Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction.

Objectives: This study aimed to estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in Oman. Methods: A cross-sectional retrospective study was conducted on all patients who presented to the emergency department at Sultan Qaboos University Hospital and Royal Hospital, Muscat, Oman, and underwent primary percutaneous coronary interventions during 2018-2019. Results: The sample included 426 patients and the median DTB time was 142 minutes. The result of the bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were 3 times more likely to have a delayed DTB time, when compared to patients who presented with typical symptoms (odds ratio [OR] = 3.003, 95% confidence interval [CI]: 1.409-6.400; P = 0.004). In addition, patients who presented during off-hours were 2 times more likely to have a delayed DTB time, when compared to patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284-4.087; P = 0.005). Conclusion: To meet the DTB time recommendation, it is important to ensure adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care.

Perception of Nursing Students About Effective Clinical Teaching Environments: A Multi-Country Study.

Background: The transition of nursing education from traditional methods to more advanced approaches is crucial for adequately preparing students to deliver competent care in tertiary care centers. Moreover, clinical faculty in nursing plays a key role in guiding nursing students through their clinical training in various healthcare settings. Purpose: This study aims to describe the perceptions of undergraduate nursing students regarding the effectiveness of the learning environment and clinical teaching in clinical areas across various countries. Methods: The study, conducted using a descriptive, cross-sectional research design, gathered data from 215 nursing students using the Clinical Learning Environment Inventory and Clinical Teaching Effectiveness Instrument. Data analysis included frequencies, percentages, mean, standard deviation, t-tests, analysis of variance, and correlation assessments to comprehend the impact of clinical teaching and learning environments. Results: Nursing students' perceptions of the clinical learning environment produced mean scores between 2.03 and 3.38 on a scale from 1 to 4, resulting in an overall mean score of 2.72 across 42 items. This indicates a general satisfaction with their clinical learning experiences. Regarding effective clinical teaching, the mean student responses varied from 3.02 to 3.40 out of a possible 5 points, with a total mean of 3.22. The study revealed notable correlations in the context of effective clinical teaching, particularly with demographic variables and the clinical learning environment. Specifically, a significant correlation with age (r = .177, p = .009) and the clinical learning environment (r = .572, p < .001) was identified. Conclusion: The study concludes that students expressed overall satisfaction with their clinical learning experiences. They recognized the importance of participating in clinical training, fulfilling clinical responsibilities for assigned patients, exerting extra effort for learning, receiving support from preceptors in clinical settings, and being attentive to communications from staff. The collaboration between clinical preceptors and academic nursing lecturers is crucial in providing a positive learning environment for students to complete clinical tasks effectively.

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman.

Objectives: This study aimed to explore the relationships between nurses' work environment, job stress and job satisfaction, along with the moderating effects of work environment and empowerment on the relationship between job stress and job satisfaction. Methods: A descriptive correlational design was utilised for this study. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. Moreover, a self-report questionnaire that included a set of instruments was used to collect the data. Results: Nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment and perceived their work environment as less favourable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction, whereas no support was found for indirect or moderating effects. Furthermore, the hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables. Conclusion: The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment and tackle job stress to enhance levels of job satisfaction.

Determinants of Physicians' Job Satisfaction: A national multi-centre study from the Sultanate of Oman.

Objectives: This study aimed to examine and assess job satisfaction of physicians across several factors, such as quality of care, ease of practice, relationship with leadership and inter-professional collaboration. Methods: The data for this descriptive cross-sectional study were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician job satisfaction and inter-professional collaboration. Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of the 396 physicians contacted, 354 responded (response rate: 89.4%). Results showed that out of the 354 physicians, 4.3% were not satisfied with their jobs, 36.5% expressed a moderate level of satisfaction and 59.2% were highly satisfied. There was no difference in the mean job satisfaction score among different groups of study participants, except for gender and the working grade (P <0.05). The overall job satisfaction rates were higher for the quality of care (mean = 3.93 ± 0.61) and ease of practice (mean = 3.89 ± 0.55) and lower for relationship with leadership (mean = 3.67 ± 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (P = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care and for ease of practice and lower for relationship with the leadership. Relationship with leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates.

Relationship between interprofessional teamwork and nurses' intent to leave work: The mediating role of job satisfaction and burnout.

