The Association of Transformational Leadership on Safety Practices Among Nurses: The Mediating Role of Patient Safety Culture.

Background: To ensure best possible patient outcomes, patient safety is a major component of healthcare delivery system that needs to be prioritized. Safety practices among nurses are essential to maintain patient safety, especially the practices of medication administration, handover, patient falls and unplanned extubations prevention. Purpose: To investigate the mediating effect of patient safety culture between the relationship of transformational leadership and safety practices among nurses. Methods: The data in this cross-sectional study were gathered from a survey targeted clinical nurses using a random sampling technique. The study was conducted in a medical city in Saudi Arabia, and two hundred nurses were surveyed. The Multifactor Leadership, Hospital Survey on Patient Safety Culture, and Nursing Safety Practice questionnaires were used in the study. Results: The results revealed significant positive associations between transformational leadership, patient safety culture, and nursing safety practices. Moreover, patient safety culture mediates the association between transformational leadership and safety practices among nurses. Conclusion: Enhancing transformational leadership capabilities among nurse managers should be considered in order to improve nursing safety practices. Additionally, patient safety culture should be measured and improved periodically to ensure better nursing safety practices.

Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000-2020: A Systematic Review and Meta-Analysis of Observational Studies.

Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide, including in Saudi Arabia. Objective: To systematically review the available literature and assess the pooled prevalence of T2DM in Saudi Arabia between 2000 and 2020. Methods: Observational studies that reported quantitative estimates of the prevalence of T2DM as their main outcome, included the general population of Saudi Arabia, and were published between 2000-2020 and in English were retrieved using three electronic databases (namely, CINAHL, Medline via PubMed, and Web of Science). Retrieved studies were screened, and relevant data were extracted. The Joanna Briggs Institute Critical Appraisal guideline was used to assess the methodological quality of included studies. A random-effects model was used to estimate the prevalence of T2DM. Results: Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis (total pooled population: 258,283). The overall pooled prevalence of T2DM in Saudi Arabia was 16.4% (95% CI: 11.6-17.5). However, there was heterogeneity in the results of the studies [I2 = 99.31%, P < 0.0001] and the summary values varied from 3.18% (95% CI: 1.46-5.95) to 94.34% (95% CI: 89.53-97.38). Although the prevalence of T2DM by age varied across studies, in most studies, it was higher among the older age groups. In addition, the prevalence of diabetes widely varied across the different geographical regions of Saudi Arabia. Conclusions: This is the first meta-analysis that determined the pooled prevalence of T2DM in Saudi Arabia, and it revealed a high prevalence over the past two decades. However, owing to data collection inconsistencies in the identified studies, neither the modifiable (such as obesity, educational status, emotional support, etc.) nor the non-modifiable (such as gender and age) risk factors of T2DM could be determined, thereby indicating the need for a nationally collective effort in determining these factors.

The Relationship between Emotional Intelligence and Pain Management Awareness among Nurses.

Background: Pain management, a crucial part of nursing care, is considered one of the most basic patient rights. To properly treat patients' pain, nurses need a high degree of pain management awareness (PMA). The researchers hypothesized that nurses' pain management awareness is affected by their emotional intelligence (EI). Purpose: Because there is a dearth of studies on this topic, the purpose of this study was to describe the relationship between emotional intelligence and pain management awareness in a sample of nurses. Methods: The study employed a descriptive design with a quantitative approach to analyze data from a survey designed with the simple random sample technique. The questionnaires were completed by 330 nurses working at six governmental hospitals in Saudi Arabia. The Statistical Package for the Social Sciences (V23) and Analysis of Moment Structures (V23) were used to determine the reliability and validity of the questionnaires and analyze the causal relationships among the variables. Results: The results revealed a significant positive relationship between nurses' emotional intelligence and their pain management awareness. Conclusions: These findings suggest that having emotional intelligence is an important nurse characteristic for effective pain management awareness and possibly the provision of pain management care. Clinical Implications: Hospital and nurse managers as well as administration should consider using the emotional intelligence variables utilized in this study to develop ways to improve pain management awareness among nurses. Such efforts may help improve hospital and patient outcomes related to pain management.

The Mediating Effect of Model-Based Learning on Attitude and Pain Management Awareness Among Nurses During COVID 19 Pandemic in Saudi Arabia.

BACKGROUND: All hospitals are required to provide high-quality pain management; one of the most critical issues in achieving high-quality pain management is that the hospitals have a clear plan to manage the patients' pain and improve the nurses' awareness of pain management during the COVID 19 pandemic. However, there is a significant gap in the literature that this study can cover. AIM: This study aimed to investigate the mediating effect of model-based learning on nurses' attitudes toward nurses' pain management awareness during the COVID 19 pandemic in Saudi Arabia government hospitals. METHOD: The Heath Beliefs Model was used, with a quasi-experimental design, with per experimental one group pre-test post-test design, and a quantitative approach using self-administered questionnaires obtained from 330 nurses working with patients suffering from pain. IBM SPSS V23 and Analysis of Moment Structures (AMOS)V23 were applied to analyze the causal relationships between the variables. RESULTS: A two-step approach to analyze the study: the first step was to test the measurement models' constructs' reliability and validity. The second step was to test research hypotheses in the structural models. The results show a significant positive relationship between model-based learning and pain management awareness among nurses during COVID 19 pandemic. Furthermore, model-based learning fully mediated the relationship between nurses' attitudes and pain management awareness. CONCLUSIONS: The study successfully improved nurses' attitudes toward pain management awareness among nurses during COVID 19 pandemic. These findings will help strengthen the debate in the existing literature, and this is a new development window in the pain management area.

