Organizational culture and readiness for evidence-based practice in the Kingdom of Saudi Arabia: A pre-experimental study.

AIM: This study aims to establish postgraduate students' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces in the Kingdom of Saudi Arabia. BACKGROUND: Nurse shortages and a reliance on a transient nurse workforce have long been a challenge in the Kingdom of Saudi Arabia. Developing a home-grown nurse workforce, a key objective of the Government of Saudi Arabia, can help to address this. Evidence-based practice offers a mechanism to address this. Evidence-based practice implementation is heavily reliant on the prevailing organizational culture. Establishing the organizational culture and readiness for evidence-based practice is crucial for sustainable evidence-based practice implementation. METHODS: A pre-experimental pilot study collected data from the same participants at three different points. As part of this, a questionnaire measuring organizational culture and readiness for evidence-based practice was administered twice. Descriptive, inferential and correlational statistics were employed to analyse the data. RESULTS: Results demonstrated improved participant perceptions of the organizational culture and readiness for evidence-based practice of their workplaces between the first (M = 76.58, SD = 19.2) and second (M = 92.10, SD = 23.68) data collection points, indicating moderate movement towards a culture of evidence-based practice. Strengths, challenges and opportunities for improvement were identified. CONCLUSION: This study established participants' perceptions of the organizational culture and readiness for evidence-based practice of their workplaces, affording insight into context-specific strategies to embed evidence-based practice in health care organizations. IMPLICATIONS FOR NURSING MANAGEMENT: Assessing an organization's culture and readiness for evidence-based practice (EBP) can afford insight on the strengths, challenges and opportunities that exist to equip nurse managers to advance evidence-based practice at individual, professional and organizational levels. This study demonstrated the importance of promoting an environment conducive to EBP and putting in place the necessary resources to support evidence-based practice implementation. Nurse managers can play a central role in this.

A pre-experimental pilot study exploring EBP Beliefs and EBP Implementation among post-graduate student nurses in Saudi Arabia.

AIM: This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA. BACKGROUND: Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme. METHODS: A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation. FINDINGS: Findings demonstrated that the educational intervention did improve participants' EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation. CONCLUSION: This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.

Senior Nursing Students' Perceptions of Their Readiness for Practice Prior to Final Year Internship: Part 2-A Qualitative Perspective.

INTRODUCTION: Preparing nursing students for their role as future registered nurses is an essential and complex endeavor. It is a responsibility that is shared between academic and clinical health care organizations. Arguably, the prevailing economic climate places additional pressures on the fiscal and manpower aspects of health care management. Maintaining a quality practice learning environment for students against this backdrop has become increasingly challenging. Indeed, students themselves have raised these concerns. The authors sought to explore these concerns further with the students, and this article will present the qualitative findings of a study exploring final-year students' perceptions of their readiness for practice in a school of nursing in the Republic of Ireland. METHODS: Two open-ended questions were included on a quantitative survey, which sought to ascertain students' self-reported level of readiness for oral medication administration. A convenience sample of 24 final-year students undertaking a 4-year BSc (honors) in general nursing program was involved. Content analysis was employed to explore and elicit the key components of participants' written responses to the open-ended questions. RESULTS: Participants highlighted the constraints that they have witnessed in some practice areas, the consequent impact on the availability of particular learning opportunities, and their level of preparedness for practice. Three key areas of concern emerged including medication management, patient caseload management, and communication. A recurring issue centered on the delegation of the more fundamental nursing tasks to students by qualified nurses, to the detriment of students' experience of the more complex aspects of holistic patient care. This proved quite exasperating for these participants. CONCLUSION: This study demonstrates that final-year undergraduate nursing students in a school in the Republic of Ireland are concerned about their readiness for practice. Specific areas of concern for students relate to their capacity to develop competence for registered practice. These findings provide both a timely reminder and opportunity for those charged with the responsibility of preparing nurses for registration, in both clinical and academic settings, to raise awareness of factors that can impact on the student experience and learning in practice. They highlight the importance of a collaborative approach to addressing the issues that emerged, if competence and patient safety are to be safeguarded and maintained in the future.

Senior Nursing Students' Perceptions of Their Readiness for Oral Medication Administration Prior to Final Year Internship: A Quantitative Descriptive Pilot Study.

