Actual Scope of Nursing Practice in Saudi Ministry of Health Hospitals.

BACKGROUND: Articulating a clear scope of practice for all nursing categories is essential for improving patient safety, quality of care, and nurse retention. However, this is not the case in many countries, including Saudi Arabia. This study aimed to analyze the actual scope of practice for nursing staff in Saudi Ministry of Health hospitals. METHODS: The study used a cross-sectional exploratory design. The sampling method used in the study was the quota sampling technique. The scale utilized in this study was the Actual Scope of Practice (ASCOP) scale. Data were collected in March 2021 through an electronic form questionnaire completed by 286 nurses in two hospitals in Al-Hasa province in Saudi Arabia. RESULTS: The overall mean score for ASCOP was 4.64 out of 6. When participants were grouped according to select characteristics (various nursing staff categories, educational levels, years of experience, nationality, gender, and type of work setting), the results revealed no statistically significant differences in overall ASCOP mean scores, except for gender and nationality. CONCLUSIONS: The overall mean scores of nursing activities performed in practice do not significantly differ across nurses with different professional categories (health assistant, nursing technician, nursing specialist, and senior nursing specialist), indicating no clear scope of practice for each nursing category, in turn leading to role overlap among them in practice. The current study's findings can guide decision-makers to develop a clear scope of practice for nurses. The findings should also urge the decision-makers to reevaluate the usefulness of having multiple professional categories of nurses who are allowed to carry out almost the same job duties.

Prevalence of co-infection of human immunodeficiency virus in diagnosed tuberculosis cases: Meta-analysis.

Objective: The objective of the study was to find pooled prevalence and risk factors of co-infection of human immunodeficiency virus (HIV) in diagnosed tuberculosis (TB) cases. Methods: Search engines including PubMed and Google Scholar were used to find literature using search terms such as "co-infection," "HIV," "Acquired Immunodeficiency Syndrome," TB and "Prevalence" among others. All original studies conducted on the prevalence of HIV co-infection among diagnosed TB patients that were freely available in full length had a clear methodology and relevant results were included in the study. Result: From 1021 initial studies, a total of 18 studies were selected for analysis. A total of 18 studies were included with a total sample size of 44943. The minimum prevalence of HIV-TB was reported in a study from Pakistan as 0.29% and the maximum prevalence of HIV-TB was found in Nigeria, that is, 44.20%. The pooled prevalence of HIV/TB co-infection was 16.291% (95%; 9.57-24.38) using the random effect method. As per Begg's test, there was no publication bias. As I2 is 99.74% so, there is high heterogeneity among studies; hence, random effect model is preferred. Conclusion: The study concludes that the pooled prevalence of HIV/TB co-infection was found to be 16.291% (95%; 9.57-24.38). The risk of mortality will be substantially raised by the co-existence of HIV-TB co-infection, so early screening and emphasizing the urgent need for integrated health-care interventions can cope with the situation.

Predictors of Leadership Competencies Among Nurse Executives in the Kingdom of Saudi Arabia.

Background: Awareness and development of nurse executives' leadership competencies has been considered a key strategy for the success of healthcare organizations. However, only a few studies about nurse executives' leadership competencies are available in the literature, and no study has been conducted about the topic within Saudi Arabian context. The aim of this study was to assess the leadership competencies of nurse executives and the predictors of these competencies. Methods: This quantitative study used a descriptive, cross-sectional, and correlational design. The study recruited a total convenience sample of 136 nurse executives who voluntarily consented to participate. The respondents self-rated the online survey, "Leadership Competency Assessment Tool: Self-Assessment." Data collection was conducted between September 2022 and November 2022. Test of correlation and multiple regression analyses were conducted. Results: The overall mean score of nurse executives' leadership competencies was 3.38 out of 5.0, which was below the level of having excellent leadership competencies. Four dimensions had mean scores below the level of having excellent leadership competencies, namely, communication and relationship building (3.48), knowledge of the healthcare environment (3.29), leadership (3.45), and business skills (3.15), while nurse executives had excellent leadership competencies only in the professionalism dimension (3.51). Age (p=0.04), highest educational attainment (p=0.01), current role (p<0.01) and length of experience (p=0.02) as nurse executive, monthly salary (p=0.03), nationality (p=0.04), and having seminars/trainings in leadership and management (p=0.01) were considered predictors of the leadership competencies of nurse executives. Conclusion: Nurse executives reported a low level of leadership competencies, thus implying necessary actions for improvement. There were personal factors that influenced the level of nurse executives' leadership competencies. To achieve quality outcomes and maintain a high level of nursing care in hospital organizations, these findings must be considered in planning strategies related to the improvement of the leadership competencies of nurse executives.

