SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
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Item Restricted The effectiveness of simulation-based learning in nursing education(University of Glasgow, 2024) Alharbi, Ali; Miller, WilliamBackground: Simulation-based learning (SBL) has emerged as a valuable pedagogical approach in nursing education, allowing students a safe and controlled environment to practice clinical skills with varying levels of fidelity. Furthermore, SBL has become an increasingly popular teaching strategy in nursing education; however, few studies have investigated the effectiveness of SBL in Saudi Arabia. Research shows that simulations can enhance student satisfaction and self-confidence. Moreover, evidence suggests that student satisfaction can contribute to building self-confidence, which may help students develop skills and knowledge. This thesis evaluates the impact of SBL on nursing students' knowledge and skill acquisition and retention. Further, assessed their perception of satisfaction and self-confidence following the simulation experience. Methods: This thesis consists of two studies. First, a systematic review was conducted from 2017 to 2023 to identify relevant studies. A total of 33 studies were evaluated using the Joanna Briggs critical appraisal tools. A narrative synthesis was used to extract and report data. Second, a quasi-experimental study employed a repetitive test design with 100 nursing students exposed to a simulation protocol during the internship year. Benner’s model and Kolb’s theory were the conceptual frameworks underpinning this work. Descriptive statistics, paired t-tests, and ANOVA were used to analyse the data. Results: The systematic review showed that most studies focused on the impact of SBL on life-saving skills like cardiopulmonary resuscitation (CPR) or other lifesupport skills, with the remaining studies examining critical care skills or clinical decision-making skills. Consistent and significant improvements in knowledge and skills were highlighted. The quasi-experimental study indicated that SBL significantly improved nursing student knowledge and skills, regardless of individual characteristics. Furthermore, the study found that students had a high level of satisfaction with the simulation experience. Most students also reported increased self-confidence in their skills. Conclusion: This thesis provides evidence supporting SBL as an effective teaching strategy within nursing education in enhancing knowledge and skill acquisition and retention, as well as student satisfaction and confidence. These findings have important implications for nursing education, particularly in Saudi Arabia, and provide valuable insights for nursing educators and policymakers on the benefits of SBL for enhancing student learning outcomes.24 0Item Restricted Pain Management in Adult Intensive Care Unit in Saudi Arabia(University of Newcastle, 2024) Alotni, Majid Ali Saleh; Fernandez, Ritin; Guilhermino, MichelleThesis Abstract The prevalence of pain among patients in the intensive care unit (ICU) resulting from invasive procedures and medical interventions remains high. This issue is particularly complex for ICU patients unable to self-report their pain, leading to undetected and untreated pain and affecting quality of life. The specific aims were to: 1. Identify the barriers to nurse-led pain management in adult ICUs through an integrative review. 2. Implement the Critical Care Pain Observation Tool (CPOT) in Saudi Arabia to improve pain assessment in patients unable to self-report pain, with the goal of improving nurse practice and patient outcomes. 3. Develop and investigate the psychometric properties of an instrument designed to measure nurses’ readiness for implementing the CPOT, in ICUs in Saudi Arabia. Method An integrative review was conducted to identify the barriers to nurse-led pain management. Which were mapped to the COM-B model. This model suggested specific strategies to address the barriers. A stepped-wedge trial was conducted to assess the effect of the implementation of the CPOT on pain assessment. Finally, nurses’ readiness to implement was tested using the cross-sectional method with validity and psychometric analysis. Results The integrative review revealed several barriers to nurse-led pain management and informed the intervention. The intervention resulted in a significant increase in the number of pain assessments (Rate Ratio: 1.77, 95% confidence interval [CI]:1.45, 2.16, p < 0.001) and re-assessment (Rate Ratio: 13.99, 95% CI: 8.14, 24.02, p < 0.001) between the intervention and control groups. There was no significant effect on patient outcomes. The content validity of the mAFt. resulted in two factors: acceptability (10 items) and feasibility (five items). Conclusion Identifying barriers to nurse-led pain management in the ICU is crucial. Selecting the most effective interventions is essential to achieving optimal outcomes for both nurses and patients.19 