Influence of demographic factors on prolonged length of stay in an emergency department.

BACKGROUND: A prolonged length of stay in an emergency department is related to lower quality of care and adverse outcomes, which are often linked with overcrowding. OBJECTIVE: Examine the influence of demographic factors on prolonged length of stay in the emergency department. METHODS: This study used a cross-sectional design. It used secondary data for all patients admitted during the specific duration at the emergency department of a governmental hospital in Saudi Arabia. The independent variables were gender, age, disposition status, shift time, and clinical acuity (CTAS) level while the dependent variable was prolonged length of stay. RESULTS: The study shows that 30% of patients stay at the emergency department for four hours or more. The results also show a significant association between demographic factors which are age, gender, disposition status, shift time, clinical acuity (CTAS) level and prolonged length of stay in an emergency department. Based on the results males are more likely to stay in the emergency department than females (OR = 1.20; 95% CI = 1.04 to 1.38). Patients aged 60 and older are less likely to stay in the emergency department than patients aged 29 or smaller (OR = 0.58; 95% CI = 0.39 to 0.84). According to disposition status discharged patients after examination stays in the emergency department more than admitted patients after the examination (OR = 2.78; 95% CI = 1.67 to 4.99). Patients who come to the night shift are less likely to stay in the emergency department than patients who come in the morning shift (OR = 0.67; 95% CI = 0.56 to 0.81). Patients who are classified in level three of CTAS are less likely to stay in the emergency department than patients who are classified in level one (OR = 0.28; 95% CI = 0.88 to 0.023). CONCLUSION: Demographic factors such as age, gender, shift time, disposition status and clinical acuity (CTAS) were important factors that needed to be considered to reduce the length of stay of patients in the emergency department. it is possible to formulate a machine learning model to predict the anticipated length of stay in the hospital for each patient. This prediction with an accepted margin of uncertainty will help the clinicians to communicate the evidence-based anticipated length of stay with the patient's caregivers. In addition, hospital managers need to provide the emergency department with enough staff and materials to reduce the length of stay of patients.

Assessing the acceptability of COVID-19 vaccine and its booster dose.

BACKGROUND AND OBJECTIVE: Coronavirus disease of 2019 (COVID-19) vaccinations are essential to control the pandemic and prevent severe COVID-19 infections. This study aims to assess the acceptability of the COVID-19 vaccine and the factors that impact the intention to take the COVID-19 vaccine and its booster dose. METHODS: A cross-sectional study was conducted in Saudi Arabia and Jordan. The study used a self-administered web-based survey (questionnaire) for data collection that was distributed via social media platforms from May 2022 to July 2022. RESULTS: In this study, among 518 participants, 54.4% had already received two doses of the COVID-19 vaccine, and out of the participants who didn't receive the booster dose, 19.9% declared a definite willingness to receive it, while 42% had already taken a booster dose, which indicated good acceptance. After adjustment for significant background characteristics, a significant association between the country and receiving the COVID-19 vaccine, the intention to get the vaccine, and infection with COVID-19 were found, in addition to a significant association between the country and the participants' opinion that electronic applications helped them to follow their vaccine schedule were found (p < .001). Also, the results showed that participants' attitudes were significantly associated with educational level and age groups (p ≤ .001, p = .032, respectively). There was a significant association between the intention to receive the vaccine booster dose and the country (p < .001). The Saudi participants were willing to get the booster dose seven times more than the Jordanians, furthermore, there was a significant association between taking the vaccine booster dose in the country, as well as age group, working in the medical field, previous COVID-19 infection, and the intention to vaccinate the children (p < .001, p = .030, .031, .025, < .001, respectively). CONCLUSION: Overall, our results emphasize a positive response and a positive attitude toward COVID-19 vaccination. In addition, define the groups to be targeted with effective communication regarding the COVID-19 vaccine and its booster dose.

Level of Patient Safety Culture Awareness Among Healthcare Workers.

