Glycaemic control and its associated factors among adult Omanis with type 1 diabetes mellitus: a cross-sectional survey.

OBJECTIVES: This study aimed to investigate the relationship between glycemic control and diabetes self-management (DSM) and other associated factors among adult Omanis with Type-1 Diabetes Mellitus (T1DM). METHODS: A cross-sectional, descriptive design was used to collect data among 210 adult Omanis with T1DM who were conveniently recruited. All tools were self-reported, whereas the HbA1c was collected from the patient's electronic medical records. RESULTS: The HbA1c mean value was 8.6 (SD = 2.5), 30.5% had optimal glycemic control (<7.0). A significant negative relationship between HbA1c and DSM (r = - 0.191, p = 0.006) and diabetes knowledge (r = - 0.153, p = 0.026) was found. Furthermore, the mean HbA1c was significantly lower for persons with a single marital status, have higher education level, have children, are unemployed, were not admitted to the hospital in the last year, and have a health care professional as a family member. Additionally, marital status, level of education, DSM, and social support were significant predictors of glycemic control. CONCLUSIONS: The results suggested that better glycemic control could be achieved by optimizing DSM, social support, and diabetes knowledge. Sociodemographic factors should be considered when treating individuals with T1DM to reach good glycemic control.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses.

BACKGROUND: Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses. OBJECTIVE: To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses. METHODS: A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables. RESULTS: Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (ß = - 0.481, p = 0.031), ethical/moral conduct (ß = - .408, p = 0.043), managerial ability and support (ß = - 0.497, p = 0.018), and adequate staffing and resources (ß = -.068, p = 0.028) were all associated with lower job burnout. CONCLUSIONS: Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

Healthcare costs and outcomes associated with surgical site infections after coronary artery bypass grafting surgeries in Oman.

BACKGROUND: Surgical site infection (SSI) after coronary artery bypass graft (CABG) surgeries is considered a key indicator of the quality of healthcare services. OBJECTIVE: This study aimed to estimate the healthcare outcomes associated with SSIs after CABG surgeries in Oman in terms of mortality rate, case-fatality rate, LOS, readmission rate and healthcare costs. METHODS: The nested case-control study design was used based on retrospective data, which was conducted from 2016 to 2017. The case group encompassed all CABG patients with confirmed SSIs within 30 days of the surgery (n = 104) while controls were CABG patients without SSIs (n = 404). RESULTS: Forty-four (42.3%) of the SSI patients were readmitted to the hospital compared to eight (2%) of the control group (p < .001). Patients in the case group had a longer LOS (M = 24.4, SD = 44.6 days) compared to those in the control group (M = 11, SD = 21 days, p = .003). The mean healthcare costs of cases (M = Omani Rial [OMR] 3823, SD = OMR 2516) were significantly greater than controls (M = OMR 3154, SD = OMR 1415, p = .010). CONCLUSION: Results from this study can be baseline data for formulating new hypotheses and testing the causal relationship between SSIs after CABG surgeries and the readmission rate, LOS and health care costs.Key messagesSurgical Site Infections (SSIs) are still a major complication after cardiac surgeries in Oman.SSIs after cardiac surgeries are associated with substantially increased healthcare costs and length of stay.SSIs after cardiac surgeries are associated with negative outcomes such as mortality and case-fatality rates.

Role transition from education to practice and its impact on the career futures of Omani nurses.

AIM: The aim of this study was to examine new Omani graduate nurses' role transition from education to practice. We also sought to describe factors that may affect the effective transition of new Omani graduates to their professional nurse role. BACKGROUND: There is a substantial literature on the process of transition from graduation to being a professional nurse in countries across the globe; however, little is known about new Omani graduate nurses' role transition from education to practice. DESIGN: This study had a descriptive cross-sectional design. METHODS: Data were collected from nurses who at the time of the study had been working for at least 3 months but not longer than 2 years. Role transition was assessed with the Comfort and Confidence subscale of the Casey-Fink Graduate Nurse Experience Survey (Casey et al., 2004). The survey consists of a 24-items that are rated on a 4-point Likert scale. We conducted a multivariate regression analysis to assess the factors that influence nurses' role transition. These factors included participants' demographic information, employment orientation durations, preceptorship duration and length of time before employment. RESULTS: The total sample consisted of 405 nurses working in 13 hospitals in Oman. Most (68.89%) had worked as a nurse for less than 6 months. The average internship and orientation durations were approximately 6 months (SD = 1.58) and 2 weeks (SD = 1.79), respectively. The number of preceptors assigned to new graduate nurses ranged from none to four. The average score on the Comfort and Confidence subscale was 2.96 (SD = 0.38). Results from the regression analysis demonstrated that age (ß = 0.029, SE = 0.012, p = .021), waiting time before employment (ß = -0.035, SE = 0.013, p = .007) and employment orientation duration (ß = -0.007, SE = 0.003, p = .018) were statistically significant factors influencing role transition experience among newly joined nurses. CONCLUSION: The results suggest that appropriate intervention strategies at the national level are needed to enhance the transition of nursing school graduates to their professional role. Strategies directed toward shortening the waiting time before employment and improving the internship experience are examples of priority-level tactics that can enhance Omani nursing graduates' transition to their professional role.

