A Measure of Barriers Toward Medical Disclosure Among Health Professionals in the United Arab Emirates.

BACKGROUND: There has been a growing awareness that patients are subject to injuries that can be prevented as a direct consequence of health care. Error disclosure is an effective technique to restore the lost trust with the health care system. OBJECTIVE: The current study aimed to develop a valid and reliable scale to determine the factors facilitating the disclosure of health professionals in health organizations. METHODS: This study had a cross-sectional design that consisted of 722 responses (response rate of 68.3%) from 1 private and 1 public hospital in Sharjah, United Arab Emirates. The data collection tool included 23 items rated on a Likert scale ranging from 5, strongly agree, to 1, strongly disagree.The internal consistency was established through calculating the split-half reliability for part 1 (12 items), which had a Cronbach coefficient of 0.65, and part 2 (11 items), which had a Cronbach coefficient of 0.62. Scale validity was assessed with the Kaiser-Meyer-Olkin measure of sampling adequacy, which had a value of 0.62, and the Bartlett test of sphericity (approximated χ = 13012.2, P = 0.0001) supported the factorability of the correlation matrix. The varimax rotation revealed 5 components that explained 77.8% of the total variance. RESULTS: The varimax rotation revealed 21 items loaded on the following 5 factors: fear of disclosure and provider image consequences (factor 1), apology (factor 2), organizational culture toward patient safety (factor 3), professional ethics and transparency (factor 4), as well as patient and provider education (factor 5). CONCLUSIONS: The disclosure of medical mistakes requires preliminary considerations to effectively and compassionately disclose these events to patients. The validity and reliability of the results support the use of this scale at hospitals as part of the health care providers' disclosure processes.

Obligation towards medical errors disclosure at a tertiary care hospital in Dubai, UAE.

OBJECTIVE: The study aimed to identify healthcare providers' obligation towards medical errors disclosure as well as to study the association between the severity of the medical error and the intention to disclose the error to the patients and their families. DESIGN: A cross-sectional study design was followed to identify the magnitude of disclosure among healthcare providers in different departments at a randomly selected tertiary care hospital in Dubai. SETTING AND PARTICIPANTS: The total sample size accounted for 106 respondents. Data were collected using a questionnaire composed of two sections namely; demographic variables of the respondents and a section which included variables relevant to medical error disclosure. RESULTS: Statistical analysis yielded significant association between the obligation to disclose medical errors with male healthcare providers (X2 = 5.1), and being a physician (X2 = 19.3). Obligation towards medical errors disclosure was significantly associated with those healthcare providers who had not committed any medical errors during the past year (X2 = 9.8), and any type of medical error regardless the cause, extent of harm (X2 = 8.7). Variables included in the binary logistic regression model were; status (Exp ß (Physician) = 0.39, 95% CI 0.16-0.97), gender (Exp ß (Male) = 4.81, 95% CI 1.84-12.54), and medical errors during the last year (Exp ß (None) = 2.11, 95% CI 0.6-2.3). CONCLUSION: Education and training of physicians about disclosure conversations needs to start as early as medical school. Like the training in other competencies required of physicians, education in communicating about medical errors could help reduce physicians' apprehension and make them more comfortable with disclosure conversations.

Over-the-counter medication patterns in households in Sharjah, United Arab Emirates.

BACKGROUND: Self-medication and acquisition of over-the-counter (OTC) medications are emerging community health issues. Besides being a cheap alternative for treating common illnesses, the behavior entails serious ramifications, such as medication wastage, increasing pathogen resistance, and adverse drug reactions. The present study was conducted to explore the extent of OTC medications in households in Sharjah, United Arab Emirates (UAE), including native UAE and expatriate families. METHODS: The study employed a population-based, cross-sectional, analytical study design. The study population included native and expatriate households residing in the Emirate of Sharjah, UAE. The snowball sampling technique was used, and the sample included a total of 335 households. RESULTS: Expatriate households acquired more OTC medications than did native households (adjusted odds ratio [aOR]=1.7). The demographic determinants for expatriate households were number of family members (aOR=1.6), age of children in the family (aOR=1.8), and annual income (aOR=0.5). Expatriate households purchased more OTC medication practices than did native households (aOR=2.2). In the statistical sense, expatriate household practices were buying medication upon relatives' advice (aOR=0.3), storage condition of medication (aOR=2.4), and disposal of expired medication (aOR=0.6). The highest percentages of OTC medications in native and expatriate households were those related to gastric and ear, nose, and throat illnesses. CONCLUSION: The presence of OTC medications in expatriate households was two-fold more common than in native households in Sharjah, UAE. There were significant associations for behaviors related to the reasons why OTC medications were purchased and stored within the household for both native and expatriate families.

Nurses' knowledge of prevention and management of pressure ulcer at a health insurance hospital in Alexandria.

Nurses' knowledge of pressure ulcer prediction, prevention and management plays a very important role in the incidence and prevalence of pressure ulcers in health-care systems. The aim of the current study was to assess the nurse's knowledge about prevention and management of pressure ulcer at one of the largest health insurance hospitals in Alexandria. A descriptive cross-sectional study using an interview questionnaire format to assess the nurses' knowledge (n = 122) regarding prevention of pressure ulcers. The overall mean per cent score for nurses was below the minimum acceptable level. The mean per cent score for nurses was below 70% for nine measures of the 15 correct measures, which accounted for 60% of the measures of pressure ulcer prevention. Correct answers for non-useful measures for preventing pressure ulcers accounted for 66% of the non-useful measures on the questionnaire. It had been concluded that the nurses' knowledge regarding pressure ulcer prevention is below the acceptable levels.