0Item Restricted Medication Safety Education in Undergraduate Pharmacy and Nursing Schools in the UK and Saudi Arabia(Imperial College London, 2023) Albadali, Hind; Woloshynowych, Maria; Franklin, BryonyIntroduction: This thesis focused on medication and patient safety from a global perspective (UK and Saudi Arabia), the rationale being the increase in medication error incidents resulting from a lack of proper patient safety education in nursing and pharmacy programmes which contribute to serious patient safety issues. Literature revealed the limitations on achieving positive outcomes in nursing and pharmacy education. Aim: to identify current medication and patient safety education in these countries and to analyse factors affecting adequate teaching and recommendations for improvement. Research Methodology: A systematic narrative review and mixed method research design were used to investigate many educational issues. Data Collection: used literature search for published papers, document review, semi-structured individual interviews and focus group for qualitative data and a questionnaire for quantitative data. Data Analysis: used systematic narrative analysis, thematic analysis and various statistical techniques to analyse data (separate data review for pharmacy and nursing). Results: revealed a disagreement on the explicitness and mode of integration, diverse content delivery, many educational didactic and interactive methods, a growing interest in simulation methods, the inter-professional learning method, curriculum guides and educational framework were rarely used and obstacles to integrating medication safety were identified. Furthermore, students’ confidence in learning about patient safety domains between classroom and clinical settings differed. Conclusion: Although medication and patient safety education is well received, strategies are needed to improve medication and patient safety education to allow for effective integration in the curriculum. UK and Saudi Arabian educational and health sector policymakers should prioritise improving medication and patient safety education. Recommendations: Future researches should investigate the content, methods of delivering medication and patient safety education, curriculum guides, framework for teaching and factors that prevent the effective integration of medication safety education. Students’ confidence in patient safety topics in classroom and clinical settings needs evaluation.17 0Item Restricted Nursing perspectives on the use of effective communication in an intensive care unit setting(Queen's University Belfast, 2024-07-09) Milibary, Amr Adnan M; Duncan, DebbieTitle: Nursing perspectives on the use of effective communication in an intensive care unit setting. Background: The critical role of communication in health care, especially in ICUs, highlights its importance for patient safety and the challenges faced by ICU nurses, such as time constraints, stress and the sharing of complex medical information. The introduction and background discuss how communication breakdowns impact patient outcomes, particularly during shift changes and the Covid-19 pandemic. The study underscores the need for improved training and interdisciplinary collaboration, emphasising both verbal and non-verbal communication. It also explores leadership and technology, including AI, in enhancing ICU communication. Overall, it stresses addressing communication challenges through organisational efforts, cultural sensitivity, education, and technology integration for safe and effective health care delivery. Aim: The main purpose of this literature review is to examine nurses’ perceptions and experiences with using communication in the intensive care unit. The second purpose of this study is to investigate communication barriers amongst nursing staff members, which may have an impact on patient outcomes in previous studies. Methodology: A precise search of electronic databases including MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO was conducted for a systematic literature review on ICU communication from a nursing perspective. Guided by the PEO model and supplemented by a thesaurus, relevant articles were identified. Reference lists were also examined and manual journal searches undertaken. The quality of each study was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. This rigorous approach aimed to comprehensively explore nursing communication in ICU settings, aligning with the review’s objectives. Results: Nine qualitative studies on ICU nurse communication were analysed. Conducted in seven countries between 2014–2022, the studies are summarised, focusing on thematic analysis that identified three main themes: communication challenges and strategies; communication training and support; nurse–patient/family communication. These themes highlight the complexities and importance of tailored communication strategies in health care. The chapter concludes by emphasising the critical role of