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman.

Background: There is limited information about the incidence and risk factors of surgical site infections (SSIs) after coronary artery bypass (CABG) surgeries in the Omani population. Aim: To estimate the prevalence and describe possible risk factors of SSIs after CABG surgeries in Oman. Method: A retrospective nested case-control design was used to screen 596 patients who underwent CABG surgeries over 2 years (2016-2017) in two tertiary hospitals in Oman. The CDC definition for SSIs was used to identify the infected cases. Results: Prevalence rate of SSIs was 17.4% and 17.5% in 2016 and 2017, respectively. The most isolated microorganism was Gram-positive bacteria (45.2%). Risk factors of SSIs include female gender (OR = 3.2, p < 0.001), diabetes (OR = 5.83, p < 0.001), overweight or obese (OR = 2.14, p < 0.05) and shaving technique [using razor shaving] (OR = 8.4, p < 0.001). Readmission rate for the case group was 44.2%. Conclusion: The infection rate of SSIs after CABG surgeries in developing countries, such as Oman, is considerably high. There is an urgent need to establish SSIs preventive program at the national level. Frequent and systematic assessment of infection control practices before and after CABG surgeries is fundamental and priority strategy to prevent SSIs.

ICU-acquired central line-associated bloodstream infection and its associated factors in Oman.

BACKGROUND: Despite the extensive use of central lines for ICU patients in Oman, no studies have been conducted among adult ICU patients to assess the prevalence, and predictors of CLABSIs. AIM: To estimate the prevalence of ICU-acquired CLABSIs, identify the most common causative microorganisms, and define possible related risk factors associated with ICU-acquired CLABSIs among adult ICU patients in Oman. METHOD: A retrospective case-control design was used to screen electronic medical records of for all adult ICU patients admitted over 2 years (2018-2019) in 2 tertiary hospitals in Oman. The CDC definition of CLABSIs was used to allocate a cases group (n = 58), and a randomly selected controls group (n = 174). RESULTS: The prevalence of ICU-acquired CLABSIs was 8.9 and 8.31 per 1,000 catheter days for the years 2018 and 2019 respectively. The most common isolated microorganisms were gram-positive bacteria (46.6%). The risk factors for ICU-acquired CLABSIs are: heart failure (Odds Ratio [OR] = 11.67, P < .001), female gender (OR = 0.352, P = .035), presence of other infections (OR = 3.4, P = .009), tracheostomy (OR = 5.34, P = .004), and Total Parenteral Nutrition (OR = 3.469, P = .020). CONCLUSIONS: The prevalence of ICU-acquired CLABSIs in developing countries like Oman is higher than most of developed countries. The current study provides baseline data that can be used as a reference for future national studies and help in building strategies to prevent and control ICU-acquired CLABSIs.

COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman.

Assessing knowledge, attitude, and practices of healthcare students regarding any infectious outbreak became a fundamental step to set an effective plan related to their preparedness. The purpose of this study was to assess COVID-19 knowledge, attitude, and precautionary practices among health professional students in Oman. Data were collected using the Web-based survey method. The sample was recruited from the largest college of Medicine in Oman, while the nursing sample was recruited from two different nursing colleges in Oman. The study tool was developed based on the most recent advisory COVID-19 recommendations from the WHO and the CDC. A total of 222 students filled the survey, of which 55% were medical students and 59.9% were females. The mean knowledge score was 16.5 (SD = 4.2), which represents 66% of the highest possible score, with 25.7% were classified as 'excellent knowledge'. Participants reported a high level of public precautionary practices (M = 44.1, SD = 5.0), which represents 84.6% of the highest score, with 61.3% were classified as 'high compliance. The mean attitude score was 40.3 (SD = 5.9), which represents 67% of the highest possible score. According to the classification categories, most students (81%, n = 180) expressed a positive attitude toward COVID-19. More efforts should be done toward preparing the healthcare students to deal with the outbreak. Preparing healthcare students with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety. Healthcare students can play a major role in increasing public awareness about COVID-19 precautionary practices.