Exploring Nurse perceptions of structural empowerment in midwifery practice in Saudi Arabia: A qualitative study.

Perceptions and experiences of midwives regarding structural empowerment during practice in Saudi Arabia were explored using a qualitative, constructive, descriptive design. Data was gathered using individual semi-structured interviews with ten midwives employed in delivery rooms, and prenatal and postnatal units of governmental hospitals in Saudi Arabia's eastern province. Data was analyzed with assistance of NVivo software, Version 12. Five themes emerged from our study: the meaning of structural empowerment, ambiguous hospital policies, the insufficient numbers of midwives, midwife-physician dynamics, and continuing education and training. Structural empowerment of midwives in maternity units may be useful in improving midwifery services in Saudi Arabia and worldwide.

What is the further research?Further studies on this topic should expand the current study's sample and include participants from more regions of Saudi Arabia. In addition, research on the psychological empowerment of midwives is needed.What is known on the subject?Midwives are educated to care for women during pregnancy, birth, and postnatal, and midwives must be empowered to fulfill this professional role. The evidence showed the importance of structural empowerment for midwives to perform their professional function and provide quality care for women during pregnancy, birth, and postnatal.What does this paper add to existing knowledge?In Saudi Arabia, there is little research evidence on how to explore the perceptions and experiences of structural empowerment among midwives. Our study provided valuable recommendations for identifying environmental practices, positive workplace characteristics, and promoting higher-quality midwifery in the workplace.What are the implications for practice?Midwife workplace empowerment is correlated with the quality of care, job satisfaction, staff effectiveness, and the positivity of the work environment. The results of this study suggest that every healthcare organization must work to bring about structural empowerment for midwives to facilitate successful practice.

Knowledge and Attitude Regarding Cutaneous Leishmaniasis Among Adult Population in Tabuk, Saudi Arabia.

Background Cutaneous leishmaniasis (CL) is a major health problem in Saudi Arabia. It is caused by the protozoa Leishmania. The vector is female sand flies. In order to develop preventive strategies to reduce the burden of this health problem, public awareness of the disease should be assessed. Objective This study aimed to investigate the knowledge and attitude toward CL among the adult population in Tabuk, Saudi Arabia. Methods A cross-sectional survey study was conducted on 385 adult participants of Tabuk between April and May 2022. The investigators assembled the survey questions from peer-reviewed articles with some modifications. Google Forms was used to create the online survey. Social media were used to distribute the survey. Results The study revealed that hearing about CL was much more common among participants older than 61 years and Saudi males. The most prominent sources of information for the participants on which their answers were based were as follows: families and friends, health care professionals, television or radio, and lastly, newspapers. Subjects older than 61 years also showed more knowledge of the risk factors for contracting CL. However, the participants showed overall poor knowledge of the clinical presentation of the disease, which gender or age group was mostly affected, or how the disease was transmitted. Likewise, their knowledge of sand flies was poor. Most participants did not know if CL was a health problem or not. Conclusions The study revealed overall poor awareness of the epidemiological aspects of CL, how it is transmitted, its clinical presentation, and proper management. Our study could help authorities correct the gap in knowledge regarding CL in Tabuk.

Exploring the Factors behind Nurses' Decision to Leave Clinical Practice: Revealing Causes for Leaving and Approaches for Enhanced Retention.

Nursing turnover has emerged as an urgent concern with a substantial influence on the financial efficiency and quality of care in healthcare frameworks worldwide. This study determined important factors associated with nurses' intentions to leave and what would bring them back. This was a cross-sectional, multisite study of nurses in three public hospitals. Convenience sampling was used to recruit 205 nurses from the selected hospitals. A questionnaire was used to measure demographic and professional background information, current job satisfaction, and the intention to leave work and return. Bivariate and multivariate analyses were run using SPSS. This study revealed that both job satisfaction (M = 47.26, SD = 11.59, range: 19-76) and intent to leave a current job (M = 14.18, SD = 4.36, range: 4-20) were reported at moderate levels. There were significant differences reported between the scores of nationality and job satisfaction (p < 0.05) and between the means of income level and intention to leave (p < 0.05). There was also a significant, negative association between satisfaction and intention to leave (r = -0.551, p < 0.05). In regression, income level (ß = 0.159, p = 0.021), incentives (ß = 0.186, p = 0.002), hospital type (ß = 0.189, p = 0.005), and intention to leave (ß = -0.454, p < 0.001) significantly influenced satisfaction. Gender (ß = -0.122, p = 0.037) and nationality (ß = -0.210, p = 0.007) were found to influence the intention to leave among participants significantly. In conclusion, this study indicated that job satisfaction and intention to leave are important factors affecting nurses' enthusiasm. Incentives also had a positive impact on increasing nurses' satisfaction levels. Future research studies should investigate what factors might lead to improved monthly salaries and provide more incentives among nurses.