effective nurse–patient communication in improving ICU patient care outcomes. Conclusions: This review examines the communication experiences of ICU nurses based on nine studies. Key challenges include time constraints, language barriers and resistance to change, exacerbated by pandemics. The findings highlight the need for tailored strategies and support for health care professionals, especially during crises. Cultural factors affect error communication, necessitating transparent, systemic approaches in health care organisations. Effective nurse–patient/family communication is crucial for holistic care, emphasising emotional support and trust. The review underscores the importance of flexible yet systematic communication interventions in ICU settings to meet diverse needs. Keywords: Nursing, Effective communication, Intensive care unit.105 0Item Restricted High-Fidelity Simulation (HFS) Intervention to Increase Advanced Cardiac Life Support (ACLS) Knowledge, Skills Performance and Self- Efficacy (SE) Acquisition and Retention for Saudi Nursing Students: A Feasibility Explanatory Sequential Mixed Method Study(The University of Edinburgh, 2024-08-09) Alshehri, Abdullah Ali; Holloway, AishaBackground As medical technologies advance and patient needs become more complex, care delivery models are undergoing transformation. An essential element for improving the learning experience is the shift from informative to transformative learning. While some countries have incorporated high-fidelity simulation (HFS) into nursing education as a contemporary teaching method, the majority of Saudi nursing schools still adhere to traditional teaching approaches. Aim Using the Medical Research Council (MRC) framework, this study sought to identify and develop a HFS advanced cardiac life support (ACLS)-focused intervention that was piloted among final-year undergraduate Saudi nursing students to investigate the acquisition and retention of ACLS knowledge and skills performance, as well as self-efficacy (SE) gains through HFS compared to traditional teaching methods. Methods This project utilised a sequential explanatory mixed-method design. A two-phased pilot randomised controlled trial (RCT) with embedded qualitative evaluation was conducted. Phase I involved the intervention development and pilot RCT (n= 28), with participants randomly assigned to intervention or control groups. Phase II comprised an embedded qualitative component of semi-structured interviews with a sub-sample of those from the trial (n= 10). The intervention group participants had access to HFS training, whereas the control group learned through traditional teaching methods, such as PowerPoint presentations and demonstrations on a static manikin. The educational content focused on ACLS algorithms. The knowledge variable was measured at three different time points: before the simulation, immediately after, and three months later. Skills performance was assessed twice; the first simulation was conducted at the beginning of the experiment and the second simulation session was three months later. The SE variable scores were obtained at the start of the study and at the end of the quantitative phase after the second simulation session. In the qualitative phase, semi-structured interviews were conducted to ascertain the perceptions of the intervention and control group participants towards the received styles of learning methods at the end of the study. The research was influenced by the effects of the coronavirus disease 2019 (COVID-19). This, in turn, affected the study's sample size due to government restrictions, guidelines, and the personal decisions of the participants. Results The study’s quantitative pilot RCT results showed that the ACLS knowledge exam total scores showed promising increases from baseline to acquisition (p < 0.001) and from baseline to retention (p < 0.004); however, this increase was not evident three months from acquisition for the intervention group (p = 1.000). With regard to skills performance, the intervention group’s ACLS skills acquisition mean score was trending higher (p < 0.001) than that of the control group. After three months, the mean ACLS skills retention score for the intervention group remained higher (p = 0.000) than for the control group. SE scores for the intervention group were moderately higher than for the control group (p < 0.001), showing initial evidence of a positive effect. The SE displayed a strong positive correlation with skills acquisition and a moderate positive correlation with knowledge. In the qualitative phase, students conveyed that HFS offered a more authentic and enjoyable experience, facilitating the application of theoretical knowledge to advanced cases compared to the traditional method, which is more suited to basic skills. The students perceived HFS as a valuable teaching approach that effectively addresses the sensitivity of a mixed-gender working environment and the associated cultural norms in the Kingdom of Saudi Arabia (KSA) context. They confirmed that HFS enhanced their non-technical skills, as well as their SE in handling complex cases upon graduation. The strength of the students’ interest in integrating the HFS into the curriculum further supports the acceptability of the study. Feasibility was confirmed, as the invited students demonstrated a willingness to participate within the nursing school, there was effective communication with the heads of departments in both the nursing school and Simulation and Medical Training Centre, and the setting was prepared to accommodate a substantial number of students for a forthcoming definitive RCT. The availability of diverse materials in the simulation centre and positive perceptions of nursing students regarding the HFS intervention further support the feasibility of the study. Conclusions The HFS intervention was well accepted and feasible with promising results regarding the final year undergraduate Saudi nursing students’ ACLS skills performance and SE. The recruitment methods and data collection procedures used in this study demonstrated feasibility for implementation in a larger, confirmatory RCT in a future definitive RCT. A sample size calculation was conducted to inform a future follow-up definitive RCT, evaluating the HFS intervention over the longer term. A major strength of the study was its adherence to the MRC framework, as well as using the Template for Intervention Description and Replication (TIDieR) checklist to guide detailed reporting of the intervention. A key limitation was the small sample size, constrained by COVID-19 impacts on subject availability and the power to make reliable inferences. More research is required to definitively determine the lasting impacts of high-fidelity ACLS simulation training on nursing education outcomes. Large-scale RCTs with larger samples, longitudinal examinations of skill translation into clinical environments, and multi-site tracking of trained nursing cohorts are recommended to further strengthen the evidence supporting wider curricular integration of simulations.26 0Item Restricted Intensive Care Unit Nurses' Experiences in Caring for Lightly Sedated Mechanically Ventilated Patients: An Extended Literature Review(Queen's University Belsat, 2024-06-14) Ali, Sarah; John, NimmyBackground: Sedation is crucial for critical care patients' comfort and treatment. The trend has moved towards lighter sedation levels than deep sedation. Lightly sedated intubated patients require more focused care in a suitable setting compared to deeply sedated patients. Intensive care unit (ICU) nurses, as carers, hold a pivotal position in care and sedation monitoring. There remains a lack of comprehensive investigation into nurses' psychological and professional experiences during the care management process. Aim: To explore ICU nurses’ experiences of caring for intubated patients under light sedation. Methodology: This dissertation employed the Extended Literature Review (ELR) method by using six electronic databases were systematically searched: the Cumulative Index for Nursing and Allied Health Professionals (CINAHL) Plus, Medline, PsycINFO, Scopus, and Web of Science. English-language studies were included and conducted between 2013 and 2023, examining nurses' caring experiences while managing light sedation with mechanically ventilated patients. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) and the Mixed Methods Appraisal Tool (MMAT) checklists. Results: Eight studies met the inclusion criteria: five qualitative, two mixed methods, and one cross-sectional study. Qualitative studies revealed that ICU nurses face significant challenges in achieving and maintaining light sedation while ensuring patient comfort. Mixed methods studies indicated that nurses were generally satisfied with patient outcomes associated with light sedation approaches. The cross-sectional study demonstrated a high level of compliance among nurses with light sedation guidelines and its implications for intubated patients. Four overarching themes emerged from the analysis, providing insights into ICU nurses' experiences during the care provided for ventilated patients under light sedation.20 0Item Restricted Ethical conflict experienced as a critical care nurse during the COVID-19 pandemic: a systematic review(Queen's University Belfast, 2024-04-30) Alotaibi, Omar; Alotaibi, OmarBackground The COVID-19 pandemic had a devastating effect on healthcare workers and healthcare systems at large. The first case of COVID-19 in the Kingdom of Saudi Arabia was reported on 2 March 2020 and, by 15 July 2021, the Ministry of Health had reported 8020 fatalities from the contagion. The COVID-19 pandemic laid bare the unpreparedness of healthcare systems across the world, and further led to a substantial shift in occupational risks and various stressors pertaining to critical care nursing. Objectives A PEO framework was used to develop the research question to investigate the ethical conflicts that intensive