Effectiveness of Implementing Emergency Severity Index Triage System in a Selected Primary Health Care Center in Oman: A Quasi-Experimental Study.

BACKGROUND: Because most primary health care centers in Oman do not use a formal triage system, there are no available data on the effectiveness of implementing this system. PURPOSE: To assess the effectiveness of implementing an Emergency Severity Index triage system in primary health care centers in Oman. METHODS: A pretest/posttest quasi-experimental design was used. The sample comprised 187 patients before Emergency Severity Index implementation and 102 patients after implementation. Waiting time, length of stay, patient satisfaction, and accuracy of classification were compared across the 2 groups. RESULTS: The mean time (hour:minute) from registration to triage was reduced in the post-Emergency Severity Index group (mean = 0:18, SD = 0:14) compared with the pre-Emergency Severity Index group (mean = 0:23, SD = 0:19) (t = 2.59, P = 0.01). Furthermore, the mean length of stay was reduced in the post-Emergency Severity Index group (mean = 1:09, SD = 0:37) compared with that of the preimplementation group (mean = 1:24, SD = 0:41) (t = 3.10, P = 0.002). Patient satisfaction in the postimplementation group was improved (mean = 66.95, SD = 8.33) compared with that of the Emergency Severity Index group (mean = 65.01, SD = 8.73), but it did not reach statistical significance (t = -1.83, P = 0.07). The inter-rater agreement of triage level in post-Emergency Severity Index implementation markedly improved in the postimplementation group (Cohen's kappa = 0.910, P < 0.001) compared with that of the preimplementation group (Cohen's kappa = 0.082, P = 0.005). CONCLUSIONS: Although this is a single-setting study, the results have shown that the Emergency Severity Index system can contribute to a decrease in the negative crowding outcomes in primary health care centers in Oman.

Healthy work environments are critical for nurse job satisfaction: implications for Oman.

AIMS: To (1) examine the level and variability of nurse work environment and job satisfaction and (2) explore how nurse job satisfaction in tertiary hospitals in Oman is influenced by the nurses' characteristics and work environment. BACKGROUND: In Oman and the Middle East, a scarcity of research addressing nurse work environment and job satisfaction exists. Such evidence is necessary for policymaking to positively impact nurse job outcomes, and therefore, quality of care. METHODS: We used a cross-sectional descriptive design employing a sample of 454 local and expatriate nurses who responded to a self-administered questionnaire. RESULTS: The work environment was favourable, and it positively correlated with job satisfaction. Nationality, education, hospital type, staffing, resources and participation in hospital affairs were significant predictors of nurse job satisfaction. The greatest amount of variation in nurse job satisfaction was explained by the work environment. CONCLUSION: The influence of work environment on nurse job satisfaction is greater than nurse characteristics and hospital and unit types. Enhancing nurse participation in hospital affairs and providing adequate staffing and resources are central means of establishing healthy work environments, which is an auspicious, cost-effective strategy for satisfying, and therefore, retaining nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: To enhance nurse work environment and job satisfaction in Oman and the Middle East, nurse and health leaders need to consider developing work and professional regulations and adopting policies to promote staffing, resources, wages, and benefits for nurses and encourage their promotion and career advancement; and foster nurse participation in hospital affairs.

The Effect of Infection Control Course on Nursing Students' Knowledge of and Compliance With Universal Precautions: A Quasi-experimental Study.

