SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted Objective and Subjective Long-Term Cognitive Outcomes in COVID-19 Survivors Managed with ECMO: A Case Series(Royal Holloway, University of London, 2024) Alanazi, Abeer; Crabtree, AnnaCOVID-19 has been associated with significant health complications, including cognitive impairments, particularly among patients requiring intensive care interventions. A subset of these patients, especially those needing extracorporeal membrane oxygenation (ECMO), face heightened vulnerability due to prolonged Intensive Care Unit (ICU) stay and extended ECMO duration, placing them at an increased risk of developing post intensive care syndrome (PICS), a multifaceted condition that affects cognitive and psychological functions among other health- related domains. This study aims to investigate the cognitive screening outcomes and characteristics of cognitive impairments among COVID-19 survivors managed with ECMO, enhancing our understanding of cognitive outcomes in this high-risk group. Eighty-five COVID-19 patients who had been treated with ECMO were contacted after their ICU admission. The Telephone Montreal Cognitive Assessment (T-MoCA) was employed to detect cognitive impairment. Neuropsychological assessment was completed with ten survivors. A case series design was employed to characterise the cognitive profile of these ten COVID-19 survivors. The mean T-MoCA score for the 49 cohort was 16.20 (SD = 2.93), indicating cognitive impairment among COVID-19 survivors managed with ECMO. T-MoCA scores for the ten patients who completed neuropsychological assessments ranged from 10 to 19, with a mean score of 16.2 (SD = 2.94). The case series analysis demonstrated impairments across domains of attention, working memory, processing speed, and memory. Cognitive impairments are evident in COVID-19 survivors managed with ECMO, presenting cognitive profiles similar to those documented in acute respiratory distress syndrome (ARDS) patients (non-COVID-19). Key words: ICU, COVID-19, ECMO, Cognitive Impairment, PICS12 0Item Restricted Intensive Care Nurses' Experiences of Burnout During the COVID-19 Pandemic in Saudi Arabia: A Constructivist Grounded Theory Study(King's College London, 2024) Alzailai, Nawal; Xyrichis, Andreas; Barriball, LouiseBackground: Burnout amongst healthcare staff, particularly amongst intensive care unit (ICU) nurses, is a critical issue that intensified during the COVID-19 pandemic. Previous research, especially within the Saudi context, has identified significant levels of burnout in ICU nurses. However, a notable gap exists in the use of qualitative methodologies to deepen our understanding of ICU nurses’ burnout in the Saudi context. Moreover, comprehending the experiences of nurses who suffered from burnout during the pandemic, focusing on the factors that contributed to their stress, has been essential for identifying developmental needs and for shaping interventions aimed at mitigating burnout amongst nurses. Despite this, the existing literature lacks a reliable theory or model that adequately captures the phenomenon of burnout within highly demanding environments like ICUs, particularly under the unpredictable and greatly challenging circumstances of disasters. Aim: To construct a theory grounded in burnout experiences of ICU nurses in Saudi Arabia during the COVID-19 pandemic, intended to act as a foundation for future research that explores burnout in high-stress environments for nurses or other healthcare staff working in similar contexts. Methods: Building from one scoping review and one systematic review, a constructivist grounded theory design was employed for this study, as proposed by Charmaz (2014a). Conducted in four distinct adult ICU departments of a tertiary hospital in Saudi Arabia, the research involved 22 ICU nurses experienced in caring for COVID-19 patients and 10 decision-makers, recruited through initial purposive sampling and subsequent theoretical sampling until theoretical saturation was reached. Data were collected through semi-structured, in-depth interviews. Field notes and a reflexive methodological journal were maintained throughout the research process. Interviews were transcribed verbatim and translated into English where necessary. The analysis followed “Charmazian” principles, which include initial, focused and theoretical coding; constant comparison; theoretical sampling and sensitivity; memo writing; and diagramming. Ethical approval was secured from King’s College London and from the relevant Institutional Review Board in Saudi Arabia. Results: The theory generated by this investigation suggests burnout is a process, resulting from multiple interrelated factors within and beyond an individual’s working environment. This process occurs in three dynamic stages affected by the coping and supportive resources that the nurse has used/received. The core category