care nurses experienced during the COVID-19 pandemic, and their impact on nurses’ psychological wellbeing and job satisfaction. The study aimed to identify and describe common ethical conflicts faced by critical care nurses during the pandemic, their psychological impacts, and offer recommendations for healthcare and relevant policymakers. Search Strategy The study adopted a qualitative approach, and a systematic literature review was conducted on existing studies. An induction approach was used in respect to the sample size of the selected studies. A systematic search was conducted across three electronic databases including CINAHL Plus, PubMed, and MEDLINE ALL. Studies conducted prior to COVID-19, those conducted on healthcare providers other than intensive care nurses, and sources published in languages other than English were exempted from the study. Results The search produced 738 articles which were further evaluated against the inclusion and exclusion criteria. A total of 12 studies matched the inclusion criteria and met the CASP threshold for quality appraisal. Upon synthesis, changes in practice or work situations (n=7), lack of knowledge (n=3), an organisation’s inefficiency in supporting nurses (n=6), psychological wellbeing (n=7), and job satisfaction (n=4) were the main themes identified encapsulating ethical issues. Conclusion Nurses had to work under unfamiliar conditions typified by a high workload, prolonged use of PPE, and an increased demand for care in ICUs, hence the potentiality for ethical conflicts. Amid the construction of new ICU centres and an increasing workload, nurses had to deal with novel experiences such as adapting to collaboration with new workers, the role of constantly acting as a supporter, and complexities linked to working with non-healthcare professionals. A failure to highlight these complexities may cause critical care nurses to perceive them as routine. Increased isolation also had emotional ramifications which could affect job satisfaction levels among ICU nurses. Involvement in practice during COVID-19 led to depression, psychological distress, insomnia, and anxiety. The study also established that discrimination over the distribution of PPE, fatigue, and burnout had a profound effect on nurses’ job satisfaction levels. There is a need for interventions tailored towards increasing organisational support, improving nurses’ wellbeing, and building capacity. Organisations should also include nurses in the decision-making process, and consider both extrinsic and intrinsic factors of motivation to enhance job satisfaction levels.20 0Item Restricted The Risk Factors of Job Burnout Among Nurses in Saudi Arabia: A Quantitative Method Systematic Review(Saudi Digital Library, 2023-12-13) Alharthi, Ibtisam; Louuise, HodgsonJob burnout, more simply referred to as ‘burnout’, describes a psychological syndrome triggered by chronic, unaddressed stress in the workplace. The high prevalence of burnout among nurses poses a significant challenge, exacerbating the already critical issue of nursing shortages worldwide. Saudi Arabia has recorded particularly high rates of burnout among nurses, at between 32% and 71%, but the factors which cause burnout in the country are not well-understood. This study reports the findings of a systematic review which examines the prevalence and risk factors associated with burnout among nurses in public hospitals in Saudi Arabia. It examines 10 studies conducted between 2018 – 2023 and provides an updated estimate of burnout based on prevalence rates reported across the country. It also identifies the leading factors associated with burnout in the Kingdom of Saudi Arabia, categorising them as either sociodemographic, occupational or psychosocial and discussing the reasons for them. The study estimates that the current prevalence of burnout among nurses in Saudi hospitals is 51.3%, with the highest rates in the north of the country and the lowest rates in the south. The main sociodemographic factors affecting burnout are gender, age, nationality, marital status, education and medical history. The occupational factors include weekly work hours, shift patterns, department, career rank, years of experience and salary level. Psychosocial factors affecting burnout include emotional demands, commitment, influence and work, reward and recognition, role clarity and health and well-being. The study concludes by discussing the implications of the research for advanced nurse practitioners and evidence-based practice and proposes a number of recommendations to reduce the risk of burnout among nurses based on the findings of the systematic review.56 0Item Restricted Occupational Stress and Burnout in Nurses Working Extended Shifts: A Systematic Review(Saudi Digital Library, 2023-11-09) Almajed, Hamedh; Kerr, ClaireBackground: Extended nursing work hours have become common internationally, due to inadequate staffing levels and increasing population demands. Extended work hours can have