Background: Patient safety is a major concern at all levels of the healthcare system, with the primary objective of reducing patient hazards when providing care. The Kingdom of Saudi Arabia has made great progress in improving the health of its citizens over the last few decades, particularly in terms of patient safety. Currently, many health-care institutions throughout the world are interested in implementing a safety culture to lower the risk of harm and the number of accidents associated with routine treatment. Purpose: This study aims to assess the level of awareness concerning patient safety culture among health-care providers in hospitals in Riyadh, Saudi Arabia. Methods: This is a descriptive cross-sectional quantitative study that used the Agency for Healthcare Research and Quality's patient safety culture questionnaire. The survey was conducted online and was completed by 204 health-care employees from three distinct hospital settings in Riyadh, Saudi Arabia: government, quasi-government, and private hospitals. Results: The results showed a low level of patient safety culture awareness among health-care workers in the 10 dimensions of patient safety. The mean score was 2.24 out of 5 and the standard deviation was 0.50. Participants assigned the highest mean scores to Organisational Learning and Continuous Improvement (Mean: 2.48, Standard deviation: 0.66), Communication About Error (Mean: 2.44, Standard deviation: 0.70), and Teamwork (Mean: 2.40, Standard deviation: 0.64). Interestingly, the scores for hospital supervisor and managerial positions are significant compared to other clinical positions (p-value = 0.047). Moreover, the patient safety rating and the number of reported events were significantly related to the overall level of awareness (p-value <0.001), (p-value = 0.042), respectively. Conclusion: In Riyadh hospitals, overall patient safety awareness is low, necessitating adequate attention and effective solutions such as encouraging reporting errors, implementing safety huddles and leadership walkarounds, and establishing a patient safety culture. Health-care executives and managers are encouraged to develop safety cultures that promote trust and justice, allowing employees to be candid about their mistakes and failings without retaliation. Moreover, this safety culture should be defined by the following qualities: a just culture, a learning culture, and a reporting culture.

Patient safety culture awareness among healthcare providers in a tertiary hospital in Riyadh, Saudi Arabia.

Patient safety is a serious concern in the health care industry. To enhance patient safety, healthcare providers are expected to minimize accidental harm to patients and enhance the quality of patient-centered care. The main objective of this study is to explore the awareness of the patient safety culture among healthcare providers. It is further intended to assess key fields and factors that hinder patient safety adoption and determine the effects of demographic factors on healthcare providers' awareness of patient safety culture. This study applied a cross-sectional quantitative design. It was conducted in a tertiary hospital in Riyadh, Saudi Arabia. The participants consisted of all healthcare providers working in a specific tertiary hospital in Saudi Arabia. A random sampling technique was applied in this study. The study sample size was 409 participants. A valid and reliable questionnaire was used to collect the required data. The T-tests, ANOVA. And regression was used. The study found that there is a moderate level of patient safety culture awareness among healthcare providers. Moreover, the findings also revealed that the age group "31-40" showed statistically different awareness levels as compared to the "more than 50 years' age group" (p = 0.012). Also, this study has found that gender and education have a significant influence on the awareness level of patient safety culture while position and work area have no influence on the awareness level of patient safety culture among healthcare providers. Managers in healthcare institutions should develop speeder response plans and make them part of the patient safety culture. Institutions offering bachelor's degrees and postgraduate in nursing should pay more attention to the subject of patient safety. The government healthcare sector, together with the private healthcare sector, should continuously train healthcare providers on patient safety procedures to improve the patient safety culture. Healthcare providers should be encouraged to report errors made during diagnosis or treatments to avoid them in the future.

Children's rates of COVID-19 vaccination as reported by parents, vaccine hesitancy, and determinants of COVID-19 vaccine uptake among children: a multi-country study from the Eastern Mediterranean Region.

