Knowledge and Attitude of Nursing Interns Toward Pressure Injury Prevention in Saudi Arabia: A Multiregional Cross-Sectional Study.

Introduction: Nursing students in internship programs can play a role in preventing pressure injuries as they engage in real clinical situations and are assigned to conduct clinical tasks. Thus, nursing students in internship programs should be adequately prepared in terms of their knowledge and attitudes to contribute to pressure injury prevention. Objective: To explore and understand the knowledge and attitudes of nursing interns toward pressure injury prevention in Saudi Arabia. Methods: This cross-sectional study included 161 nursing interns from various public hospitals across three provinces in Saudi Arabia and used an online questionnaire. The Pressure Ulcer Knowledge Assessment Tool and Attitude toward Pressure Ulcer Prevention instrument were used to collect data from nursing students in the internship program. The Statistical Package of the Social Sciences Program version 28 was used for the data analysis. Results: Participants reported inadequate knowledge regarding the prevention of pressure injuries, with a mean knowledge score of 48.15%. Additionally, the participants showed unsatisfactory attitudes toward the prevention of pressure injuries, with a mean score of 61.36%. Significant differences were observed in knowledge (P = 0.008) and attitude (P < 0.001) levels between sexes, with female participants scoring higher than male participants. Additionally, students who completed longer internships had better knowledge levels than those who completed shorter internships (P = 0.007). In the open-response question, participants reported a lack of preparation and support during the internship and suggested recommendations to address these deficiencies in preparation and support. Conclusion: Nursing interns need pre-internship preparation and continuous learning and support during the internship to manage and prevent pressure injuries.

Women's attitudes, prevalence, related factors, and perceived barriers of birth companionship in Saudi Arabia.

BACKGROUND: The World Health Organization recommends companionship as a critical element of respectful maternity care. However, there is paucity of literature regarding women's attitudes, related factors, and barriers of implementation in Saudi Arabia. OBJECTIVE: This study aimed to assess women's attitudes toward birth companionship during labor and delivery, related factors, and barriers of implementing labor companionship in Saudi Arabia. DESIGN/METHODS: This study was carried out in Al Ahsa, Saudi Arabia, using a cross-sectional design. The data collection took place over a period of approximately 6 months, specifically from 16 August 2021 to 20 February 2022. A total of 418 women who had given birth at three governmental hospitals and three private hospitals in Al Ahsa participated in the survey. The study included women between the ages of 18 and 49 years who had delivered during the study period. RESULTS: The study revealed that while around 82.8% of mothers expressed a desire for companionship during labor, only 43.2% actually had a labor companion present during delivery. The primary obstacle to labor companionship reported by 21.5% of respondents was hospital policies. Other barriers identified included husbands' fear of being present during labor (4.7%) and limited availability of time for companionship (3.8%). CONCLUSION: The study concludes that birth companionship is highly desired by women in the study area. However, various physical, emotional, and institutional barriers, such as hospital policies and regulations, impede its implementation. Addressing these barriers and promoting supportive policies are essential to facilitate the provision of birth companionship and improve the childbirth experience for women in Al Ahsa.

A Study on Patient Safety Incidents and the Second Victim Phenomenon Among Healthcare Providers in Al-Ahsa, Saudi Arabia.