Professional Values and Self-Reported Clinical Competence of Acute Care Nurses in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Professional values are the foundation of nursing practice. Current research evidence on the influence of professional values on clinical competence among acute care nurses in the clinical area is lacking. PURPOSE: The purpose of this study was to examine the professional values and self-reported clinical competence among acute care nurses. METHODS: This quantitative study used a cross-sectional, correlational design. A convenience sample of 403 nurses was recruited to answer the survey utilizing the Nurses Professional Values Scale-3 and the Nurse Competence Scale. The Pearson correlation coefficient was computed to test the relationship between study variables, and a stepwise multiple regression analysis was then performed to investigate the predictors of nurses' professional values and clinical competence. RESULTS: The professional value of "caring" received the highest mean score, followed by "professionalism", while the factor "activism" was rated the lowest. Education was a significant predictor of all three factors of professional values. For clinical competence, "managing situations" was rated as the highest dimension, while "ensuring quality" was rated as the lowest. Moderate positive correlations were revealed between the three factors of professional values and all dimensions of nurses' clinical competence. Area of practice and "activism" were the only significant predictors of the nurses' clinical competence. CONCLUSIONS: Nurses perceived all three factors of professional values with high importance in influencing their clinical competence. These findings can contribute to the development of educational interventions to improve and sustain professional values and clinical competence among acute care nurses.

Development of Nursing Research in Saudi Arabia: Implications for Policies and Practice.

Background: Nursing research in Saudi Arabia can be evaluated based on productivity as well as the quality of publications. The scope of scientific inquiry in nursing research expands to include clinical, health system, and outcome-based research, education, and administration. Aim: The purpose of this article is to track the development of nursing research in the Kingdom of Saudi Arabia. Design: Systematic review. Methods: This study used keywords, databases including MEDLINE, CINAHL, and PubMed to search for published articles on nursing in Saudi Arabia. The search resulted in the identification of 681 publications, from which 360 articles met the inclusion criteria and were included in the review. Results: The highest percentage of studies (56.7% of articles) focused on nursing clinical practice, and 76.0% of the studies were conducted in a hospital setting, followed by an educational setting. Most of the studies were quantitative and non-funded. More than 50.0% of the studies were first authored by Saudi scholars. Conclusions: This study concluded that nursing research in Saudi Arabia is still in its infancy, with notable improvements in the last 5 years. This correlated with an increasing number of nurses holding postgraduate degrees. With the Saudi government's strong support, the number of scientific research papers published on Saudi nursing has steadily increased over the last year.

Healthcare Managers' Perception on Patient Safety Culture.

Introduction: This paper takes a detailed look at safety culture, different roles, and powers shared by managers, lessons from which can be applied in any form of management. It also focuses on the job of managers in enhancing safety standards in a health institution. The objective of this paper was to examine the managers' perception of patient safety culture. Methods: This study followed a quantitative cross-sectional design. The research procedure involved all middle-level managers in Aseer Central Hospital in Abha, Saudi Arabia (N = 52). To assess the status of patient safety culture and the role of healthcare managers in the field study, the researchers constructed a study questionnaire; it included questions adapted and modified from the Safety Attitudes Questionnaire, the Hospital Survey on Patient Safety Culture questionnaire, the 10 Mintzberg managerial roles and the six types of power for healthcare managers. Results: Most participants were Saudi nationals (73.1%) aged 31 to 40 years (44.2%). The managerial role practiced frequently was leadership (85%), but the least managerial role was the figurehead (23%). Mangers held positive attitudes toward patient safety culture with 100% positive replies. No significant association was found between sex, nationality, years of experience, and professions concerning patient safety. Additionally, the results indicated that most managers were willing to uphold a safe environment for their patients and ready to involve employees in decision-making strategies to motivate them. Conclusion: The managerial choices in Aseer Central Hospital are based on the culture and tradition of the community, which might negatively undermine the capability of other individuals handling the same office based on their educational backgrounds and competency. Such situations also may demoralize the employees, leading to poor employee performance Suboptimal achievement was exhibited primarily by middle-level healthcare managers of all six power types: resource allocator, negotiator, liaison, spokesperson, figurehead, and entrepreneur. Therefore, there is a pressing need to improve managers' attitudes toward patient safety and activate managerial roles to ensure patients' safety is practiced unequivocally.