BACKGROUND: Knowledge of and compliance with universal isolation precautions are important issues and were found to be low in many previous studies. However, there were no Jordanian studies that have examined the effect of an infection control teaching course on nursing students' knowledge of and compliance with universal precautions. PURPOSE: This study aimed to assess knowledge and compliance levels, assess the relationships between knowledge and compliance, and examine the effect of infection control teaching courses on knowledge of and compliance with universal precautions among university nursing students. METHODS: A quasi-experimental pretest/posttest design using a convenient sample of 130 third-year nursing students was applied. The experimental group (n = 60) were third-year nursing students who registered for infection control clinical course for 3 months. On the other side, the control group (n = 70) were students at the same academic level but did not register for the course and never attended the course. RESULTS: The mean knowledge of and compliance with universal precaution were quite low, with a mean (SD) of 7.82 (1.98) and 49.36 (11.13) respectively. There was a statistically significant weak positive correlation between knowledge of and compliance with standard precaution (r = 0.28, P = .003). An independent t test indicated a significant effect of the infection control clinical course (t119 = -5.36, P = .01) on knowledge mean score (mean [SD], 15.51 [1.41]) and compliance with universal precaution mean score (mean [SD], 89.00 [10.17]; t119 = 6.26, P = .02) compared to the control group. Paired t test revealed that knowledge and compliance were significantly higher in the posttest than in the pretest in the experimental group compared with the control group. CONCLUSION: Knowledge of and compliance with universal precautions were relatively low among nursing students. The application of an infection control teaching course helps improve both knowledge of and compliance with universal precautions among university nursing students.

Psychometric Properties of an Arabic Version of the Patient Satisfaction With Nursing Care Quality Questionnaire.

BACKGROUND: Quality measurements are crucial to healthcare quality improvement, and patient satisfaction with nursing care is widely adopted as a key outcome indicator of the overall quality of healthcare. There is a lack of instruments to measure patient satisfaction with nursing care in an Arabic context. PURPOSE: The purpose of this study was to develop and validate an Arabic version of the Patient Satisfaction with Nursing Care Quality Questionnaire and to explore patient satisfaction with nursing care across hospital units. METHODS: This was a cross-sectional, methodological research study. A forward-backward translation process and face and content validation using a panel of experts and a pilot test were used to produce an Arabic version of the Patient Satisfaction with Nursing Care Quality Questionnaire. A convenience sampling technique was employed to recruit 292 adult patients who were hospitalized for more than 48 hours. Data were collected over the first quarter of 2016 using a secure electronic survey method. RESULTS: The item-level content validity index ranged from .83 to 1, and the scale-level content validity index was .94. Evidence of construct validity was obtained. Exploratory factor analysis revealed a two-factor model that explained 69.3% of the total variance. Confirmatory factor analysis showed that the two-factor model fits the observed data. Internal consistency was satisfactory and similar across different hospital units. Cronbach's alpha estimates for Factors 1 and 2 were .83 and .96, respectively, with an overall Cronbach's alpha estimate of .96. Level of patient satisfaction with nursing care was quite high (mean = 4.30/5, SD = 0.74). CONCLUSIONS: This study provides a 17-item, Likert-scaled, self-reporting instrument, which is psychometrically sound for its content, comprehension, readability, and practicality, to measure patient satisfaction with nursing care quality in an Arabic context.

Lived experiences of Jordanian mothers caring for a child with disability.

PURPOSE: Caring for a child with a disability in the family is associated with a major increase in care-giving demands and burden. This qualitative study explores the perspectives, challenges and adaptations of Jordanian mothers living with a child with disability. METHODS: Phenomenological qualitative tradition was utilized. Seven Jordanian mothers of children with disability were purposefully selected as having rich experiences for caring for a child with a disability. In-depth interviews were conducted using a semi-structured guide, audio-taped and transcribed verbatim. Interpretive phenomenological analysis was used to extract main themes and subthemes. RESULTS: Mothers' experiences were reflected into four main themes: (1) increased perceived stigma, (2) fear for the future, (3) increased perceived care-giving burden and (4) adaptations to the child's disability. CONCLUSIONS: This study highlights key gaps in the provision of family-centered services for this population as well as multiple sociocultural issues impacting participation and quality of life. Healthcare professionals must deal with the child's disability from a family-centered and cultural perspective. Implications for rehabilitation When therapists meet the whole family's needs through a family-centered approach, the child with disability is less likely to be ignored, maltreated or abused. Family-centered practice adopts a sociocultural model which looks at the child from a wider point of view rather than just the disability itself. It requires therapists to review the context in which the child lives and address the specific needs of parents, siblings and other involved family members. Culture plays a huge role in shaping the family's perspective on disability and has a huge impact and implications for service delivery and development, quality of life and participation for children with disability and their families. Rehabilitation professionals must accommodate their time schedules to provide families with the communication, education, advocacy and consultations needed.