BACKGROUND: A second victim (SV) is a healthcare worker who is traumatized by an unexpected adverse patient case, therapeutic mistake, or patient-associated injury that has not been anticipated. Often, the second victim experiences direct guilt for the harm caused to the patients. Healthcare organizations are often unaware of the emotional toll that adverse events can have on healthcare providers (HCPs) who can be harmed by the same incidents that harm their patients. Second victims (SVs) were present in 10.4% up to 43.3% of cases following an adverse event. AIM: This study aims to examine the second victim phenomenon among healthcare providers at Al-Ahsa hospitals, its prevalence, symptoms, associated factors, and support strategies. METHODS: Four major public hospitals participated in this cross-sectional study. The study used the German standardized questionnaire "SeViD-I survey." The directors of the four hospitals sent invitations with links to participate to healthcare providers who had worked in their hospitals for over six months after completing their internship program. RESULTS: More than one-quarter of the respondents (90 (28%)) have been victims of a second victim incident before; of those, 63 (70%) have had it once, 12 (13.3%) twice, and 15 (16.7) repeatedly. In our study, the risk factors for a second victim only appeared in the male gender and were statistically significant. Strong reactivation of situations outside of the workplace was reported in 36 (40%) participants. Thirty-five (38.9%) participants reported reactivating the situation on the job site. Twenty-eight (31%) participants reported aggressive psychosomatic reactions (headaches and back pain). In 28 (31.1%) participants, sleep problems or excessive sleep needs were pronounced. The median of feeling symptoms was 7.2. As for supporting strategies, 64 (71.1%) respondents considered emotional support and crisis management to be very helpful. Sixty-six (73.3%) respondents found a safe chance to be very helpful. CONCLUSION: The findings of this study indicate that healthcare providers in Al-Ahsa, Saudi Arabia, suffer from second victim traumatization at high rates. Several symptoms appear in the second victim, and most do not receive enough support.

The Role of Clinical Decision Support Systems in Preventing Stroke in Primary Care: A Systematic Review.

Computerized clinical decision support systems (CDSS) are increasingly being used to facilitate the role of clinicians in complex decision-making processes. This systematic review evaluates evidence of the available CDSS developed and tested to support the decision-making process in primary healthcare for stroke prevention and barriers to practical implementations in primary care settings. A systematic search of Web of Science, Medline Ovid, Embase Ovid, and Cinahl was done. A total of five studies, experimental and observational, were synthesised in this review. This review found that CDSS facilitate decision-making processes in primary health care settings in stroke prevention options. However, barriers were identified in designing, implementing, and using the CDSS.

Metabolic profiling and in vivo hepatoprotective activity of Malpighia glabra L. leaves.

Although Malpighia glabra Linn. fruits are well studied for their nutritional and medicinal prominence; little attention has been given to the leaves. Our study intends to investigate the leaves metabolic profile using Q-TOF LC/MS/MS (Quadrupole-Time-of-Flight-Liquid-Chromatography-Mass-Spectrometry), and to explore their in vivo hepatoprotective activity in rats using CCL4 -induced hepatic damage model and silymarin as standard. Fifty metabolites were characterized, belonging to different classes; coumarins (capensine, daphnoretin, and scopoletin), flavonoids (mainly quercetin and apigenin glycosides), phenolic acids (cinnamic acid and quinic acid derivatives) and amino acids (adenosine, homoisoleucine, and phenylalanine).These compounds are detected in the leaves for the first time. The hepatoprotective activity at three doses (200, 400, and 800 mg/kg) was investigated. The dose of 800 mg/Kg showed the highest hepatoprotective effect as it reduced the elevated serum levels of ALT, AST, NO, and TNF-α liver content by 26, 24, 23, and 42%, respectively, it also remarkably increased the serum level of catalase by 102%. All the tested doses showed higher reduction in serum level of TNF-α compared to silymarin which suggests their strong anti-inflammatory potential. M. glabra leaves are revealed to be a rich source of secondary metabolites and proved to possess significant hepatoprotective potential. PRACTICAL APPLICATIONS: The performed analyses in this study shows the richness of Malpighia glabra Linn. leaves in a plethora of beneficial and safe phytochemicals which are well-known to have a pivotal role in protection against different diseases including liver disorders. The carried-out investigations were done using Q-TOF LC/MS/MS analysis which is a reliable technique for the determination, characterization and identification of bioactive metabolites; in addition to evaluation of the hepatoprotective effect of the leaves. Therefore, this study may emphasize that Malpighia glabra Linn. leaves may have the same nutritional and medicinal importance as its fruits, and they could be incorporated into pharmaceuticals and foods instead of discarding them.