BACKGROUND: Reducing nurse turnover is a top priority for nursing management globally. While evidence has demonstrated that working in a favorable environment with greater interprofessional teamwork is essential in increasing nurse retention, few studies have explored the mechanism underlying this relationship. AIM: To examine the direct and indirect effects of interprofessional teamwork on nurses' intentions to leave their jobs via the intermediary roles of job satisfaction and burnout. METHODS: A cross-sectional study was conducted to collect data from 2113 nurses working in 21 hospitals in Oman. Data were collected using a survey questionnaire measuring teamwork, job satisfaction, burnout, and intention to leave. Logistic regression was used to investigate the direct effect of teamwork on intent to leave. A sequential mediation model was conducted to examine the mediating role of job satisfaction and burnout. RESULTS: Interprofessional teamwork was directly associated with nurses' intentions to leave. The influence of teamwork on intention to leave was indirectly mediated by both job satisfaction and job burnout. CONCLUSION: Findings illustrate the potential benefits of enhancing interprofessional teamwork in reducing nurses' intentions to leave. Interventions intended to foster teamwork could create satisfying workplaces, reduce perceived burnout, and ultimately contribute to organizational strategy for reducing nursing shortages.

Health-Related Quality of Life of Children and Adolescents with Sickle Cell Disease in the Middle East and North Africa Region: A systematic review.

Sickle cell disease (SCD) can significantly impair the health-related quality of life (HRQOL) of children and adolescents. This review aimed to assess current evidence regarding the HRQOL of children and adolescents with SCD in the Middle East and North Africa region. A systematic search of various databases was conducted to identify relevant articles, including MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), Scopus® (Elsevier, Amsterdam, the Netherlands), Cumulative Index to Nursing and Allied Health Literature®, Masader (Oman Virtual Science Library, Muscat, Oman) and EBSCOhost (EBSCO Information Services, Ipswich, Massachusetts, USA). A total of 533 articles were identified; however, only 10 were eligible for inclusion in the final analysis. Results from these studies showed that children and adolescents with SCD had compromised HRQOL compared to their healthy peers, particularly in terms of physical, psychosocial, familial, financial and academic functioning. Therefore, interventions are necessary to improve overall HRQOL outcomes for this population.

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.

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.

Factors influencing nurses' willingness to lead.

AIM: To identify factors influencing nurses' willingness to lead. BACKGROUND: Given the ageing workforce and the projected retirement of nurse leaders, there is a concern about nursing leadership shortages in the next decade. Several studies have shown that nurses are not interested in pursuing leadership positions, but studies investigating nurses' willingness to lead and related predictors remain limited. METHODS: A workforce survey of 1,201 direct-care nurses was conducted in Oregon. Logistic regression modelling was used to identify factors influencing the likelihood of nurses' willingness to lead. RESULTS: Fifty-three percent of nurses were willing to pursue leadership roles. Years of experience, job burnout, the perception of the work environment, adequacy of leadership preparation, and the amount of salary and compensation were significant predictors of nurses' willingness to lead. CONCLUSION: Increasing nurses' participation in hospital affairs and providing adequate leadership preparation, parts of the work environment, prior to engaging them in leadership roles is recommended to improve their attitudes about leading. IMPLICATIONS FOR NURSING MANAGEMENT: Recruitment of future nursing leaders should not be based solely on demographics such as age and gender. Rather, recruiters should focus on creating more favourable work environments in which to lead.

Simulation debriefing for clinical judgment development: A concept analysis.

OBJECTIVE: The aim of this review was to provide an in-depth analysis of debriefing in nursing simulation-based learning. Specifically, the authors sought to describe the debriefing concept within the context of enhancing nursing students' clinical judgment skill. DESIGN: Concept analysis. DATA SOURCES: A literature review was conducted using five electronic databases with the addition of references for relevant papers reviewed. Medline Ovid, Cumulative Index to Nursing and Allied Health (CINAHL) Plus, Educational Resources Information Center (ERIC), ScienceDirect and Google Scholar were searched for articles published in English between 2005 and 2015. Search terms included clinical judgment, debriefing, and simulation. REVIEW METHODS: The Walker and Avant systematic approach was utilized as a concept analysis framework. The analysis informed how the concept is defined in the existing literature. RESULTS: The search resulted in a total of 47 articles. The concept of debriefing was analyzed using seven themes from Walker and Avant: concept definition, defining attributes, antecedents, consequences, empirical referents, uses of the concept, and a model case. Based on the analysis, an integrative simulation debriefing guide for promoting students' clinical judgment was presented as a vehicle for a consistent approach. CONCLUSIONS: This review identified simulation debriefing as a structured and guided reflection process in which students actively appraise their cognitive, affective, and psychomotor performance within the context of their clinical judgment skill. Reflective debriefing provides students with an opportunity to assume an active role during the learning process. Following a structured debriefing guide can help educators and even students facilitate a learning environment that enhances students' clinical judgment development.