In health care, it is crucial to ensure that new nurse graduates are equipped to deliver care that is safe, of high quality, patient-centered, and based on the best available evidence. Medication management encompasses many responsibilities and consumes a significant portion of a nurse's working day and is a substantial concern for students approaching the latter stages of their undergraduate education. The theoretical content on this area, as well as exposure to/hands-on experience in practice, can vary from program to program. It is nonetheless imperative to ensure that students feel adequately prepared and confident to undertake this responsibility. A recurring stressor reported anecdotally by student nurses within the authors' faculty is the area of medication administration and management and whether they feel ready for this responsibility. Listening to what students have to say in this regard should be one of the key drivers to shaping how best to prepare them. This article describes a pilot study of final-year students' self-reported level of readiness for oral medication administration in advance of becoming licensed registered nurses. METHODS: A non-experimental, descriptive pilot study was undertaken to ascertain perceptions of student preparedness for practice with regard to oral medication administration. A convenience sample of 24 final-year students undertaking a 4-year BSc (honors) in general nursing program in the Republic of Ireland was involved. Participation involved completion of a 17-item survey. The tool, "Preparedness for Oral Medication Administration Questionnaire," adapted by Aggar and Dawson (Nurse Educ Today 2014;34(6):899-903), originated from a 13-item competency-based assessment tool developed by Fisher and Parolin (Collegian 2000;7(3):21-27) to measure student nurses' clinical performance. RESULTS: From a sampling frame of 87 students, 24 students completed the survey, yielding a response rate of 28%. The total scale score produced in this sample was 63.3 (±13.1) out of a range of 17 to 102, Higher scores indicate greater perceived levels of preparedness for oral medication administration. This score (63.3) suggests that participants generally perceived that they are not as adequately prepared for their role in the administration of oral medication as they perceive they would need to be. Individual item means ranged from 2.58 (±1.1) to 4.71 (±.86). CONCLUSION: This pilot study revealed that students did not feel adequately prepared for their role in oral medication administration. Key contributors to this were pharmacology knowledge acquisition and application, along with lack of opportunities in practice to undertake oral medication administration roles and responsibilities. A streamlined approach to address these challenges involving nurse educators, clinical preceptors, and, most importantly students, is paramount. Despite the small scale of this single-site study, it did provide useful insight into students' perceptions of their readiness for oral medication administration and factors influencing this.

The strategic role of education in the prevention of medication errors in nursing: part 2.

It has been established that medication errors are a significant cause for concern in healthcare settings. In Part 1 of this paper the gravity of this problem in addition to the some of the contributing factors were discussed. The shared nature of the problem across disciplines was highlighted in addition to the potential benefits of multi-disciplinary collaboration in resolution of the problem. The contribution that education can make in this regard is unquestionable both at pre-registration (undergraduate) and post-registration level. A variety of pragmatic proposals will be presented for consideration. In addition, clinical and educational measures that have been shown to reduce medication errors will also be proffered and the way(s) forward to ensure optimal medication management and patient safety will be explored from a nursing perspective. The specific aim of this paper is to illuminate the significant role that education, in both academic and clinical settings, can play in the preparation of nurses for their roles in medication management and the marked reduction in errors and improved patient outcomes in this area of practice that they can yield.

Let's do no harm: medication errors in nursing: part 1.

In the current climate of global economic chaos and increasing healthcare litigation, it is perhaps simultaneously unsurprising and yet perplexing that patients continue to fall foul of healthcare systems worldwide. Major incidents in patient care such as serious misdiagnoses, medication errors, the proliferation of superbugs and malpractice persist leading to injury or death of patients, emotional trauma to their families and, understandably, a reduction in the public's confidence in the healthcare system not to mention the financial consequences. Many, if not most or indeed all, of these incidents are preventable and should not happen. Yet the systems in place within healthcare permit their occurrence, with worrying regularity, it would appear. The area that this paper will focus on specifically is that of medication errors. The worrying trends with regard to medication errors will be presented. Potential contributing factors will be examined. The specific aim of this paper is to illuminate the extent and severity of the problem of medication errors in practice and to explore elements within the practice setting that can compound the problem. The multi-faceted nature of the problem will also be considered.

Essential elements in developing evidence-based practice.

This article addresses the principles of evidence-based practice and considers the essential elements involved in the process. The overall aim of the article is to equip nurses with the necessary knowledge and skills to use evidence-based practice competently and to make a positive contribution to patient outcomes.

Student's perceptions of the learning experience in a large class environment.

This study investigated the learning experiences of nursing students in a large class environment. The setting was one school of nursing located in a major academic teaching hospital in the Republic of Ireland. The purpose of the study was to identify students' perceptions of the learning experience in large groups and key factors that affect the teaching and learning experience. Data were gathered using a semi-structured questionnaire that incorporated elements of both qualitative and quantitative approaches to inquiry. Respondents were asked their perceptions of the impact of class size on the learning experience. Their perceptions were analyzed to identify key factors thought to contribute to the learning experience in large classes. Respondents agreed that class size affected levels of participation, but they perceived this as only one of a number of influential factors, including teaching and learning strategies, teacher behaviors, and elements of classroom organization and management.