The Use of Electronic Medical Records in Jordanian Hospitals: A Nationwide Survey.

No previous nationwide study has estimated to what extent electronic health records have been implemented in Jordanian hospitals. The purpose of this descriptive, cross-sectional study was to explore the level of adoption and use of electronic health records in Jordanian hospitals across all major healthcare service providers. The standardized American Hospital Association annual survey was used. The level of use of electronic functionalities of electronic health records was determined. The association of certain hospital characteristics with the adoption of electronic health records was examined. A proportion of 10.3% of the participating hospitals had a comprehensive use of electronic health records in all units, and 15.5% had a basic system in at least one unit. Most (74.2%, n = 72) had not implemented electronic health records. The hospitals with a higher rate of adoption were found to be larger, government, urban, and teaching hospitals that had coronary care units. The level of adoption of electronic health records in Jordan is relatively low. This fact should impel policy makers to resolve the challenges and obstacles for such adoption. National strategic plans are needed to address the goals and implementation processes of electronic health record systems in all Jordanian hospitals.

A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

BACKGROUND: The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. METHODS: A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. RESULTS: A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. CONCLUSIONS: This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals.

Exploring changes in nursing students' attitudes towards the use of technology: A four-wave longitudinal panel study.

BACKGROUND: It is essential for nursing students to be equipped with the necessary technology skills throughout and after their study period. Their acceptance of this technology depends largely on their attitudes towards technology. OBJECTIVES: To explore the evolution in nursing students' attitudes towards technology, and to determine whether there was a change in participants' formal education in technology over their four years of study. METHODS: A longitudinal panel study was conducted in a single school of nursing in Jordan. A total of 140 students were followed over their four years of undergraduate study. They completed the same tool (the Technology Attitude Scale) each year, to capture any changes in their attitudes towards technology across the years. RESULTS: In all four waves of data collection, students showed positive attitudes towards technology, with the highest attitude scores being in their final year (M=6.19, SD=0.72). As the students spent more time on their nursing education, they were found to have a more positive attitude. Thus, a strong positive relationship existed between this formal education in technology and attitudes: as the students' education in technology increased, their attitudes were more positive. CONCLUSION: A remarkable development in students' attitudes towards technology is reported in this study. The positive attitudes displayed by the students should be enhanced by providing technology-related subjects during their studies in nursing schools at a very early stage.

Infection control practices among intensive care unit registered nurses: a Jordanian national study.

AIMS: This study aimed to evaluate infection control (IC) practices among Jordanian registered nurses (RNs) working in intensive care unit (ICU) settings. BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends periodic assessment of IC practices for health care workers as an effective strategy to control infections. DESIGN: Cross-sectional descriptive design. METHODS: A stratified, cluster random sampling technique was used. The sample consisted of ICU RNs from all major health care service providers and from all geographical areas in Jordan. The IC-Practices Tool (Cronbach α = 0·88) a self-report instrument was used. RESULTS: A total of 21 hospitals participated in the study, of which, 8 were governmental, 7 military, 4 private and 2 university-affiliated. The final sample consisted of 247 RNs from 56 critical care units. Of the total sample, 36% of RNs were from governmental hospitals. Of the total sample, 51% were female with a mean age of 28·5 years (SD = 5·2), and 54·7% worked in general ICUs. The mean overall IC practice score was 122·6 (SD = 13·2). Nurses who reported that they had been trained about IC procedures in their hospital scored higher on the IC practice scale (M = 124·3, SD = 12·3) than nurses who never received any IC training in the hospital (M = 117·3, SD = 14·6, p < 0·001). CONCLUSION: This study demonstrated the importance of conducting IC educational programmes as an effective strategy to increase staff compliance with standard IC practices. RELEVANCE TO CLINICAL PRACTICE: Educational role of IC nurse is important to enhance RNs compliance with standard IC practices.

Nursing students' knowledge and practices of standard precautions: A Jordanian web-based survey.