The association between nurse managers' transformational leadership and quality of patient care: A systematic review.

AIM: To examine and summarize the reported association of nurse managers' transformational leadership and quality of patient care based on the perceptions of registered nurses. BACKGROUND: Transformational leadership behaviors of nurse managers result in staff nurses' satisfaction and retention and patient satisfaction. Patient safety and quality of care are vital to high-performing healthcare organizations. Perceptions of registered nurses are important because nurses are frontline healthcare providers fundamental to patient safety and quality of care and are considered the final line of defense in preventing adverse events and errors and improving the safety of patients. MATERIALS AND METHODS: We  searched the CINAHL, ProQuest, PubMed, Science Direct, and Web of Science databases for evidence published between 2018 and 2022 in the English language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in carrying out this meta-analysis. RESULTS: Nine quantitative studies were appraised using the Joanna Briggs Institute checklists and were included in the final review that involved a total sample of 3633 registered nurses. The included studies were reported across Asian, Middle East, and European countries within the past five years. The association between the transformational leadership behaviors of nurse managers and the quality of patient care was found in varying degrees (i.e., insignificant, weak, indirect, and strong direct association) based on the perceptions of registered nurses. CONCLUSIONS: There is a direct and indirect association between the transformational leadership behaviors of nurse managers and the quality of patient care internationally. This association is influenced by confounding and mediating factors, including gender, organizational culture, structural empowerment, and job satisfaction. IMPLICATIONS FOR NURSING AND HEALTH POLICIES: Healthcare organizations need to support nursing leaders to have a stronger transformational leadership style by considering several factors that influence their leadership to improve the quality of patient care their staff nurses provide at the bedside.

Knowledge, Attitude, and Psychological Impacts of COVID-19 in Saudi Arabia.

Background: The world has been facing an unprecedented pandemic of COVID-19 with over 336 million people infected and millions of deaths. This required an enormous communication effort response from governments, international, and individuals to keep the public informed about the outbreak. When a pandemic affects communities, individuals' knowledge and attitude are important factors to contain the outbreak. Thus, the purpose of this study is to measure individuals' knowledge and attitude toward COVID-19 and ascertain whether a need exists for mental health services for those who were affected by the pandemic. Methods: A cross-sectional design was used to measure the knowledge, attitude, and psychological impacts about the COVID-19 pandemic among the Saudi population. Research participants were recruited using a snowball sampling technique through the social media platform WhatsApp. A total of 482 eligible individuals participated from various locations in Saudi Arabia represented almost all Saudi regions. The questionnaire consisted of seven questions evaluating knowledge, seven gauging attitudes, and 16 questions assessing anxiety and perceived need for mental healthcare services. Results: A modest level of knowledge (59%) was found among the Saudi population sampled about the COVID-19 pandemic, and satisfactory knowledge (>80%) about its preventive measures. Anxiety and stress existed among the participants (79% obsessed with COVID-19), with an 88% approval rate for obtaining mental health services for individuals highly affected by the pandemic. Conclusion: There is a need to increase awareness and provide continuous updates regarding the pandemic situation. Promoting access to mental health services is critical, as well as finding creative and suitable strategies to deliver mental health services to those who need them.

Relapsed hip stiffness after recovery of range of motion in a hip treated for developmental dysplasia of the hip? Think again: A case report.

INTRODUCTION: Several complications have been reported following treatment of developmental dysplasia of the hip (DDH). Local muscular spasm is an extremely rare complication. This case serves to enlighten orthopedists about various and unique presentations of idiopathic local muscular spasm, natural history of such condition, and appropriate treatment. PRESENTATION OF CASE: A two-year-old child presented with bilateral acetabular dysplasia for orthopedic evaluation and treated with bilateral simultaneous Dega osteotomy and postoperative cast for 12 weeks. Full range of motion (ROM) of both hips was regained three months after removal of the postoperative cast. Five months later, the child presented with apparent leg length discrepancy, and severe and painless global limitation of the right hip ROM, which initially was thought to be relapsed hip stiffness. Laboratory and radiological investigations were normal apart from pelvic obliquity on radiographs. Symptoms persisted for one month. Examination under anesthesia (EUA) was then performed and revealed full ROM of the involved hip. Physical therapy was started, and hip ROM fully recovered within 3 months without further intervention. DISCUSSION: Stiffness, which is one of the most reported complications following surgical treatment of DDH, is usually related to lengthy periods of immobilization and/or surgical treatment. Clinically, local muscular spasm of the hip can mimic stiffness. EUA is invaluable to differentiate the common postoperative stiffness from the rare local muscular spasm. CONCLUSION: Idiopathic local muscular spasm of hip might present clinically as stiffness that pose a diagnostic dilemma to the treating physician. Close observation coupled with physical therapy is sufficient.