Hourly-block and standard patient scheduling systems at two private hospitals in Alexandria.

INTRODUCTION: Patient appointment systems are of great importance for efficiently managing outpatient clinics as well as patient satisfaction as an indirect indicator for quality care rendered. PURPOSE: To describe the hourly block and standard sequential scheduling appointment systems at two different hospitals, as well as to assess the patients' opinions regarding their waiting time in both systems. STUDY SETTINGS: The study was conducted at ENT (Ear, Nose, and Throat) clinics in two of the biggest and reputable private hospitals in Alexandria. Hospital A follows the standard appointment system and Hospital B follows the hourly block appointment system. STUDY DESIGN: A cross-sectional descriptive study was designed to compare the two settings. RESULTS: For new cases, the mean time was longer for the standard system with regards to access time (12.2 ± 5.9) days, while the mean time was longer in the hourly block system with regards to punctuality, waiting time, and consultation time (28.5 ± 12.3, 27.5 ± 17.1, and 14.5 ± 9.0 minutes, respectively). For return cases, the mean time was longer for the standard system with regards to access and punctuality times (14.5 ± 6.1 days and 48.9 ± 27.0 minutes, respectively), while the highest mean times in the hourly block system were for waiting and consultation (19.4 ± 6.9 and 12.3 ± 3.9 minutes, respectively). Most of the patients in both systems preferred the standard appointment system to the hourly block system (73.3% for Hospital A and 55.0% for Hospital B). CONCLUSION: Every health care organization should know how to choose the most appropriate method of appointment system and how best to organize it to meet the needs of its patients. Patient scheduling is an important tool for efficient outpatient department management as well as rationally operating outpatient resources and critical areas like physician productivity, patient satisfaction, and practice profits.

Constructing a nurse appraisal form: A Delphi technique study.

OBJECTIVE: The study was conducted with the aim to construct a unified nurse appraisal format to be used at hospitals performing under different healthcare organizations in the Eastern Province in the Kingdom of Saudi Arabia. METHODOLOGY: The study included hospitals representing different healthcare organizations within the Eastern Province. The target population included Hospital head nurses and nurse supervisors and the snowball sampling technique was employed to select the panel subjects. RESULTS: The final draft resulted into the agreed upon performance dimensions which included namely; quality standards, work habits, supervision/leadership, staff relations and interpersonal skills, attendance and punctuality, problem solving, oral communication, productivity results, coordination, innovation, record keeping. CONCLUSION: Nurse managers have to continuously assess competence of practicing nurses to assure qualified and safe patient care. A nurse appraisal form was constructed concurrently with this study results and was proposed to be used at all Eastern Region hospitals. This study is considered an initial step for further efforts and studies to be conducted to reach both national and international nursing appraisal dimensions and unify them for the sake of best health promotion.

Quality of nursing care provided in a neonatal intensive care unit. Structure assessment.

Structure is considered one of the three major approaches to the evaluation of quality the other two being process and outcome. Appraisal of structure involves the attributes of the settings in which care is delivered that includes the material resources, the human resources, and the organizational structure. The aim of the study was to assess the quality of nursing care provided at tne neonatal intensive care unit (NICU) at Princess Badia Teaching Hospital, Jordan, as regards the various components of structure domain within the context of quality. A checklist for structure assessment was developed which included criteria classified under three main areas namely, material resources, human resources, and organizational structure. Results revealed certain deviations from the recommended compliance scores for each area. Recommendations were proposed to stress the importance of the NICU being specifically built to reflect practice, environment, and cultural needs, as well as continuous education activities of NICU staff. Documented policy and procedure manuals were also recommended for assuring maintained quality care at the NICU.

Job satisfaction and stress among MCH physicians in Alexandria.

Physician satisfaction with their job is a topic of importance to physicians in practice, physicians in training, health administrators, and health executives. Stress among physicians arises due to inadequate demands of the job in relation to worker's abilities, frustrated aspirations, and dissatisfaction with regard to aimed goals. The cross-sectional study design was conducted at 7 randomly selected Maternal and Child Health (MCH) centres, affiliated to seven medical zones in Alexandria. The study sample consisted of all physicians working at the studied MCH centres. A questionnaire designed for data collection was distributed to all physicians available and who accepted to participate in the study. The questionnaire included 4 sections measuring, socio-demographic characteristics, overall satisfaction and global satisfaction, an eight-dimension satisfaction scale, and a four-dimension stress scale. The questionnaire was distributed to 100 physicians out of whom 77% responded. Satisfaction scale was on a scale ranging from 6 (greatly satisfied) to 1 (greatly dissatisfied). Stress was on a scale ranging from 6 (greatly stressed) to 1 (greatly unstressed). The total mean satisfaction score for the sample under study was 3.3 +/- 0.6 with a significant difference among zones (F = 4.4, p < 0.05), and the total mean stress score for the sample under study was 3.8 +/- 0.7 with a significant difference among zones (F = 2.4, p < 0.05). It is recommended that decision makers at the MOHP find ways to raise the physicians' pay, efficient planning of resources, and find opportunities for future promotion.