that emerged, ‘we fought and now we need to be healed’, encapsulates the essence of the nurses’ experiences with perceived burnout and their vital need for recovery and support. This finding led to the development of the BuRN-ICU19 model, a comprehensive framework representing the ICU nurses’ experiences with burnout during the COVID-19 pandemic and informed by results from two fundamental reviews: a scoping review and a systematic review. Conclusion: This thesis offers novel insights into the experiences of burnout among ICU nurses in Saudi Arabia during a disaster situation. It highlights the critical need for targeted interventions and policy reforms to alleviate burnout in, improve the well-being of and effectively support ICU nurses in demanding situations. The BuRN-ICU19 model presents a valuable framework for future research and practical application in ICU nursing, with potential implications extending beyond the Saudi context.45 0Item Restricted Nurses' knowledge and attitudes towards non-pharmacological interventions for managing pain in the Intensive care unit: an extend literature review.(The Queen’s University of Belfast, 2024-03-22) Almatrafi, Rehab; Martin, DaphneBackground: Effective pain management in critical care units is crucial for patient outcomes and satisfaction. Although pharmacological approaches are commonly used, they can have adverse effects. Non-pharmacological interventions (NPIs) offer alternative methods for pain management and reduce reliance on medications. Aim: This literature review aimed to explore nurses’ knowledge of and attitudes towards NPIs for pain management in intensive care units (ICUs). It also sought to identify factors hindering nurses from using NPIs in the ICU. Search strategy: A total of 20 keywords were used, and six databases were consulted: CINAHL, MEDLINE, PsycINFO, Embase, Scopus and Web of Science. They were selected for their relevance to the research topic. The search strategy was verified by a subject librarian and a supervisor, and a systematic approach was followed. Additionally, the reference lists of relevant articles were hand-searched. The quality of the included studies was assessed using appropriate tools. Results: The review included six studies: two qualitative studies, three cross-sectional studies and one mixed-methods study. These studies examined nurses’ knowledge and attitudes concerning NPIs for pain management in the ICU. Overall, the results indicated that nurse training, education and policy support are crucial for enhancing the use of NPIs and improving nurse knowledge. Conclusions: Nurses’ knowledge of NPIs in the ICU was low to moderate, with a positive attitude towards their use. This lack of understanding may hinder the development of educational programmes for nurses, which could increase the use of NPIs. Barriers affecting nurses’ knowledge and attitudes concerning NPIs include professional barriers, ICU setting barriers and hospital policy barriers. Therefore, healthcare systems should establish a supportive environment, equip nurses with knowledge and skills, and encourage patient and family engagement in treatment plans.38 0Item Restricted The Impact of Conservative Oxygen Therapy on Mortality Among Critically Ill Adult Patients in Comparison to Liberal Oxygen Therapy(Saudi Digital Library, 2023-08-23) Alajmi, Sarah; Katherine, HillBackground: Liberal Oxygen Therapy (LOT) has the potential to prevent hypoxemia/hypoxia, but it can also cause hyperoxemia/hyperoxia, which can result in oxygen toxicity, infection and increased mortality rates. Although hyperoxia and hyperoxemia have been associated with a variety of potential adverse effects, most clinical practices advocate for the prompt and unmonitored delivery of high-concentration oxygen therapy to critically ill patients. Conservative Oxygen Therapy (COT) is the administration of less supplemental oxygen to patients, resulting in a reduced level of arterial oxygenation. This strategy attempts to reduce the risk of oxygen toxicity by limiting a patient's exposure to excessive oxygen. Aim: This systematic literature search and structured literature review aimed to determine the impact of COT on mortality among critically ill adult patients in comparison to LOT. Methods: Four electronic databases, including Embase, PubMed, CINAHL (EBSCOhost) and Cochrane Library, were utilised to conduct a systematic search for quantitative studies comparing the effectiveness of COT to LOT from the last ten years up to June 2023. The search was conducted using a substantive list of keywords, related terms and predetermined inclusion and exclusion criteria. Results: A comprehensive search was conducted and an automated tool was utilised, thereby resulting in the identification of 2060 studies. Duplicates were eliminated using EndNote software. Subsequently, a comprehensive screening process was conducted on 1571 studies, which