Infection Prevention and Control Challenges With First Pregnant Woman Diagnosed With COVID-19: A Case Report in Al Ahssa, Saudi Arabia.

This study report focuses on facts on a pregnant woman of COVID-19 who admitted to Al Ahsa Maternity and Children Hospital on March 2020, with suspicion of COVID-19 infection. The patient was complaining of labor pain prior to presentation. The objective of this study is to report the case and to describe the challenges that are faced while dealing with a case of COVID-19 pregnant patient, during labor, delivery, and surgical intervention. This case reports a patient in labor pain with suspicion of COVID-19 infection due to contact with a positive COVID-19 family member. With no clinical signs or symptoms consistent with the disease, and positive polymerase chain reaction (PCR) outcome for COVID-19 later on, the hospital main departments conducted an active contact tracing and reviewed the preparation and infection prevention control precautions. The most common problem with COVID-19 is the low level of awareness between healthcare workers related to infection prevention and transmission of the COVID-19 virus. The illness can be better handled and the medical team can be more secure by enhancing the education, case triage, proper guideline and protocols to be implemented appropriately.

Perceptions and Practice of Labor Pain-Relief Methods among Health Professionals Conducting Delivery in Minia Maternity Units in Egypt.

INTRODUCTION: In low-resource settings (LRSs), pain relief during labor is often neglected. Women and health professionals (HPs) may lack awareness of analgesic options, may not accept these options, or may have concerns regarding their safety. Furthermore, even if women or HPs preferred labor analgesia, options may not be available at the hospital. This study was carried out to explore how HPs perceive and practice pain management during labor in Minia maternity units in Egypt. METHODS: A structured, self-administered questionnaire from 306 HPs in Minia maternity units from August 1, 2016, to August 30, 2017, after approval by the organizational Ethical Review Committee. RESULTS: The response rate was 76.5%. The majority, 78.2% of participants, believed in pain relief during labor. However, their practices are different. In the first stage of labor, almost 44.9% used nonpharmacological methods, whereas 36.8% used neither pharmacological nor nonpharmacological methods. Hospital-related factors were the major barriers against using pain-relief methods, as stated by HPs. CONCLUSION: Although most HPs understand the role of analgesia in labor pain relief, there is a wide gap between the use of pain-relief methods and women's need in Minia, Egypt; HPs claim this is due to health care facilities. There is an urgent need to identify the barriers against and raise the awareness among the community and HPs of the need to use pain-relief methods as part of improving the quality of care during labor.

Acaricidal activity of Swietenia mahogani and Swietenia macrophylla ethanolic extracts against Varroa destructor in honeybee colonies.

The acaricidal (miticidal) activity of 90% ethanolic extracts of leaves and stem bark of Swietenia mahogani and Swietenia macrophylla were tested against Varroa destructor mite. Four concentrations were used over two different time intervals under laboratory and field conditions. In general, it was noticed that the acaricidal effect based on mortality and LC(50) of all tested extracts against the Varroa mite was concentration and time dependant. The acaricidal action against Varroa mites was relatively the least for the S. macrophylla stem bark extract at 500 ppm concentration after 48 h while it reached 100% and 95% in case of S. mahogani bark and S. macrophylla leaves, respectively. The% infestation with Varroa in colonies treated with the different extracts at various time intervals showed that the rate of infestation decreased to 0.0% after 12 days from the beginning of treatments with 500 ppm of S. mahogani leaves extract compared to 0.79% decrease after treatment with Mitac, a reference drug (60 mg/colony). The rate of infestation in case of treatments with S. mahogani bark, S. macrophylla leaves and S. macrophylla bark was decreased to 0.11%, 2.41% and 1.08%, respectively. The highest reduction was observed with S. mahogani leaves extract followed by S. mahogani bark. All the tested extracts showed less or no effect on honey bees at the different concentrations and at different bioassay times. This study suggested that the use of natural plant extracts or their products as ecofriendly biodegradable agents could be of high value for the control of Varroa mite.