Impact of an Educational Program on the Knowledge and Attitude About Pain Assessment and Management Among Critical Care Nurses.

BACKGROUND: Pain assessment and management are imperative parts of nursing care and considered as one of the most fundamental patient rights. The role of pain management education is well established in improving knowledge and attitude among nurses. OBJECTIVES: This study aims to evaluate the impact of pain management educational program on the knowledge and attitudes of intensive care unit (ICU) staff nurses toward pain assessment and management. The baseline score of pain assessment and management knowledge and attitude of ICU nurses has been identified in a previous research, and the result showed immense lack of knowledge and poor attitudes among ICU nurses toward pain assessment and management when dealing with ICU patients. METHODS: This is a pretest-posttest experimental study, utilizing a self-reporting questionnaire tool to obtain information about nurses' knowledge and attitudes toward pain assessment and management after implementation of new pain management educational program for critical care nurses. Data were collected using the Knowledge and Attitudes Survey Regarding Pain tool that measures knowledge with 22 question items and measures attitude with 17 question items. Paper-based questionnaire was distributed to nurses for data collection. RESULTS AND CONCLUSION: The results showed significant improvement in knowledge and attitudes about pain assessment and management among ICU nurses; it was evident after delivering pain management education program. At baseline, 204 ICU nurses gave consent and completed the questionnaire and thus included in baseline measurement before implementing the intervention. In the postintervention measurement, the questionnaire was distributed to the same participants included in the baseline phase from which 181 participants completed the questionnaire for the second time, with a response rate of 89%; the deficits and preconception in pain assessment and management can be improved through implementing pain management educational programs.

Mercury cycling in the terrestrial, aquatic and atmospheric environment of the Slovak Republic - an overview.

INTRODUCTION: Mercury release in the environment is mainly the result of human activity, particularly from coal-fired power stations, residential heating systems, waste incinerators, and as a result of mining for mercury, gold and other metals, which have led to widespread global mercury pollution. Excessive exposure to mercury is associated with a wide range of adverse health effects, including damage to the central nervous system, digestive and immune systems, and to lungs, kidneys, skin and eyes. OBJECTIVE: The main aim of the study is to summarize the selected mercury sources in the environment of the Slovak Republic, regarding waste incinerators, landfill waste, crematoria, chemical plants, rivers and soils. BRIEF DESCRIPTION OF STATE OF KNOWLEDGE: Although the neurologic symptoms of Minamata disease were identified sufficiently for specialists to classify mercury as the causative agent, the acceptance of mercury´s environmental impacts will require several decades of research. Several new issues have arisen - the need for energy conservation leads to the use of fluorescent lighting, which contain mercury; emissions driven by increases in coal combustion, incineration and economic development have sent more mercury into the air, soil and water. CONCLUSIONS: Mercury is toxic to human health, posing a particular threat to the development of the child in utero and early in life. The systematic analytical controls of contaminants in water, soil and air are important. The installation of modern cleaning technologies to comply with the maximum emission level can substantially minimized the environmental impact of incinerators. Since human cremation is also an increasing practice, further research on mercury emissions is necessary.

Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study.

BACKGROUND: Many sedation scales and tools have been developed and compared for validity in critically ill patients. However, selection and use of sedation scales vary among intensive care units. OBJECTIVE: The aim of this study is to compare the reliability of 2 sedation scales-Ramsay Sedation Scale and Richmond Agitation-Sedation Scale (RASS)-in the adult intensive care unit. METHOD: Four hundred twenty-five patients were recruited in the study. Informed consent had been obtained from each patient guardian/relative. However, only 290 patients (68.24%) completed the study and were independently assessed for sedation effect by investigator and bedside nurses simultaneously using Ramsay scale and RASS. RESULTS: Agreement between the nurse and investigator scores on Ramsay scale (weighted κ = 0.449, P < .001) indicated weak level of agreement. Agreement between the nurse and investigator on RASS (weighted κ = 0.879, P < .001) indicated a strong level of agreement. Cronbach α analysis showed that 10 items of RASS had an excellent level of internal consistency (α = .989) compared with good level of internal consistency of Ramsay scale (α = .828). DISCUSSION: Richmond Agitation-Sedation Scale showed excellent interrater agreement compared with weak interrater agreement of Ramsay scale. The results also support that RASS has consistent agreement with clinical observation and practice among different observers. The results suggest that use of RASS is linked to a more reliable assessment of sedation levels in the intensive care unit.