BACKGROUND: The main purpose of this web-based survey was to evaluate Jordanian nursing students' knowledge and practice of standard precautions. METHODS: A cross-sectional, descriptive design was used. Six public and four private Jordanian universities were invited to participate in the study. Approximately, seventeen hundred nursing students in the participating universities were invited via the students' portal on the university electronic system. For schools without an electronic system, students received invitations sent to their personal commercial email. RESULTS: The final sample size was 594 students; 65.3% were female with mean age of 21.2 years (SD=2.6). The majority of the sample was 3rd year students (42.8%) who had no previous experience working as nurses (66.8%). The mean total knowledge score was 13.8 (SD=3.3) out of 18. On average, 79.9% of the knowledge questions were answered correctly. The mean total practice score was 67.4 (SD=9.9) out of 80. There was no significant statistical relationship between students' total knowledge and total practice scores (r=0.09, p=0.032). CONCLUSION: Jordanian nursing educators are challenged to introduce different teaching modalities to effectively translate theoretical infection control knowledge into safe practices.

Use of Electronic Health-Related Datasets in Nursing and Health-Related Research.

Datasets of gigabyte size are common in medical sciences. There is increasing consensus that significant untapped knowledge lies hidden in these large datasets. This review article aims to discuss Electronic Health-Related Datasets (EHRDs) in terms of types, features, advantages, limitations, and possible use in nursing and health-related research. Major scientific databases, MEDLINE, ScienceDirect, and Scopus, were searched for studies or review articles regarding using EHRDs in research. A total number of 442 articles were located. After application of study inclusion criteria, 113 articles were included in the final review. EHRDs were categorized into Electronic Administrative Health-Related Datasets and Electronic Clinical Health-Related Datasets. Subcategories of each major category were identified. EHRDs are invaluable assets for nursing the health-related research. Advanced research skills such as using analytical softwares, advanced statistical procedures, dealing with missing data and missing variables will maximize the efficient utilization of EHRDs in research.

Compliance of Jordanian registered nurses with infection control guidelines: a national population-based study.

BACKGROUND: This national study aims to evaluate compliance of Jordanian staff nurses with infection control guidelines. METHODS: Cross-sectional, descriptive design was used. Proportional-multistage, probability sampling was used to obtain a sample of 10% of all staff nurses working in Jordanian hospitals. Standardized self-reported instruments were used to evaluate the compliance. RESULTS: The total sample consisted of 22 hospitals, of which 8 were governmental, 7 military, 5 private, and 2 university-affiliated hospitals. Of the total 889 participating nurses, 52.6% were females, 81.9% holding a bachelor degree. The mean age was 29.0 years (standard deviation [SD] = 5.9) with a mean of experience of 6.9 years (SD = 5.8). According to the scale categories, 65.0% of participants demonstrated "high compliance," 32.3% "weak compliance," and 2.7% "unsafe compliance." Nurses who received infection control training in the hospital demonstrated higher compliance (mean = 120.2, SD = 13.6); than those who never received such training (mean = 115.8, SD = 15.2), P < .001. Nurses who work in university affiliated hospitals demonstrated higher compliance than other types of hospital (P < .001). CONCLUSION: This study provides information about infection control practices in various health care sectors in Jordan. Results from this study expected to guide efforts to develop educational tools, programs, and curricula to improve infection control practices in Jordan.

Laboratory-confirmed, health care-associated bloodstream infections in Jordan: a matched cost and length of stay study.

BACKGROUND: No studies have been carried out in Jordan to examine length of stay (LOS) and extra cost associated with health care-associated bloodstream infections (HCABSIs). This study aims to estimate the extra LOS and cost associated with HCABSIs among adult hospitalized Jordanian patients. METHODS: Five-year data were retrieved from 1 large university-affiliated hospital in Jordan. Matched case-control design was used in this study. Cases were determined based on confirmed positive blood culture after 48 hours of admission. Matching criteria were age (±5 years), gender, admission diagnosis, and LOS in comparison group equal to the LOS (±5%) before blood culture for the case group. RESULTS: Of the total 445 infected patients 125 (28.1%) were matched with uninfected patients. The mean LOS after infection for cases was 12.1 days (standard deviation [SD] = 17.2) compared with 8.3 (SD = 7.9) days for the controls (P = .02). The total mean inflation-adjusted charges for cases was M (mean) = US $7,426, SD = $7,252 compared with M = $3,274, SD = $4,209 for controls, P < .001. Using multiple regression modeling, LOS after acquiring HCABSIs, admission to critical care units, and being infected with HCABSIs were significant predictors of patients' total charges. CONCLUSION: Figures generated from this can be used to inform health care researchers, policy makers, and professionals about the impact of HCABSIs.