adverse effects on the psychological well-being of nurses, including the manifestation of occupational stress and burnout.Aim: This review aims to explore if and how nurses working extended duty hours experience occupational stress and/or burnout.Methodology: A systematic search was conducted on four electronic databases: CINAHL Plus, MEDLINE, PubMed, and PsycINFO. A methodical search strategy was developed in collaboration with an expert librarian. Medical subject headings, keywords, and synonyms were utilised. Reference lists of papers eligible for inclusion in the review were also hand searched. The quality of each study was evaluated using the Joanna Briggs Institute's quality appraisal tool for cross-sectional studies. Meta-analyses were not possible; thus, findings were synthesised narratively.Results: Five studies were included, all focusing on the impact of extended shifts. One study focused on the nurses’ experience of occupational stress mainly; one study focused on the nurses’ experience of burnout; and two studies focused on the contributing factors of stress and burnout. The methodological quality of these studies was deemed satisfactory. The prevalence of 12-hour shifts was high, and evident across various countries. Long working hours and other variables such as inadequate rests, break-times, and fatigue contributed to the nurses’ experience of occupational stress and burnout. Conclusions: Extended shifts in nursing are a widely observed practise internationally. This systematic review sheds light on the effects of extended shift patterns and the prevalence of occupational stress and burnout among nurses. A better understanding of these concepts may help in building organisational initiatives and strategies to support nurses who work long shifts.14 0Item Restricted Exploring the impact of various leadership styles on nursing turnover in healthcare organisations: a systematic review(Saudi Digital Library, 2023-11-03) Almalki, Abdulmajeed Ali Saeed; Brown, Michael; Rainey, DeborahBackground: In healthcare, nurse managers utilise diverse leadership approaches, such as the transformational, passive-avoidant, transactional, situational, servant, laissez-faire, and compassionate styles, in order to develop nurses' competencies, relationships, culture, and values. Many studies have examined the implications of these leadership styles on nurses’ behaviour and experiences in various clinical settings. The relationship between these styles and nurse retention or turnover is complex because it depends on several factors including empowerment, fostering a positive work environment, effective communication, and continual support. Although current systematic reviews emphasise the effect of leadership styles on nurse competencies and patient outcomes, they do not explicitly reveal the influence of these styles on nurse retention and turnover. Aim: This study aims to determine the influence of nurse leadership styles on nurse retention and turnover. Methods: A systematic literature review was conducted using online databases such as CINAHL, MEDLINE, Cochrane Library, ERIC, and EMBASE, spanning September 2013 to 2023. The research question was formulated using the PEO model (Population, Exposure, Outcome) to ensure clarity and relevance. Relevant studies were examined, with measures taken to avoid redundancy. Specific eligibility criteria were used for study selection. Results: Eight articles met the inclusion criteria. These qualitative studies were carried out across a variety of countries and settings, to investigate the impact of leadership approaches on nurse retention and turnover. The articles exhibited minimal bias as assessed by the CASP checklist. A thematic analysis highlighted the importance of certain leadership characteristics for nurse managers. These characteristics included support, adept communication, respect, a visionary perspective, and proactive initiative. Such leadership styles improved nurse retention by encouraging competency development, innovation, adaptive change, and cultivating a positive atmosphere. Conversely, poor leadership practices diminished nurse satisfaction and increased their intention to leave clinical roles. Notably, transformational leadership was viewed favourably. Conclusion: Healthcare nurses’ commitment, retention, and satisfaction are directly impacted by leadership styles. This review underlined how specific attributes and qualities of leaders can significantly improve nurse dedication and morale. The most effective leadership style in relation to retention is transformational leadership, which fosters an environment that values creativity, inclusivity, and teamwork. These can be combined with other effective leader attributes, such as ethical leadership and spiritual leadership, to increase nurse retention and drastically reduce turnover. These findings can help inform related policy, clinical practice, education, and practice development to improve nurse retention and reduce turnover.18 0