included the evaluation of their titles, abstracts and full texts. This rigorous assessment strictly adhered to the predetermined criteria established for inclusion. A comprehensive systematic search yielded nine studies that were included in the dissertation. Conclusion: In comparing the COT to the LOT, there was no observed reduction in mortality rates among critically ill patients; however, ongoing studies have the potential to yield accurate and trustworthy results.38 0Item Restricted The Impact of Positive End-Expiratory Pressure on Mortality Rate among Patients with Acute Respiratory Distress Syndrome(Saudi Digital Library, 2023-08-23) Alrayes, Mashael; Hunter, JoannaBackground: High levels of Positive End-Expiratory Pressure (PEEP) have been found to potentially increase lung volume and improve oxygenation in patients with Acute Respiratory Distress Syndrome (ARDS). They also increase the risk of lung injury caused by overdistention. ARDS has a high mortality rate; however, the impact of increased PEEP on clinical outcomes in patients with ARDS is variable. Aim: The aim of this dissertation is to examine the available studies that compared the impact of high PEEP levels with that of low PEEP levels on the reduction of ARDS mortality rates. Methods: A comprehensive search of literature on Randomised Controlled Trials (RCTs) and cohort studies was conducted using four databases—MEDLINE, Embase, Cochrane Library and CINAHL (EBSCOhost) from the last 15 years to June 2023. The inclusion criteria were studies that examined the ARDS mortality rate in patients subjected to high PEEP levels (as the intervention group) and to low PEEP levels (as the control group). An automation tool was utilised, along with duplicates removal options through Endnote and Rayyan reference management tools. Results: A total of 1637 studies were identified. They were screened through the evaluation of their titles and abstracts and then, of their full text, in accordance with predetermined inclusion and exclusion criteria. Finally, seven studies were selected and included in this dissertation. Conclusion: The mortality reduction in patients with ARDS who received higher levels of PEEP did not differ significantly from that in patients with ARDS who received lower levels of PEEP.33 0Item Restricted Intensive care nurses' knowledge, perceptions, and experiences about noise exposure in the intensive care unit.(Saudi Digital Library, 2023-11-03) Athuwaybi, Sami; McKinney, AidinBackground: Intensive care unit (ICU) noise can have significant impacts on patients and nurses. Ultimately, it directly influences patient outcomes, nurse well-being, and overall quality of care. Understanding how nurses view noise in intensive care is essential in order to explore and build helpful noise control strategies. Comprehending the subjective perceptions of noise among nursing professionals in the ICU is of paramount importance, as it serves as a foundational step in elucidating, formulating, and implementing effective noise mitigation strategies. Aim: This systematic review aims to identify intensive care nurses' knowledge and perceptions about noise exposure in the intensive care unit. Methodology: For this systematic review, a comprehensive search spanning the years 2003 to 2023 was conducted across three prominent databases: CINAHL, MEDLINE, and Embase. The researcher incorporated studies with different research methods including qualitative, quantitative, and mixed methods studies. They employed the Mixed Methods Appraisal Tool (MMAT) to assess the quality of the included studies, while the synthesis and analysis of the findings were conducted using thematic analysis. Results: The review included 7 studies that revealed variations in nurses' knowledge and perceptions of ICU noise. While some were aware of elevated noise levels exceeding recommended limits, others had low levels of knowledge. Noise sources, including human-related activities and medical devices, were recognised, but overall knowledge varied. Furthermore, nurses had varying degrees of understanding of the physiological and psychological effects of noise on patients and staff, with some demonstrating limited understanding of the chronic physiological changes that could arise in patients exposed to excessive noise. Strategies for noise control, such as improving ICU design and addressing human factors, were also proposed, but awareness and implementation varied. 8 Conclusion: Nurses' knowledge and perceptions of ICU noise vary, with some staff members indicating limited understanding of acceptable noise levels, sources and impacts of noise, and strategies to reduce noise levels. This highlights the need for targeted interventions to improve nurses’ knowledge and implement more effective noise control measures. Addressing ICU noise could enhance patient outcomes and create a more conducive working environment for nurses.59 0