Saudi Cultural Missions Theses & Dissertations
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Item Restricted The impact of nurse work environment on nurse outcomes, nurse-perceived quality of care and patient safety in Saudi Arabia(University of British Columbia, 2018) Alharbi, Amal Ali; Dahinten, SusanBackground: The current shortage of nurses jeopardizes the quality and safety of patient care globally, and is particularly serious in Saudi Arabia. There is ample evidence that nurse work environments are important to nurses’ job satisfaction, burnout, and retention, and the quality and safety of patient care. However, most of this research has been conducted in the United States and Europe with very little emanating from Saudi Arabia or the Middle East. Purpose: This study investigated relationships between components of nurse work environment and nurse outcomes and nurse-perceived quality of care and patient safety. Methods: This correlational study was conducted using cross-sectional data collected from 496 registered nurses working in a large tertiary hospital in Riyadh, Saudi Arabia. Participants completed an online survey similar to that used in RN4Cast studies. Nurse-reported measures were used to assess nurses’ perceptions of their work environments, nurse-outcomes (i.e., job satisfaction, burnout, and intent to leave), and nurses’ perceptions of quality of care and patient safety. Hierarchical logistic regression was conducted to examine the relationships between components of nurse work environment and nurse and patient outcomes, after controlling for nurse and patient characteristics. Findings: Nurses’ perceptions of staffing and resource adequacy was predictive of all nurse outcomes except for intent to leave whereas nurse manager ability and leadership was found to be predictive only of job satisfaction. In terms of patient outcomes, staffing and resources adequacy and nursing foundation for quality of care were found to be the only independent predictors of quality of care and patient safety. Implications for Nurse Leaders: Nurse leaders in Saudi Arabia should give special attention to staffing and resources adequacy, nursing management and leadership, and nursing foundation for care delivery at the unit level. Hospitals in Saudi Arabia should strive for magnet-like qualities as they play a critical role in the recruitment and retention of nurses and contribute to better quality and safe care delivery. Conclusion: Magnet-like work environments that are culturally sensitive are critical to attracting and retaining Saudi nurses and nurses from other countries who are currently vital to alleviating the nursing shortage in Saudi Arabia.16 0Item Restricted Adaptation and validation of the U.S. hospital survey on patient safety culture 2.0™(SOPS®) : the Saudi version(University of British Columbia, 2024-07-12) Alharbi, Amal Ali; Dahinten, SusanBackground: The U.S. Hospital Survey on Patient Safety Culture 2.0 (HSOPSC, 2.0), released by the Agency of Healthcare Research and Quality in 2019, is the most widely used instrument for measuring patient safety culture in healthcare organizations. However, it has not been cross-culturally adapted nor validated within the context of the Saudi healthcare system. This two-phased study aimed to adapt the U.S. HSOPSC 2.0 to be suitable for use by registered nurses working in Saudi hospital settings, and to assess the construct validity of the revised Saudi tool. My approach to psychometric testing was informed by Messick’s view of unified validity (1980, 1995), and guidelines provided by the International Test Commission (2017). Methods: Instrument adaptation was performed in Phase 1 using a committee-based approach, two focus-group interviews, and expert panel reviews. Construct validity of the adapted tool was assessed in Phase 2 using confirmatory factor analyses, reliability testing, and hierarchical logistic regression, drawing on cross-sectional data collected from 534 registered nurses working in a large tertiary hospital setting in Saudi Arabia. Results: Phase 1 resulted in a 33-item instrument that demonstrated excellent content validity. In Phase 2, confirmatory factor analysis yielded the 26-item Saudi-HSOPSC 2.0 with a 10-factor structure consistent with the U.S. HSOPSC 2.0. Reliability testing yielded acceptable reliability coefficients for eight subscales. Hierarchical logistic regression provided further evidence of the instrument’s construct validity, with seven of the 10 dimensions found to be uniquely predictive of at least one of the three patient safety outcomes. Conclusion: The findings provide initial evidence of the content and construct validity of the Saudi-HSOPSC 2.0. Together, the findings provide evidence supporting five aspects of Messick’s (1980) view of unified validity. Future research should assess the validity of the Saudi instrument within a broader validation context and investigate the potential impact of included negatively worded items. With additional evidence supporting the psychometric properties of the Saudi-HSOPSC 2.0, Saudi administrators and nurse leaders can use it to assess the status of patient safety culture in their hospitals and inform future interventions aimed at improving patient safety and quality of care in Saudi hospital settings.11 0