BACKGROUND: Huge efforts are being made to control the spread and impacts of the coronavirus pandemic using vaccines. However, willingness to be vaccinated depends on factors beyond the availability of vaccines. The aim of this study was three-folded: to assess children's rates of COVID-19 Vaccination as reported by parents, to explore parents' attitudes towards children's COVID-19 vaccination, and to examine the factors associated with parents' hesitancy towards children's vaccination in several countries in the Eastern Mediterranean Region (EMR). METHODS: This study utilized a cross-sectional descriptive design. A sample of 3744 parents from eight countries, namely, Iraq, Jordan, Kuwait, Lebanon, Palestine, Qatar, Saudi Arabia (KSA), and the United Arab Emirates (UAE), was conveniently approached and surveyed using Google forms from November to December 2021. The participants have responded to a 42-item questionnaire pertaining to socio-demographics, children vaccination status, knowledge about COVID-19 vaccines, and attitudes towards vaccinating children and the vaccine itself. The Statistical Package for Social Sciences (SPSS- IBM, Chicago, IL, USA) was used to analyze the data. A cross-tabulation analysis using the chi-square test was employed to assess significant differences between categorical variables and a backward Wald stepwise binary logistic regression analysis was performed to assess the independent effect of each factor after controlling for potential confounders. RESULTS: The prevalence of vaccinated children against COVID-19 was 32% as reported by the parents. Concerning parents' attitudes towards vaccines safety, about one third of participants (32.5%) believe that all vaccines are not safe. In the regression analysis, children's vaccination was significantly correlated with parents' age, education, occupation, parents' previous COVID-19 infection, and their vaccination status. Participants aged ≥50 years and those aged 40-50 years had an odds ratio of 17.9 (OR = 17.9, CI: 11.16-28.97) and 13.2 (OR = 13.2, CI: 8.42-20.88); respectively, for vaccinating their children compared to those aged 18-29 years. Parents who had COVID-19 vaccine were about five folds more likely to vaccinate their children compared with parents who did not receive the vaccine (OR = 4.9, CI: 3.12-7.70). The prevalence of children's vaccination in the participating Arab countries is still not promising. CONCLUSION: To encourage parents, vaccinate their children against COVID-19, Arab governments should strategize accordingly. Reassurance of the efficacy and effectiveness of the vaccine should target the general population using educational campaigns, social media, and official TV and radio channels.

Exploring the Gap Between Patients' Expectations and Perceptions of Healthcare Service Quality.

Purpose: This study aimed to explore the gap between patients' expectations of healthcare service quality in Jordanian hospitals against their perceptions of service received using SERVQUAL model. Methods: The study used a cross-sectional design. The study data were collected randomly from 415 patients (participants) who completed the SERVEQUAL questionnaire. The data were analyzed using statistical procedures such as descriptive, t-test, and ANOVA. Results: The results showed that there is a gap between mean score of patients' expectations of what should be available in the hospital and patients' perceptions of the service received in the hospital. Patients' expectations were higher than their perceptions on all five SERVQUAL domains (Tangibles, Reliability, Responsiveness, Assurance, and Empathy). Conclusion: Hospital managers should take necessary actions to improve healthcare services in their hospitals with respect to all SERVQUAL domains. These actions should be directed to reduce the gap between patients' expectation and their perceptions in order to provide services meet patients' needs.

Attitudes and Commitment Toward Precautionary Measures Against COVID-19 Amongst the Jordanian Population: A Large-Scale Cross-Sectional Survey.

Aims: This study aimed to (1) assess the non-pharmaceutical intervention (NPI) measures that were used by the Jordanian population against COVID-19, and (2) determine the sociodemographic and behavioral predictors of contracting COVID-19 with a focus on the utilization of personal precautionary measures. Methods: A descriptive questionnaire-based cross-sectional survey was used in this study. A structured web-based questionnaire was disseminated to the Jordanian community through social media platforms. Participants were asked a series of questions about socio-demographic characteristics, in addition to the knowledge, attitudes, and commitment toward using various personal precautionary measures (e.g., face mask, hand washing, social distancing) against the COVID-19. Data were analyzed using descriptive statistics, cross-tabulation, and binary logistic regression through SPSS®. Results: Responses from 7,746 participants were included in our final analyses. Descriptive statistics showed that most participants (82.6%) believed that face mask protects against COVID-19. Around 69.5% of the participants were completely committed to wearing a face mask, while 65% of the participants were completely committed to hand washing. The results of the regression analysis revealed that female gender (AOR = 1.2; 95% CI: 1.07-1.35; p = 0.002), having a family member infected with COVID-19 (AOR = 8.5; 95% Cl: 7.51-9.70; p = 0.001), having a health-related work or study (AOR = 1.2; 95% Cl: 1.09-1.38; p = 0.001), believing that face masks do not protect against COVID-19 (AOR = 1.3; 95% Cl: 1.12-1.47; p = 0.001), and partial commitment to handwashing (AOR = 1.2; 95% Cl: 1.11-1.75; p = 0.006) were all associated with an increased odds of contracting COVID-19 among the participants. Conclusion: Overall, commitment to non-pharmaceutical intervention (NPI) measures, such as wearing a face mask, hand washing, and physical distancing, was not optimal among Jordanians. This might explain the dramatic increase in the infectivity rate of the COVID-19 virus in the past few months in the country. More sustainable efforts regarding health promotion and strict policies are required to prevent a third wave of hitting the country and to prevent similar infectious threats in the future.