionnaire, Pressure Ulcer Knowledge Assessment Tool, Attitude toward Pressure Ulcer Prevention, Pressure Ulcer Prevention Barriers instrument, and Intention to Use Pressure Injury Preventive Measures instrument. Data were analyzed using descriptive and inferential statistics. RESULTS: Nurses lack of knowledge about pressure injury preventions. However, they possessed positive attitudes toward pressure injury preventions. Nurses faced some barriers to prevent pressure injuries. Most nurses agreed that there was social pressure to prevent pressure injury. They had an intention to use preventive measures to prevent pressure injury. Nurses performed pressure injury prevention frequently. The bivariate and multivariate analyses showed only barriers to prevent pressure injury were negatively associated with frequency of performing pressure injury prevention. CONCLUSIONS: Several factors that may influence ICU nurses' behavior to perform PIPs have been identified. The participants reflected positive attitude, positive social pressure, and intention to perform PIPs. Nevertheless, they need to improve their knowledge of PIPs and reduce the barriers prevented them from performing PIPs.

Exploring Levels and Correlates of Depression Literacy Among Older Korean Immigrants.

OBJECTIVES: Despite the high prevalence of depression among older Korean Americans (KAs), there has been very little research on depression literacy among older KAs. This study identified specific areas of improvement in depression literacy to address mental health promotion among KAs. Twenty-two items on the depression literacy scale were grouped under five key themes: incidence and prognosis, differential symptoms, symptom recognition, non-pharmacological effectiveness, and pharmacological knowledge. This study aimed to assess the level of understanding depression literacy based on five domains and identify factors associated with depression literacy and its domains among older KAs. METHODS: A cross-sectional study with 178 KAs aged 60 years and older was conducted in the Washington DC Metro area. Interviewer and self-administered questionnaires were used to collect data. Multiple linear regression analyses were conducted to identify factors associated with depression literacy and its domains. Statistical significance was set at p < .05 for analyses. RESULTS: Knowledge pertaining to all 5 depression literacy domains was low, particularly on pharmacological treatment and differential symptoms were noticeably low. The majority of participants had misconceptions about antidepressants. 86% believed that antidepressants can have a rapid effect on symptoms, 82.6% believed people with depression should stop taking antidepressants as soon as they feel better, and 66.3% believed antidepressants were addictive. CONCLUSION: Misperception about depression and antidepressants may be associated with poor mental health outcomes among older KAs. Culturally-tailored education for older KAs with limited English proficiency could be beneficial in promoting depression literacy and reducing stigma or misconceptions regarding depression and treatments.

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.

English Language Usage and Academic Achievement Among Nursing Students: A Cross-Sectional Study.

Introduction: Nursing students who speak English as a second language (ESL) face academic challenges such as academic and clinical underperformance and slower course progression. English language usage and its effect on Saudi undergraduate nursing students' academic achievement is limited in the literature. Objectives: To identify the level of and the effect of English language usage on academic achievement among Saudi undergraduate nursing students. Methods: A cross-sectional, correlational descriptive design was employed. Data were collected from a convenience sample of nursing students (N = 90) attending a public nursing program in Saudi Arabia using English Language Usage Scale (ELUS-11). Data were analyzed using univariate, bivariate, and multivariate statistics. Results: Saudi nursing students' academic achievement was high. However, their English language usage was low. Yet, the student's highest average score was related to listening, followed by reading, general, writing, and speaking. The general linear model revealed that English language usage influenced academic achievement (B = .026, p <.001) after controlling the sample gender and academic level. Conclusions: The findings showed English language usage was associated with academic achievement. Saudi nursing students were willing to succeed in their studies despite their low levels of English skills. Providing English resources such as courses through extracurricular activities and workshops for the students might enhance their use of English, which might improve their academic achievement.

Professional Quality of Life Among Nurses: Compassion Satisfaction, Burnout, and Secondary Traumatic Stress: A Multisite Study.