Evaluation of the effectiveness of mobile diabetes management system with social networking and cognitive behavioural therapy (CBT) for T2D.

BACKGROUND: In the Saudi Arabia region there are no previous studies related to the use of social networks combined with the management of mobile diabetes. In this sense, the aim of this feasibility investigation is to evaluate the application and utility of the SANAD system (Saudi Arabia Networking for Aiding Diabetes) to support Saudi type 2 diabetes adult patients. METHODS: Twenty patients from a clinic in Saudi Arabia-Dammam were recruited to use the SANAD system. The study design was a randomized controlled trial (RCT) with two groups: an intervention group using SANAD system and a control group using conventional diabetes treatment. Glycated hemoglobin (HbA1c), diabetes knowledge test (DKT) and Self-efficacy Scale (SES) were documented. RESULTS: Nineteen patients completed the study. Mean baseline HbA1c (%) was 8.14 (SD 1.20) and decreased to 7.54 (SD 0.96) after the SANAD intervention process [mean (SEM) decrease 0.600 (0.102)]. A paired-samples t-test showed this change to be significant (P=0.000). Linear regression analyzed each study group separately, and revealed that age significantly predicted change in HbA1c (%) in the intervention group, with older age (i.e., 41-50 years) associated with higher HbA1c (%) at 6 months, as compared with baseline values (ß=0.865, t=3.67, P<0.05). The mean diabetes knowledge score prior to the intervention (baseline) was 12.11 (SD 2.09), which rose to 14.56 (SD 1.59) afterward. This increase [mean (SEM), 2.44 (0.530)] was shown to be significant using the paired-samples t-test (P=0.002). Linear regression demonstrated that age, gender, and educational level were not related to increased diabetes knowledge in each study group. The mean self-efficacy score prior to the intervention (baseline) was 5.17 (SD 0.45), which rose to 6.17 (SD 0.39) afterward. This increase [mean (SEM), 0.944 (0.192)] was shown to be significant using the paired-samples t-test (P=0.001). Linear regression demonstrated that age, gender, and educational level were not related to increased self-efficacy in each study group. CONCLUSIONS: This study demonstrates that using of SANAD system is acceptable, and feasible in supporting diabetes care in Saudi Arabia. This study is the first in Saudi Arabia to demonstrate similar benefits of using this technology on social diabetes and management. A national clinical trial is needed to assess precise benefits of self-care and knowledge.

The use of planned behavior theory in predicting cigarette smoking among Waterpipe smokers.

BACKGROUND: Waterpipe and cigarette smoking have been found to be associated with each other as cigarette smokers were more likely to be waterpipe users than non-cigarette smokers. Also, waterpipe smokers were likely to be former daily cigarette users. The aim of this study is to examine the likelihood of waterpipe use leading to cigarette use among current waterpipe users using theory of planned behavior. METHODS: Four hundred six current waterpipe smokers who initially had started tobacco use with the waterpipe were recruited from 15 waterpipe lounges in 2015. From a total of 70 waterpipe lounges in Riyadh, the 15 waterpipe lounges were selected randomly and participants were also selected randomly inside each waterpipe lounge based on the table or section number. The survey was developed using the Qualtrics Online Survey Software and participants completed a survey using iPad tablets. RESULTS: Cigarette smoking and intention to smoke cigarettes were predicted by attitude and perceived behavioral control. There was no direct effect of subjective norm on the cigarette use behavior, yet subjective norm had a statistically significant indirect effect on intentions through attitude and perceived behavioral control. CONCLUSIONS: The findings of this study could be useful in prevention/intervention programs aimed at reducing tobacco smoking behaviors among waterpipe users. Intervention programs might be directed at the attitude and perceived behavioral control by targeting underlying behavioral and control beliefs. The theory of planned behavior provided solid explanations of intention to use cigarettes among waterpipe smokers.