Introduction: Increased stressors and decreased job satisfaction are major challenges in nursing. Important factors of better professional quality of life include compassion satisfaction, burnout, and secondary traumatic stress. It is critical to assess these factors to help improve nurses' clinical practices. Objective: The purpose of this study was to determine the relationships between the three factors and associated factors. Methods: A cross-sectional, multisite study was conducted on a convenience sample of 464 nurses working at three public hospitals in Saudi Arabia. The Professional Quality of Life Version 5 was used to collect data. Bivariate and multivariate analyses were run using SPSS. Results: Scores were slightly moderate on the compassion satisfaction, burnout, and secondary traumatic stress levels. Compassion satisfaction was statistically significantly and negatively associated with burnout. A statistically significant relationship was reported between compassion satisfaction and secondary traumatic stress. Further, there was a statistically significant association between burnout and secondary traumatic stress. In regression, only the secondary traumatic stress model was statistically significant. Conclusions: Nurse managers should use highly standard guidelines to reduce secondary traumatic stress levels. Further actions addressing potential issues for improving compassion satisfaction and reducing burnout levels among nurses are also recommended.

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.

Reducing potential errors associated with insulin administration: An integrative review.

RATIONALE, AIMS, OBJECTIVES: Around one-third of medication errors resulting in death within 48 h involve insulin therapy. Despite a growing number of interventional strategies that have been published over the past decade, it remains unclear which of these interventions is effective in reducing insulin errors. Therefore, the study aimed to synthesize interventions to reduce the frequency of insulin errors in either home or health care settings. METHODS: This integrative review was conducted based on Whittemore and Knafl's four steps, which includes problem identification, literature search, data analysis and presentation. Six databases including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Scopus, PsychInfo and Cochrane were searched from January 2010 through July 2021. The level of evidence quality was assessed according to the Johns Hopkins Nursing Evidence-Based Practice grading scale. RESULTS: Sixteen studies meeting inclusion criteria were reviewed. The results provide strong support for teaching patients how to use automated bolus calculators and educating patients to self-administer insulin to prevent insulin errors in the home setting. Computerized protocols, education and double-checking procedures were also found to be effective strategies for minimizing insulin errors in healthcare settings. CONCLUSION: While the strategies might be effective in reducing insulin administration errors in the home settings, computerized protocols, continuing education and the manual validation of insulin products appear to be the most effective strategies for reducing such insulin errors in healthcare settings. Understanding these findings may help clinicians and patients to decrease the number of insulin errors administration.

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.

Nurses' evidence-based practice knowledge, attitudes and implementation: A cross-sectional study.

AIM AND OBJECTIVES: To examine the influence of staff nurses' individual factors on knowledge, attitudes and implementation of evidence-based practice in Saudi Arabia and to identify facilitators and barriers to evidence-based practice implementation. BACKGROUND: Evidence-based practice has been considered as a key for healthcare quality measure. The literature, however, shows that nurses worldwide are not implementing evidence-based practice as expected and recommended by governing agencies. In Saudi Arabia, evidence-based practice implementation has not been addressed sufficiently. DESIGN: A cross-sectional, correlational design was used. We have complied with the guidelines of STROBE Checklist in presenting this research. A convenience sample of staff nurses (n = 227) was selected from four hospitals in Riyadh, Saudi Arabia. The survey questions included the Evidence-based Practice Questionnaire and individual factors. Data were analysed using multiple linear regression models. RESULTS: Attitudes towards evidence-based practice had the highest mean followed by evidence-based practice knowledge and implementation means. Evidence-based practice training and research involvement were associated with knowledge in the bivariate and multivariate analyses. None of the individual factors were associated with attitudes. However, knowledge was associated with attitudes. Knowledge and attitudes influenced evidence-based practice implementation positively. Unexpectedly, receiving evidence-based practice training made it more difficult for nurses to participate in evidence-based practice implementation process. We found that attitudes partially mediated the relationship between knowledge and evidence-based practice implementation. CONCLUSION: Nurses in Saudi Arabia are willing to be involved in the evidence-based practice process. However, nurses identified that they need to improve their knowledge and skills in order to be active participants in the process. RELEVANCE TO CLINICAL PRACTICE: Organisations and nursing leadership may benefit from developing a comprehensive strategy to promote staff nurses' involvement in the evidence-based practice process through providing continuing education and mentoring programmes about evidence-based practice.